Inspection on 04/08/05 for Berwick Bridges

This inspection was carried out on 4th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Berwick Bridges 28/02/07

Berwick Bridges 15/01/06

Berwick Bridges 16/02/05

Berwick Bridges 06/10/04

Berwick Bridges 02/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Berwick Bridges 4a Roberts Lodge Tweedmouth Berwick upon Tweed TD15 2YD Lead Inspector Dennis Bradley Announced 04 August 2005 10:00 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. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Berwick Bridges Address 4a Roberts Lodge Tweedmouth Berwick upon Tweed TD15 2YN 01289 303173 01289 303173 bbt.berwick@btinternet.com Berwick Bridges Limited 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) Mrs J A Murray CRH 6 Category(ies) of LD Learning Disability - 6 registration, with number of places Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Of whom 2 may have an additional physical disability. Date of last inspection 16.02.05 Brief Description of the Service: Berwick Bridges, at 4a Roberts Lodge, provides care and support for up to six individuals with a learning disability. The Home is a purpose built bungalow and is situated in a small residential estate in Tweedmouth, on the outskirts of Berwick upon Tweed. Community facilities are within walking distance and Berwick is only a short drive or bus ride away. The Home has an adapted people carrier and the area is well served by public transport. The accommodation includes six single bedrooms, plus a staff ‘sleep-in’ room, an open plan lounge, dining and kitchen area and a separate utility room. Adequate toilets and bathing/showering facilities are provided. The Home is domestic in character and decorated and furnished to a good standard. There is an enclosed garden/patio area to the side of the building as well as a small car park. The Service is operated by Berwick Bridges Ltd. a voluntary organisation that was set up to provide a service for people with learning disabilities from the local area. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that started at 10.00am. The inspection lasted 8.5 hours. Three residents were spoken to as well as three members of staff. The inspector was shown around the house and three of the residents showed him their bedrooms. The inspector also had a meal with the residents and staff. Records were also examined. Four of the residents completed a Service Users Comment Card. What the service does well: What has improved since the last inspection? What they could do better: Residents’ plans of care need to be developed to more adequately address their long-term needs. Residents must be given the opportunity to express their wishes in relation to ageing, terminal illness and death. The Home’s recruitment practices and personnel records need to be reviewed to ensure compliance with the Care Homes Regulations. The Home’s quality assurance policy needs to be fully implemented. Each member of staff needs to take part in fire drills and receive fire instruction at suitable intervals. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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 Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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. Suitable arrangements were in place to assess the needs and wishes of prospective residents to ensure that these could be met at the Home. EVIDENCE: Prior to moving into Berwick Bridges each resident had undergone an assessment. These assessments were carried out by Social Services and/or Health professionals. The prospective resident and, where appropriate, their families were also involved in this process. The Home also carries out its own pre-admission assessment and uses this as the basis of the initial plan of care for the resident. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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, 7 & 9. Plans of care and risk assessments were in place for each resident that provided staff with appropriate information about each person’s support needs and how to minimise identified risks. However, the plans of care did not adequately address the longer term and anticipated needs of the residents. The arrangements for supporting residents to make decisions about their daily lives and preferences were satisfactory. EVIDENCE: Each resident had an individual plan of care that described how their needs would be met at the Home. The plans included a range of risk assessments and there was evidence that these were regularly reviewed and updated. The risk assessments clearly detailed the steps to be taken by staff to minimise the risks that had been identified. Records indicated the involvement of relevant professionals and agencies such as GPs, opticians and dentists. Each resident had a key member of staff who oversaw their plans of care. The plans of care clearly addressed the current needs and goals of the residents. For example, in supporting a resident to withdraw money from their bank independently. However, residents’ longer term and anticipated needs were not so well addressed in the plans of care. The Manager intends to introduce a new approach to planning the care of residents. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 10 Each resident had been involved in drawing up their individual plan of care. Staff supported and encouraged residents to make decisions about their daily lives and routines, such as what time they went to bed and what they wanted to eat or drink. Residents were also involved in choosing outings and activities as well as the décor of their bedrooms and the communal rooms. Some of the residents were not able to leave the Home without the support and supervision of staff and this was recorded in their care plan. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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, 15, 16 & 17. Suitable arrangements were in place for residents to take part in appropriate activities in line with their needs and preferences. The residents and staff had good links within the local community and the arrangements for supporting residents to maintain contact with their friends and family were satisfactory. The relationships between staff and residents were good and personal support was provided in such a way as to promote and protect residents’ privacy, dignity and independence. The meals in the Home were satisfactory and provided residents with a varied diet. EVIDENCE: On weekdays all the residents attended day services that had been identified as meeting their needs. These included attending the local adult training centre and, for two residents, attending a service organised to meet the needs of older people. One of these residents was also a member of a walking club. Each resident had one day a week where they received individual staff support to develop and maintain their self-care and daily living skills. The residents used local amenities such as the shops, pub, theatre and cafés as well as the local healthcare services. Staff said the residents knew the neighbours and got on well with most of them. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 12 Relatives of the residents could visit the Home and staff supported the residents to visit their friends and relatives. There was clear written guidance for staff regarding how they should respect and safeguard the residents’ right to privacy. Residents confirmed that staff respected their privacy. The residents had unrestricted access to all areas of the Home other than the office and each other’s bedrooms. They all helped with household tasks such as clearing up after the evening meal and cleaning the utility room. Throughout the inspection staff were observed talking to, and engaging with the residents. Residents and staff prepared a weekly menu and residents were encouraged to assist with the food shopping and, where appropriate, the preparation of meals. The records of meals provided indicated that they were varied, well balanced and nutritious. Alternatives were available and healthy eating was encouraged. All of the residents who were asked said that they liked the food at the Home. The staff had all received training in food hygiene. The inspector joined the residents and staff for their evening meal. This was a relaxed, enjoyable, social occasion. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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) 18, 19, 20 & 21. Suitable plans of support were in place and staff had a good understanding of each resident’s support needs. The arrangements for monitoring and meeting the health care needs of residents were satisfactory. The arrangements for the administration and recording of medication were also satisfactory and safeguarded residents. Appropriate arrangements had not yet been made for consulting with residents about their wishes in relation to growing older, terminal illness and death. EVIDENCE: Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 14 Residents confirmed that they felt well cared for and that staff treated them well. Support plans were in place for each resident regarding their personal and general care needs and preferences. They described how staff should provide this care. Residents were supported to make choices about their daily lives and routines. Staff also supported and assisted the residents to choose their own clothes, hairstyles and toiletries. The health care needs of the residents had been assessed and were recorded in their plans of care. Their health care needs were monitored and regularly reviewed. Each resident was registered with a local GP. Residents were supported to access health care services such as dentists, opticians and, where appropriate, specialist services such as a dietician. None of the residents were responsible for administering their own medication. No problems were noted in the sample of medication records examined. A lockable storage facility was available for the safe storage of medication. Written consent had been obtained from each resident’s doctor for the administration of non-prescription medication. All of the staff responsible for administering medication to residents had had training in the safe handling and use of medicines. The Manager advised that she was meeting with residents’ care managers to explore appropriate methods of addressing with each resident their preferences and how to best plan for, and deal with, their aging and death. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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) 22. Suitable arrangements were in place for handling complaints and there was evidence that residents’ felt they could confide in staff and that their views were listened to. EVIDENCE: Two of the residents spoken to said that they felt they could raise any issues or concerns with any of the staff at the Home. Residents confirmed that they felt safe living at Berwick Bridges and that they knew who to speak to if they were unhappy about their life in the Home. A Complaints Policy and related procedures were in place. The Service Users Guide contained guidance on how to make a complaint. The Home’s Complaints Record indicated that no complaints had been received by the Home since October 1999. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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 & 30. The arrangements for keeping the Home clean and tidy were satisfactory. The standard of the décor and furniture and fittings was satisfactory and provided residents with a comfortable and homely place to live. EVIDENCE: The Home was clean, tidy and homely in appearance. The premises were accessible to all of the residents. The Home is situated close to local amenities and public transport within a small housing estate of similar housing in Tweedmouth. The furniture and fittings were of a good standard. Maintenance and redecoration is carried out at regular intervals. Cleaning materials and other potentially hazardous substances were safely stored. Policies and procedures were in place relating to the Control of Hazardous Substances and Infection Control and other Health and Safety matters. Staff received regular Health and Safety training including Food Hygiene. Staff demonstrated an awareness of infection control procedures and an appropriate hand washing facility was available in the kitchen. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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) 34 & 36. The arrangements for the supervision, support and appraisal of staff were satisfactory. However, the Home’s staff recruitment practices were not fully adequate. EVIDENCE: A sample of staff personnel files was examined. For some staff documentary evidence that the required checks had been carried out before they commenced work at the Home was not available. For example, the Criminal Record Bureau check for one person had been done by their previous employer and was not at the required level or suitable for people working with vulnerable adults. Also, 2 written references were not in place for one member of staff and only one was on the file of another. There was also no evidence confirming that these staff were physically and mentally fit for the work they were employed to carry out. All staff appointments were subject to a three month probationary period. Regular staff meetings were being held. Staff had regular recorded supervision meetings with their senior/manager and they also had an annual appraisal. Staff said they felt supported by their Manager and the Trustees of Berwick Bridges. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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) 39 & 42. The arrangements for monitoring the Service provided by the Home were satisfactory although it was not adequately demonstrated that residents’ views underpinned any review and development of the Service. The arrangements for protecting the health and safety of residents were not fully adequate. EVIDENCE: A Residents Quality Assurance Policy was in place and this included consulting residents on a regular basis about the quality of the service they receive. However, this had not been implemented. Monthly monitoring visits to the Home were being carried out. Staff received regular core training that covered moving and handling, health and safety, first aid and basic food hygiene. Risk assessments were in place covering safe working practices. Regular ‘in house’ checks of the Home’s fire equipment were being done. Some staff had not had fire instruction, or taken part in a fire drill during the previous 12 months. The fire risk assessment did not specify how often staff should take part in fire drills. The Home’s electrical Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 19 equipment and electrical installations had been checked in December 2004 and arrangements were in place for the Home’s gas appliances/boiler to be regularly serviced. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 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 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 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 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Berwick Bridges Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 21 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 1 Regulation 4&5 Requirement The aims and objectives of Roberts Lodge should be reviewed in light of the changing needs of service users and the Home’s Statement of Purpose amended to reflect any changes arising from this review.The home’s Statement of Purpose must be updated to reflect current management arrangements within the company. (Previous timescale of 31.5.05 not met.) Residents individual plans of care need to be developed to address each persons anticipated long term needs. (Previous timescale of 31.5.05 not met.) All Service Users, supported by a representative where required, must be given the opportunity to express their wishes in relation to dealing with growing older, terminal illness and death. This information must be recorded as part of each person’s individual assessment. (Timescale of 31.05.05 not met) The Registered Person must ensure that: 1. The appropriate Timescale for action 30.10.05 2. 6 15 30.11.05 3. 21 12 & 17 30.10.05 4. 34 19 30.9.05 Page 22 Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 5. 42 23 check via the Criminal Records Bureau has been completed before a person starts work at the Home; 2. The information and documents specified in Schedule 2 of the Care Homes Regulations 2001 is in place for each person working at the Home and available for inspection. The Registered Person must ensure that staff receive fire instrucution and take part in fire drills at the frequency recommended by the Fire Authority. 30.9.05 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 39 42 Good Practice Recommendations Take action to implement the Homes Residents Quality Assurance Policy. Revise the Homes Fire Risk Assessment to include reference to the frequency staff should participate in fire drills. Berwick Bridges B53-B03 S617 Berwick Bridges V229180 040805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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. 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