Inspection on 15/11/06 for 1 Bradd Close

This inspection was carried out on 15th November 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Bradd Close 28/11/08

1 Bradd Close 25/10/05

1 Bradd Close 25/10/05

1 Bradd Close 23/11/04

1 Bradd Close 12/07/04

1 Bradd Close 06/11/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Bradd Close (1) 1 Bradd Close Off South Road South Ockendon Essex RM15 6SA Lead Inspector Nicola Dowling Unannounced Inspection 15th November 2006 11:00 Bradd Close (1) DS0000015522.V320908.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 Bradd Close (1) DS0000015522.V320908.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. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradd Close (1) Address 1 Bradd Close Off South Road South Ockendon Essex RM15 6SA 01708 670568 01708 670568 diane.harley@estuary.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider Name of registered manager Type of registration No. of places registered (if applicable) Estuary Housing Association Limited Mrs Diane Helen Harley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983 25th October 2005 Date of last inspection Brief Description of the Service: Bradd Close is a Care home with Nursing for eight service users with a learning disability. It is situated in South Ockendon, and is near to local shops and transport. The cost of care at this home is £1604.85. The premises are on one level and are divided into two identical areas at each end. Each area consists of four single bedrooms with their own sink unit. A bathroom, shower, lounge, dining room and kitchen. There is a large garden at the rear of the premises with covered seating areas and raised flowerbeds. The home provides transport for the resident’s and also employs the services of an aromatherapist. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection site visit took place over a five hour period on one day. The site visit consisted of a tour of the home, talking with staff and service users, observing the care given and reading of documents. All the residents were seen, however due to communication difficulties only two residents were spoken to. In addition the survey forms that were received back from the service users and their relatives were used and contributed to this report. The inspector would like to thank the staff and residents for their help and hospitality during the visit. What the service does well: What has improved since the last inspection? What they could do better: Information needs to be updated on the key contacts page of the Service User Guide, Statement of Purpose and the complaints procedure regarding the role of the Commission for Social Care. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 6 Monitoring of fridge temperatures that contain medication was poor. There were no notices regarding the storage of oxygen, however the home are waiting for these to be issued to them. Recruitment records to ensure that staff are suitable to work with vulnerable people did not contain identification of some staff members. 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. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good documentation to support and safeguard the residents who move to the home. EVIDENCE: There have not been any new service users admitted to the home since 2004 therefore the evidence was gained from written records and comments from surveys. Three of the five surveys returned said they had the option of choosing a home and felt Bradd Close was the best to meet their relatives needs. All said that they were happy with the care provided for their relatives. The assessment process is undertaken by an experienced member of staff. There is a comprehensive written addmission procedure that gives prospective service users time to try the home out before accepting a place there. A contract is in place for residents that stated the fee that they pay and the room that they reside in. This is in picture format to help the resident understand it. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are well looked after and supported by staff. EVIDENCE: On the day of inspection one service users was having a review with family, staff and other professionals. The care plans that were checked were up to date and relevant to the residents current needs. Risk had been incorporated into the care plan to enable the service user to be cared for in a safe way. Residents are able to make small decisions for themselves. Otherwise decisions are made with family members and the multi-disciplinary team. For example large expenditures are made at a meeting that involves the relatives, professionals and the service user. This could include items of furniture or holidays. A written record is kept of expenditure and pictures are taken of trips out to help the service user remember and show others. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users have good food and different activities are based on the residents’ ability and enjoyment of them. EVIDENCE: The home have started to record in picture format activities that the residents enjoy and can manage. For example there are pictures of service user’s cooking and gardening. There are no regular day centre placements for the residents as they have closed in the local area. The home are currently developing activities with service users at the home and each service user has an activity schedule. On the day of inspection an aromatherapist was at the home giving leg and hand massages, and staff were playing an oversized jenga game with other service users. A music man also regular visits the home to provide entertainment. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 11 Trips are arranged for the service users. One service user goes to the British Grand Prix every year at Silverstone. As well service users go out on trips to the cinema bowling theatre and meals out. The latest trip was to Cabury’s World, two service users remembered this and said they enjoyed. Six relative surveys were received back and all said that they were made to feel welcome in the home and that they can have a visit in private if they want to. Staff were seen to interact with the residents and cared for them in a dignified manor. Service users are able to choose if they want to spend time in their own room or in the sitting room. Meals are home cooked and menus are different at each side of the home. On the day of inspection service users at one end were having Turkey and at the other end they were having shepherds pie. Lunches are served flexible and the residents were asked what they wanted to eat. Currently there are no service users that need a special diet, however the home can manage special diets if required. Service users all have a nutritional record and staff are aware how service users need their food presented to them. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 12 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): 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home manages the physical and mental health care of the service users well. EVIDENCE: Personal care and health care for the service users is undertaken in the privacy of their own room. The home maintains the service users health care appointments. Staff are aware of service users anxiety over attending health care appointments and provide extra staff for these visits. The service users health is monitored and good records are kept relating to health care and other health professionals who become involved in the service users care. Medication is stored correctly and records are kept of medicines received into and leaving the home. Oxygen has recently been delivered to the home. The home have order safety notices and stands for this equipment. There is a medication fridge, however the monitoring of the fridge temperature was poor. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 13 All the service users have had a flu jab. This was administered by the nurses that work in the home, as it would have caused distress to the service users to take them to a clinic and a strange person give the injection. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The complaints policy and adult protection policy are satisfactory EVIDENCE: There have not been any adult protection incidents at the home since the last inspection. The adult protection policy contains a clear procedure about what to do if abuse is suspected and there is evidence that staff have had training on this topic. There have been no recorded complaints since the last inspection. Information on how to complain is available in the hallway of the home. The Key contacts information in the complaints procedure requires rewording. This area was discussed with the staff and will be amended. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 15 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, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean and comfortable home that is safe for them. EVIDENCE: The premises are safe comfortable airy and clean with no offensive odours. The home is on one level allowing access to the entire home for the residents. Areas of the home have been redecorated and the furnishing are domestic in style. Following repairs to the dishwasher one kitchen has been left damaged. This has been raised and the budget for next year will incorporate repairs for this area. Service users’ bedrooms are decorated according to their taste and they all contain personal possessions. One service user has recently had new wardrobes fitted and is waiting for a flat screen TV to be mounted onto the wall of the room. This service user was very pleased with the room. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 16 Moving and handling equipment is used in the home and these are regularly maintained for safe use. Staff were observed practicing good hand hygiene. The hygiene around the home was good. There is a sluice area and a well maintained separate laundry area. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 17 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, 33, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by trained staff that have the skills to care for them. EVIDENCE: There is a stable staff team that work at the home that ensures consistency for the service users. The staff on duty were familiar with the service users and demonstrated good relations with them. The home use agency staff however they try to ensure that agency staff have worked at the home before so that they know the care of the service users. The staffing numbers are; one qualified nurse on each day shift, with three support workers. At night there is one qualified nurse and one support worker. Recruitment records were checked and all staff had a Criminal Record Bureau (CRB) check. CRBs are being renewed and there is evidence that staff have been checked against the protection of vulnerable adults list. Four staff files were checked and one file had no identification in it. Two other files had Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 18 photocopies of photographs in them. These records were very unclear and would not be able to identify the staff member. There is evidence that supervision take place and this is recorded in the staff file. There has been training in; Manual Handling, diabetic care, medication administration, communication with people with learning disability, fire training health and safety, risk assessment. Of the ten care staff that work at the home four have achieved an NQV. There is on going training at the home and the nurses pin numbers kept up to date and checked by the home manager. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This is a well managed home that is run with the interest and safety of the service users in mind. EVIDENCE: The manager is a trained nurse and has the appropriate experience to manage the home. There is also evidence that the manager has updated skills and training. Estuary Housing Association seek the views of the residents in all of their homes and this is called their Quality Network Review. The organisation produce an annual report reflecting the findings of the review and an action plan to improve their service which is informed by the residents. However Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 20 although the home hold service user meetings and the keyworkers know the service users well to ensure that their views are heard. There is not yet a report that reflects the views of family friends and others on how the home is achieving goals for the service users at Bradd Close. Safety certificates were up to date and the manager is in the process of reassessing the COSHH risk assessments. Water temperatures are regularly monitored and there are checks for legionella in place. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 21 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 3 5 3 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 3 25 x 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 x 3 x 3 x x 3 x Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 22 YES 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 05/01/07 4. YA34 Schedule 2 The Registered Person must ensure that the medication fridge temperatures are monitored. That safety notices are in position for the safe storage of oxygen. The Registered Person must 05/01/07 ensure that staff working in the home have proof of identification that includes a photograph. Timescale of 05/07/06 not met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA22 YA12 Good Practice Recommendations The statement of purpose and the complaints procedure need to be re-worded regarding the role of the Commission for Social Care Staff should continue to develop service users activities DS0000015522.V320908.R01.S.doc Version 5.2 Page 23 Bradd Close (1) 3 YA39 The home should produce a quality assurance report that reflects the service users views in Bradd close. Bradd Close (1) DS0000015522.V320908.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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