Inspection on 26/02/08 for Bridge House

This is the latest available inspection report for this service, carried out on 26th February 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridge House 05/11/05

Bridge House 06/07/05

Bridge House 02/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Bridge House Green Hills Barham Canterbury Kent CT4 6LE Lead Inspector Lois Tozer Unannounced Inspection 26th February 2008 1:50 Bridge House DS0000023349.V357756.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 Bridge House DS0000023349.V357756.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. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridge House Address Green Hills Barham Canterbury Kent CT4 6LE 01227 831545 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) Family Investment (Four) Ltd Annette Norton Care Home 8 Category(ies) of Learning disability (0) registration, with number of places Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - (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 (LD) number of places: Learning Disability (LD) maximum number of places (8) The maximum number of service users to be accommodated is 8 2. Date of last inspection 7th March 2007 Brief Description of the Service: Bridge House provides residential care for up to eight adults who have a learning disability. This is a detached house that stands in its own spacious garden. There is a steep drive leading to the front of the house and a car park for about 6 cars. It is situated in the rural village of Barham. There is a post office shop, village hall, bowls club and two churches in easy walking distance. There is also a regular bus service to the city of Canterbury and neighbouring towns. The home has bedrooms on both floors. Five of the eight single rooms have en-suite toilet and shower. The communal space consists of a main lounge and a kitchen/diner. Bridge House is part of a group of homes owned by Family Investment (Four) Ltd. The families of each resident purchase a share interest in the property prior to admission. Families play an active role in the conduct of and care provided in the home. Family Investment offers a wide range of day services, which form an integral and significant part of the lives of the residents. There is a day centre run by the Fifth Trust in Barham and in the Elham Valley, a vineyard, teashop and pottery. People who attend Family Investment Day Care Services come from Family Investment Homes and from other parts of the community. Fees to live at the home start from £494.42. Each individual will pay a fee according to the level of support they require. Previous inspection reports can be obtained from the home, as can information about action they will take to Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 5 address requirements made during this visit. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key site visit took place on 26th February 2008 between 1:50pm and 7:00pm. The manager, people who live at the home and staff assisted with the process. The inspector who carried out the site visit was made welcome. We received an AQAA (Annual Quality Assurance Assessment) before the inspection. The manager had filled this in and some areas had not been completed. This is the first time the manager has dealt with such an assessment, so feedback was given. Eight people live at the home. Two staff, 4 residents and 2 parents returned comment cards before this visit took place. We spoke to all residents and they told us clearly that they loved living at Bridge House. One resident was kind enough to show us around the building and tell us all about the future plans. We spoke in detail to 3 people, who, amongst many positive things said ‘Staff do help me, but only if I need it. They never take over or do my jobs for me’. ‘We go on these trips to the Theatre, and save up so we can afford to do it as much as possible’. ‘I go out by myself, and staff help me to stay safe by discussing what I have done that day. They write it down [shown form] and I say how I got on’. The inspection process consisted of information collected before, during and in the few days after the visit to the home. Lots of detail about maintenance and environmental safety checks was taken from the AQAA. Some of the information we saw included assessment and care plans, medication records, duty rota, health support plans, and staff training files. The overall star rating for this home is ‘Two Star’, which means the home is providing a good service. What the service does well: Everyone who lives at the home has had their needs assessed. Any future residents can be sure they will be assessed to make sure the home is right for them. Everyone has their own support plan. People are supported and encouraged to make decisions about all parts of their lives. This includes running the home, choosing a holiday, going out with friends and continuing education or work experience. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 7 People are treated as individuals and are helped to develop their goals and interests. The staff team have had good training and know that they are there to support individuals develop and learn skills. There is an excellent variety of work, educational and social activities for people to choose from. Everyone is an equal partner in running the home. The residents know the staff will help them out if needed, but mainly support people to be as independent as possible. Some people are managing their own medication. What has improved since the last inspection? What they could do better: Residents told us that they are involved in planning, but there is no clear evidence of this. The manager is considering using a person-centred planning tool. This would let all people, regardless of communication or support needs to make decisions for now in for the future. Assessments and support around medication could improve. This would help people be more independent and less reliant on staff to do this essential task. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 8 Everyone needs a proper assessment to see it they could manage some part of looking after their medication. Some of the ways staff handle medication need to improve, so they are safer. There needs to be a complaints procedure in a format that everyone understands. Better safety arrangements around personal banking details need sorting out. 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. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 9 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 Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 10 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): 2 People who use the service experience good quality outcomes in this area. People who are thinking of moving to the home will have their needs and aspirations assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are interested in living at Bridge House will have a full assessment of their needs carried out. The individual, their care manager and friends or relations will all have a say in the assessment. People would be invited to stay at the home for a week before they move in so they could try out the home. The people who live in the home and the staff would be asked to fill out a questionnaire to say if they thought the person was a good match. The documentation in the folders that we saw showed that this is a carefully thought out process. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 11 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 who use the service experience good quality outcomes in this area. People know that their assessed and changing needs will be supported by a staff team that are keen to encourage individuality and independence. Decisions made by residents about their care could be recorded in a way that better shows how much they have been involved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a set of support plans that is unique to their needs. It has been generated from assessments. They are in a format that makes it easy for staff to use, but we found that there were some improvements that could benefit both residents and staff. One example is particular behavioural support information is spread across many places. This makes it hard to clearly know how best to support the person. Because the current staff team have been around for along time, they know how to support the person, but Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 12 the particular achievements and development this person has made have not been clearly recognised on the actual care plan. Guidelines by the community nurse say that particular strategies must be reviewed with the resident and positive feedback given where they have done well, but this has not found its way to the support plan. Risk assessments for independent living, associated with this support have been very well reviewed and achievements documented. It is important that the basic support plan reflect these achievements, as there is a danger that new staff reading the care plans may miss that the person has developed new skills. Staff write up daily notes, and these contain both basic and developmental information. We saw that these reflected the staff viewpoint of the resident’s day, but not the resident’s viewpoint. We discussed this with the manager who said that she would consider if daily notes could involve residents more. She said that condensing and cross-referencing information would help make care plans more accurate, and that there had been discussion in the management team of adopting ‘person-centred’ planning paperwork. This said, the feedback we received from residents during the visit and from the four surveys returned showed us that people were fully consulted about their lives. Decisions were not being made for people, and there was an excellent understanding between residents and staff that they were there to support each other. They told us that they have goals and dreams, and that the manager and staff help them hold residents meetings to discuss particular house events too. We saw that daily routines had been chosen by and reviewed by residents. All of the risk assessments and approaches were set up to develop independent living skills and give people opportunities to increase their personal potential. For example, people had received support to travel independently and records showed that because reviews in this area were so good, extra help had been provided straight away when problems occurred. This meant people got back on track with their goals with the minimum break. We saw people planning ahead for the following day, discussing what they had been up to and the achievements they had accomplished that day. One resident said ‘We run this house together and the staff are there to help us, but only if we need it. They never do our jobs for us, because we can do them ourselves’ - this statement summed up all residents views. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 13 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 who use the service experience excellent quality outcomes in this area. People who live at the home are encouraged to have the lifestyle that supports their development, suits and interests them. Staff are on hand to lend support and guidance when its needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individuals have chosen all of the activities that take place within the home and when they attend ‘day services’. Each person has their own plan of what they will be doing. We spoke to all of the residents during the visit, and they all said they would say if they wanted to change anything they had planned. Three people assured us that staff would help them make other plans. Two people brought back their college work, and were pleased to explain it to us. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 14 One person was having their ‘house day’, which meant they (with staff support) did cleaning, cooking, laundry and ironing. Everyone gets a house day, and meals are always planned, prepared and cooked by residents. The routines are set down and reviewed by the residents. Meeting minutes showed household chore concerns being raised and put right by the resident group. The residents, who are responsible for cooking the meal they have chosen for that particular day, write the menus. We saw that there was a wide selection of fresh vegetables and good quality food available. People were encouraged to be aware of healthy living, and there were no restrictions to the kitchen or any of the foodstuffs. People were able to make drinks and snacks as they wanted. The home is in a village, and residents come and go to the village shop independently and regularly. There is a frequent bus service to Canterbury, and several residents use this for unaccompanied trips to the city. We discussed the things people do in their spare time, and were told by one resident that an ‘activity club’ had been set up. They told us that if you wanted, you paid in some money each month and this bought tickets to shows and other events. They said they were always out and about seeing good shows. Several other people showed us photos of them having fun and confirmed they sort out their own social life, with support from staff if needed. We asked if friends could come over to visit and stay. Residents told us they had friends over sometimes, and they thought they might be able to stay if they arranged it first. Everyone said that they keep in contact with their families and records showed that the manager and key-workers keep families informed of any issues of concern. The manager confirmed that anything the resident requested not be shared with families would be honoured, although this had not happened. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. Support with health and personal care is good, but medication management and planning needs to improve on safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at two care plans and spoke to residents about personal support. They and the plans told us that there is very little direct care given, and that staff act mainly as advisors and to give prompts. People are actively encouraged to be independent. Health care records showed that people were given support to attend ‘well person’ sessions and to keep up to date with routine health checks. Some emotional health care support was tracked, and we found this had been valuable to the individual and well documented at the time. The work had not been carried over into the persons day-to-day, longer term support plan, and this was a recommendation of the nursing team. Some concerns over medication withdrawal were discussed and the potential for harm that existed. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 16 Although the staff and manager have had medication awareness training, sudden medication withdrawal was not questioned with the GP. This indicates that the policy for medication reviewing should be revisited, with staff becoming more aware of the predicted outcomes documented in medicine journals. To protect resident’s health, such directions given by the GP need to be queried, and potentially a concern raised with the local PCT. There were no ‘health action plans’ in place. These are documents that support residents to take more of a lead in their health matters. Having these are good practice recommendations that would help close the gap of support identified. We were pleased to see that several people are taking charge of administering their own medication. One resident told us the full procedure and we found staff had given them lots of help to do this safely. There were many good practices in this area, but we saw that staff were ‘secondarily dispensing’ tablets into personal dose packs. This is dangerous and not permitted (The Medicines Act 1968). We checked the company policy, and this made it clear this must not happen. We noticed that medicine put in dose packs by the pharmacist did not have ‘tamper-proof’ tags in place or the full directions labels with the medicine. We asked the manager to discuss this with the pharmacy and seek improvement. Other people’s medication is being administered centrally and we saw that this was done safely, but without the individual residents involvement. We discussed this with the staff and manager. There was no clear reason as why all people had not been assessed to take some bigger role in this. We discussed this with the manager as a possible area for development. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. People are physically protected from abuse, neglect and self harm but need an easier complaints procedure to use and be supported in a safer way around looking after their money. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager told us that there had not been any recorded complaints or referrals to social services protection team in the last 12 months. Residents told us that they knew who to speak to within the home if there were problems. They said that mostly problems were sorted out when they were small, because there were meetings and discussions about things. A resident showed us the complaints procedure and this told people what response they could expect. We asked if everyone could read this, and knew what to do if they wanted to complain about, for example the manager. The resident said that some people found reading hard, and thought the suggestion of pictures and simple text was good. They said that they would discuss it at the next meeting and that they would make one as a group. Staff know about the whistle blowing procedure and the importance of reporting incidents. There have not been any incidents to report. The manger Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 18 assured us that we would be alerted to any issues should they occur. Staff have had protection of vulnerable people training. We looked at the way money is handled. Resident’s told us that they open their bank statements and give them over to staff to be checked off. There is a system for comparing withdrawals and the balance each month. We were concerned to find that personal PIN numbers, along with the account number, were written in the care plans. All staff have full access to this confidential information. This places residents and staff at risk. We discussed the need to improve safety straight away. The manager agreed to remove all such documents the following morning. It is a requirement that safer ways of supporting people with money are put in place. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 19 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 People who use the service experience excellent quality outcomes in this area. All residents enjoy the house and gardens and the organisation make sure the facilities are kept in excellent condition. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is very comfortable, clean, homely and pleasant. All eight people have unique, personalised bedrooms. Five have en-suites, and plans have been approved that the remaining residents will have private bathing facilities by the end of the year too. The two communal bathrooms need some minor repairs, and this is planned for when the en-suites are installed. In the meantime they are safe, clean and hygienic. The lounge, kitchen and dining room are central to the house. They are very well furnished and maintained. Both the kitchen and laundry are freely Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 20 accessible to all residents at all times. The garden is in excellent order, and the house has a really friendly, welcoming atmosphere. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 21 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 who use the service experience good quality outcomes in this area. Residents know that the staff team will give them support in a way that is right for them and encourages their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Half of the small staff team are qualified with NVQ 2 or greater. There is a good atmosphere between residents and staff, with each helping the other out. We continually saw that staff listened to residents and used sensitive prompts to help people be independent. They gave opportunities to do activities and chores without support. Staff have a range of training, including looking at the Mental Capacity Act 2005. Training type has been provided as resident’s care needs have shown a need, such as managing anxiety and anger. There has not been any person centred support, care planning or risk assessment training in recent years, which could be beneficial. Residents said that the staff were great. They said Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 22 that they gave help and advice, but not too much, they always respected what each person said. The manager told us that residents are involved in recruitment in an informal way. We were told that a new staff member would, prior to employment, be invited for a meal. Residents would then give feedback. The manager hopes that (when there is a vacancy) residents can become more formally involved. She is considering discussing this in advance at a residents meeting. We had verbal confirmation that all employment checks were in order. The manger said that the right documentation was now kept in the home. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 23 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 who use the service experience good quality outcomes in this area. People living in this home know that they will have a big say in service development. The manager and team will support them to run the home in the way they have collectively agreed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home manager, Annette Norton has managed the home for several years and is registered with CSCI. She has worked in care settings for people with mental health and learning disabilities. She has obtained the City in Guilds Advanced Management for Care. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 24 The home runs smoothly, and staff are encouraged to take on responsibilities, whilst supporting residents to do the same. Through our discussions during the visit, we found that some areas of improvement had been overlooked, and these form requirements. The home is close to being excellent in so many aspects, but the manager needs to find a way of self-assessing and reevaluating practice that is unsafe and historically accepted. This may mean reviewing the way the monthly visits by the responsible person take place. Possibly it could mean finding more effective ways of keeping up to date with good practice, for example, seeking some person centred support training. We discussed using the AQAA and standards guidance log as a self-monitoring tool as an aid for reflective practice. The bigger picture of involving residents in the running and decision making in the home was clearly demonstrated as excellent. Areas around medication management and protection need more work to become excellent. An individual, in detail, told us the plans for the home. Each resident we spoke to knew that they had charge of their lives, and could voice their opinion openly at residents meetings. Plans for supported, paid employment are happening, and satisfaction surveys take place annually. The home bases its development around all these things. The AQAA told us that all the safety certificates were up to date. The residents told us that they had been involved in fire evacuation and knew why staff checked the fire panel each week. Staff training records showed that they had been received and had updates on health and safety training. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 25 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 X 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 2 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 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 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 26 No 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. 1 Standard YA20 Regulation 13(2) Requirement Timescale for action 10/03/08 2 YA20 13(2) 3 YA23 13(6) For the safety of staff and residents, and to adhere to the Medicines Act 1968 secondary dispensing of medication must stop and a safer way of supporting people is implemented. For everyone’s safety, make sure 10/03/08 that medication received from the pharmacy has the full directions notice supplied. To protect residents and staff 27/02/08 personal bank PIN numbers must be removed from the individual files. A safer way of managing this situation must be implemented. Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 27 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 3 4 5 Refer to Standard YA6 YA6 YA19 YA20 YA20 Good Practice Recommendations Recommendation – To involve residents fully in planning, a person-centred planning tool should be used that is in a format suitable for the individual. Support strategies from the community nurse should be clearly documented in the individual’s current care plan and supported by staff. Residents should have support with health action planning, as recommended by the Department of Health. Residents should be assessed and be supported to participate in whatever parts of their management they can. The policy on medication reviewing, understanding medication effects and awareness of such matters as sudden withdrawal within the staff team should be reviewed and improved. For the safety of all concerned, consult the dispensing pharmacy in respect of using tamper proof tags on medicines that are supplied in dosette boxes. So everyone has equal opportunities to make and take a complaint to the right person within the organisation, an accessible procedure should be easily available. 6 7 YA20 YA22 Bridge House DS0000023349.V357756.R01.S.doc Version 5.2 Page 28 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. 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