Care Home: Bracken Ridge Manor Nursing Home

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What the care home does well Staff encourage and support people to maintain and improve their independence whilst living in the home. People who live at the home are encouraged to participate in individual interests and hobbies, which, they undertake both inside the home and in the local community. Care plans examined showed the individuals interests and how staff encouraged people to aspire to them. Care plans are evaluated and reviewed on a regular basis. The inspector observed good interaction between people who live at the home and staff. Staff were seen to meet peoples needs in a relaxed, friendly and respectful manner. One person told the inspector she was `happy` at the home and `liked living there`. The manager has a training plan in place and ensures staff receive supervision and training regularly. What has improved since the last inspection? The care home continues to provide a good service to the people who live there. What the care home could do better: The record of the CRB would benefit from further development to include date obtained, level of check, and the signature of the person receiving the information. Regulation 26 visit reports should be completed and made available for inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bracken Ridge Manor Nursing Home 16/18 High Street Loftus Saltburn-by-Sea TS13 4HW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Bassett     Date: 2 9 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Bracken Ridge Manor Nursing Home 16/18 High Street Loftus Saltburn-by-Sea TS13 4HW 01287640776 01287640776 helen.tyreman@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Barbara Hoggarth-Ewens,Miss Carol Holdsworth care home 17 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: One named individual who is above the age category is allowed to reside in the home. This condition allows the Home to take one named person with a mental disorder aged over 65 years. Date of last inspection Brief description of the care home Bracken Ridge Manor is a 17-bedded care home with nursing for Adults with Mental Health Problems. The home is a converted property on 3 floors with the majority of bedrooms being on the first floor and second floor and the usual living accommodation on the ground floor. There are 11 single rooms and 3 double rooms, 2 rooms have ensuite WC and hand basins. The home is situated on the High Street at Loftus with easy access to local amenities and directly on a bus route. Many of the people who live at Braken Ridge Manor have lived in the home for a number of years. Bracken Ridge Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 1 17 Brief description of the care home Manor creates a homely, clean and welcoming environment for the people who live there, which allows for a domestic and family feel. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Care Quality Commission ( CQC) say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 24 During the inspection the inspector carried out an unannounced visit to the home. The inspection visit lasted five and a half hours. During this time the inspector looked at a range of documentation including, files of people who live there and staff files. The inspector spoke to two people who live at Brakin Ridge Manor, three staff members and the manager. The manager of the home completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to 13 people. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures that should ensure that prospective service users have their needs assessed. Evidence: During discussion with the manager she was able to describe the process that is followed to obtain information about a prospective service users needs including an assessment by staff from the home, visits to the care home by the prospective service user and an assessment from the care manager if that person is funded by a local authority. The manager stated the information would be used to ensure the home could meet that persons needs and preferences. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved where able in decisions about their lives and play a role in planning the care and support they receive. Evidence: During the visit the inspector examined the files for three people who use the service. Each was found to contain assessments and plans of care in relation to that persons activities of daily living. Files seen also contained assessments for risks identified in the care plans. Both plans of care and risk assessments were seen to be reviewed on a regular basis. The inspector observed a good rapport between people who use the service and staff. Staff who spent time with the inspector had a good knowledge of peoples needs, likes and dislikes. Staff spoke of promoting individuals choice and independence. One staff member stated we always put the person first. One person who uses the service who spent time with the inspector confirmed people were able to make choices about their lifestyle. Care Homes for Adults (18-65 years) Page 11 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to make choices about their lifestyles. Social, educational and recreational activities meet individuals expectations Evidence: Plans of care seen by the inspector included a brief life history. Staff who spoke to the inspector had a good knowledge of individuals needs and how these are met. The home employs a part time activities co ordinator. People have access to board games, snooker table and a computer. A number of people attend the local branch of MIND and a lunch club. The inspector was told people who use the service are able to make choices as to how they spent their day. A number of people are able to access the local community independently whilst others require varying degrees of support from the staff. One person spoke of holidays they have been on and of plans for future trips. The inspector was told there is an open door policy and families can visit when they Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: wish. People who use the service are encouraged and enabled to visit families in their own homes when possible. People at Brakin Ridge Manor are involved in decisions within the home e.g. choice of menus and choice of activity. One person who spent time with the inspector confirmed this, she said she was happy at the home and liked living there. Another person said he had lived at the home for a number of years and it was ok. The menus showed that a variety of home cooked food is offered to the people who live at the home. One person told the inspector the food was good, however another person said he did not always enjoy the meals. The inspector observed a good interaction between people who live at the home and staff. Care Homes for Adults (18-65 years) Page 13 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect dignity and privacy are put into practice. Evidence: The care plans examined detailed the personal support needed and given. People who use the service have their own General Practitioner, some attend appointments on their own and others require an escort. A psychiatrist also sees people at least annually. During the visit the inspector examined the files of people two who live at the home. Each was seen to contain evidence of involvement of health care professionals such as GPs. Records for each person included detail of the care given. People who spoke to the inspector indicated people were generally happy with the care and support they receive. Staff members were seen to communicate effectively with people live at the home. Staff were seen to meet peoples needs in a relaxed, friendly and respectful manner. Staff who spoke to the inspector were able to demonstrate a good knowledge of individuals needs and how these are met. Staff spoke of promoting individuals privacy, dignity and independence. Information contained in the AQAA returned to CQC indicated the home has policies and procedures in relation to the safe handling of medication. The inspector was told Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: qualified nursing staff administer the medication. A sample audit of medication systems found no major concerns with ordering, storage and recording. Information is kept in relation to each medication administered. A sample audit of Medication Administration Records (MAR) examined were seen to be completed with no gaps in entries. Care Homes for Adults (18-65 years) Page 15 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. Evidence: Information in the AQAA returned to CQC indicated the home has policies and procedures in relation to handling complaints and safeguarding people from abuse. These were seen to be available. Further information in the AQAA indicated the home received no complaints in the previous twelve months. Staff confirmed they had received training on how to deal with the Protection of Vulnerable Adults. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take if they became aware of a concern. All demonstrated a commitment to protecting people who use the service from abuse. Care Homes for Adults (18-65 years) Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is attractive homely and comfortable for the people who live there. All areas were safe, well maintained and clean. Evidence: During the visit the inspector walked around the building. It was seen that the home provides a clean, odour free & homely environment. The home offers a range of communal areas for people to use. These include lounges and dining room. Peoples bedrooms were seen to be decorated and personalised to the individuals taste. Garden areas are well maintained and accessible. Information contained in the AQAA returned to CQC indicated the home and equipment are maintained as required. Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. The home has a recruitment procedure that promotes the safety and wellbeing of people. Evidence: The Registered Manager had the required qualifications and experience to run the home. A person who lives at the home and staff who spoke to the inspector indicated there were sufficient staff on duty to meet current care and social needs. Information in the AQAA indicated the home has a policy and procedure in relation to recruitment, and all appropriate checks are carried out. The inspector examined the file for a staff member most recently recruited. This was found to contain evidence of application, two written references, CRB (Criminal Record Bureau) check and PIN (Professional identification number) check. The record of the CRB would benefit from further development to include date obtained, level of check, and the signature of the person receiving the information. The manager told the inspector that where possible people who use the service are involved in interviewing prospective staff members. The file seen by the inspector contained evidence the staff member had received training including infection control, mental capacity act, protection of vulnerable Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: adults, palliative care, first aid, and food hygiene. A number of staff who spoke to the inspector confirmed they had completed training in safe handling of medication, dementia awareness, protection of vulnerable adults, fire safety, infection control and incontinence. Information given to the inspector indicated 5 care staff had successfully completed NVQ at level 2 or above. Records seen by the inspector indicated staff receive regular formal supervision. Staff who spoke to the inspector confirmed this, and spoke of the support they receive from the manager and qualified staff. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has quality assurance systems that should promote the safety and well being of people who use the service. Evidence: People who spoke to the inspector indicated communication is good. There is an open door policy and regular meetings are held for both people who live at the home and staff. A quality assurance assessment was carried out by an independent assessor (RDB) in December 2008 giving the home a 5 star rating. Staff who spoke to the inspector told her the team work well together and supported each other. The inspector was told the providers visit on a weekly basis and talk to both staff and people who live at the home however there was no evidence of monthly Regulation 26 reports. Accidents are recorded and are analyzed, fire alarms are checked weekly. Records of peoples personal monies held by the home included details of all transactions and receipts. A sample audit of peoples monies held by the home found no discrepancies between the amount held and the amount recorded. Information contained in the AQAA returned to CQC indicated the home has a range of policies and Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: procedures that should promote the safety and well being of people who use the service, and these were reviewed in December 2008. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 34 The record of the CRB would benefit from further development to include date obtained, level of check, and the signature of the person receiving the information. Regulation 26 visit reports should be completed and made available for inspection. 2 39 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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