Inspection on 18/04/07 for Bradbury House

This inspection was carried out on 18th April 2007.

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

Bradbury House 20/05/09

Bradbury House 25/10/05

Bradbury House 20/04/05

Bradbury House 02/11/04

Bradbury House 29/04/04

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 House New Street Braintree Essex CM7 1ES Lead Inspector Kathryn Moss Unannounced Inspection 18th April 2007 10:00 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 House DS0000017777.V336683.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 House DS0000017777.V336683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradbury House Address New Street Braintree Essex CM7 1ES 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) 01376 348181 01376 327225 Greenacres Homes Limited Mrs Nicola Lyndsay Leaney Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 21 persons) 25th October 2005 Date of last inspection Brief Description of the Service: Bradbury House is situated in the centre of Braintree, with easy access to town centre shops and amenities. The home is registered to provide care to 21 Older People (i.e. over the age of 65), and is not registered to admit people with dementia. The home provides 24-hour personal care and support, and has appropriate equipment to meet the needs of people who have limited mobility (e.g. through floor passenger lift, mobile hoist, grab rails, assisted bathroom, etc.). The home is an older style property, decorated and furnished in a homely manner. Service users are accommodated in fifteen single rooms and three double rooms; all three double rooms have ensuite toilets, as do ten of the single rooms. Communal areas consist of an open plan lounge area, a separate dining room and an outside patio area with seating. The home is owned by Greenacres Homes Ltd., and the registered manager is Nicola Leaney. The current fees range from £440.51 to £560 per week. The statement of purpose and service user guide are available in the home on request. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that took place on the 18th April 2007, lasting seven hours. The inspection process included: • • • • • • • • Discussion with the manager Inspection of communal areas Inspection of a sample of records and policies Conversations with four staff Conversations with six residents Feedback questionnaires from seven residents Feedback questionnaires from seven relatives Feedback questionnaires from one health care professional This report also draws on any other information relating to the home received by the CSCI since the last inspection (e.g. notifications from the home, complaints, quality of care reports, reports of visits by the responsible individual, etc.). 29 Standards were inspected, and the outcomes for residents against these standards were all good. There were no requirements resulting from this inspection, but some good practice recommendations have been made. The home continues to provide a consistently good level of care and support: this has been maintained over several years, with positive feedback from residents and relatives, and consistent progress towards meeting standards. What the service does well: Bradbury House has a warm, friendly and homely atmosphere, and feedback from inspections consistently comments on this. Staff are very caring and are committed to the residents, and the home has a strong person-centred focus, with staff showing an individual approach towards each person. Comments from residents and relatives included: “the manager and staff treat all the residents with kind and loving care at all times”, “they provide a cheerful, happy atmosphere, where everyone is part of a big family” and “this care home is extremely well run, with all staff exceeding every possible duty asked of them, to keep the residents healthy and happy”. The home provides residents with an extremely good level of stimulation through activities and one-to-one interaction, seeing these as an integral part of people’s care and daily lives. All staff are involved with activities, but the home also has a dedicated activities person. Activities are available every day in the home, and include regular opportunities to go on trips out of the home. Feedback from residents included: “I have done many things I couldn’t Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 6 manage when at home, now going shopping, out for meals, etc.” and “I enjoy all the activities that go on throughout the home, of which I love best pub lunches and shopping!” A relative stated: “The care they show to the residents is of the highest quality, both for their needs and their welfare. They stimulate them mentally: my relative has shown a vast improvement since being in their care”. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 7 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 House DS0000017777.V336683.R01.S.doc Version 5.2 Page 8 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): Standards 1, 3, 4 and 5 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are given sufficient information about the home to make an informed choice about where to live, and assessment processes ensure that they are confidant that the home will meet their needs. EVIDENCE: The manager had updated the home’s Statement of Purpose since the last inspection. This includes good information about Bradbury House, and included information about the development of end of life care practices within the home. There was also a new section on staff training: whilst this contained good information on Bradbury House staff qualifications, it also included information on other training provided by the company that was not relevant to Bradbury House (e.g. learning disability training). The manager Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 9 was advised to delete this, as it does not reflect the service provided at Bradbury House. Several new people had come to live at the home in the last year. Those spoken to confirmed that they had visited the home beforehand, or had already known the home through visiting friends who lived there. They reported that when they came to live there they had been made welcome, had settled in well, and were very positive about the manager and staff. One person said that they had chosen the home because of its ‘caring, homely feel’. Another stated, “This is my home and a better home than I had before, I could not wish for better”. Seven residents completed feedback questionnaires as part of this inspection, and all seven felt that they had received enough information about the home to decide if it was the right place for them. All seven also confirmed that they had received a contract, with terms and conditions of residence (the home’s contract was not inspected on this visit). The manager of the home places a strong emphasis on ensuring that prospective residents are helped to make the right decision about moving in to the home. As part of this she encourages them to spend one or more days in the home before making a decision to move in, and also to visit other homes and read their inspection reports. The manager confirmed that assessments are carried out pre-admission (not inspected on this occasion), to ensure that the home can meet the person’s needs. Files were seen to contain admission checklists, showing that staff make sure that new residents have all the information they need to settle into the home. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9, 10 and 11 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ health and personal care needs are clearly set out in individual plans of care, ensuring that their needs are fully met within the home. Residents are protected through the home’s medication practices. Residents are treated with respect, and end of life care practices ensure that residents’ needs and wishes are met. EVIDENCE: The manager confirmed that assessments carried out prior to admission are reviewed promptly when a new person comes to live in the home, and again after a few weeks, to ensure that they monitor how people are adapting to life in the home and get to know their wishes and preferences. She stated that initial care planning was done within a few days from admission. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 11 Files viewed for two residents contained a good range of well-completed risk assessments, covering relevant risks (including pressure sores, falling out of bed, moving and handling, nutrition, etc.). All these referred to care plans where appropriate. Care plans viewed were clearly written, covered a wide and relevant range of needs, contained good detail of the action required by staff (with key issues highlighted), and included pressure area preventative care. There was a separate sheet of review notes for each care plan, showing that these were regularly monitored to ensure they still met people’s needs. The manager and staff showed a vigilant, responsive and person-centred approach to both personal care and health care needs. Records showed clear evidence of contact with medical professionals, and records of daily care and well-being. A health professional who provided feedback as part of this inspection reported that staff were “consistent in their efforts to ensure prompt advice” to manage and improve people’s health care needs, and felt that staff had the right skills and experience to support residents’ healthcare needs. Staff training records showed training in relevant care issues (e.g. pressure area prevention, care assessing and planning, dementia awareness). At handover, staff demonstrated good understanding of peoples’ needs, and identified appropriate issues for passing onto the next shift. Residents spoken to were all very happy with the way staff supported their personal care needs. All residents consulted felt that they always got the care and medical support that they needed (including support with chiropody and eye appointments), and that staff were always available to them. One person reported that “the staff always get the doctor in if I’m ill and take me to my hospital appointment and look after me very, very well when I’m ill”. Relatives who completed feedback questionnaires all said that they were kept up-to-date with issues affecting their relative, and felt that the home gave their relative the support they expected and looked after them properly. One person wrote: “the staff at Bradbury House always inform me if (my relative) needs a doctor or if a doctor has been called in to them”. When a resident needed medical treatment following an accident, the relative reported: “we were phoned and told straight away, we were informed what happened, the action taken by staff and the care and treatment they were given. We were very pleased to have been informed and how the situation was handled and dealt with”. Residents spoken to were all extremely positive about the manager and staff at Bradbury House. They felt they were treated with respect, and both residents and relatives commented on the considerable level of care and affection staff gave. Care plans reflected respect for individual wishes and preferences, and people’s preferred names were clearly recorded in care documentation. A health professional providing feedback felt that “care staff make every effort to understand and provide for any individual need”. Medication policies were not inspected on this occasion. Medicines were observed to be safely stored and managed within the home. A senior carer Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 12 confirmed that they ask doctors to review medications whenever they are visiting residents. Medication Administration Records seen were well completed, showing a clear record of medications received by the home and consistent recording of medicines administered. Standard codes were used to explain any reasons for non-administration, and new entries were made if the dosage of a drug was changed. The home had clear processes for returning drugs to the pharmacy. Care records included a medication profile (showing each medication details and its purpose), and self-administration assessments showing whether each resident wished to administer their own medication, and assessing their safety to do so (with evidence also that this was regularly reviewed). Routine medication training is provided by Boots, but five staff also completed a distance learning medication course in 2006. Training records showed all senior carers had completed med training, although in a few cases this had not recently been updated. The manager is in the process of formally developing ‘end of life care’ practices within the home. The home has always had a strong focus on supporting people to remain in the home until their death (evidenced by notifications of deaths sent to the CSCI, most of which take place in the home), and has in the past admitted people with quite specific end of life care needs and met these very well. The manager had recently attended an end of life care conference, and was in the process of implementing some specific documentation with current residents and their relatives, looking at their wishes and choices in relation to end of life care. She had established links with the local Care Trust lead person on end of life care, in order to obtain advice and support in this area of care. The manager had already accessed useful information on this subject relating to care homes. She is commended on this initiative, and for the informed and sensitive way that this was being introduced into the home. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a varied, individual and fulfilling lifestyle for residents, who have a high level of choice and control over their lives. Residents’ quality of life is enhanced though opportunities to maintain contact with family and with the local community. Residents’ well-being is promoted through the provision of appealing and nutritious meals. EVIDENCE: The manager reported that the home sees activities as a central and important part of daily life in the home, and ensures that staff have time to spend with residents. On the day of the inspection, despite the lounge being out of use in the morning due to the fitting of new carpets, staff had made alternative arrangements to ensure residents were not left alone in their rooms (e.g. residents sitting with each other in their bedrooms or in arm chairs in the dining room), and were monitoring residents regularly. During the morning the activities co-ordinator was seen reading to a resident, a carer took Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 14 someone out shopping, and two residents were taken out to a local lunch-time concert; in the afternoon, quizzes were seen taking place with two separate groups of residents, another resident was taken out shopping, and a volunteer came in to play dominoes with another person. This is a very high level of interaction, and it was noticeable that most residents were present in communal areas, and were awake and alert and enjoying themselves. Attention to individual needs and preferences was very clear (e.g. one person had art materials set up by their seat, another had a small flat screen TV on a table in front of them, another was being supported to attend church each Sunday, etc.). The home ensures that someone is always available to initiate activities, but also has a dedicated activities person who is enthusiastic and actively explores new ideas. The manager and activities co-ordinator had recently attended a workshop on activities for older people, and spoke positively about this. A newly introduced initiative was regular ‘tea at three’ sessions, where the activities co-ordinator invited small groups of residents to have afternoon tea in the dining room with her, with special sandwiches and cakes provided by the cook, and with a focus to the event (e.g. a particular object) to stimulate discussion and reminiscence. Other in-house activities include quizzes, games, poetry reading, massage, visiting entertainment, parties for special events and Chinese takeaway evenings! One relative wrote on their feedback questionnaire: “On several occasions when I have visited, my (relative) has been involved in playing different games, word games etc., which they have really enjoyed. On one occasion they were having a facial and their arms and legs were being gently massaged while listening to lovely classical music. How lovely! This one-to-one made my (relative) feel very special; I was so happy for them, it was lovely to see them so happy and being spoilt”. The home also offers a wide range of opportunities to go out. The close location to the town centre enables regular trips to the shops and the local park. Other trips include garden centres, meals out, ten-pin bowling, local theatre performances, and monthly picnics to hear a local Brass Band during the summer. One relative reported: “All the staff put a lot of effort – sometimes in their own time – to provide entertainment and social events for the residents. They regularly go out to lunches and other trips, which the residents really enjoy. They put a lot of time and effort into making these outings great fun”. All seven residents who completed feedback questionnaires reported that there were ‘always’ activities they could take part in, and one resident said “I have done things I haven’t done before”! Residents reported that they were able to have regular visitors, and one was pleased that their visitor could join in activities and stay for lunch. The staff help people keep in contact with families, and all relatives who provided feedback felt that the home kept them up to date with any issues. One relative said that “ manager and staff …also extend their kindness and care to relatives…”, and another reported that “I visit all sorts of times and days, and Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 15 each time I visit I’m made welcome”. Restrictions on visitors were only imposed at residents’ request. Bedrooms were personalised, and individual belongings were welcomed in the home (including one person’s fish tank and budgie!). Staff provide assistance with financial issues when required, supporting a couple of residents to go to the bank when necessary. Daily routines were clearly flexible, with residents choosing how and where to spend their time. It was good to see a late lunch being provided to residents who had been out to a lunch-time concert, and one relative reported that “my (relative) sometimes likes to stay in bed a little longer or go to bed a little later. They are free to do this, nothing is forced on them”. The home continues to offer a varied range of well-balanced meals: menus showed that choices were always available, and food is predominantly home baked. All seven residents who completed feedback questionnaires were positive about the meals, with one saying that they were ‘much superior than meals I had when I lived in another home’. The cook shows a very flexible approach to meals, and is willing to meet individual wishes and preferences and make last minute changes if people change their minds. A new assistant cook has been involved in residents’ meetings to seek their ideas on food, and minutes showed that she had introduced some new ideas at their request. The home has now achieved a Silver Award for Food Standards Agency standards two years in a row. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices in the home generate few complaints, and residents are confidant that any concerns will be listened to. Systems in place in the home protect residents from abuse. EVIDENCE: The home has a complaints policy, which was not viewed on this occasion; the manager confirmed that any complaints received are recorded. There had only been three complaints since the last inspection, all relating to instances when the lift had broken down. Theses situations had been rectified as soon as possible on each occasion, and appropriate arrangements made to monitor residents. No complaints had been notified to the CSCI over the last year. Most relatives who completed feedback questionnaires confirmed that they knew who to complain if they needed to; any who had raised concerns felt that the service had responded appropriately. Similarly, all the residents consulted were clear that they knew who to complain to, and those spoken to were clearly confidant to raise issues. One reported that they would tell the “senior carer or manager, who always sort things out!” Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 17 No Protection of Vulnerable Adult (POVA) concerns have been raised in the home. The home has procedures for responding to any such concerns, and the manager stated that a specific POVA session forms part of every staff meeting, and has also now started holding evening staff meetings to ensure that night staff can attend. The home has POVA video training packs that are used with staff, and the manager has attended POVA courses and cascades this training to staff. A senior carer spoken to confirmed that they had received training on this topic, and that it was discussed in staff meetings. The home’s training records showed that all care staff had received POVA training in the last 2 years, as had the cooks. Domestic staff did not appear to have received POVA training, and it is recommended that they do. It was good to see a Whistle Blowing notice clearly displayed on the office wall, which informed staff of who to contact if they had any concerns about a resident’s well-being. The manager was confidant that staff would speak up if they had any concerns. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 18 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, 20 and 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, well-maintained and clean environment, which is suitable for residents’ needs. EVIDENCE: Areas of the home viewed on this inspection were in a good state of repair. New carpets were in the process of being fitted in the downstairs lounge and corridor, and the lounge and dining room had been redecorated, providing a fresh and light décor; in the lounge, overhead lighting had been replaced and new curtains fitted. This has made communal areas considerably more attractive and homely places to spend time, and the home is commended on this. Additionally, corridors and several bedrooms had been redecorated, some also with new furniture, and the ground floor bathroom had been tiled Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 19 and decorated, and a bath seat/hoist installed in the bath to provide an additional assisted bathing facility in the home. This shows good progress in updating the facilities in the home. The manager had plans for some ongoing work in the home, including the development of a small garden area to the front of the home to make it a better environment for residents. Maintenance and decoration records were not viewed on this occasion, but the home maintains records of all maintenance requests, and regular premises audits demonstrated this. A maintenance person is employed by the home for a few hours a week to assists with routine work and health and safety checks, but the home also has access to a qualified maintenance team provided by the company, which the manager reported had improved the response time for repairs. The home’s laundry room is away from areas where food was prepared or stored, and it was good to see that this had also been refurbished since the last inspection. The laundry area was suitably equipped with a washing machine that provided a sluice wash and hot wash function. A sluice sink was located in an area off the laundry, and hand-washing facilities were available. The laundry was clean, tidy and orderly. Training records showed that most care staff had attended infection control training, although in most cases this had been several years ago. On previous inspections it was noted that the home has infection control procedures, and provides staff with appropriate personal protective equipment (e.g. disposable gloves and aprons). The home was very clean on the day of the inspection, despite being in an upheaval because of carpets being fitted. It was noted that the staff reorganised the ground floor very quickly once the workmen finished, ensuring that the impact on residents was minimal. One relative reported that ‘I visit all sorts of times and days, and each time I visit I notice, and other people do, that the home does not smell and is always fresh’. All seven questionnaires completed by residents confirmed that the home was kept fresh and clean. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 20 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): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good staffing levels and staff training ensure that residents are in safe hands. The home’s recruitment practices protect residents. EVIDENCE: The home maintains a good level of staffing, which is provided flexibly in order to make staff available to take residents out and to join in with activities. The home has a dedicated and committed staff team, who often voluntarily give extra time for special events and activities. Agency staff are rarely used, with the staff and manager covering any shifts shortages. One relative observed that: ‘sometimes they are short staffed, but (the resident) never seems to suffer because of this”. The files of two new staff were inspected: both contained evidence that all the relevant documents and appropriate checks had been carried out before each person started work, including a full Criminal Records Bureau check. Both files contained evidence of previous training and of induction training within the home, and also evidence that they had been given a copy of the General Social Care Council code of practice. The home uses an induction checklist based on the Skills for Care ‘Common Induction Standards’, which is signed off by the manager once completed. The Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 21 home maintains a database showing all training completed by staff, and uses this to monitor the training attended or required. A copy of this was provided by the home and showed that all staff had current training in fire safety, Moving and Handling, and POVA. The majority had attended Health and Safety training in last couple of years, and there had been a good level of attendance at training in Care Assessment and Planning, pressure area prevention, and first aid. Two staff had also attended a dementia awareness course last year, and the manager and activities co-ordinator had attended a workshop on activities for older people. Catering staff had also attended all relevant training (food hygiene, moving and handling, fire safety, infection control, etc.), and domestic staff had attended fire safety, infection control, Health & Safety, and first aid training. It is recommended that they also attend POVA and moving and handling training. Staff in the home had also completed a good level of NVQ training. Of the sixteen current care staff, ten had achieved qualification to NVQ level 2 or above (several had NVQ 3 and one had NVQ 4), and two more were in the process of doing this training. Two new staff had achieved NVQ qualifications in previous jobs. In addition to this, it was good to hear that two domestic staff were doing NVQ courses in Housekeeping, and one staff member was doing an NVQ in cooking. This represents a very good level of qualification being encouraged and achieved amongst the staff team. Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 22 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): Standards 31, 32, 33, 35, 36 and 37. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the sound management of the home, and the home’s person-centred ethos ensures it is run in their best interests. Practices in the home protect residents, and promote a safe environment. EVIDENCE: The home’s manager is experienced and well qualified for her role. She is a registered nurse (although not working in that capacity in the home), and completed the Registered Manager’s Award (NVQ level 4) last year. Discussions during the inspection demonstrated that she attends workshops to Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 23 update her knowledge and skills (e.g. recent workshops in activities for older people, and in end of life care), and actively seeks out new information relevant to the home. One relative commented: “This care home is extremely well run, with all staff exceeding every possible duty asked of them to keep the residents healthy and happy”. Both staff and residents were very positive about the manager, finding her supportive and approachable. The manager regularly works shifts in the home, enabling her to monitor and support staff in their work. A supervision log maintained by the manager showed that virtually all staff had received six supervisions last year, showing a very good level of formal supervision being maintained. The manager promotes a strong person-centred ethos in the home; this is evident within the staff team, and had been noted by a relative who reported that “Each resident is looked at individually”. One staff member spoken to felt that the particularly good things about Bradbury House were the good teamwork and the focus on the residents, and a relative observed that the staff “provide a cheerful, happy atmosphere, where everyone is part of a big family”. The home should be commended on the individual way it treats each person. Regular resident meetings are held, enabling residents to make suggestions about the home, and with some meetings addressing specific topics (e.g. meals). The enthusiasm of manager and staff encourages residents to participate in these: a recent meeting had been held over lunch at a local pub, and eleven residents, one visitor and several staff had attended! The registered provider has established quality assurance systems in place. The home had a quality assurance file containing evidence of regular internal audits carried out, including monthly monitoring reports on a range of issues (e.g. care plan reviews, health and safety, training, residents weights, etc.). An annual survey of residents’ views is carried out and evaluated by the company (last done in 2006), from which the manager receives an evaluation report identifying any action required. The Responsible Individual also carries out regular visits to the home, talking to staff and residents and auditing a range of records and practices, and completing clear reports that highlight any action to be taken by the home. The home continued to maintain safe systems for the safekeeping and recording of any monies looked after on behalf of residents. Any cash held was clearly identified and individually stored, and a sample of cash, receipts and records balanced when checked. The company’s regional administrator periodically visits the home and checks a sample, recording this on individual record sheets. Health and safety policies and guidance had been seen to be available on previous inspections, and were not reviewed on this visit. Staff training records demonstrated a good level of staff training in health and safety issues, and the manager was aware of current changes in health and safety law and guidance (e.g. new fire regulations, guidance on moving and handling training, etc.). The company carries out bi-annual buildings checks, and the home completes Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 24 monthly room checks, records of which showed checks on furniture, water temperatures, etc. Systems were in place to monitor risk of Legionella, a new fire risk assessment had been implemented, and a general areas safety checklist had been completed (which generated any work place risk assessments). Information provided to the CSCI by the home prior to the inspection showed that servicing and checks on utilities and equipment are kept up-to-date. Records of other checks were not specifically inspected on this occasion. Bradbury House DS0000017777.V336683.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 3 X 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 2 Refer to Standard OP1 OP9 Good Practice Recommendations It is recommended that the registered provider only include in the statement of purpose details of staff training that is relevant to and provided by the home. It is recommended that the registered person ensure that all staff responsible for administering medication receive regular training updates in this subject, to ensure their knowledge is up-to-date. It is recommended that infection control training be periodically updated with all staff. It is recommended that domestic staff receive training in POVA and moving and handling. 3 4 OP26 OP30 Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. Extracts may not be used or reproduced without the express permission of CSCI Bradbury House DS0000017777.V336683.R01.S.doc Version 5.2 Page 28 - 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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