Inspection on 03/10/05 for 4 Bruddel Grove

This inspection was carried out on 3rd October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

4 Bruddel Grove 27/02/07

4 Bruddel Grove 14/03/06

4 Bruddel Grove 08/02/05

4 Bruddel Grove 16/08/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Bruddle Grove (4) 4 Bruddel Grove The Lawns Swinson Wiltshire, SN3 1PW Lead Inspector Alyson Fairweather Unannounced 3 October 2005 rd 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 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 Stationary 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. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bruddel Grove (4) Address 4 Bruddel Grove The Lawns Swindon Wiltshire SN3 1PW 01793 642378 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rethink Ms Thelma June Wilson Care Home 5 Category(ies) of MD Mental Disorder registration, with number of places Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 8th February 2005 Brief Description of the Service: 4, Bruddel Grove is a residential home offering accommodation for up to five people who have mental health needs. The service is run by Rethink, formally known as the National Schizophrenia Fellowship, with the property owned by Bromford and Carinthia Housing Association. The home is located in the Lawns area of Swindon, within easy access to Old Town, local shops, and other amenities. It is a two storey semi-detached building, and is situated in a cul-de-sac with a large, mature garden at the back, and parking outside at the front. The manager and staff of 4, Bruddel Grove, provide staff cover to another local Rethink project. This service provides supported accommodation, and is called 588 Cricklade Road. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in October. The registered manager was on duty, as well as several care staff. Three staff members and two residents were spoken to during the inspection. One resident showed the inspector her bedroom, and the inspector would like to thank the resident for spending time chatting and showing her family photographs. Records examined included care plans, health and safety records, medication administration records and staff training files. What the service does well: What has improved since the last inspection? What they could do better: Medication procedures have been improved and more checks are now being done on how medicines are dispensed and stored. However, there were still areas which could be improved on, and the manager has been asked to make sure that this is done. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 6 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. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 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 standard(s) 2 Prospective service users have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. EVIDENCE: There is a well-established process for the assessment of prospective users. Referrals are usually initiated by other professionals, as residents of Bruddel Grove have generally come from other settings within the mental health system. The referring mental health teams provide a copy of the most recent Care Programme Approach (CPA) plan, which gives details of how the potential resident can best be supported with their mental health needs. A risk assessment form is also sent to the referrer at this stage. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 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 standard(s) 6 and 9 Care plans reflect the needs and personal goals of respite guests, which means that staff are able to support them in the way they wish. EVIDENCE: Each resident has a care and recovery plan which is reviewed on a regular basis by the resident and their key-worker. These plans focus on individual’s strengths as well as any need or problem, and contain sections on communication abilities, domestic abilities, mental health, physical health and sleep patterns, among others. Residents have the opportunity to record their comments on the reviewed care plan. A daily dairy is also kept for each resident, and this records what they have done during the day. Each resident has a keyworker, and staff spoken to were very sensitive to the needs of residents and the different approaches needed by individuals to help build their confidence. Each resident also has a care plan meeting (CPA) on a regular basis with the local Community Mental Health Team (CMHT). Each person also has a crisis self-management form on file. This takes the form of an advance directive, which confirms who the resident would like to be notified and what treatment they would like, in the event of them becoming ill or being admitted to hospital. This also applies to PRN medication. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 10 Risk assessments had been done for each resident and these included things such as relationships, finances, and smoking safely, and ways of minimising risks were identified. Residents are, however, supported to take acceptable risks as part of their independent lifestyle, and these are reviewed on a regular basis. One resident who likes to do things for himself in the kitchen has a domestic risk assessment relating to the use of the cooker and toaster. There was also a risk assessment on file regarding the disposal of “sharps”, although the manager was not sure if this was needed any more. It is recommended that this risk assessment is clarified, and is removed if not needed. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 11 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 standard(s) 12, 13 and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. EVIDENCE: Residents have access to a range of community activities. One person enjoys playing netball and badminton and sometimes goes swimming. Other residents enjoy music, television and video evenings. People go shopping, out for meals, to the cinema, play board games and have video evenings. Staff are aware of most local activities and ensure residents are made aware of these. There are also a range of options open to residents via a notice board in the hallway which contains information on various available trips, outings and courses. All residents went on holiday last year, although two people did not enjoy that. This year a day trip was organised to Barry Island, as staff shortages and the poor physical health of one of the residents meant that a full holiday was more difficult to take. Barbeques were also held in the garden over the summer. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 12 Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time, and can entertain and choose to see who they like either in the privacy of their own bedrooms or in the communal areas available. One resident visits her parents at regular intervals, and they often take her out for day trips. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 13 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 standard(s) 19 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. The home’s medication policies and procedures ensure that service users are safe when their medication needs are being met. EVIDENCE: All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. One resident has had recent physical problems, and staff have supported all the physiotherapist appointments needed. All residents have an annual health check done by their GP. Medication records examined were in good order. The home has a policy in place for all medication storage and administration, and all staff have medication training. One resident looks after her own medication, and staff support and encourage this. There is a complicated system in place to record this self medication process, and advice is to be sought from the pharmacy inspector at the Commission for Social Care (CSCI) about how to simplify this. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 14 When the medication of one resident was checked, the amount which should have been in the bottle was exactly correct, and the manager explained that medication stock is counted each night and the total amount left is recorded. One resident had recently had his medication changed and this was not kept in the MDS system which others use. It is recommended that a running total is kept of all medication, in line with current practice. It is also recommended that the start date is recorded when bottles of liquid medication are opened, in order to allow for a more accurate stock take. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 15 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 standard(s) 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. Two staff members have received Swindon’s Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 16 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 standard(s) 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: Bruddel Grove is an attractive home, with two lounges, a dining room and a big, domestic style kitchen. It is light and airy, with comfortable furnishings. Each resident has their own bedroom, and these were homely and contained individual personal items. To the rear of the house is a large, secluded garden which has recently had work done, making it a safe and attractive feature for residents to use. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. There is a weekly cleaning rota, and all service users have a daily household task which they are encouraged to undertake with the support of staff. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents’ individual and joint needs are met by staff who have had induction and specialist mental health training. EVIDENCE: All staff have standard induction training which includes Health and Safety, First Aid, Food Hygiene, Mental Health Awareness, Cultural Competence, Violence and Aggression and Anti-discriminatory Practice. Staff have also had training in Motivation Towards Recovery, Medication Administration, Suicide Awareness and Early Intervention in Psychosis. Other specialist training has included information on depression, anxiety disorders, manic depression, schizophrenia, eating disorders and personality disorders. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 and 42 The home’s record keeping policies and procedures safeguard the best interests of the residents. The training, policies and procedures in place promote and protect the health, safety and welfare of the people using the service. EVIDENCE: All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell is tested weekly and the emergency lights and fire fighting equipment are tested monthly. The home has three designated fire officers who can all do fire training. There are quarterly fire drills, and records are kept of when these take place and who takes part. Fire extinguishers are Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 19 checked annually, with the last service taking place on 19th August 2005. At a visit by the Swindon & Wiltshire Fire Brigade in January 2005 it was recommended that a magnetic catch should be placed on one of the downstairs doors, and this has not yet been done. Although the manager said that it was in hand, it is recommended that this is now dealt with as a matter of priority. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 20 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 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bruddle Grove (4) Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 3 x D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 21 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. 2. Standard 20 20 Regulation 13 (2) 13 92) Requirement A running total should be kept of all new medication delivered outside the MDS system. The start date should be recorded when bottles of liquid medication are opened, in order to allow for a more accurate stock check. Timescale for action 03/10/05 03/10/05 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 9 42 Good Practice Recommendations The Risk Assessment for the use of “sharps” should be clarified, and should be removed if not needed. The recommendation of the fire officer that a magnetic catch should be placed on one of the downstairs doors should now be done as a matter of priority. Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bruddle Grove (4) D51_D01_S3203_BruddelGrove(4)_V245455_031005_Stage4.doc Version 1.40 Page 23 - 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. 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