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Care Home: Brandon House

  • 29 Douglas Avenue Exmouth Devon EX8 2HE
  • Tel: 01395267581
  • Fax: 01395270806
  • Planned feature Advertise here!

0 35Brandon is registered to provide personal care for up to 35 older people who may or may not have a physical disability. The detached property is situated in a residential area of Exmouth with large gardens and patio areas. There is a dining room and three lounges. Bedrooms are large and all have en suite facilities. Current fees charged are between £450 and £650 per week. The summary of inspection reports is available to every resident in a folder in their rooms and to others on request.

  • Latitude: 50.618000030518
    Longitude: -3.3919999599457
  • Manager: Mrs Wendy Pamela Marsh
  • Price p/w: ~
  • UK
  • Total Capacity: 35
  • Type: Care home only
  • Provider: Mrs Wendy Pamela Marsh,Mr John Howard Marsh
  • Ownership: Private
  • Care Home ID: 3346
Residents Needs:
Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 19th August 2009. CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Brandon House.

What the care home does well All of the people we talked to, and those who completed a questionnaire, told us they were happy with the standard of care and the facilities. Many people expressed exceptionally high praise for the home, and even those who told us about some areas they felt the home could make some improvement in, were otherwise very positive. Comments included, "All Mum`s needs are well cared for, Brandon House is spotless, the food is excellent, rooms are comfortable and pretty, the garden is delightful and the carers are sensitive to her needs and ALWAYS cheerful and positive. I would also like to credit them on their support for me during a very difficult and emotional time". "Brandon is a warm, caring, well organised home where our mother is very settled. The staff are always cheerful and welcoming and our mother`s needs are well met". "I think it is exceptionally caring and well run." "They provide good care, food and accommodation but also make proper allowances for each person`s particular issues". People have received very good information and opportunities to visit and get to know the home before deciding to move in permanently. Their needs have been carefully assessed by the home to make sure they will be able to provide the right support and facilities. There were excellent care planning systems in place that included detailed risk assessments on all potential areas of risk. Any risks identified have been explained in care plan. The care plans are clear, comprehensive and easy to read. Every person had been given a copy of their care plan - these were included in the service user guide in each person`s room. Medicines have been stored and administered safely. Staff have received training on the safe administration of medicines. People told us they felt confident they could speak out if they had any concerns or complaints. All staff have received training on the prevention of abuse and there were good systems in place to ensure the correct action is taken if any allegation of harm or abuse is raised. All areas of the home have been decorated, furnished and maintained to a very high standard throughout. The rooms are spacious and comfortable and people have been encouraged to bring furniture and personal effects to make their rooms feel homely. All bedrooms have en suite facilities. The gardens were attractive and well tended with plenty of places to sit or walk safely. While a few people told us they felt the staff were sometimes rushed, most people told us they thought the staffing levels were good. We found the home had followed careful procedures when recruiting new staff, and all staff have received a very good level of induction and ongoing training. A high proportion of the staff team hold a relevant qualification, and the remaining staff were in the process of obtaining a qualification. Many people praised the skills and cheerful and caring manner of the staff team. The home is well managed. The owners are well respected and have many years of relevant experience. There is a good management structure within the home and there are staff appointed to ensure that all tasks within the home are carried out smoothly, including administration, cooking, cleaning, laundry, gardening and maintenance.All areas of the home were found to be clean and safe. Staff have received training on all aspects of health and safety, and there were good systems in place to make sure all potential areas of risk have been regularly assessed, and equipment regularly serviced and maintained. What has improved since the last inspection? The home has good systems in place to make sure they continuously monitor and improve the quality of care. These include talking to people and seeking their views using anonymous questionnaires. What the care home could do better: While most people told us there are always or usually activities provided that they enjoy, a few people said the home could provide a better variety, including more outings. The weekly timetable we saw provided at least two different activities every day, but we suggested that the home could possibly do more to consult with each person to make sure all individual interests are catered for as far as possible. Most people told us they enjoyed the meals, but a few people said the food could sometimes be improved. We suggested the home should consider ways of improving the level of choice and regularly consult people about the menus and the quality of food in order to improve the overall level of satisfaction. While the home has not received any formal complaints in the last year a few people have made some comments or grumbles. These have not been recorded in one file and we recommended the home keeps them in one place so that they can readily provide evidence to show how all complaints and grumbles, no matter how minor, are always taken seriously and acted upon. One person told us that laundry sometimes goes missing. We talked to the laundry person and heard that wherever possible the staff try to make sure items are marked before they are taken to the laundry. However, sometimes this does not always happen and this sometimes may result in items not being returned to the correct person promptly. We suggested the home looks at ways they can improve the marking of clothing to minimise the risk of items going missing. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brandon House 29 Douglas Avenue Exmouth Devon EX8 2HE     The quality rating for this care home is:   three star excellent 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: Vivien Stephens     Date: 1 9 0 8 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 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 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 Older People Page 2 of 30 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 Older People Page 3 of 30 Information about the care home Name of care home: Address: Brandon House 29 Douglas Avenue Exmouth Devon EX8 2HE 01395267581 01395270806 brandonhouse29@aol.com 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) : Mrs Wendy Pamela Marsh,Mr John Howard Marsh care home 35 Number of places (if applicable): Under 65 Over 65 35 0 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 35 Brandon is registered to provide personal care for up to 35 older people who may or may not have a physical disability. The detached property is situated in a residential area of Exmouth with large gardens and patio areas. There is a dining room and three lounges. Bedrooms are large and all have en suite facilities. Current fees charged are between £450 and £650 per week. The summary of inspection reports is available to every resident in a folder in their rooms and to others on request. Care Homes for Older People Page 4 of 30 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: Several weeks before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment (AQAA) They completed and returned this by the required date. The form provide us with excellent information about all aspects of the home and how it is managed. We also sent a supply of questionnaires to the home and asked them to distribute these to a random selection of people. We received 15 completed survey forms from people who live in the home, 13 from staff, 6 from health and social care professionals, and 12 from relatives, carers and advocates. During our visit to the home we carried out a tour of the house, looking in a random Care Homes for Older People Page 5 of 30 selection of bedrooms and all of the communal areas. We talked to the owners, two staff and four people living in the home. We looked at the assessments and care plans and all associated records for those four people including medication records, meals, and accident reports. We also looked at other records the home is required to maintain including staff recruitment, training and employment records, and health and safety records. What the care home does well: All of the people we talked to, and those who completed a questionnaire, told us they were happy with the standard of care and the facilities. Many people expressed exceptionally high praise for the home, and even those who told us about some areas they felt the home could make some improvement in, were otherwise very positive. Comments included, All Mums needs are well cared for, Brandon House is spotless, the food is excellent, rooms are comfortable and pretty, the garden is delightful and the carers are sensitive to her needs and ALWAYS cheerful and positive. I would also like to credit them on their support for me during a very difficult and emotional time. Brandon is a warm, caring, well organised home where our mother is very settled. The staff are always cheerful and welcoming and our mothers needs are well met. I think it is exceptionally caring and well run. They provide good care, food and accommodation but also make proper allowances for each persons particular issues. People have received very good information and opportunities to visit and get to know the home before deciding to move in permanently. Their needs have been carefully assessed by the home to make sure they will be able to provide the right support and facilities. There were excellent care planning systems in place that included detailed risk assessments on all potential areas of risk. Any risks identified have been explained in care plan. The care plans are clear, comprehensive and easy to read. Every person had been given a copy of their care plan - these were included in the service user guide in each persons room. Medicines have been stored and administered safely. Staff have received training on the safe administration of medicines. People told us they felt confident they could speak out if they had any concerns or complaints. All staff have received training on the prevention of abuse and there were good systems in place to ensure the correct action is taken if any allegation of harm or abuse is raised. All areas of the home have been decorated, furnished and maintained to a very high standard throughout. The rooms are spacious and comfortable and people have been encouraged to bring furniture and personal effects to make their rooms feel homely. All bedrooms have en suite facilities. The gardens were attractive and well tended with plenty of places to sit or walk safely. While a few people told us they felt the staff were sometimes rushed, most people told us they thought the staffing levels were good. We found the home had followed careful procedures when recruiting new staff, and all staff have received a very good level of induction and ongoing training. A high proportion of the staff team hold a relevant qualification, and the remaining staff were in the process of obtaining a qualification. Many people praised the skills and cheerful and caring manner of the staff team. The home is well managed. The owners are well respected and have many years of relevant experience. There is a good management structure within the home and there are staff appointed to ensure that all tasks within the home are carried out smoothly, including administration, cooking, cleaning, laundry, gardening and maintenance. Care Homes for Older People Page 7 of 30 All areas of the home were found to be clean and safe. Staff have received training on all aspects of health and safety, and there were good systems in place to make sure all potential areas of risk have been regularly assessed, and equipment regularly serviced and maintained. 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 Older People Page 8 of 30 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 9 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information and plenty of opportunities to visit and get to know the home before they decide to move in. The home follows careful assessment procedures that ensure they fully understand peoples care needs and can be confident they will be able to meet those needs. Evidence: We looked at the information given to people who may be thinking about moving into Brandon House. The home has a comprehensive information pack that includes the homes Statement of Purpose, Service User Guide, a sample of the homes contract of residence and details of the homes complaints procedure. A copy of this information has also been placed in each bedroom. All of the people who completed a survey form before this inspection told us they felt they had received enough information to help them decide if the home was suitable for Care Homes for Older People Page 10 of 30 Evidence: them. Four people we talked to told us that they had visited the home, some with assistance from their families, before they moved in. We heard that people had also visited several other homes other homes in the area, and had decided that Brandon House was the place they wanted to live. They all said they had made the right decision. We looked at the way the home has assessed peoples needs before agreeing to admit each person. We looked at four care plan files, including the file of one person who had recently moved in. The home has a detailed checklist that has helped them to gather a wide range of information on all aspects of each persons care needs. This meant that the home could be confident that they were fully prepared for the persons arrival and would be able to provide the support, equipment and facilities to meet their needs. Care Homes for Older People Page 11 of 30 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. The home has taken great care to make certain that care workers have clear and comprehensive information about all aspects of peoples health and personal care needs, and to explain how each person wants to be assisted and supported. Medicines are stored and administered safely by well trained staff who have followed clear instructions and safe procedures. Evidence: During our visit to the home we looked at the way the home had planned and delivered the care to four people who live there. We tracked their care from their initial assessments, and looked at their care plans, risk assessments, medication records, accidents and falls records. We also spoke to each person to check that the information we had seen was correct. We found that the home had drawn up comprehensive and easy to read plans that clearly set out every aspect of the support and services each person needed. Care Homes for Older People Page 12 of 30 Evidence: Important care tasks were explained in sufficient detail so that care workers understood clearly how the person wanted to be assisted. The files were neat and tidy and it was easy to find information quickly. At the front there was a page covering essential information such as date of birth, next of kin, doctor and other relevant professionals along with a photograph of the person. There was an information sheet that staff could give to ambulance personnel if the person was admitted to hospital in an emergency. The files also contained a copy of the persons wishes in respect of resuscitation. Comprehensive risk assessments had been carried out on all potential health risks including nutrition and fluid intake, medication, constipation, skin care and falls. These had been reviewed every month, relevant health checks carried out including a record of each persons weight, and where necessary the information has been used to amend the main care plan, giving staff clear instructions on how to monitor and reduce the level of risk. The care plan files also contained daily report sheets completed by care workers, and records of any visits from health professionals. Each person had been given a copy of their care plan. These had been placed in the folder in each persons room that also held the service user guide, statement of purpose and complaints procedure. We talked to the people whose care plans we had read. We found that the care plans were accurate and gave a very clear picture of the persons care needs. People told us they were very happy with the support given by the staff team. We heard many positive comments about the care provided by the home from people living in the home, relatives, health and social care professionals and and staff who completed a survey form before this inspection. Comments included - The quality of care that X has received is excellent. We cannot fault Brandon House. The care is very good, they have looked after me very well even when I was quite ill. I feel safe and secure with them. One person told us that they would like to receive a bath more often than once a week. We talked to the owner, Wendy Marsh about this. She said that people can, and do, have baths more often, but for some people baths could take approximately one hour of staff time and therefore it was not always possible for people to have a bath as often as they may wish. Each person had either and en suite bath or shower room and those with baths had hoisting equipment if needed. Wendy Marsh said that if people Care Homes for Older People Page 13 of 30 Evidence: wanted a quick shower this could be provided every day. She said if people requested a bath or shower more often than initially agreed she was happy to talk to them to try to find a solution, although it may not be possible to provide a bath every day if took up a lot of staff time. We received six completed survey forms from health and social care professionals who regularly visit the home. They told us they were always or usually satisfied with the way the home has planned, provided and reviewed each persons care needs. Comments included - Residents always seem happy and content, carers always display kindness and respect residents. Staff at Brandon House endeavour to follow (speech and language therapy) advice as closely as possible; they refer appropriately and appear to show great respect to their residents. We looked at the way the home stores and administers medications. We found that there were two secure storage cupboards situate in different wings of the home. Correct storage facilities were provided for controlled drugs. We looked at the records of medicines administered and found that the records had been well maintained. All medicines received into the home had been carefully checked and the amounts recorded. Balances of stocks held at the end of each month were recorded. Any medicines that had not been administered as directed by the GP had been correctly recorded on the back of the administration record. Those people who wanted to hold and administer their own medications have been allowed to do so, and a risk assessment has been completed to make sure that any potential risks have been recognised and actions have been taken where possible to minimise the risks. Each persons care plan file contained a detailed form setting out the name, dose and instructions for each medication administered. The information also explained any possible side effects, any special administration instructions, and instructions to staff about anything they must look out for. This demonstrated excellent practice. Medications that must be kept cool were kept in a refrigerator and Wendy Marsh told us they were about to obtain a new refrigerator that is designed specifically for medications providing the recommended security and temperature control. We looked at the way creams and lotions were administered. These were kept in each persons bedroom and staff recorded the task in the daily notes. Containers had been dated when opened. We suggested the home considers keeping recording sheets with the creams and lotions to make sure staff always complete the records immediately Care Homes for Older People Page 14 of 30 Evidence: after administration. All care workers have received training and instructions on the safe administration of medicines. Policies and procedures were in place covering all aspects of medication receipt, storage, administration and disposal of unused medication. Care Homes for Older People Page 15 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered a good choice of activities, and wholesome and nutritious meals although there may be room for improvement to suit most peoples preferences. Evidence: Most people told us they were generally happy with the level of activities provided by the home, although a few people said that at times they felt more activities could be provided. One person told us that the level of activities had improved recently. We talked to the owner, Wendy Marsh, about this and we heard that she had recently been away from the home for a few weeks and during that time some of the regular activities had not always been provided. She assured us that since her return all activities were once again being provided as planned. We were given a copy of the weekly activity plan and saw that every morning exercise sessions are provided with the aim of keeping people fit and helping people reduce the risk of falls. In the afternoons a range of different activities are regularly provided including manicures and massage sessions, music, discussion groups, cards and scrabble, art classes and quizzes. On Sundays a church service is held in the home. We also heard that a coach outing had been arranged for the near future. Care Homes for Older People Page 16 of 30 Evidence: One health/social care professional commented they thought the home could provide more one to one staff time to take people out of the home, for example to the shops. A relative also commented It would be even better if there were extra staff at times who had the time to spare to take interested residents on outings. We asked how the home planned the way they met individual and group daily activity needs and interests. We heard that there is a Residents Committee who met regularly. We also heard that there were daily informal discussion with people, usually in the dining room. They also consulted with people through the use of questionnaires. On relative told us about some of the things they felt the home did well Letting her make choices. Offering opportunities to do things outside her room. Friendly approach of staff. A person living in the home told us Brandon House has an excellent reputation and is highly regarded by the outside community. The general air of freedom enjoyed by most residents - ie the right to go out to a meal or invite a friend to lunch occasionally; the freedom to make ones own agenda providing enough due notice is given; the privilege of being able to entertain a small committee from time to time are much appreciated by those still able to use them. We looked at the way the home involves and communicates with peoples families and friends. The people we talked to told us their families and friends were always made welcome whenever they visited. We also saw good evidence to show that the home had good communication with families especially when people were poorly. We looked at the way the home planned the menus and how they made certain that people had good choices that met their individual likes and dislikes, and also their dietary needs. While many of the people who completed a questionnaire before this inspection told us they were happy with the meals provided, and few told us the meals could sometimes be better. Comments varied from The food is top quality in all aspects. to Meals are good generally but sometimes could be improved. One person said the home should Not give me so much to eat. I sometimes feel overwhelmed with food. I have no interest in food these days. We were given a copy of the menu for the current week. At lunch time there was only one main meal offered. A note at the bottom of the menu said that sandwiches will also be available daily on request. We heard that staff went around to each person every day to tell them what was on the menu that day and check they wanted this. Alternatives would be provided according to peoples likes and dislikes. Supper time Care Homes for Older People Page 17 of 30 Evidence: meals offered greater choice including soup, a hot dish, desserts, cheese and biscuits or sandwiches. Records have been maintained of the meals actually provided to each person. We looked at the way the home met peoples dietary needs, for example, diabetic foods. We saw good information in the care plans covering all aspects of dietary needs. We talked to Wendy Marsh about the way the home met special dietary needs and we were given firm assurance that the home took good care to provide people with a good range of foods to meet their individual diets. We talked to one person living in the home with specific dietary needs and they told us they were satisfied with the meals provided. Wendy Marsh told us that fresh fruit and vegetables are purchased from a local farm shop and they take great care to provide fresh, good quality, home cooked meals using local produce. One person told us how much they appreciated the way the home always remembered residents birthdays. Care Homes for Older People Page 18 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that they can raise any concerns or complaints safe in the knowledge that they will be listened to and their concerns will be acted upon. The home has taken all possible measures to make sure people are safe from the risk of abuse. Evidence: Since the last inspection no complaints have been received by the Commission. The home told us in their AQAA that they have received no formal complaints in the last year. However, during our visit to the home we heard that some people had raised minor grumbles. The home had kept records of these in individual files. We suggested that they keep a record of all complaints and grumbles, even if they may appear to be of a minor nature, in one file so that the home can quickly provide evidence of how they have listened to people and acted on any issues raised. In the last year the home has made one alert to the local safeguarding team. All professionals involved in this matters were satisfied that the home had followed good procedures at all stages of the investigation and subsequent action. Every person has been given a copy of the homes complaints procedures. All of the people we talked to, and those who completed a survey form told us they were confident they could always talk to someone if they had any concerns, complaints or Care Homes for Older People Page 19 of 30 Evidence: grumbles and felt confident the home would take the right action. Comments we received included - (The home) Listen if you need to talk. A well run home with excellent staff who always listen to you. All of the staff team have received training on the protection of vulnerable adults, and how to recognise and prevent abuse. The home has policies and procedures in place covering all aspects of protection. Care Homes for Older People Page 20 of 30 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. People live in an attractive, spacious, well maintained and comfortable home that has been decorated and furnished to a high standard throughout. Evidence: We found there were large attractive gardens surrounding the home with well maintained lawns, attractive flower beds and shrubs, and various places to sit or walk where people could safely enjoy the gardens. There were plenty of parking spaces in the grounds and also parking on the road outside. Several people told us how much they enjoyed sitting or walking in the gardens during warmer weather. We carried out a tour of the home, looking in approximately one third of the bedrooms at random, all of the lounge and dining areas, the kitchen and the laundry. All areas were clean, bright, and free from any odours and had been well maintained. The communal areas had been decorated in a style that was in keeping with the period of the building. There were attractive pictures, ornaments, plants and flowers around the home providing interest and reflecting a pride shown by the owners and staff in the home. People told us how much they appreciated the standard of accommodation provided. Care Homes for Older People Page 21 of 30 Evidence: One person living in the home told us It provides comfortable rooms with access to the garden via French windows if your room is downstairs, and you are allowed to bring your own furniture if you so wish. A relative told us about the things they felt the home did well Keeping the home free of smells that might result from peoples incontinence. Finding her the best possible room. One member of staff told us Brandon House is a lovely place. The house is beautifully maintained and I feel part of a good team. All bedrooms were found to be spacious, with either en suite bathroom or shower facilities. The rooms were attractively decorated and furnished to a high standard. Many people had brought items of furniture, pictures and personal effects that made their rooms appear very homely. On the day of this inspection there were four domestic staff employed with responsibility for keeping all areas clean. The home had a good range of hoists and equipment to help people move around the home safely. On the day before this inspection the homes kitchen was inspected by the Environmental Health Officer. We did not see a copy of their report but the owner of the home, Wendy Marsh, assured us that everything was satisfactory. We looked at the laundry and found that the room was clean and tidy, well laid out and well equipped. The home employs a laundry person. One person told that sometimes they had problems with the laundry and we talked to the laundry person to find out what difficulties they might have. We heard that each person was expected to keep their clothing marked with their names, and the care staff were expected to check the name labels when they collect items to be washed. However, items often turned up in the laundry without a name label and this might delay the items return to the correct owner once it had been laundered. We suggested the home reviews this issue to see if they can find ways of reducing the risk of items going missing. Care Homes for Older People Page 22 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the support and assistance they need from staff who have been carefully recruited, well supervised, and trained to a high standard. Evidence: On the day of this inspection there were 34 people living in the home. Staff present on the day included the senior person who is known in the home as the manager (although this person is not registered), 5 care workers plus 1 trainee, 4 cleaning staff, 1 cook, 1 kitchen assistant, and 1 administrator. The owners Mr and Mrs Marsh were also present. We asked people if the staffing levels were sufficient. A few people told us the staff were sometimes rushed. One person told us They could employ more staff. I have to manage without help so often because I know staff are rushed off their feet, so I cannot ask them for help I really need. We also received two comments from people who thought the home could employ more staff at times to take people out. On the other hand, the majority of people told us they were satisfied with the staffing levels. Positive comments included Everything is clean, well presented and there are plenty of staff. All the staff go to SO much trouble to look after those who live there - and their patience is wonderful. Care Homes for Older People Page 23 of 30 Evidence: All of the staff who completed a survey form said the home runs smoothly and there were usually enough staff. Comments included The way the home is run is very good. There is good communication. The routine works well with the zones. On the day of this inspection we observed staff stopping to talk to people and assisting people in a calm and unhurried manner. All of the staff were relaxed, cheerful and positive and routines were carried out effectively. We looked at the way the home recruited, inducted, trained and supervised the staff. We checked four recruitment files of staff who had started working in the home in the last year. We found that at least two satisfactory references and a protection of vulnerable adults check had been obtained before each member of staff had been confirmed in post. A Criminal Records Bureau (CRB) check had also been carried out. This demonstrated good practice. We also looked at the induction training for new staff. The home had previously used their own induction checklist to make sure new staff received instructions on all important aspects of their job. The home had recently started using an induction training framework by the organisation known as Skills for Care and we were shown a workbook that a new member of staff was in the process of completing. This demonstrated that the homes induction training now meets nationally recognised standards. At the time of this inspection 17 out of 23 care staff held a nationally recognised qualification known as NVQ to at least level 2. The remaining staff team were in the process of obtaining this qualification. Some staff who held NVQ level 2 were in the process of obtaining NVQ level 3. This showed that the home placed a high priority in ensuring all staff are qualified and competent. We also saw evidence to show that the home provides regular training and updates on all required health and safety related topics and also other relevant topics including protection of vulnerable adults. A course of six training sessions has been booked for the near future on health related topics provided by the local hospital. We received many positive comments about the skills of the staff team, including The quality of care is very good and friendly. The team are very professional. One member of staff who completed a survey form told us Since starting her all staff and residents have been great. Im always offered training when necessary and I have started and NVQ2 which was all organised by the home. I believe the residents get all the appropriate care. Another staff member commented Brandon House promotes independence. We all work well as a team, all the staff are friendly and help in any Care Homes for Older People Page 24 of 30 Evidence: way they can. Management are always there to support us. Staff have received formal supervision approximately every 2 months. We heard that regular planned staff meetings have not been held regularly, although ad hoc staff meetings had been called when necessary. Care Homes for Older People Page 25 of 30 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 home is well managed and safe and is run in the best interests of the people living there. Evidence: We received many positive comments about the way the owners, Wendy and John Marsh, manage the home. Comments included, The staff are caring and helpful and Wendy and John do a wonderful job in caring for all of us, and are there if we need help or advice. Brandon House itself is a beautiful place with a real family home feeling - and is of course set in a lovely position - but it takes GOOD staff to make it complete, and this comes, obviously, from the top, the owners themselves. Wendy (Proprietor) does her utmost best to offer residents the best possible care in comfortable, enjoyable and nice surroundings. Wendy Marsh is has qualifications and experience both as a nurse and as an environmental health officer. She has many years experience of owning and managing Care Homes for Older People Page 26 of 30 Evidence: a care home. She has completed the Registered Managers Award. We looked at the way the home checks the quality of the services they provide. They have sought the views of people living in the home by regularly asking people to complete an anonymous questionnaire. The results have been collated and outcomes of these have been given to people so that they can see that their views are important. A copy of the results have been placed in the service user guide file in each persons room. The home does not hold any cash or valuables on behalf of people living in the home. If people do not want to hold large sums of cash in their rooms the home will pay for items such as hairdressing or newspapers and send them a bill once a month for these items. Risk assessments have been carried out on all areas of the home and safeguards put in place to reduce identified risks where possible, including low surface temperature radiator covers and window restrictors on upper floors. Staff have received regular training and updates on all health and safety topics. Regular checks and maintenance have been carried out on all equipment including fire safety precautions. Care Homes for Older People Page 27 of 30 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 28 of 30 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 12 People should be consulted on the variety and of activities offered to make sure as many individual preferences and interests are catered for as possible. The menus should be reviewed to ensure people are offered a good choice of meals to meet all tastes, preferences and dietary needs. A record of all complaints and grumbles should be maintained to provide evidence of how the home has listened to people and acted on all issues raised. The home should review the system of marking peoples clothing to reduce the risk of laundry items not being returned to the right person. 2 15 3 16 4 26 Care Homes for Older People Page 29 of 30 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. 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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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