Care Home: The Brambles

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What the care home does well The service provides a warm, friendly and welcoming atmosphere. The service provides a good standard of accommodation, which is accessible and provided with a range of specialist equipment to meet the needs of guests staying there. The service censures that detailed pre- admission assessments are carried out prior to any guests receiving a service, which forms the basis of the development of the care plan. A guest spoken with said, "I was impressed with the information that the service had obtained". Guests using the service benefit from a staff team who have good awareness and knowledge of their needs. Guests have detailed and comprehensive individualised care plans, which have been carried out in consultation with them.The service has systems in place for gaining feedback and views from guests using the service including surveys and meetings. Information seen demonstrated that the service responds to the views of guests and act on what they say. Staff were observed to provide good interaction with guests who were seen to be respectful, caring and attentive to their needs. A number of positive comments were received from guests spoken wit including: "Brilliant place" The staff are very helpful; "The staff are well trained" and they are very kind and caring". What has improved since the last inspection? Since the previous visit the service now ensures that guests care plans are in place within twenty-four hours of admission. People who may be at risk of having falls are identified. Medication is stored appropriately and all medication administered to people is signed for. All staff have now received up to date training in safeguarding vulnerable adults from abuse. The services safeguarding vulnerable adults from policy has been reviewed and updated and this procedure is bought to the attention of staff. What the care home could do better: No requirements were made as a result of this inspection. One good practice recommendation was identified CARE HOME ADULTS 18-65 The Brambles Suffolk Close Massetts Rd Horley Surrey RH6 7DU Lead Inspector Lisa Johnson Unannounced Inspection 22nd April 2008 09:20 The Brambles DS0000013356.V361022.R02.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 The Brambles DS0000013356.V361022.R02.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. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Brambles Address Suffolk Close Massetts Rd Horley Surrey RH6 7DU 01293 771644 01293 784478 kcroll@brambles.org.uk www.mssociety.org.uk Multiple Sclerosis Society 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) Ms Kay Croll Care Home 28 Category(ies) of Physical disability (28) registration, with number of places The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) 2. The maximum number of service users to be accommodated is 28 Date of last inspection 3rd April 2007 Brief Description of the Service: The Brambles Respite Care Centre provides short-term respite care for people who have been diagnosed as having Multiple Sclerosis, and who are aged 18 years or over. The Centre is owned by the MS Society and is a registered provider of both nursing and personal care for 28 adults. The Brambles was purpose built for people with a physical disability and all accommodation for guests is situated on the ground floor in single rooms. All rooms offer the facilities of a toilet, washbasin and hands free telephone systems, TV and DVD. All 28 bedrooms have overhead electrical ceiling hoists and the bathrooms have a variety of baths such as hi-lo, Jacuzzi and parker baths and one bathroom has a wheel-in, walk-in shower. There is a large lounge area, including a licensed bar, where alcoholic and soft drinks can be purchased by guests and visitors. There is also a dining room, conservatory and a separate smoking lounge where guests are permitted to smoke. The physiotherapy department also offers a hydrotherapy pool. The home is situated in a quiet cul-de-sac, close to Horley Town centre and set in pleasant, well-maintained gardens. Parking is provided to the front of the building. Subject to levels of dependency weekly fees range from £819.00-£1,300. There are extra charges for some therapies, hairdresser, chiropody and outings. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of a key inspection. The site visit was unannounced and took place over nine hours commencing at 09.20 am and finishing at 6.20 p.m. Mrs. L Johnson Regulation Inspector carried out this visit. Mrs. K Croll Registered Manager represented the service. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA) This is a self-assessment that focuses on how well outcomes are being met for people using the service. Reference is made to this assessment throughout this report. We were informed that people using the service prefer to be known as guests and shall be referred to as such throughout this report. A full tour of the premises took place. Care plans, risk assessments, medication administration records staff personnel files, training records and policies and procedures were seen during this visit. During this visit we were able to speak to eight guests, clinical manager, catering manager and three members of care staff. The inspector would like to thank the guests and staff for their time, assistance and hospitality during this inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. What the service does well: The service provides a warm, friendly and welcoming atmosphere. The service provides a good standard of accommodation, which is accessible and provided with a range of specialist equipment to meet the needs of guests staying there. The service censures that detailed pre- admission assessments are carried out prior to any guests receiving a service, which forms the basis of the development of the care plan. A guest spoken with said, “I was impressed with the information that the service had obtained”. Guests using the service benefit from a staff team who have good awareness and knowledge of their needs. Guests have detailed and comprehensive individualised care plans, which have been carried out in consultation with them. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 6 The service has systems in place for gaining feedback and views from guests using the service including surveys and meetings. Information seen demonstrated that the service responds to the views of guests and act on what they say. Staff were observed to provide good interaction with guests who were seen to be respectful, caring and attentive to their needs. A number of positive comments were received from guests spoken wit including: “Brilliant place” The staff are very helpful; “The staff are well trained” and they are very kind and caring”. 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. The Brambles DS0000013356.V361022.R02.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 The Brambles DS0000013356.V361022.R02.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 People using the service experience excellent outcomes in this area This judgement has been made using available evidence including a visit to this service. Prospective people considering using this service are provided with information they need to make an informed choice about its suitability. The needs of prospective guests are assessed prior to admission to the service. EVIDENCE: The service user guide and statement of purpose is updated annually and is provided to all guests, which was confirmed by one guest spoken with. The information provided a comprehensive description of the services that are provided including the up to date fees. The service provides a brochure and information can also be provided on DVD. Prior to admission the service acquires a pre- assessment application form, which is assessed by the clinical manager. Prospective guests and families are encouraged to visit the centre. The clinical manager will also contact guests again prior to admission to ensure that there are no changes since the preadmission form had been received. During this visit three pre- admission assessments were sampled which were detailed and comprehensive and covered a range of areas including health, personal, social and cultural and religious needs. The assessment also includes The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 9 information about guest’s preferences for support and any identified aids and specialist equipment. The service also obtains information from other professionals including care managers, health care professionals and the General Practitioner. The manager has identified in the Annual Quality Assurance Assessment that they plan to review their pre- admission assessments to address the requirements of the Mental Health Capacity Act. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 10 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 People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. People are provided with a care plan, which records their individual needs and goals and they are supported to make decisions about their lives. People using the service are supported to take risks as part of an independent lifestyle. EVIDENCE: Each guest has a comprehensive care plan in place, which is based on the preadmission assessment, and they are designed to enable personal, health, and social care needs of each guest to be addressed. Care plans are reviewed at each admission in consultation with guests. One guest spoken with told us about the process that takes place during admission and said, “I was impressed with the amount of information that the centre had gained”. During their stay guests maintain a copy of their care plan in their bedroom. Daily records sampled detailed the care and support given, which qualified nurses also check. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 11 People using the service are supported to make decisions about their lives and their cultural and religious needs were respected. The service has in their possession a copy of an advanced directive for one guest. Information recorded in one guests care plan stated that this person likes to have time alone for prayer and another guests care plan identified that they choose to attend church, which was confirmed by this person during this visit. The communication needs of guests are considered and one person’s plan identified that they use an alphabet board. Guests are able to participate in monthly forum meetings and the service carries out a thirteen-week guest survey to gain feedback. The service has demonstrated that they respond to people’s requests such as changing mealtimes and providing equipment. Risks assessments are included in each care plan with appropriate actions identified to reduce the level of risk. Plans sampled including moving and handling, falls, use of bedrails and pressure areas. Risk assessments are carried out in consultation with guests. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 12 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 People using the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are provided with a range of appropriate activities and engage in a range of leisure pursuits. People are supported to take part in the local community and their rights and responsibilities are respected. The home is able to demonstrate that people are provided with a well-balanced and nutritious diet. EVIDENCE: Guests are provided with a range of recreational, therapeutic and social activities. As part of the pre- admission assessment people are asked to state their preferred hobbies and interests. There is an activities coordinator in post and a weekly programme was available which was seen on display in guest’s bedrooms. The service holds quizzes, entertainment and has its own bar to purchase drinks and we were informed that an St Georges day celebration had been arranged. A computer is available with Internet access and the home has recently purchased a games console. Each bedroom is provided with a flat The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 13 screen digital television with DVD, which had been requested by guests and a large, wide screen television has been purchased for the lounge. Guests maintain links with the community, which was confirmed by one guest who said that they were going out clothes shopping with a member of staff to the local town centre. During this visit some people attended an outing to the Blue bell railway and in the evening a trip to the theatre was taking place. Four guests spoken to say that they were happy with the activities provided. One guest said that the service said, the service tries to meet the diverse needs of everybody”. The Service has a policy on relationships and sexuality and guests are able to choose whom they wish to see and they are able to receive their visitors in private. All rooms have hand free telephones to enable people to maintain contact with families and friends. One guest said, “As I need some help with using the phone staff help me”. Information provided in the Annual Quality Assurance Assessment states that information on advocacy services is made available. Good interaction was observed between staff and guests. Staff were seen to be respectful, caring and attentive to the needs of guests throughout this visit. Some guests chose to have a rest after lunch and their preference to go their rooms was seen to be respected. Information provided demonstrates that the service provides is a varied menu and caters for a wide range of diets including vegetarian, specialist diets and meals to meet people’s cultural backgrounds. Staff receive training in nutritional awareness. At the request of guests the main meal is now provided in the evening. At lunchtime snack type meals are provided which consisted of nine choices serving both hot and cold meals. Guests are are provided with an opportunity to have cooked breakfast if this is their preference and receive their meals in their rooms. The lunchtime meals were well presented and guests spoken with said that they were satisfied with the meals provided. One person said, “there are plenty of choices” and another person spoke positively about the fresh salad provided daily and fruit salad. The lunchtime meal was seen to be relaxed and unhurried. The dining room offers a pleasant surrounding and tables were nicely laid with tablecloths and flowers Staff was observed to provided appropriate support to people who require assistance with eating. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 14 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): 8, 19 & 20 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that people living in the service receive personal support in the way they prefer. People’s physical and health needs are met and they are protected by robust medication administration procedures. EVIDENCE: The service ensures that guests receive care and services in the way they are used to and prefer. This was demonstrated by information recorded the preadmission assessment which identified guests preferred gender of staff to provide support and their preferred name of address is respected. All guests spoken with said that staff respect their privacy and that staff knock before entering their rooms and the service has acquired new signage for guests doors to avoid disturbance. A number of guests spoke positively about the support they receive from the home. Comments included “This place is The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 15 brilliant”: “the staff are very helpful and “The staff are wonderful and very caring”. The health needs of guests were identified in their care plan. Two peoples plans contained clear information how people are to be supported when eating their meals and the equipment that they require. Staff demonstrated during the lunchtime meal that this was carried out as recorded in the care plan. Appropriate specialist interventions take place supported by suitably qualified nurses who have undertaken the required training. The service employs physiotherapists who were providing therapies to people during this visit. The centre also has their own hydrotherapy pool. The centre provides the necessary equipment to people to meet their needs including tracking/hoists, electric beds and air mattresses. Guests are allocated rooms that are adapted to meet their needs. One guest told us. “ Before my stay I request a room that meets my needs which is always accommodated”. A local General Practioner surgery provides cover to the service and if necessary guests own General Practitioner or community nurse are contacted for advice and discharge letters are sent to them if there have been any changes during the stay. The service is also able to make arrangements for chiropody visits. We were informed that the service maintains links with a neurologist if advice is required. During this visit the centres medication administration practices were examined. Guests bring their own medication into the service, which is then hand transcribed on to the medication administration record, which is checked and signed by two members of qualified nursing staff. All quantities received are recorded. Qualified nurses only administer medication and a list was maintained of all nurses that that administer medication. A homely remedy medication agreement was also in place. We were informed that a medication training update is to take place shortly. All medication administered had been signed for and medication was stored appropriately including any controlled medication. Guests are able to retain and administer their own medication and a guest spoken with said that thee is a lockable facility in the bedroom. Self medication is supported by risk assessments. Since the previous visit we received one notification regarding a medication error. Although the service has taken appropriate action in respect of this matter the manager was advised to ensure that any actions are documented on the notification form at the time. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 16 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): 32 & 33 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service is able to demonstrate that the views of people are listened to and acted upon and safeguards people from abuse and takes action to follow up any allegations. EVIDENCE: There is a complaints procedure in place, which is available with the service user guide. Since the previous visit the Commission has received no complaints or concerns. The service has received one complaint, which was appropriately followed up by the manager. Information supplied in the Annual Quality Assurance Assessment states that new guests have the opportunity to express any concerns at a three day follow up visit, there is a suggestion box and the service holds guest forums. Guests spoken with said that they were happy with the care and support provided by the service and that they felt that staff listened to any worries and concerns. The local authority safeguarding adult procedures were available and the service has their own procedure which had been reviewed since the previous inspection, although further discussion took place with the manager in respect of clarifying the term “non serious” and that all allegations or suspicions should be reported to the local authority social care team This matter was attended to The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 17 during this visit. The manager was also in the process of issuing staff with safeguarding vulnerable adults from abuse alert cards. Since the previous visit one matter was referred by the home to the local authority following the safeguarding vulnerable adults from abuse procedures. A decision was made by the local authority that this matter be investigated by the home which was completed and is now closed. Since the previous visit all staff have completed safeguarding vulnerable adults from abuse training, which was confirmed by the staff-training schedule. It was recommended that the registered manager attend the local authority safeguarding vulnerable adults from abuse training. Three members of staff spoken with during this visit confirmed their attendance at safeguarding training and that the procedures are bought to staff’s attention during their induction. Staff were also clear about the action they should take if they witness or are made aware of any incident where the safety or protection of a vulnerable person is compromised. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 18 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, 25, 26 & 30 People using the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receiving the service have a safe and well-maintained environment that is homely, clean, comfortable, pleasant and hygienic The service makes sure that people have the right specialist equipment that encourages and promotes their independence. EVIDENCE: The centre is built for purpose and meets the needs of guests using the service. All of the communal areas and the grounds are accessible for wheelchairs. Since our previous visit considerable refurbishment has taken place including the corridors and dining room, which provides a homely environment. There are also plans to refurbish the sitting room. The service has considered the comfort of guests by purchasing adjustable height tables. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 19 All rooms are air-conditioned and a new pushing, pressing or blowing has call system has been installed. New cool touch radiators have been lighting with integrated emergency lighting. All bedrooms are single occupancy and they have also been refurbished. Each Bedroom is provided with shower and toilet and some sinks are height adjustable. A disabled user-friendly wardrobe has also been installed. Three assisted bathrooms are available for people who prefer baths. One bedroom is provided with a wet room to assist guest’s to maintain their independence and a wide range of specialist equipment is provided to meet peoples assessed needs including hoist tracking, beds and call bell systems. Guests staying in the service benefit from a clean and hygienic environment. One guest spoken with said the service is “spotless and another guest said that the centre is always clean”. Policies and procedures are in place for infection control and staff receive training. The laundry room was maintained to a good standard and new washing machines have recently been purchased. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 20 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 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service are provided with appropriate support as there are enough staff on duty at all times. People are supported by staff that have the appropriate qualifications and skills and are protected by robust recruitment procedures. EVIDENCE: A staff team that comprises of qualified nurses professional therapists and the care staff support the guests. Since the previous visit rotas have been adjusted to be more flexible to meet the needs of guests during busy times of the day. The staffing numbers reflect the numbers and needs of guests staying at the time. Staff spoken with said that the increase of staff during the twilight shift has been beneficial. The service has their own team of bank nurses and carers and the service uses occasional agency to cover any shortfalls. There are some staff vacancies although the service is continuing to recruit. Catering, ancillary, administration and maintenance staff also supports the service. The home employs staff who are of mixed ethnicity, although the manager is aware is aware that the care staff team does not reflect the mix of gender of guests as it is predominately female. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 21 Guests spoken with said that the staffing levels meet their needs, although two people said that there have been occasional delays in responding to call bells which is usually at busy times. This was bought to the attention of the Manager The atmosphere in the service between the staff and guests was seen to be caring, professional and respectful. Staff are also provided with the General Social Care Council code of conduct. The home has a programme of planned training in place that is produced annually. Training needs are identified through the appraisal process. A training schedule maintained for all members of staff along as evidence of training undertaken. This includes statutory training as well as specialised training, which meets the needs of guests including catheter care, peg feeding and pressure area. Training takes place both internally and externally and there are some opportunities to attend conferences. The service has obtained the Investors in People award training in recognition of their staff training and development which is due to be reassessed this year. Staff spoken with told us about their training and development and a new member of staff said that she was provided with information about multiple sclerosis. One guest spoken with said, “ the staff are very good and they are well trained”. Information supplied in the Annual Quality Assurance Assessment states that eighteen care staff hold National Vocational Qualifications (level2) or above. An induction programme based on Skills for Care core induction standards is undertaken and recorded for all new members of staff. Staff recruitment is based on an equal opportunities policy. We were informed that candidates have the opportunity to be introduced to guests when they attend the service. The recruitment files were sampled for three members of staff, which contained the required information including a fully completed application and two written references. Protection of Vulnerable Adult (POVA) checks and en Criminal Record Bureau Checks are conducted. The manager stated that no person is employed in the home until this information has been received. One file sampled for a qualified nurse contained their up to date registered nurse personal identification number, which ensures that they are competent to practice The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 22 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 People using the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. An experienced registered manager manages the home, which is run in the best interests of people using the service The environment is safe for people because health and safety practices are carried out. EVIDENCE: The registered manager is a registered general nurse who holds the registered Managers Award and has completed in qualifications in supporting people with multiple sclerosis. There is a clinical manager in post who is also completing the Registered Managers Award. The inspector observed the managers to have an open approach and to make themselves accessible to guests. The manager said that she operates an open door policy for both staff and guests. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 23 The centre provides feedback surveys to guests, which are analysed and was available to view. A report is also maintained with in the service user guide. It was clear that views expressed by people had been responded to such as changing the call bell system and meal arrangements. The service also carries out comprehensive regular quality assurance audits and monthly visits required by the Commission for Social Care Inspection, which were detailed and demonstrated that the views of guests were considered. The centre also holds monthly guest forums and conducts staff surveys. A copy of the Commission for Social Care Inspection is also maintained with the service use guide which one guest confirmed that they had seen. During a tour of the premises all substances hazardous to health were appropriately stored and records were maintained. Staff receive relevant health and safety training. The fire records were sampled which indicated that regular alarm checks and fire evacuations are conducted and regular water temperature checks are maintained. Insurance certificates were up to date. Regular health and safety audits are conducted and certificates were maintained of all servicing and maintenance of equipment, which were up to date. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 24 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 3 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 4 25 4 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X X 3 X The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA23 Good Practice Recommendations It is recommended that the manager attend the local authority multi agency safeguarding adults from abuse training. The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 The Brambles DS0000013356.V361022.R02.S.doc Version 5.2 Page 27 - 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. 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