Inspection on 25/10/05 for Bradbury House

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bradbury House 20/05/09

Bradbury House 18/04/07

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 25th October 2005 10:15 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.V261371.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 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.V261371.R01.S.doc Version 5.0 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.V261371.R01.S.doc Version 5.0 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) 20/04/05 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 accomodated 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. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 25th October 2005, lasting six hours. The focus of this inspection was primarily on premises and health and safety issues. The inspection process included: discussions with the manager, 3 staff and 5 service users; inspection of the premises, including a sample or bedrooms, bathrooms, communal areas and laundry; and inspection of a sample of policies and records. 16 standards were covered, and 3 requirements and 4 recommendations have been made, all relating to premises issues. Information on core standards not covered on this inspection can be found in the report of the inspection that took place on 20th April 2005. What the service does well: What has improved since the last inspection? Since the last inspection, the manager has entered all care plans onto computer, enabling residents’ files to contain typed format care plans that are easier to read and can be more easily updated when needs change. The home continues to promote an individual approach to residents, encouraging individual interests. Examples of initiatives since the last inspection included finding space in the home for two residents to now have their own electric mobility scooters, and supporting someone to have the opportunity to go into a swimming pool. The manager had researched and made plans for arrangements in the event of having to evacuate the home or the breakdown of utilities or equipment. She had produced a clear Contingency Plan detailing emergency contacts, agreed procedures and alternative accommodation, which was a useful document. Bradbury House DS0000017777.V261371.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 DS0000017777.V261371.R01.S.doc Version 5.0 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.V261371.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None. Standard 6 is not applicable at Bradbury House. EVIDENCE: None of these standards were inspected on this occasion. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The home has written care plans that clearly set out each resident’s health, personal and social care needs, and the action required of staff to meet these. EVIDENCE: Only one person’s care plans were viewed on this occasion: these contained clear details of the action required of staff to meet the person’s needs. Since the last inspection, all care plans had been produced on the computer, so that printed care plans could be produced (rather than hand written), making them easier to read and enabling care plans to be updated more easily. This is commendable. The manager stated that they were now in the process of transferring risk assessments onto the computer also. Residents spoken to continued to be very happy with the assistance received from staff, and with the way staff supported their personal and healthcare needs. Staff were observed to treat residents with care and respect. The home had acquired a seated weighing machine since the last inspection, to enable the weights of any non-weight bearing residents to be monitored. The manager encouraged a positive and supportive approach to dealing with death and dying in the home, and provided staff with appropriate training. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 The home promotes a lifestyle and a range of recreational activities that meet residents’ expectations and preferences. The home encourages residents to exercise choice and control over their lives. EVIDENCE: Residents spoken to continued to be happy with the lifestyle and choices available to them at Bradbury House. They reported having choice over how and where they spent their day, when they got up and went to bed, and of what to eat at meal times. Residents spoken to continued to be happy with the quality and variety of meals offered to them, and the manager had recently carried out a detailed survey of residents’ views on meals and meal times. Residents were encouraged to exercise choice and control over their lives, including managing their own financial affairs where able. Access to records and information on advocacy services were not discussed on this occasion. It was noted that residents’ rooms were well personalised, and that they were able to bring personal possessions into the home with them. Friends and relatives were able to visit at any time. There continued to be a good range of activities available to residents, both in and out of the home. It was good to see the home continuing to encourage and enable residents to go out, accessing the local community and supporting Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 11 individual activities and interests: one new resident told the inspector that they had been out more since coming to live at Bradbury House than when they had been at home, and were clearly enjoying this. Staff regularly took people out into the local town, and supported those who were able to go out on their own (e.g. enabling two of them to have their own mobility scooters). Over the summer, residents had been on a trip to Clacton, and a large group of them had also spent an afternoon out at a private garden and swimming pool, with staff supporting two residents to go into the pool (one of whom had learnt to swim since coming to live at the home) and others to paddle at the edge. Many had recently been out for the evening to a local theatre, and the home was planning a Halloween party and a quiz night for residents and relatives. On the day of the inspection, a quiz took place in the afternoon and three residents were taken out for the afternoon. It was noted that the home maintained a good photographic record of events and activities, displaying these in the home, and for an outing to see squirrels and roses in a local park the manager had bought residents disposable cameras to enable them to take photos. The home’s continued attention to providing opportunities for recreation and stimulation is commended. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a clear complaints policy, and residents were confident that their concerns would be listened to and acted on. EVIDENCE: The home’s complaints policy was seen to be displayed in the home, and was also in the service user guide, a copy of which was in each resident’s room. No complaints had been received by the home since the last inspection. Residents spoken to had no complaints or concerns about the home, but were clearly aware of who to speak to if they had a concern, and were confident to do so. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-21 and 23-26 inclusive. On the day of the inspection the home was clean and hygienic. It generally provided a safe and well-maintained environment; however, a few areas requiring repair or renovation were noted. The home provided service users with sufficient personal and communal space, which was homely and suitably furnished, with appropriate heating and lighting; however, some furniture appeared worn. The home has sufficient toilet facilities, but assisted bathing facilities were not adequate for the needs of the home. EVIDENCE: The home was clean, tidy and free from unpleasant odour on the day of the inspection. It was generally safe and well maintained, although damaged flooring was noted in a bathroom and in the laundry, and some areas of the home would benefit from some attention (e.g. a ground floor toilet and bathroom were not well maintained). Several bedrooms had been decorated during the year; another resident reported that they would like their room refurbished, as they felt it was in poor repair (e.g. the furnishings were uncoordinated, and the carpet was torn near the door), and the manager Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 14 confirmed that work on this room was planned. The home employed a maintenance person for eight hours a week, but this did not appear sufficient to carry out all the ongoing essential checks, maintenance and decoration tasks needed within the home. The manager kept records of maintenance and redecoration work carried out. The home has a communal lounge and a separate dining room: these were homely and generally well furnished, although a few lounge chairs were becoming worn. The communal areas were well-lit: as noted on previous inspections, the overhead lighting in the lounge could appear glaring, due to the exposed design of the light bulbs and the low ceilings. It was good to see provision being made for residents to maintain their interests and hobbies (e.g. tables for residents to put their books on when reading, a personal small TV screen on a table in-front of another person, and space for someone’s art materials). The home has limited outside space, but the use of this area has been maximised to make it a pleasant and safe seating area. There had been no change to assisted bathing facilities since the last inspection, and no immediate plans to address this. The home has three bathrooms, but only one provides a fully accessible assisted bath; this is therefore the bathroom routinely used within the home. A second bathroom contained a standard bath that could be used with a mobile hoist, but the restricted space in the bathroom made manoeuvring a hoist difficult; a third bathroom was small and contained a standard low-level bath. The provider should review this and take action to ensure that the home has sufficient useable assisted bathing facilities. Thirteen bedrooms had ensuite toilets, and there were other toilets available in the home, including some close to communal areas. Some communal toilets and bathrooms would benefit from refurbishment; a large supply of clinical waste bags were observed on a shelf in one toilet, and it was suggested that more appropriate storage should be found. The home has three double bedrooms and fifteen single bedrooms. Individual rooms varied in size: those viewed appeared to have sufficient space to meet each individual’s needs. Most rooms were in a satisfactory state of decoration, and contained an appropriate range of furniture and furnishings. It was noted that in many rooms the furniture was becoming worn and shabby: the provider should review this and replace furniture as necessary. Bedrooms and lounges were central heated, naturally lit and ventilated, and had wall and overhead lighting (plus emergency lighting throughout the home). Radiators in the bedrooms viewed were covered to prevent risk from hot surfaces, and hot water taps were regularly checked to ensure they stayed close to 43 °C to reduce risk of scalding. Systems in place to prevent risk from legionella included an annual chlorination treatment, regular running of showerheads, and the monitoring of central hot water storage temperatures. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 15 The home’s laundry room was away from areas where food was prepared or stored; it was suitably equipped with a washing machine with a sluice wash and hot wash function. A sluice sink was located in an area off the laundry, and hand-washing facilities were available. As noted on previous inspections, the laundry floor was damaged, presenting a potential infection control hazard. The home has infection control procedures, and provides staff with appropriate personal protective equipment (e.g. disposable gloves and aprons). Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The number and skills of staff on duty were meeting residents’ needs. EVIDENCE: Rotas were no specifically inspected on this occasion, but on the day of the inspection the home was appropriately staffed, with staff skills and numbers meeting residents’ needs. Residents spoken to were happy with the staffing levels, and felt that their needs were being well met. Recruitment and training standards were not specifically inspected on this occasion, but it was noted that the home continued to provide a good range of training to staff, some of which is referred to in the next section in relation to health and safety training. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The registered manager is fit to be in charge and is competent to run the home. The home is run in the best interests of residents, and has formal quality assurance processes in place to monitor practices affecting residents’ welfare. Processes for managing monies looked after for residents are appropriate and safeguard residents’ finances. The health and safety of staff and residents are protected though the practices and procedures in the home. EVIDENCE: The registered manager has many years experience of managing a care home, and competently manages Bradbury House. She is a registered nurse (although not working in this capacity at Bradbury House), and is currently completing her Registered Manager’s Award (NVQ level 4 in care). She demonstrates good awareness of the needs of older people, and a positive approach to promoting independence and fulfilment for the people living in the Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 18 home. Staff and residents were all very positive about the manager, finding her supportive and approachable. The home has achieved ISO 9000, and had a good framework of internal quality monitoring systems. These included: monthly monitoring visits and reports by the responsible individual, a plan of key events in the home and their outcomes, an internal monthly medication audit and annual risk assessment audit, annual audits by the provider of care plans and records and of staff files, a monthly management report by the manager (including monthly updates on training completed), and an annual survey of service user views by the provider (from which a report is produced). The manager had recently implemented a questionnaire for people visiting the home to seek their views on their visit, and had just completed a comprehensive survey of residents’ views on meals. The home’s policies’ manual contained an index that showed that policies were regularly updated. Policies were not specifically inspected on this occasion. The home does not manage the financial affairs of any residents, but does look after small amounts of money on their behalf. Procedures for managing money were seen to be safe and efficient: the home maintained clear individual records, and receipts for all expenditure. In a sample checked for one resident, the money, receipts and records all balanced, and two staff signed for any money taken out. No residents’ valuables were being looked after by the home, but the manager confirmed that secure storage facilities were available if required, and that any items looked after by the home would be recorded and a receipt given. The home had a clear health and safety policy statement, and additional information and guidance on various aspects of health and safety. These included new ‘work instructions’ on a good range of relevant issues such as ‘entering kitchen and food areas’, ‘safe handling of laundry’, ‘hand washing’, etc. The manager stated that copies were given to staff where relevant to TOPSS and NVQ training, and that health and safety issues were routinely discussed in staff meetings. The home’s training summary record showed that the majority of staff had current moving and handling and fire safety training, and that staff had attended other relevant health and safety training (e.g. COSHH, food hygiene, first aid, health and safety). Records showed that appropriate servicing and checks were carried out on facilities and equipment (e.g. hoists and lift; fire alarms, emergency lighting and call systems; gas safety check; electrical installation and portable appliance testing; etc.). It was noted that the electrical installation certificate indicated that this should be redone three yearly, and was therefore out of date. Records of internal checks on fire alarms, lighting and equipment were not inspected on this occasion. The staff training summary contained a record of fire drill dates for staff, but all dates were over a year old; the manager must ensure that all staff attend regular fire drills. The home maintained records of Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 19 regular checks on hot tap water temperatures, and the manager confirmed that records were maintained of regular checks on hot water storage temperatures to prevent risk of Legionella. Risk assessments on safe working practices were maintained, including Legionella and use of chemicals, and were reviewed regularly. Accident records were maintained and regularly monitored. The manager had recently developed a ‘Contingency Plan’ for the home: this detailed arrangements that had been made for access to a local community resource where residents could be provided with safety and shelter in the event that the home had to be evacuated, contingency arrangements for various breakdowns (e.g. lift, kitchen equipment, etc.), and information on emergency contacts (re water, gas, electricity, etc.). This was a good initiative, containing useful information and available to staff. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 20 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 X X X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 3 2 X 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP19OP26 Regulation 13 and 23(2)(b) Requirement The registered provider must ensure that damaged flooring is repaired, particularly in areas where soiled items or body fluids may be present. The registered person must provide service users with sufficient and suitable assisted bathing facilities. This is a repeat requirement for the second time (previous timescales 31/10/05 & 31/3/05). The registered provider must ensure that worn furniture is replaced in bedrooms and lounges. Timescale for action 31/12/05 2 OP21 23(2)(j) and (n) 31/03/06 3 OP19OP20 OP24 16(2)(c) 23(2)(b) 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations The registered provider should ensure that all areas of the home are adequately maintained and decorated. DS0000017777.V261371.R01.S.doc Version 5.0 Page 22 Bradbury House 2 3 4 OP19 OP38 OP38 It is strongly recommended that the registered provider review the amount of personnel support available to the home for routine maintenance and decoration. It is recommended that the registered person ensure that the home has a current periodic electrical installation certificate. It is recommended that the registered manager ensure that there is evidence that all staff have attended regular fire drills. Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bradbury House DS0000017777.V261371.R01.S.doc Version 5.0 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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