Care Home: Brantwood Residential Care Home

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What the care home does well The information about how the home works and who it is for, known as the statement of purpose and service user guide, is included in an information pack which is given to people who may be interested in living in the home. Assessments of need are carried out by the manager on people who want to live in the home. This is to ensure that the home can provide the care to meet the person`s needs. The plans of care and risk assessments for the people who live in the home show how the health and personal care needs of the person are to be met. There is up to date information and guidance for staff so they know what they must do to meet the needs of each person. Staff provide support for people who live in the home to enable them to keep in touch with their families and friends. We saw that people living in the home were comfortable with staff who were working with them and were able to seek advice and support from them. There is a complaints procedure in place for the home that shows how complaints will be recorded, how they are investigated and by whom and what action will be taken. This helps to make sure that people living at the home know their concerns will be taken seriously and acted upon. The general decor and appearance of the home, both inside and outside, is of a high standard so ensuring the people who live at Brantwood do so in comfortable and safe surroundings that are suitable for their needs. Staff have received training on safeguarding adults, moving and handling, medication, fire training, basic food hygiene and infection control. This will make sure that staff know how to provide safe care for the people who live in the home. The manager for the home has worked in care homes for older people for over twenty nine years and has achieved an NVQ Level 4 and the Registered Managers Award. She has also attended other training courses to update her knowledge and skills in managing a care home. Eight people who live in the home and four staff sent us back their completed comment cards with their views about the home. Comments from the people who live there included `the home is well organised`, `Cleanliness is first class, staff are extremely well mannered, food is excellent and relaxed and friendly atmosphere`, `Looks after us well`, `There is always someone to attend to my needs`. What has improved since the last inspection? The detailed questionnaire, called the annual quality assurance assessment, which was completed by the manager, told us that during the twelve months before our visit, improvements had been made by continuing to refurbish the home, providing new equipment to help people move around more easily and continued staff training. What the care home could do better: The comments in the surveys sent back to us included, `It would be nice if someone was available to go to the shops to purchase extras sweets and things of that nature`, `Increase staffing levels by one extra night carer and better holiday cover`.The annual quality assurance assessment said they are going to `Improve the home`s pre-admission assessment forms, try to arrange more outings for clients, try to encourage more families to participate with outings and parties and have another go at a suggestion box`. Key inspection report Care homes for older people Name: Address: Brantwood Residential Care Home 112 Congleton Road Sandbach Cheshire CW11 1HQ     The quality rating for this care home is:   two star good 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: Val Flannery     Date: 2 0 0 8 2 0 0 9 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 26 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) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Brantwood Residential Care Home 112 Congleton Road Sandbach Cheshire CW11 1HQ 01270760076 01270753013 brch@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Robert Shaw care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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 - Code OP. The maximum number of service users who can be accommodated is 21 This home is registered for a maximum of 21 service users in the category of OP (old age not falling within any other category) Date of last inspection Brief description of the care home Brantwood is a large detached Victorian house set in its own grounds in Congleton Road, Sandbach. It is a privately owned home that provides care for older people. It has 21 single bedrooms but two of these could be used as double rooms if necessary. All of the rooms have en suite facilities. Accommodation is on two floors and is accessible via two staircases, one of which has a stair lift. There are two lounges, a dining room, conservatory and a sitting room, which is adjacent to the reception area. There are enough toilets and bathrooms for the number of people living in the home. Care Homes for Older People Page 4 of 26 Over 65 21 0 Brief description of the care home There is a kitchenette next to the dining room where people who live in the home or visitors can make themselves drinks and snacks if they wish. There is a large enclosed garden at the back of the house with a gazebo for people to use; this is fully accessible to the people who live in the home and is well maintained. Information on the fee payable for this service is available from the home owners. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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 overall quality rating for the home is two stars. This means that the people who use the service experience good quality outcomes. This visit took place on the 20 August 2009. It was carried out by one inspector and took a total six hours. The report will say we when referring to what we did and what we found because it is written on behalf on the Care Quality Commission. During the visit we spoke with the people living in the home, relatives, a GP who was visiting the home, the manager and staff. The visit was just one part of the inspection. The home manager had completed a questionnaire to provide detailed up to date information about the home. CQC questionnaires were made available to the people who live in the home and staff so they could tell us what they think about it. The last inspection of this home was a short inspection and was carried out on 6 Care Homes for Older People Page 6 of 26 February 2009. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The comments in the surveys sent back to us included, It would be nice if someone was available to go to the shops to purchase extras sweets and things of that nature, Increase staffing levels by one extra night carer and better holiday cover. Care Homes for Older People Page 8 of 26 The annual quality assurance assessment said they are going to Improve the homes pre-admission assessment forms, try to arrange more outings for clients, try to encourage more families to participate with outings and parties and have another go at a suggestion box. 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 9 of 26 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 10 of 26 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. Assessments of the care needs of people are carried out before they come to live in the home so ensuring the staff have the skills and training to meet that persons needs. Evidence: During our visit we saw a copy of the information about how the home works and who it is for. This had been reviewed and updated by the manager in June 2009, including up to date contact details for the Care Quality Commission if people wanted to contact us. This meant that people being given the statement of purpose would have up to date information about the home. We were told that people who may wish to live in the home are given an information pack that would include further information about the home, including its complaints procedure. This would help them to make a decision about whether the home would be right for them. We saw the care files of two people who had recently moved into the home. This Care Homes for Older People Page 11 of 26 Evidence: contained checks on the persons care needs which had being carried out by the manager before the person moved into the home. One of the care files also contained a copy of an assessment of care needs that had carried out by a care manager from the local authority as well as information about the person provided by healthcare professionals. These all help to make sure that the persons needs can be met at the home and that Brantwood is the right place for them to live. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were up to date with clear information about how the needs of the people living at Brantwood are to be met. This means that staff are aware of what to do to make sure that safe and appropriate care is provided to keep people well and healthy. Evidence: The plans of care we saw for the people who live in the home showed how their care needs were to be met by staff at the home. This included the help people required with their mobility, personal care such as dressing and undressing, using the bathroom and toilets and with their prescribed medication. We saw risk assessments that identified possible risks to the safety and well being of the people who live in the home and the action to be taken to reduce those risks without unnecessarily limiting peoples choices. The plans of care showed that peoples healthcare needs were being monitored and action was being taken to deal with any concerns staff had. This included getting advice and treatment from doctors, specialists, and other healthcare professionals. We spoke with a doctor who told us staff from the home are very good at contacting the practice if they have any concerns or worries about the health of the people living in the home. He also said staff will follow the advice and guidance offered Care Homes for Older People Page 13 of 26 Evidence: by doctors and nurses. He said the he, and his colleagues in the practice, have not received any complaints or concerns about the home and the way they care for the people who live there. We saw staff support the people who live in the home with personal care tasks such helping them to the bathroom and moving about the home. We also saw staff talking with people and offering reassurance if they had any concerns or worries. The support was offered in a discreet and respectful manner and ensured the privacy and dignity of the people was maintained. For example, we saw staff knock on bedroom doors before they entered and close the doors to the toilets and bedrooms. We also saw staff encourage and support people to be as independent as possible with their daily routines. We saw staff administer medication to the people who live in the home. This was done in a discreet manner and staff supported people to take their medication. We looked at a sample of the medication administration records and found these were completely satisfactorily. The medicines were being stored securely and appropriately. In February 2009, we did a short inspection at Brantwood and at this visit we found that the management of controlled drugs had improved, and the medication policies and procedures had been reviewed and updated. This all helps to make sure that people living in the home receive their medicines safely, without any errors and as their doctors have prescribed. Care Homes for Older People Page 14 of 26 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 who live at the home are offered choices and consulted about their daily routines so they have a say in what they do each day. The quality of meals was good so ensuring peoples dietary needs were met. Evidence: During our visit we spoke with two relatives who were visiting Brantwood. They told us that they are able to visit the home as they wish and are made to feel very welcome by staff. They said they are kept of informed of events affecting their relatives and that they are able to see them in the privacy of the bedrooms. One person said they and other family members visit the home at different times during the week and they have not seen or heard anything to cause them concern. Both said they were made aware of the complaints procedure and whom to raise issues of concern with in the home. We looked at the care files for two people who live in the home to see what care they receive. The files included plans of care with important information about the person such as their likes and dislikes, the important people in their lives, their wishes and choices and their daily routines. This information is important as it helps staff to make sure that they provide individualised care in the way that each person prefers. Care Homes for Older People Page 15 of 26 Evidence: We spoke with five people who live in the home. They said they can go to bed and get up when they please. They said they have singers and other musical entertainment and that they have parties at Christmas and for their birthdays. They told us that they would like to go out to the local community but that is not always possible because staff are not always available to escort them. The manager said they are in the process of interviewing for the post of activity co-coordinator so the home will be able to offer more activities. During our visit we observed a meal being served and saw this was a relaxed and unrushed occasion. We saw staff support people with their meal in a quiet and kind manner. The people who live in the home, and one of the relatives, said the food offered is well cooked and presented and that they always have plenty to eat and drink. We saw staff offer drinks to the people who live in the home at various times during the time we spent at the home. Care Homes for Older People Page 16 of 26 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. The complaints and safeguarding procedures and staff training help to make sure that people living at Brantwood can be confident that their concerns will be listened to and they are protected from harm and abuse. Evidence: The manager told us they have not received any complaints about the home. The copy of the complaints procedure that we saw contained up dated information on how to contact the Care Quality Commission. We spoke with people who live in the home and two relatives who told us they had been given a copy of the complaints procedure. They also said they knew who to raise issues of concern with and that they were confident their concerns/worries would be listened to and acted upon. The manager also said they have not made any referrals under the local safeguarding adults procedures. We spoke with staff who told us they have received training on safeguarding adults. The manager provided us with a copy of the staff training that showed six staff received this training in 2009 and two staff had received the training in 2008. This helps to make sure that staff know what to do to protect the people who live at Brantwood from possible harm. Care Homes for Older People Page 17 of 26 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 good 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 maintained so that the people who live at Brantwood do so in comfortable, clean and safe surroundings that are suitable for their needs. Evidence: The home is on the main Sandbach to Congleton road and is within walking distance of Sandbach town centre. It is also close to junction 17 of the M6 so it is easy for people to reach. All the bedrooms in the home are single rooms located on the ground and first floors of the two storey building. Access between the ground and first floors is via the stairway or stair lift. We were told that seven of the bedrooms have ensuite showers and toilets, two have ensuite baths and toilets and the remainder have ensuite toilets. We saw two of the bedrooms during our visit and they had been made more homely with personal possessions of the people living in them. During our visit we walked round the home and it was clean, tidy, comfortable and well maintained. We saw communal toilets which were close to the communal areas so they were easy for people to reach. There is a walk in shower/wetroom and other bathing facilities. We saw a number of communal lounges, including a conservatory, which are easily accessible to the people who live in the home. We saw people moving freely between the communal areas and their bedrooms. Care Homes for Older People Page 18 of 26 Evidence: The area at the front of the home provides car parking for visitors. There is a secure, well maintained garden at the back of the home for people living there to use in the better weather. Grab rails have been provided so people with mobility problems can walk in the garden in safety. People who live at Brantwood and visitors told us that the home is always clean and tidy and that the bedrooms are comfortable and warm. The laundry facilities for the home are located so that soiled linen does not have to be taken through the food preparation area. This means that there is no risk of cross infection from dirty laundry. Care Homes for Older People Page 19 of 26 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. The people who live in the home are supported by staff who have received the training they need to make sure they can care for them safely and well. Evidence: During our visit to Brantwood we saw staff talking with and supporting people who live in the home with personal care such as helping them to the bathroom, eating and drinking and moving about the home. The people living in the home were seen communicating with staff and were relaxed in their company. We saw people asking staff for drinks and for help. Staff responded in a caring and sensitive manner to requests for assistance. They ensured the privacy and dignity of the people was maintained at all times. We spoke with people who live in the home and two relatives who were visiting the home during the inspection. They said staff are very welcoming and kind. The relatives said staff keep them informed any any accidents or incidents that may effect their relatives who live in the home. The staffing rota we saw during our visit showed that there are normally two care staff on duty during the day and one on waking night duty. In addition the manager and other joint proprietor are available to provide cover and support. Care Homes for Older People Page 20 of 26 Evidence: We looked at staff files to check how they had been recruited. The files we saw showed that all the necessary checks, including references and Criminal Record Bureau checks has been obtained to make sure that staff were suitable to work with the people who live at Brantwood. The staff training and qualifications records we were given by the manager during our visit showed that staff training on moving and handling, safeguarding adults, fire safety, medication (senior care assistants only), health and safety and food hygiene were up to date. The information provided showed provided that none of the eight staff have achieved an national vocational qualification (NVQ) although four of them were in the process of completing their NVQ Level 3 in care at the time of our visit. These are nationally recognised qualifications for staff working in the field of care and achieving them shows that staff are competent to provide good quality care. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of the home is good so ensuring the health, safety and well being of the people living in the home are being maintained. Evidence: The manager for the home, who is also the joint proprietor, has worked in care homes for older people for twenty nine years. She has an NVQ Level 4 in management and has completed the Registered Managers Award. She has also attended training in order to update her knowledge and skills in caring for older people. We spoke with people who live in the home, relatives and staff who told us that the home is very well managed, that they are consulted about any proposed changes and they are confident their complaints or concerns will be listened to and acted upon. They also said any maintenance issues are addressed very quickly. We saw blank copies of questionnaires made available to people who live in the home, relatives and advocates so they can give their views about the service offered by the home. We were given a copy of the Annual Quality Assurance Survey Outcomes Care Homes for Older People Page 22 of 26 Evidence: (clients) for 2008. This showed that the people who live in the home are generally satisfied with the care offered by the home. We were told by the manager that they do not get involved in the finances of the people who live in the home and that they encourage them to manage their own finances. However, the home will support people who require help with their finances to access advocacy services such as Age Concern. We saw a sample of service and health and safety records during our visit. The fire safety record showed that the fire alarms are tested weekly, the emergency lights are tested monthly and that regular fire evacuation drills are carried out. This is to make sure that staff know what to do to protect people if there was a fire. We saw records that showed that the chair lift is serviced on a regular basis and a copy of the gas safety certificate which was up to date. This shows that the home and the equipment in it is regularly serviced to make sure that it is safe for the people living at Brantwood. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 24 of 26 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 25 of 26 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). 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