Care Home: Community Care Solutions (Brambling Way)

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What the care home does well Information about the home is available in different formats to enable people to decide if it is the right place for them. Staff members have access to the information they require to meet individual needs. Support plans are kept under review and are amended to reflect changes in people`s condition. People who use the service are encouraged to make decisions about their lives, wherever possible. Several people regularly travel into Leicester using public transport. Meetings are held at which people have an opportunity to discuss issues such as trips out and menus. People who use the service are happy with the support they receive from staff members. Action is taken to ensure that personal support & healthcare needs are met and people are encouraged to attend routine health checks. Individual needs are met by well-trained staff. Staff members spoke positively about the quality & quantity of the training provided. Very good quality assurance systems are in place to ensure that standards are continually monitored and improved. Regular surveys of the views of people who use the service, their families and staff have been completed. In addition, people who use the service are able to express their views at regular meetings. A Quality & Compliance Manager visits the home every month to monitor the service provided. When asked what the home does well, the comments of staff members included the following: `Provides a homely atmosphere for service users. Promotes the service users` independence. Provides a high quality service for the service user. Provides excellent training for all staff`; Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 6`Always training given. Always have support for staff and service users 24/7`; `The training given by the company is very good and is regularly updated`; `I think at Brambling Way we have a good staffing team which works together well being led by a very good manager, who ensures policies & procedures are followed to a high standard`. What has improved since the last inspection? The building has been re-wired; restrictors have been fitted to windows; and the lounge & kitchen areas have been refurbished. CARE HOME ADULTS 18-65 Community Care Solutions (Brambling Way) 53 Brambling Way Oadby Leicester Leicestershire LE2 5PB Lead Inspector Martin Hefferman Unannounced Inspection 11th August 2008 10:30 Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Community Care Solutions (Brambling Way) Address 53 Brambling Way Oadby Leicester Leicestershire LE2 5PB 0116 2719644 F/P 0116 2719644 bramblingwaymanager@communitycaresolution s.com www.communitycaresolutions.com Community Care Solutions Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Manager post vacant Care Home 9 Category(ies) of Learning disability (9), Mental disorder, registration, with number excluding learning disability or dementia (9) of places Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider 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 category: Learning disability – Code LD Mental disorder excluding learning disability or dementia – Code MD 2. The maximum number of service users who can be admitted into the home is 9. 16th August 2006 Date of last inspection Brief Description of the Service: Brambling Way, Oadby is part of a group of homes owned by Community Care Solutions. The home provides care and support for up to nine adults who have learning disabilities and / or mental health disorders. 53 Brambling Way is a modern detached house, situated on an estate close to the centre of Oadby. There are two single bedrooms and one double bedroom at ground floor level and three single bedrooms and one double on the first floor. There are bathroom and toilet facilities on both floors. Two rooms have en-suite facilities. Communal areas consist of an open-plan style kitchen, lounge and conservatory extension, which is used as a dining area. There is a lawned garden to the rear of the property with seating. People who use the service are encouraged to live an independent lifestyle, while receiving the necessary care and support from the staff team. At the time of the visit, the fees ranged from £344 to £416 per week Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. A visit to the home took place on 11th August 2008, lasting approximately five and three quarter hours. The main method of inspection used on that day was ‘case tracking’ which involved selecting two people who use the service and tracking the care they receive through review of their records, discussion with them & staff and observation of care practices. Five people who use the service were spoken to during the course of the visit. This inspection has also taken into account all information received since the date of the last visit, including the home’s annual quality assurance assessment. Comment cards were received from five people who use the service and four members of staff. What the service does well: Information about the home is available in different formats to enable people to decide if it is the right place for them. Staff members have access to the information they require to meet individual needs. Support plans are kept under review and are amended to reflect changes in people’s condition. People who use the service are encouraged to make decisions about their lives, wherever possible. Several people regularly travel into Leicester using public transport. Meetings are held at which people have an opportunity to discuss issues such as trips out and menus. People who use the service are happy with the support they receive from staff members. Action is taken to ensure that personal support & healthcare needs are met and people are encouraged to attend routine health checks. Individual needs are met by well-trained staff. Staff members spoke positively about the quality & quantity of the training provided. Very good quality assurance systems are in place to ensure that standards are continually monitored and improved. Regular surveys of the views of people who use the service, their families and staff have been completed. In addition, people who use the service are able to express their views at regular meetings. A Quality & Compliance Manager visits the home every month to monitor the service provided. When asked what the home does well, the comments of staff members included the following: Provides a homely atmosphere for service users. Promotes the service users’ independence. Provides a high quality service for the service user. Provides excellent training for all staff; Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 6 Always training given. Always have support for staff and service users 24/7; The training given by the company is very good and is regularly updated; I think at Brambling Way we have a good staffing team which works together well being led by a very good manager, who ensures policies & procedures are followed to a high standard. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. Information about the home is available to enable people to make an informed choice about where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they had received enough information about the home before they moved in to enable them to decide if it was the right place for them. A guide to Brambling Way has been written in plain English and contains photographs of the home. It is also available in large print, audio and widgit (symbol) formats. The requirements of Standard 2 (Needs Assessment) could not be fully assessed on this occasion. No one has moved to the home since the date of the last inspection. The people who were chosen for the purposes of case tracking moved in during 1995 and 1999. Records indicate that their needs have been kept under review. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. Staff members have access to the information they require to meet individual needs. People who use the service are encouraged to make decisions about their lives, wherever possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff members indicated that they are always given up to date information about the needs of the people they support. Individual plans were available for the people who were chosen for the purposes of case tracking. Both of the plans that were inspected had been reviewed recently and one of them had been amended to reflect a deterioration in the persons condition. Documents have been signed by the person who uses the service to indicate that they are in agreement. Person centred plans were also available, setting out information about peoples likes & dislikes, their hopes for the future, their preferred routines and the relationships that are important to them. Risk assessments have been completed on a wide range of areas, detailing the measures that need to be taken to minimise the risks that have been identified. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 10 People who use the service indicated that they can make decisions about what they do each day. Several people stated that they regularly travel into Leicester using public transport. One of the people who were chosen for the purposes of case tracking spent the day of the visit at home. Staff members offered her a choice of activities in the morning and afternoon. She was also involved in the preparation of a snack at lunchtime. It was evident on the day of the visit that people who use the service are able to make full use of communal areas and their bedrooms. Regular meetings are held at which people have an opportunity to suggest activities and decide on menus. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. The well being of people who use the service is promoted through their attendance at age appropriate activities. They are encouraged to maintain links with their families and are offered a healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service attend a range of daytime activities including colleges and day centres. One of the people who were chosen for the purposes of case tracking attended an Age Concern day centre on the day of the visit. The second person spent the day at home undertaking activities with a member of staff. The importance of following a set routine for this person, particularly in the evenings, was documented in her individual plan. Daily records indicated that staff members are implementing this routine. People who use the service stated that they enjoyed a recent trip to Skegness and that they were looking forward to visiting Twycross Zoo later in the month. Several people reported that they regularly go into Oadby and the Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 12 centre of Leicester using public transport. Records indicate that people who live at Brambling Way are in contact with their families where possible. People who use the service stated that they enjoy the food that is provided. They are able to suggest meals that they would like added to the menu at regular house meetings. They are offered a choice of meals and the opportunity to prepare snacks & drinks. The acting manager was reminded that a record must be kept of all of the food provided to people living at the home. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. People who use the service receive appropriate personal support and their health & medication needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service stated that they are happy with the support they receive from staff members. The individual plans that were inspected detailed the personal care each person requires. They also set out details of any healthcare needs that have been identified and of any action that is felt to be necessary as a result. Records indicate that support plans are kept under review and are amended to reflect changes in peoples condition. Health action plans have also been completed since the date of the last inspection. Records of appointments attended by people living at the home indicate that they are in contact with a range of healthcare professionals when necessary. They also indicate that people are encouraged to attend routine well man and woman appointments. None of the people who were chosen for the purposes of case tracking manage their medication. Records of the medicines administered by staff met relevant requirements. A contract pharmacy inspected medication arrangements at the home during May 2008. Records of that inspection indicate that no issues were Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 14 identified. Temazepam was stored in a locked tin within the medication cabinet at the time of this visit. The acting manager was advised of the need for Controlled Drug storage to comply with the requirements of the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. Staff members have received medication training. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. People who use the service are protected by the home’s arrangements for handing complaints and responding to allegations of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they know who to speak to if they have any concerns. The homes complaints procedure is available in an accessible format. Information provided prior to the visit indicates that the home has not received any complaints in the last twelve months. The home has policies and procedures on the protection of vulnerable adults and whistle blowing. Staff members have received training on safeguarding adults and indicated that they are aware of the action they should take in the event of an allegation or suspicion of abuse. Financial records are signed by the person who uses the service wherever possible & two members of staff. Receipts were available for inspection. The acting manager agreed to rectify a minor discrepancy in one of the records that were inspected. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. People who use the service live in a clean and comfortable home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service stated that they are happy with the environment in which they live. They indicated that the home is always fresh and clean. Since the date of the last inspection, the building has been re-wired; restrictors have been fitted to windows; and the lounge & kitchen areas have been refurbished. A fire exit in a downstairs bedroom, however, remains locked. The room was not in use at the time of the visit and the acting manager stated that people would be evacuated through other exits. This practice should, however, be reviewed and the fire officer consulted as it would appear to constitute a health and safety risk. Alternative ways of balancing security with fire safety should be explored. Some of the areas that were inspected need to be re-decorated. The acting manager stated that she was in the process of obtaining quotes for this work, which will include the replacement of some windows (as recommended at the time of the last inspection) and the fitting of radiator covers. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 17 Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. Peoples individual needs are met by well trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they are always treated well by staff members. There appeared to be a positive relationship between the people who live at the home and the staff who were present at the time of the visit. The records relating to two members of staff were inspected. Whilst one indicated that appropriate pre-employment checks had been carried out, the second revealed that a member of staff had been allowed to work unsupervised before her Criminal Records Bureau disclosure had been received. New members of staff complete a programme of induction training to the standards set by Skills for Care. Information provided prior to the visit indicates that one of the three permanent members of care staff has completed National Vocational Qualification level 2 or above and that the service plans to increase the opportunities available for staff to obtain these qualifications. Records indicate that staff members have received training on a range of issues relevant to their work including dementia, epilepsy and Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 19 managing challenging behaviour. Staff members spoke positively about the quality & quantity of the training provided. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. People who use the service benefit from a well run home. Very good quality assurance systems are in place to ensure that standards are continually monitored and improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager stated that she was in the process of applying to be registered. She has obtained National Vocational Qualifications in care at levels 2 & 3 and will start level 4 later this year. Community Care Solutions completed a survey of people who use the service, their families and staff during March 2008. The results indicate that people are generally satisfied with the service provided. In addition, people who use the service are able to express their views at regular meetings. A Quality & Compliance Manager visits the home every month to monitor the service provided. A formal report is made of this visit and is available for inspection. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 21 Records indicate that he has recently audited medication & financial arrangements at the home. Staff members have received training in fire safety, food hygiene, first aid, health & safety and moving & handling. Fire tests & drills have been completed at the required frequency. The acting manager agreed to check when the emergency lighting system would next need to be serviced. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 4 X X 3 X Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 Requirement Timescale for action 30/11/08 2. YA24 23 Storage of Controlled Drugs must comply with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 to provide increased protection against misuse and theft. 30/09/08 The practice of locking the fire exit in a downstairs bedroom should be reviewed (including consultation with the fire officer), as this would appear to constitute a health and safety risk. Alternative ways of balancing security with fire safety should be explored. The previous timescale of 30/09/06 was not met. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA34 Good Practice Recommendations Arrangements should be made to ensure that all parts of the home are reasonably decorated. Staff members should not work unsupervised until all recruitment checks have been completed. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Community Care Solutions (Brambling Way) DS0000064677.V370100.R01.S.doc Version 5.2 Page 26 - 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. 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