Inspection on 27/04/07 for Bradbury Home

This inspection was carried out on 27th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Bradbury Home 03/04/09

Bradbury Home 03/04/08

Bradbury Home 26/10/07

Bradbury Home 22/11/05

Bradbury Home 09/06/05

Bradbury Home 24/01/05

Bradbury Home 26/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Bradbury Home 2 Roots Hall Drive Southend on Sea Essex SS2 6DA Lead Inspector Carolyn Delaney Unannounced Inspection 11:00 27th April & 24th May 2007 X10015.doc Version 1.40 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 Bradbury Home DS0000034348.V336002.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 Older People. 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. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradbury Home Address 2 Roots Hall Drive Southend on Sea Essex SS2 6DA 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) 01702 435838 01702 434406 The Salvation Army UK Territory Vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (36) of places Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Number of service users for whom personal care is to be provided must not exceed 36 (total number not to exceed thirty six) Personal care to be provided to no more that 36 older people over the 65 years of age (total not to exceed thirty six) Personal care to be provided to no more than 10 service users with dementia over the age of 65 years of age (total not to exceed ten) Date of last inspection Brief Description of the Service: Bradbury is a purpose built home which opened in May 1992 and is run by the Salvation Army. Accommodation is provided over three floors that are accessed by a shaft lift. There are 32 single rooms and 2 double rooms. All rooms are en suite. Two floors have a kitchenette where residents can prepare their own snacks and drinks. The kitchenette / lounge on the second floor has been developed to accommodate those residents who have dementia. Meals are served in a dining room that overlooks the garden. There is a hairdressing room and a treatment room so that residents can meet with nurses, chiropodists and other health professionals in private. There is one large lounge and two smaller lounges as well as areas with seating outside the lounges. The garden has patio areas and seating. Ramps allow access for those residents who use wheelchairs. The garden is secure. A staff room with lockers and a kitchenette is also provided. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key inspection carried out on 27th April & 24th May 2007. As part of the inspection process a number of residents relatives were contacted by post and given the opportunity to make comment about the home. The comments and views of residents and those people who responded to questionnaires have been used in conjunction with the findings of the inspection visit so as to make a judgement about the level of services provided by the home and have been included throughout the report. Records including assessments, care plans, daily care notes, and medication records and risk assessment documents in respect of a number of people living at the home were examined. Four members of staff including the homes acting manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at each key inspection. Key standards are identified for each section of the report. Where other standards have not been assessed these will have been assessed at previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. Below is a brief summary of the findings of the inspection. More detail is contained within the main body of the report. What the service does well: The spiritual needs of people are provided for. People living at the home said that they enjoyed the food provided by the home. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 6 Since the employment of the new manager the views of residents are being obtained and measures are being implemented so as to improve the quality of care and the lifestyle experience for the people who live at the home. What has improved since the last inspection? What they could do better: Improvements need to be made in every outcome area, which has been inspected. This is a brief summary in respect of some of the areas where the home could do better. People who have moved into the home have not had their care needs assessed so as to ensure that the home will be able to meet them and that the home is suitable for the person. In particular people who have dementia do not receive a good level of care. Information about peoples needs is poorly recorded and is not updated when there are changes to the person’s condition. Staff do not always take appropriate action when a persons condition changes. Risks to people health and safety such as risks of malnutrition, weight loss and falls are not identified and managed and it is only recently that staff have made records in respect of accidents and falls at the home. Some of the people who are more dependent upon the support of staff do not always receive the level of support they need. Staff have not received training in respect of the safe administration of medicines and there was little evidence that staff take appropriate action such as informing a persons doctor if the person regularly refused medication or if Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 7 their condition deteriorates making it difficult for them to take medicines in the prescribed form (tablets). Complaints have not been recorded and there was no evidence that where people were unhappy with care or the services provided by the home that staff took any action to address the issues. Initially residents were reluctant to raise concerns with the inspector however a number of people said that the home has ‘deteriorated’ and had some complaints about lack of care, activities and lack of staff working at the home. A number of residents have commented that staff are ‘rude’ to them. Staff have not had training in respect of the protection of people who may be vulnerable from abuse, harm and neglect. Staff working at the home do not appear to have a good understanding of issues around the protection of vulnerable people. Residents who were spoken with during the inspection said that they would like more activities. Both staff and residents confirmed that there was very little available in the way of activities provided by the home. This was particularly evident for the people who are less mobile and more dependent on staff for support. The home is regularly short of staff and this impacts upon the level of care provided. Some residents have commented that they cannot have baths as frequently as they would wish. Others have said that staff are often too busy to assist them. Some staff appeared caring however others did not engage or interact with residents when offering support and assistance. 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. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The current practices for accepting people into the home are inadequate and do not ensure that the home will be able to meet the peoples care needs. EVIDENCE: The home has statement of purpose document, which sets out the aims, and objectives of the home and the range of services provided. This document needs to be updated so as to include all of the information as described in Regulation 4 of the Care Homes Regulations 2001 (as amended). People who are admitted to the home are provided with a service users guide, which includes information about the facilities and routines in the home. On the first day of the inspection staff told the inspector that the preadmission assessments for the three people who most recently had moved into the home was not available as they ‘were on the computer’. On the second day of the inspection the files for these three people were available. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 10 As part of the process for application for admission to the home a person completes an application form and obtains a medical report from their general practitioner. A social services assessment document (CC5) or a hospital discharge letter is also obtained where appropriate. However these documents contained very little information about the persons care needs. There is a dedicated document for recording the findings of an assessment of persons, however this had not been used by staff to assess the persons needs before they moved into the home. There was no evidence that staff working at the home had carried out an assessment of each persons needs so as to determine that the home can, taking into account the needs of those people already living in the home and the numbers and skills of staff that the home will be able to provide the care that the person requires. The home is registered to provide care and accommodation for up to ten people who have dementia. However there was evidence that the needs of people who have dementia are not being met. The homes acting manager has been in post for a few months. He acknowledged that assessments of a persons needs have not been carried out prior to them being offered a place at the home and said that this would be implemented. Upon moving into the home residents should be provided with a residency agreement which sets out the terms and conditions for living at the home. These had not been signed / agreed for two of the three people whose records were examined. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living at the home do not always receive the care and treatment, which they require. EVIDENCE: The home has a ‘resident care profile’ in which the needs of the person should be recorded. However the five care profiles, which were sampled, were poorly maintained and there was very little information recorded about residents care needs. Where information had been recorded this had not been reviewed and revised in light of changes to the persons condition. Risks to resident’s health, safety and welfare were not assessed so as to minimise these risks. One resident’s health had deteriorated significantly over a period of time including loss of weight due to the person’s inability to swallow. This resident was observed o the day of the inspection and was noted to be very thin and frail. During the lunchtime meal this resident was clearly struggling to eat due Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 12 to their inability to swallow. It was recorded in this persons care plan that they ‘eats well but most of the time they choke when drinking.’ The person had lost over 1stone in weight over a period of a year and staff had been unable to weigh the resident since March 2006, as the resident was unable to stand on the weighing scales. The information in the residents care profile had not been updated to reflect the residents deteriorating condition. There was no evidence as to what actions had been taken by staff in light of the changes to this person’s condition and their inability to eat, drink and take medication. Where a resident had sustained a serious injury following a fall there had been no assessment of risk or plan of care developed so as to minimise further risks. Some residents living at the home are fairly independent and can express their needs effectively to staff however a number of residents are more dependent and some cannot always express their needs and for these people there was insufficient information available about the persons care needs and how staff are to care for and support the person. A number of people living at the home commented that they do not receive the level of care and support they expect. Some residents commented that they do not have baths as regularly as they would wish and that they are not supported in the morning to get up, washed and dressed at a time they prefer. The home is registered to provide care and accommodation for up to a maximum of ten people who have dementia. Staff have not received training in respect of meeting the needs of these people and there was evidence that in many cases the needs of these residents is not being met. The homes acting manager said that he was arranging for a review of residents needs. There were a number of issues of concern identified in respect of the arrangements for administering medicine to residents living at the home. For example one resident was prescribed Carbamazepine 100mg three times per day (to control epileptic seizures). However staff have been administering this only once per day ‘at the residents request’. Another resident has been prescribed Diazepam 2mg each evening. This has been administered one alternate days ‘at the residents request.’ There was no evidence that the resident’s general practitioner had been informed of the decision of the resident not to take medicines in accordance with how they have been prescribed. One resident who had been prescribed medication to control the affects of Parkinson’s disease had not received their medication for a number of weeks and they had been unable to swallow. This person’s condition had deteriorated rapidly during this period. There was no evidence that this person general practitioner had been informed of their deterioration or that advices had been sought in respect of providing an alternative form of medication for this person. Staff working at the home who are responsible for the safe receipt, storage, administration of medicines have not received recent training. A recent audit Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 13 had been carried out in respect of the practices in the home relating to medication and a number of shortfalls were identified including the failure of staff to sign Medication Administration Records (MAR), staff’s lack of awareness of the homes policy for safe administration of medicines, lack of appropriate training for staff and medicines being stored inappropriately and the failure of staff to ensure that medicines, which were no longer used are disposed of appropriately. It was also identified that the hoes policy required review and revision as it did not provided detailed information for staff working at the home. Resident’s wishes for how and where they would wish to be cared for in the event of deterioration in the health were not recorded for those people whose care notes were examined. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The routines of the home and staff practices are not always flexible so as to ensure that residents living at the home live their lives in a manner, which meets their expectations and suits their needs and capabilities. EVIDENCE: A number of residents and their residents have commented that there could be more activities provided by the home. Some people indicated that staff shortages in the home impacted upon the provision of activities at the home and the time that staff have to spend with residents. Opportunities are provided for prayer each day. The information provided to residents in the service users guide indicate that there is a programme of activities provided at the home, which includes games, puzzles, sing songs and visiting singers and groups, local outings. There was no evidence that these activities are available and residents, relatives and staff have all confirmed that these activities have not been provided for some time. The homes manager has organised a ‘shop’ in the home where residents can purchase items of Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 15 confectionary and has asked for suggestions from residents as to what other items should be stocked. There are also some plans for outings in the summer. In April two bread makers were donated and these were to be made available for residents to use with the supervision of staff. However this had not been implemented at the time of the inspection. Some residents are independent and can occupy themselves during the day. On the day of the inspection some of the more able people living at the home were seen to spend time in the garden area. One resident enjoys drawing and another befriends the cats who visit the home regularly for food. There are a number of people living at the home who are very dependent on staff for meeting their needs. These residents including those who have dementia are provided with very little opportunity for social and occupational activities. Each of the five residents relatives who completed residents surveys in December 2006 said that they were always welcomed to the home and can see their relatives in private. Of the three relatives who completed ‘Have your say about surveys in May 2007 one said that the home helps residents to keep in touch, ones said that the home usually does and the other said that the home never does. Meals are served at the home at the following times; breakfast from 8.30 am, Lunch from 12 noon, high tea from 4pm and supper from 6.30pm. In addition drinks are served in between 6.30 and 7.00am, 10.30 and 11.00am and 2.30 to 3pm. Hot and cold drinks are available upon request at any other time. Residents have a choice of meals each day. On the day of the inspection residents had the choice of fresh cod in batter with chips and peas or cod in parsley sauce with mashed potatoes and peas for lunch and the choice of scrambled eggs on toast or sandwiches for the evening meal. Resident’s who were spoken with during the day of the inspection commented that the food provided by the home was very good and each of the three residents who completed ‘Have your say about..’ surveys said that they always enjoyed the meals provided by the home. The majority of residents take their meals in the dining room on the ground floor. Meals are served to residents in a congenial setting and a range of condiments and sauces to compliment the meals were available. Residents were observed to enjoy their meal and residents were seated in groups where they could engage with conversation with others. A number of people require assistance and support at mealtimes, particularly those people who have dementia. On the day of the inspection staff practices were observed in assisting and supporting those people who are more dependent. Two members of staff were available to support eight residents. One male member of staff was noted to sit and interact with residents while assisting them with their meal. The other member of staff stood while feeding Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 16 a resident and did not engage in any conversation with the resident during this activity. One resident was noted to struggle to swallow and staff said that the resident had been unable to swallow for some time. The resident looked very thin and frail. There was no evidence that staff working at the home had sought and medical or other specialist advice in respect of this person’s nutrition and weight loss. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Concerns raised by residents are not dealt with appropriately and some staff practices have put the health and welfare of residents at risk. EVIDENCE: During the first day of the inspection staff were unable to locate the records, which are kept in relation to any complaints made about the home. Staff when asked what they would do if someone made a complaint said that they would make a record and pass it on to the homes manager. Residents who completed surveys indicated that they knew who to speak with if they were unhappy of if they wished to complain about anything. During the second visit to the home the manager confirmed that there have been no records made in respect of complaints. Residents who were spoken with during the inspection were initially somewhat reluctant at to speak about the home. However a number of residents said that the standard of care was not as good as it has been in the past. From the minutes of the residents meeting held in April 2007 it was clear that many residents had concerns about a number of issues including insufficient numbers of staff working at the home, the attitude of some staff, lack of activities and the general deterioration of standards at the home. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 18 Staff working at the home have not received recent training in respect of the protection of people living at the home from abuse, harm and neglect. Staff do not have a good understanding of what constitutes abuse and some staff did not appear to be aware of the various forms of abuse such as neglecting peoples needs or speaking to residents in an inappropriate manner. Some residents have said that some staff are ‘rude’ to them and two residents told the inspector that when they request assistance from staff to go to the toilet that they are told ‘to wait..’ This was observed during the inspection despite staff chatting with each other at the time. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. More could be done so as to ensure that the furniture and decoration of the home meets resident’s needs and that residents have access to all of the communal areas and facilities in the home. EVIDENCE: Bradbury home is a purpose built home. Accommodation is provided over three floors that are accessed by a shaft lift. There are 32 single rooms and 2 double rooms. All rooms are en suite. Two floors have a kitchenette where residents can prepare their own snacks and drinks; however there was no evidence that residents use or are encouraged to use these facilities. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 20 The more able residents can access the garden areas however there was no evidence that staff support those less mobile people to use the garden when the weather is good as on the day of both inspection visits. The seating arrangements in the lounge area on the ground floor are very institutional, with all of the chairs arranged in a large semi circle. This does not promote interaction between residents and this was evident during the inspection. The manager said that the home in general requires cleaning and that some of the furniture in the home belonged to previous occupants and does not suit the needs of current occupants. The communal accommodation provided for people who have dementia is quite sparsely furnished and decorated and is not particularly homely in nature. There were no unpleasant odours detected in any parts of the home during the inspection. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff are not employed in sufficient numbers at the home for the needs of residents. Staff have not received training to enable them to best care for the people living at the home. EVIDENCE: Residents in the home have commented that there are not always enough staff and this meant that the care received was not good because staff were ‘tired’. Some residents and relatives who completed ‘Have your say about..’ surveys also commented that residents do not always receive the care and support they need and that staff were not always available when needed. The minimum staffing levels at the home should be five during the day and three at night. However an assessment of staff duty rotas indicated that there have been a number of occasions where there have been four staff during the day and two during the night. The home only employs additional agency cover if staff are required to administer medication. The home uses a local employment agency and the acting manager was advised that where agency staff are employed that there should be information about each agency staff who is employed to work at the home. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 22 On the first day of the inspection there were only four members of staff on duty for the morning duty, however one person came to work late and another had left the home to escort a resident to the hospital for a routine appointment. The homes manager said that due to staff restructuring in the home that there are care staff vacancies at the home and these vacancies should be filled within the next few weeks, which should solve this problem. Records in respect of the checks carried out before a person is employed at the home were not available when requested on the first day of the inspection and it was not possible therefore to determine that staff are recruited to work in the home in a consistent and robust way so as to ensure the fitness and suitability of the person to care for older people. A copy of the matrix for staff training was provided by the manager on the second day of the inspection. From this it was noted that the majority of staff have not received moving and handling training since 2005. Some staff did not appear to have had moving and handling training since 2004. The majority of staff have not undertaken health and safety training since 2002. Staff working at the home have not received fires safety training since 2003. Of the fifteen members of staff who have received training in respect of protecting people from abuse, harm and neglect, twelve received this training in 2005 and the remaining three received this training in 2004. Senior care staff who are responsible for managing and administering medicines have not received training since 2004. Staff working at the home have not received appropriate or recent training for the needs of people who have dementia. The manager agreed that staff have not received training in respect of the roles they are to perform and the needs of the people living at the home and has identified a number of shortfalls in care practices including the moving and handling of people and the administration of medicines. There are plans to ensure that all staff working at the home receive regular training. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has not been managed in the best interests of the people who live there however the new acting manager intends to improve the way in which the home is managed. EVIDENCE: The homes registered manager left the home in January 2007. The Commission was not informed. The current manager was spoken with during the second day of the inspection and the issues of concern were discussed, many of which he had identified and was planning to implement measures to affect improvement. The manager has completed the Registered Managers Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 24 Award (RMA) a recognised qualification for people who wish to manager social care establishments. Since his employment at the home the manager has initiated change processes within the home such as identifying training needs for staff, arranging staff supervision as there is no system in place and staff are not supervised and dealing with the issues as identified within this report. Where the home holds monies on behalf of residents records are maintained in respect of monies received and any financial transactions made such as payments for hairdressing etc. At the time of this inspection the organisations process for monitoring and improving the quality of care and services was not being implemented in the home. Some improvements have been made in terms of listening to residents and acting upon what they say and there was evidence that the acting manager had made some changes following the most recent residents meeting. There is a system in place for checking and maintaining at regular intervals the equipment and systems in the home such as equipment for detecting and dealing with the outbreak of fire in the home. However records were poorly maintained. The home has a system for carrying out a risk assessment every six months however records indicated that this had not been carried out since 2003. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 1 2 2 Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 26 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. 1. Standard OP3 Regulation 14(1) (a) Requirement People must only be offered a place at the home once a detailed assessment of their needs has been carried out by a suitably skilled person and it is determined that following this assessment that the home will be able to meet the persons needs. A plan of care must be developed for each persons care needs, which is reviewed and revised at any time where there is a change in the persons condition or the support, care or treatment they are to receive. Where risks to a persons health, safety or welfare are identified these must be so far as possible minimised. Staff must ensure that people living at the home receive the medicines, which have been prescribed for them. A range of activities must be provided which meet the needs and capabilities of people living at the home. Complaints must be dealt with DS0000034348.V336002.R01.S.doc Timescale for action 30/06/07 2. OP7 15 30/07/07 3. OP8 13(4) (b) (c) 12(a) 13(2) 16(2) (m) (n) 22 30/07/07 4. OP9 30/06/07 5. OP12 30/08/07 6. OP16 30/06/07 Page 27 Bradbury Home Version 5.2 7. OP18 13(6) 8. 9. OP27 OP30 18 18(1) (c) 10. OP33 24 11. 12. OP36 OP37 18(2) (a) 17 13. OP38 23(2) (c) 23(4) and responded to in line with the homes complaints policy and Regulation 24 of the Care Homes Regulations 2001. Arrangements must be made and implemented in the home so as to ensure that so far as it is possible that people are protected from abuse, harm and neglect. Staff must be employed in sufficient numbers for the needs of the people living in the home. Staff working at the home must receive training for the roles they are to perform and the needs of residents. A system for reviewing, maintaining and improving the quality of the services provided by the home which includes the views of residents, relatives and any other stakeholders must be implemented and reviewed periodically. Staff working at the home must receive supervision. Records in as required by regulation must be maintained up to date and made available for inspection at any reasonable time. Equipment and systems in the home must be checked regularly and maintained in safe working order. 30/07/07 30/07/07 30/09/07 30/10/07 30/08/07 30/07/07 30/08/07 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 Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 28 1 2. OP11 OP19 Wherever it is possible the wishes of residents for how and where they wish to be cared for should their condition deteriorate should be obtained and recorded. More could be done so as to ensure that residents have access to all parts of the home including the garden area and that communal areas are comfortable and suited to the needs of residents. Bradbury Home DS0000034348.V336002.R01.S.doc Version 5.2 Page 29 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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