CARE HOME ADULTS 18-65
Bradbury House The County Durham Cheshire Home Worthington Close Crook Durham DL15 8NL Lead Inspector
Mrs Tanya Newton Unannounced Inspection 12th December 2005 01:00 Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bradbury House Address The County Durham Cheshire Home Worthington Close Crook Durham DL15 8NL 01388 768380 01388 768519 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) Leonard Cheshire Mrs Linda Blair Care Home 24 Category(ies) of Physical disability (24) registration, with number of places Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Physically disabled 18 years and over Date of last inspection 5th July 2005 Brief Description of the Service: Bradbury House is owned by The Leonard Cheshire Foundation and is regisered as a Care Home with Nursing. The building was designed to meet the needs of disabled people and was purpose built in 1992. The home is situated close to the town centre of Crook in County Durham and provides easy access to shops, the library and other local leisure facilities. Bradbury House provides spacious communal and private living space with wide corridors and doorways which helps to ensure ease of access for wheelchair users. Communal space is made up of central, open plan areas used as sitting and dining rooms. Resident’s accomodation consists of spacious bed-sits some with kitchinette facilities. All have lounge and bedroom facilities. All bed-sits have en-suite bathrooms with toilet, wash basin and with bath or shower facilities. Patio doors from all bed-sits allow easy access to patio areas and the homes gardens. The home also provides a Day Care facility for upto 9 people each weekday. This is located in designated areas within the homes communal space. Residents of Bradbury House can join in with day care activities if they wish. The home has their own specialist vehicles that have been especially adapted for the needs of service users. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out between the hours of 1pm and 5.45 pm. Eight service users and two staff were spoken to during the inspection. Time was also spent with the manager. A tour of the building took place. This was the second inspection of the home this year; in line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion were addressed in the previous inspection for the home, which took place in July 2005. Issues raised in the last inspection were also examined. What the service does well: What has improved since the last inspection?
Residents meetings are taking place more frequently. Systems to review and monitor the quality of care being delivered continue to be developed. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these outcomes/standards were formally assessed on this occasion. They were addressed in the previous inspection of the home, which took place in July 2005. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these outcomes/standards were formally assessed on this occasion. They were addressed in the previous inspection of the home, which took place in July 2005. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 & 17 Individual residents rights are respected and staff support residents in being as independent as possible. Residents are able to maintain close contact with their friends and relatives following their admission to the home. Service users receive a varied menu. EVIDENCE: Resident’s rights are respected; they are supported in developing social and independent living skills. Residents are encouraged to choose their own hobbies and interests with support and encouragement from staff. Staff always knock on the door before entering and were said to be kind and friendly. One of the residents spoken with stated “I am well cared for here, I get good support from the home, my privacy is respected and it’s my home”. Another resident commented “Residents meetings are held monthly, I am treated well, I choose when I want to get up and go to bed and if I want to go out somewhere I ask the staff and someone would take me”.
Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 11 Residents confirmed that they maintained contact with their families and friends; many of the residents were looking forward to visits to and from their families over the Christmas period. The cook was spoken to; she confirmed that residents were offered a full cooked breakfast every morning and were offered a choice, residents were able to request specific items and specialist diets could and would be catered for. The cook has attended the focus on food training and gains information regarding specialist diets from dieticians and the hospital. Comments from residents included “the food is alright, you get a choice and we have a say in the menu”. One of the residents commented “some of the food is beautiful, although sometimes it can be a bit cold”. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The physical and health needs of the residents are well met with support from other health professionals being sought where this is required. EVIDENCE: Healthcare needs were being well met; one of the residents spoken to stated, “my G.P visits weekly and the dentist also comes out to the home. I feel well cared for”. Another resident commented “I am well cared for here, there are some nice people, staff provide good emotional support if you get upset”. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Resident’s views are listened to and acted upon. EVIDENCE: All residents spoken to confirm that they would feel confident in raising any complaints. Some of the comments from residents included “I could tell someone if I had any problems” and “the managers make time for you, if you want to see them you can knock on their door and talk to them”. Residents meetings are held and residents are given the opportunity to share their views with others. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Residents live in a safe, homely and comfortable environment, which has been purpose built to meet the needs of people with a physical disability. The home is clean, pleasant and hygienic for residents. EVIDENCE: The home is a purpose built care home, designed to meet the needs of adults with a physical disability and is fully adapted throughout. Resident’s own bedsits are decorated and furnished in their own personal style. Communal areas of the home were homely. The home was found to be clean and hygienic and free from any offensive odours. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 The staff are trained and competent to do their jobs maintaining the safety and well being of residents. EVIDENCE: Comments regarding the number of staff on duty were mixed. A number of residents felt that the present staffing numbers were insufficient; the following comments were received “Staff have no time to come and talk, they are so busy, I’m sure they would if they could - they’re lovely”, “The staff are nice people. Staff made the following comments “It’s a canny place, the staff get on well together and work well as a team. We work in twos, there’s lots of equipment and we get well looked after and supported by the management. There are lots of training opportunities; I’ve recently attended a 2-day course on MS”. Another staff member commented, “We could do with more staff, it’s more demanding now, the buzzers never stop. It’s a nice place to work with job satisfaction”. The manager confirmed that during the day there were six staff on duty and five during the afternoon. There are three staff on duty during the night. The home should continue to monitor the numbers of staff on duty to ensure that residents needs continue to be met.
Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 The home is well managed and run. Quality assurance systems are in place to seek and promote choice making from residents. EVIDENCE: The staff spoken with confirmed that they were given good support from the manager. The staff have a clear understanding of their roles; staff confirmed that morale was high and good working relationships were in place. The home seeks feedback from residents and their relatives. Residents are involved in chairing meetings, attending meetings and in the recruitment of staff. The home carries out in depth audits of the service, the information is then collated and action plans would be developed where necessary. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Bradbury House Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000000700.V272579.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA33 Good Practice Recommendations The home should continue to monitor the numbers of staff on duty to ensure that that they are sufficient to meet the assessed needs of the residents placed. Bradbury House DS0000000700.V272579.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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