Care Home: Bramble Cottage Retirement Home

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What the care home does well The service provides an excellent level of care for the service users placed in the home. Service users speak very highly of their stay. The accommodation is very comfortable and service users appear very happy and settled in the home. The home was very clean and welcoming on the day of the inspection. Staff spoken with informed the inspector at how happy they were working in the home and how approachable the manager was. Staff could demonstrate a good understanding of the residents needs. What has improved since the last inspection? The service has continued to update care plans and risk assessments since the last inspection and have maintained a comfortable and welcoming environment. Additional training on dementia issues have been provided for staff to accommodate the changing needs of one of the service users placed. What the care home could do better: No requirements were made at this inspection. However the service should ensure that the Providers Regulation 26 visits are carried out on a monthly basis as apposed to the current bi monthly process in place. Key inspection report Care homes for older people Name: Address: Bramble Cottage Retirement Home 18 Carden Avenue Brighton East Sussex BN1 8NA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Bramble Cottage Retirement Home 18 Carden Avenue Brighton East Sussex BN1 8NA 01273565821 01273562381 bramble@invictanet.co.uk www.bramblecottagebrighton.com Bramble Care Homes Limited care home 28 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 78 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender:Either : Whose primary needs on admission to the home are within the following category: Old age not falling within any other category (OP) Date of last inspection Brief description of the care home Bramble Cottage is registered to provide accommodation and personal care for up to 28 older people. The registered provider is Bramble Care Homes Ltd. The responsible individual is Mr M. Newman. The registered manager is Diana Shaw. The home is located in Brighton with access to local amenities. It is set out over three storeys and has a passenger lift to all floors. There are 26 bedrooms, all of which have full en-suite facilities. There is a good range of communal space, including a main lounge, dining room and large rear garden. The current range of fees are available from the home. Care Homes for Older People Page 4 of 23 Over 65 28 0 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection began at 10.15am and finished at 2.15pm. The inspector spent time additionally to this examining the training records of the home and an up to date AQAA document. The inspector spent time with service users in the home and individually with two service users who were part of the case tracking. The inspector also spent time with one other service user in private and spoke with the Registered Manager, senior carer and care team member. The inspector also observed other staff interacting in a positive manner with service users during the inspection. The inspector case tracked three service users, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the complaints procedure, copies of service users meetings, care plan meetings and staff meetings. Staff recruitment files and staff induction training sheets were also examined, as were a sample of the sheets which Care Homes for Older People Page 5 of 23 record the administration of medication and the duty rota. The plan of staff supervisions and the services Service user guide were also viewed, as was the services quality assurance documents. A partial environmental tour was carried out which included all communal areas, lounge, dining area, small lounge reception area, kitchen and the three bedrooms of the service users case tracked. In the report the inspector has included comments from people met on the day of the inspection. Information was also taken from the AQAA which was comprehensively filled in and returned by the due date. Please note the service is registered to take 28 service users not 78 as pre populated into the service information. Care Homes for Older People Page 6 of 23 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 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 Older People Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Service users benefit from receiving relevant and up to date information, which is made available to them prior to admission, allowing them to make an informed choice about the home prior to moving in. The processes in place for ensuring that suitable Pre Admission Assessments are conducted is good, with services being offered to only those service users whose needs can be met. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with service users. The inspector had the opportunity to speak to three service users in private. The inspector also had the opportunity to speak with the Registered Manager, senior carer and care team member. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the Care Homes for Older People Page 9 of 23 Evidence: external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. The inspector examined the service user guide and service users information pack and can confirm that they are clear document which contain relevant information. The home has had two recent admissions, evidence was supporting to confirm that service users are involved in the admissions process and are given choice, the service had comprehensive assessment document in place which were used to assess someone referred to the service. Also available to view was collated information with regard to service users in the home, and their referring documents. This highlighted that the Registered Manager obtains background information and up to date CPA and mental health assessments if applicable prior to offering a place in the service. Comments received on the day of the inspection included The home is very good, the manager is very good no complaints, very clean, excellent food and presentations. I knew someone who lived her before, so I didnt look round the home first. Intermediate care is not offered by this home. Care Homes for Older People Page 10 of 23 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and procedures in place are sufficient to ensure that a good provision of health care and personal support is provided to service users by the home. Care is administered in a way that protects residents privacy and dignity. Medication procedures are in order. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with two of these individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with service users. The inspector also had the opportunity to speak with one other service user in private, the Registered Manager, senior carer and care staff member. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Care plans examined were clear and easy documents to follow. Evidence was supporting to confirm that service users are respected and Care Homes for Older People Page 11 of 23 Evidence: personal care is delivered maintaining individuals privacy and dignity. The inspector evidenced through out the care plans good practise examples in the way service users were to be encouraged and their independence promoted and maintained. Comments received on the day of the inspection included, very happy in home, lots of shelves in the room, very clean smelling home. The home is very good, the manager is very good, no complaints, very clean, excellent food and presentation. On the day of the inspection not all care plans and risk assessments had been formally reviewed, although the Manager was in the process of completing this task. Care Homes for Older People Page 12 of 23 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Evidence was supporting to confirm that a range of social, cultural and recreational activities are on offer with the wishes of the service users being central to the provision. The menu is varied and specialist diets are provided for service users, with service users choice and wishes being respected. Evidence: As part of the inspection the inspector case tracked three service users in the home and spent time with two of these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with service users. The inspector also had the opportunity to speak with one other service user in private and the Registered Manager, senior carer and care team member. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Evidence was supporting to confirm that relatives feel welcomed into the home. Menus are varied. Activities are on offer in the home, and evidence was supporting to confirm Care Homes for Older People Page 13 of 23 Evidence: that individuals wishes with regard to activities are taken into consideration, and that staff have a good understanding of individual service users likes and dislikes and indeed their history; this information they use to encourage service users to be involved in activities. Service users views are taken into consideration with regard to the activities and this was evident. Comments received on the day of the inspection included The manager is good she keeps everything on a even keel, I have the best of both worlds, I like it here very happy been here for x years, sometimes do the activities and some times go out with my family. I Like a gin and tonic before lunch. Friends and family are welcome at any time and in accordance with service users wishes. Personal relationships and family relationships are encouraged. Evidence was supporting to confirm that the service has updated their policies regarding Equality and Diversity. Care Homes for Older People Page 14 of 23 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a robust and efficient complaints procedure, whilst the homes procedures and processes protect residents. Staff training in Protection of Vulnerable Adults is up to date. Evidence: During the inspection the inspector examined copies of notifications, and accidents and appointments, evidence of external reviews, and the complaints procedure. Evidence was supporting to confirm that all staff received training in SOVA, and that the Registered Manager deals with complaints effectively. In addition evidence was supporting to confirm that residents and relatives felt able to raise concerns with the Registered Manger or staff and that these would be dealt with. Care Homes for Older People Page 15 of 23 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Accommodation at the home is provided in such a manner that it is safe, hygienic and odour free. Appropriate infection control procedures are in place, in order to reduce or eliminate the risk of infection to staff and service users. Service users live in a comfortable pleasant home. Evidence: As part of the inspection the inspector carried out a partial environmental tour of the home, which included all communal areas, dining room, and lounge. The service users bedrooms who were involved in case tracking were also viewed. The home is well maintained and all areas of the home, including the garden, and all areas are accessible to service users. The home has an ongoing plan of refurbishment in place. The size, location and layout of the home are suitable for its stated purpose. The home was clean and odour free throughout. There is a daily cleaning schedule in place. The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. Care Homes for Older People Page 16 of 23 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staff recruitment procedures are effective and protect service users from potential harm or risk associated with poor recruitment practises. Evidence: As part of the inspection the inspector examined the recruitment files of three newly recruited staff to the service these were found to be in good order. The service uses the skills for care induction booklets, and a list of staff training was also seen as were copies of staff meetings. Evidence was supporting to confirm that staff are well trained, supervised and attend staff meetings. In discussion with staff it was evident that they provide personal care with sensitivity and respect. Staff are also trained in areas relevant to the needs of service users and the deputy manager in the home had carried out training in dementia care to update staff in the care of one of the residents placed within the home. Members of staff were seen on the day of the inspection interacting positively with service users in an encouraging manner. Staff meetings are held annually but evidence was available to show that management Care Homes for Older People Page 17 of 23 Evidence: and senior staff meetings are held on a monthly basis. In discussion with staff it was also evident that they have a good contact and access to the Registered manager and a staff hand over time on a daily basis. Care Homes for Older People Page 18 of 23 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manger has ensured that service users live in a safe and well managed service which is run in their best interests, however they must ensure that Regulation 26 visits are carried out on a monthly basis. Evidence: Evidence through out the inspection was supporting to confirm that service users received an excellent level of service. Care plans and risk assessments were informative, activities are provided and service users dignity and independence is respected. Staff are well managed, supervised and trained. Service users are protected by the homes policy on recruitment and handling of finances and valuables. Comments were received by the inspector on the day of the inspection and were also taken from the quality assurance documents in the home These comments included the following: I did not look at any other home a friend of mine X was so happy here, pleased with everything, staff are very kind and patient. Care Homes for Older People Page 19 of 23 Evidence: Nothing was too much trouble for staff wonderful service the warm welcome from all the staff. Perfectly alright at present, is happy with the home and the room, find the staff very good no problems at present. I cant tell you how amazing the home is, staff are all wonderful, We sometimes have food meetings and we suggested spaghetti bolognaise and we had the result of that today as we had spaghetti bolognaise for dinner. They are so patient(staff) you sometimes hear them with the other residents they are really patient, nothing is to much trouble. Evidence in the AQAA confirmed that policies and procedures are in place with regard to health and safety. The service is carrying out Regulation 26 visits bi monthly these should be carried out on a monthly basis. Care Homes for Older People Page 20 of 23 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 Older People Page 21 of 23 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 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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