This inspection was carried out on 25th October 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOME ADULTS 18-65
182 Bromham Road Bedford Bedfordshire MK40 4BP Lead Inspector
Katrina Derbyshire Unannounced Inspection 25th October 2005 02:50 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 182 Bromham Road Address Bedford Bedfordshire MK40 4BP 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) 01234 357238 Lansdowne Care Services Mrs M Hoath Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: 182 Bromham Road is a large Victorian House situated on the west side of Bedford. It was registered in 1996 to provide residential care for 6 adults with learning disabilities. There are six single bedrooms on two floors and toilet and bathing facilities on both floors. The communal space, comprising of a lounge, dining room and activity room are on the ground floor as is the domestic style kitchen and utility room. There is a spacious garden to the rear. The home is conveniently situated for access to Bedford with all its amenities and bus and rail services. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 25th October 2005. The Team Leader, Mrs Jackie Wright was present throughout the visit. During the inspection several areas of the home were visited and the inspector spent time with many of the residents in the dining area and lounge. The care of two residents was examined in depth by looking at their records and interviewing the residents and staff who look after them. What the service does well: What has improved since the last inspection?
The home has changed the way the staff receive training to give a special type of medication and this has improved safety for both the residents and staff. They have also changed the way they write in the daily notes of residents. They write down the observations made of the things the resident has done each day and they make sure that the staff’s opinion is not part of this recording. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 6 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. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The way the homes involves the residents in care planning is good this enables residents to influence the way they live their lives. EVIDENCE: Within the care records of residents it was noted that a personal statement from the resident had been included. This document explained clearly all things spiritual, physical and social that were important to the resident. This information alongside the views of the resident at their care review is then used as part of their plan of care; this was also noted to be in place within the individual care records of the resident’s. Observations were made of the care and support given to the resident’s and this was noted to take into account the information that had been written in the care plan. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 & 16 Opportunities to participate in social activities are very good so residents partake in a varied and fulfilling activity programme. EVIDENCE: One resident spoke of the varying trips and activities that he had been part of including a personal interest in transport. Entries seen within his care records showed that staff had supported him in his individual interests and accompanying him on his annual holiday. The staff spoke of their work and the importance of involving the home with the local community. Information was noted to be available on local entertainment examples included at the theatre, pictures and within Bedford. Documents within the care records and staff confirmed that residents also attend a variety of day services to assist them in their personal development and education. These attendances alongside ‘at home days’ formed part of their individual programmes, where residents are able to learn and widen their domestic, social and development skills. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The personal support given to residents is of a good standard so residents receive care that respects them as individual people and maintains their privacy and dignity. EVIDENCE: Through observations it was noted that staff approached all residents in a sensitive manner when addressing them. Residents on returning from their day outing were supported by staff in maintaining their personal hygiene to making themselves refreshments. When a resident required support to access the toilet this was done discreetly by the staff member, who ensured the relevant doors were kept closed and who offered constant verbal reassurance to the resident. Care plans contained entries that gave clear guidance to staff in how to offer personal support to each resident. In addition the review of residents also ensured that the care provided was also changed when required by the resident. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The systems in place to protect vulnerable adults in the home is robust and reduces the risk of the residents from being at risk of harm. EVIDENCE: The homes policy on the protection of vulnerable adults is a comprehensive document. It includes varying types of abuse and examples including, physical, financial and sexual abuse. The home uses the local protection of vulnerable adults policy and this contains guidance to staff on how to report any allegation of abuse. Staff also confirmed that they had received training in this area. In addition the home also had in place a very clear complaints procedure. Reference is also made within the homes statement of purpose on how anyone may complain about the services in the home. One staff member said “ its not a bad thing getting a complaint, it just means we sometimes have to change and then things get even better”. The policy was noted to meet with this standard and did inform the reader how they would be responded to and within what timescale. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The décor and furnishings within the home is domestic and of a good standard and assists in creating a homely environment for the residents to live in. EVIDENCE: All areas seen within the home were very clean and free of any odours. The domestic style furnishings and décor alongside the use of pictures assisted in creating a homely environment. The residents and staff use the dining area located in the heart of the home frequently, this area provides a seating area and facilities to play music and is also very close to the kitchen facilities. All residents have their own individual rooms, which contain personal items that each resident has chosen. In addition to the shared indoor communal space there is a large well-kept garden at the rear of the home, this was seen to be easily accessible to the residents. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Access was not available to staff records therefore these standards were not able to assessed at this inspection. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed. 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 4 X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
182 Bromham Road Score 4 X X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000014886.V261591.R01.S.doc Version 5.0 Page 17 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. 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. Refer to Standard Good Practice Recommendations 182 Bromham Road DS0000014886.V261591.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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