Random inspection report
Care homes for adults (18-65 years)
Name: Address: Bridlington House 4 Bridlington Avenue Hull East Yorkshire HU2 0DU one star adequate service 06/10/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Angela Tew Date: 2 0 0 5 2 0 1 0 Information about the care home
Name of care home: Address: Bridlington House 4 Bridlington Avenue Hull East Yorkshire HU2 0DU 01482217551 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anita Shepherdson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Akintola Oladapo Dasaolu care home 22 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 22 The maximum number of service users who can be accommodated is: 22 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Mental Disorder, exluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Bridlington House is a care home providing accommodation and personal care for 22 persons who have enduring mental health problems. An individual privately owns the care home. The building is a detached property and it is situated within walking distance of the City Centre, shops, and local community centres, churches other places
Care Homes for Adults (18-65 years) Page 2 of 11 0 6 1 0 2 0 0 9 Brief description of the care home of interest are also nearby. The home has 6 single and 8 double rooms; four of the single rooms and two double rooms have en-suite facilities. The home has four bathrooms, one assisted and 12 communal toilets. There are two lounges and a dining room. There is a garden to the rear and a small parking area to the front of the property. The registered manager stated that all residents are given a service user guide and this contains the last inspection report. The registered manager also stated that prospective residents are offered a copy of the homes statement of purpose and service user guide. Care Homes for Adults (18-65 years) Page 3 of 11 What we found:
This random inspection took place following CQC receiving anonymous information about the home not having sufficient staff on duty, the cooker hood requiring repair and essential work for gas safety not being carried out, the manager giving conflicting information and staff not able to complete surveys in confidence. The inspection took place over four hours and specific areas were looked at. People living in the home, staff and the manager were spoken to and their views recorded. Other records including care plans, risk behaviour management plans, recruitement, safeguarding and incidents, staffing rotas, training were looked at. We saw that two people who had recently gone to live at the home had pre-assessments in place and a full assessment of their needs following admission had also been undertaken by the home. There were risk and relapse plans from placing authority and risk behaviour management plans had been developed by the home. The manager told us that she is confident that people have their needs assessed before a place is offered to them and the home can be sure that their needs can be met. People living in the home told us that they had had the opportunity to visit the home and meet the other residents, before making their decision to move in. They also stated that the manager had met with them and discussed their needs and whether Bridlington House could meet their needs and support them. We looked at two files of people who had recently come to live at Bridlington House. Each file contained a pre-assessment document giving basic information about the person, their medical history, support network, current medication and social care needs. The manager told us that these are carried out before the person is offered a place to live, I visit the person and gather information to make sure that the home can meet the persons needs. The files also contained an assessment that was undertaken upon admission and included mental health diagnosis, contact and support details, medication, mobility, diet, interests/hobbies. A personal profile has been developed since the previous inspection giving details about family and friends, what is important to the person and how it is best to support them. One person had some restrictions in place with regard to how many cigarettes they were allowed and the staff had control over this. From looking at the paperwork and speaking to the manager it was clear that this person had these restrictions imposed at the home the person had previously resided in. A mental capacity assessment had not been undertaken with the person to deem whether they could make that choice or decision for themselves and there was nothing recorded in the care plan or risk management plan detailing the smoking restriction or that this had been agreed in a multi-agency setting. The manager had already held discussions with the placing social worker and during the visit contacted them again in order to arrange a mental capacity assessment and a multiagency review in order to discuss the restrictions in place. People who live in the home were spoken to during the visit confirming that they had been involved in the process and had signed the documentation. The manager and staff told us that the new system is being implemented at the moment and by the next key
Care Homes for Adults (18-65 years) Page 4 of 11 inspection will be fully operational. Staff told us, I understand what is in the care plans and we are adapting the care plans currently to improve them. The care plans were not looked at in detail during this visit and will be fully assessed at the next inspection. We saw that both of the care files contained a mental health risk and relapse plan that had been developed by the supporting mental health team and there was a mental health care plan in place that gave a brief overview of need and support required. The manager showed us the updated risk management plans and these covered a variety of areas including smoking, self-harming behaviour, aggression, self-neglect, risk to others, medication, personal care and overall they give a good overview of what the risks are, some triggers and intervention. However, the intervention required is minimal for example, one plan stated use diversional techniques to alleviate any problems and staff to use a consistent approach in diffusing potential situations. This is not specific to the person reading the risk management plan and they would benefit from including clear points of action explaining in detail what diversional techniques are to be used. What happens if behaviour escalates, who to contact and timescales etc. One plan also stated that staff must work in twos due to risk, however in a second risk document it stated that staff should work in twos where possible. It should be acknowledged that the manager and staff have worked very hard in updating paperwork. However, both care plans and risk behaviour management plans require further development to ensure that they are very clear about not only the needs the person may have, but also need to be specific in how that person is to be supported, how risk is to be reduced or managed and the person to be fully involved in the process. People told us that choice is sometimes promoted and they can choose to go out when they wish to, choose their own clothes, take care of their own money. The manager told us that all staff have either undertaken or are booked onto the training with Hull Social Services training department and evidence was seen to confirm this was accurate. The manager said, since the last inspection the training section from Hull City Council have been brilliant and offered 1-1 support with staff around person centred thinking, all training has either been undertaken or places booked. Staff told us they feel the training has improved and some comments included, I think the training is good, I feel it has improved and I have done my safeguarding adults training. Other training that would meet more diverse needs have been offered to staff including diversity and difference, mental health awareness. This requirement will be fully assessed at the next inspection. Staff were spoken to about their understanding regarding safeguarding adults and they could describe the different types of abuse and that they would report this to their line manager. However, an incident occurred in January 2010 where a staff member had allegedly become verbally aggressive and threatening to a person living in the home, staff didnt pass on the information to the manager until the next day and it was at that point that a safeguarding alert form was completed. Staff confirmed that they would not complete the alerter, but would let the manager know what had happened. During the visit we found that the kitchen was in working order, the cooker hood had been repaired and the cook confirmed that the working conditions were good. Other documentation was seen confirming that work had been carried out on the hot water. The
Care Homes for Adults (18-65 years) Page 5 of 11 manager could not locate the invoice to confirm that all gas safety work had been carried out nor could she confirm that the electrical wiring certificate was up to date. There was evidence confirming that the water system had been tested, but this did not state whether the water had been tested for Legionella. The manager contacted the registered provider immediately and arranged for the certificates and invoices to be forwarded to CQC. During the visit the manager told us that the staffing levels have increased since the last inspection and the home currently offers 390 care hours per week. She also said that she is using the residential forum tool when the numbers and needs of people living in the home changes. The manager said, we have a new rota commencing next week and then there will be three carers on duty during the daytime shift with two waking night staff. The third staff member will focus on activities with people. The residential forum currently recommends a minimum of 414 care hours for the current number of people living in the home. People told us that they felt the staffing numbers were good and confirmed that when they needed assistance this was available. Three staff members were spoken to who confirmed that the staffing levels were sufficient for most of the time. Some comments included, yes I do, there are usually three carers on duty and activities take place like bingo or singing, yes during the day there are always three carers on duty. Two files of new staff members were looked at confirming that the home recruited safely. New staff undertake an induction programme and essential training within six months of appointment. Staff told us that they received supervision and support on a regular basis. During the visit the manager told us that the CQC surveys are given to staff and they can return them in confidence. She said, I would not ask staff to share the content of those surveys, I do discuss the homes own surveys as this is the only way I can address what has been highlighted. Three staff members were spoken and they told us that those who had received one had been able to complete the CQC survey in confidence. Staff also told us that the manager and registered provider are supportive and approachable. Some comments included, the manager is always supportive and available, yes she is quite good and I can go to her if I need to. One new member of staff told us, I have settled in well, I have done my induction and I am shadowing other staff. The management are approachable and offers advice. What the care home does well:
People have their needs assessed before a place is offered to them and they are able to visit the home before they decide to move in. The care planning and risk management process is currently under review and there have
Care Homes for Adults (18-65 years) Page 6 of 11 been some improvements made. All staff have either completed the safeguarding adults training or they are booked onto a course. Maintenance work has been carried out in the kitchen and other areas within the home. People told us that the staff and manager were supportive and approachable. The homes recruitment procedure is robust, therefore people are supported by staff who have been properly vetted. Training has improved since the previous inspection and a variety of courses that meet diverse needs are now offered. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 6 15 The care plans require development to include specific direction to staff about what they need to do and any preferences to how the person receive their support. This would ensure that care plans are developed in a way that includes the persons choices and preferences and would give clear direction to staff. 07/02/2010 2 9 12 Where people present 07/02/2010 behaviours that are either harmful to themselves or others, there must be a behaviour management plan giving clear guidance to staff about how to manage these behaviours. This would ensure that staff are clear about what risks where present and how they are managed. Care Homes for Adults (18-65 years) Page 8 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 12 People must be able to make 25/09/2010 decisions for themselves and any restrictions are made in conjunction with other stakeholders and there is a mental capacity assessment and this is clearly recorded. To ensure that people are able to make decisions for themselves where possible. 2 37 10 The home must ensure that incidents are managed effectively, ensuring that other staff follow the safeguarding procedure. To make sure that people live in a well-run home that maintains their safety. 25/09/2010 3 42 12 The home must maintain the 25/06/2010 environment and have the gas and electricity safety tested, with records in place. The water must be tested for Legionella on an annual basis. This would ensure that Care Homes for Adults (18-65 years) Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action people live in a safe and well maintained home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 6 Care staff who are key worker to people living in the home should be involved in the review process. This would ensure that everyone who offers support and care are involved in the review and monitoring process. Staffing levels to be monitored and reviewed on a regular basis, to ensure that there are sufficient staff on duty at all times. 2 33 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
