Care Home: Brambles

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What the care home does well We looked at the care of two people who use the service. One person had started using the service since the last key inspection and one person was very frail and needing a lot of care from the care staff. Overall the care plans were very well written, person centred and they gave staff the information they needed to ensure they carried out a consistent standard of care to the people using the service. Staff had carried out recent assessments of these person`s personal and social care needs and this information had been used to develop a person centred care plan. We spoke to staff who were looking after these people. They had a very good knowledge of the social and personal care needs of the people they were caring for. We found that there was good documentation and recording of all medicine records. We looked at the majority of medication administration record (MAR) charts and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We saw that the times of administering medicines were clearly highlighted on the MAR charts and we saw clear directions recorded for the application of any external preparations such as creams or ointments. This ensured that staff knew when to give medicines. This means that there are arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labelled and supplied for. New air conditioning units had been installed in each medicine store room. We found that the temperature records for storage of medicines were documented daily and all medication was stored within the recommended manufacturers guidelines. Medication that required special storage in controlled drug cabinets were stored safely following the Misuse of Drugs (Safe Custody) Regulations. Information about peoples medicines were generally recorded in their care plans and any medicine that was prescribed on a when required or as needed basis was fully detailed in each persons care plan to ensure the person was safe from harm. Staff told us they had received training updates for care planning since the last inspection. We looked at the training records for staff since January 2010 and this showed staff had received training about care planning and staff who administeredmedication had also received refresher training. We looked at how the home manage foul and communal linen such as sheets, towels and flannels. We spoke to the laundry staff and the hotel services manager and they told us they were now washing these items on a hotter wash to ensure there is no risk of cross infection. We looked at the monthly visit reports carried out by a representative of the Provider. The deputy manager confirmed these visits are now unannounced. The most recent visit for March 2010 was being carried out in accordance with the Regulation, which enabled the Provider to have a much better overview of the quality of the service being provided and enabled them to identify any actions which needed to be taken to improve the standards in the home. What the care home could do better: The service need to ensure a risk assessment is in place when staff have been requested by the person using the service to lock their door for them at night to prevent people wandering into their bedrooms. The risk assessment needs to be discussed with and there needs to be written evidence that the actions being taken by staff have been agreed by the person using the service. Risk assessments for nutrition and the risk of developing pressure sores need to be reviewed each month. Where the outcome of the risk assessment shows the person is `at risk`, this information needs to be included in the relevant care plan so that staff know what care this person needs to prevent them becoming malnourished or developing sore skin. When changes are made to the prescribed creams applied by staff to people to prevent their skin from becoming dry and sore, this needs to be updated in the care plan to ensure this information is available for all staff. Random inspection report Care homes for older people Name: Address: Brambles Birchfield Road Redditch Worcestershire B97 4LX one star adequate service 08/01/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sandra Bromige Date: 1 5 0 4 2 0 1 0 Information about the care home Name of care home: Address: Brambles Birchfield Road Redditch Worcestershire B97 4LX 01527555800 01527548888 brambles@orbit.org.uk www.heart-of-england.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Frances Hook Type of registration: Number of places registered: Conditions of registration: Category(ies) : Heart of England Housing and Care Limited care home 60 Number of places (if applicable): Under 65 Over 65 0 60 0 dementia old age, not falling within any other category physical disability Conditions of registration: 60 0 60 The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 60 Dementia (DE) 60 Physical Disability (PD) 60 Date of last inspection 0 8 0 1 2 0 1 0 Care Homes for Older People Page 2 of 8 Brief description of the care home Brambles is a purpose built home for older people who may have a physical disability and/or mental health needs associated with old age. Additionally the home has registration for one older person with a learning disability and registration for one person under 65 who has a physical disability and mental disorder. The home is set in a residential area of Redditch which is about half a mile from local amenities and convenient for public transport. It is on three floors, there is a passenger lift to all levels and handrails fitted where necessary. All bedrooms are single and have en-suite facilities. Communal adapted toilets and bathrooms are available on all floors. There is also a garden area, which can be accessed by residents. The home is owned by Heart of England Housing and Care Ltd, for whom the responsible individual is Ms Michelle Shawcross. The registered home manager is Mrs Margaret Hook. Up-to-date information relating to the fees charged for the service is available on request from the home. Care Homes for Older People Page 3 of 8 What we found: This was an unannounced inspection which took place over one day and was carried out by one Inspector and a Pharmacist Inspector. The reason for the visit was to see if the service had complied with the seven requirements made at the key inspection in January 2010. We found good outcomes of care for the people whose care we tracked. The service had complied with the seven requirements, which relate to the health, safety and welfare of the people who use the service. What the care home does well: We looked at the care of two people who use the service. One person had started using the service since the last key inspection and one person was very frail and needing a lot of care from the care staff. Overall the care plans were very well written, person centred and they gave staff the information they needed to ensure they carried out a consistent standard of care to the people using the service. Staff had carried out recent assessments of these persons personal and social care needs and this information had been used to develop a person centred care plan. We spoke to staff who were looking after these people. They had a very good knowledge of the social and personal care needs of the people they were caring for. We found that there was good documentation and recording of all medicine records. We looked at the majority of medication administration record (MAR) charts and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We saw that the times of administering medicines were clearly highlighted on the MAR charts and we saw clear directions recorded for the application of any external preparations such as creams or ointments. This ensured that staff knew when to give medicines. This means that there are arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labelled and supplied for. New air conditioning units had been installed in each medicine store room. We found that the temperature records for storage of medicines were documented daily and all medication was stored within the recommended manufacturers guidelines. Medication that required special storage in controlled drug cabinets were stored safely following the Misuse of Drugs (Safe Custody) Regulations. Information about peoples medicines were generally recorded in their care plans and any medicine that was prescribed on a when required or as needed basis was fully detailed in each persons care plan to ensure the person was safe from harm. Staff told us they had received training updates for care planning since the last inspection. We looked at the training records for staff since January 2010 and this showed staff had received training about care planning and staff who administered Care Homes for Older People Page 4 of 8 medication had also received refresher training. We looked at how the home manage foul and communal linen such as sheets, towels and flannels. We spoke to the laundry staff and the hotel services manager and they told us they were now washing these items on a hotter wash to ensure there is no risk of cross infection. We looked at the monthly visit reports carried out by a representative of the Provider. The deputy manager confirmed these visits are now unannounced. The most recent visit for March 2010 was being carried out in accordance with the Regulation, which enabled the Provider to have a much better overview of the quality of the service being provided and enabled them to identify any actions which needed to be taken to improve the standards in the home. 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 2. Care Homes for Older People Page 5 of 8 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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, 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 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. 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