Inspection on 08/05/07 for Bradbury Wing

This inspection was carried out on 8th May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bradbury Wing 01/02/06

Bradbury Wing 22/06/05

Bradbury Wing 14/01/05

Bradbury Wing 15/09/04

Similar services:

The Highlands

Blenheim House

1 Lanark Close

Beaconsfield Court Care Home

Ann Charlton Lodge

The Gardens Care Home

Westmoor View Nursing Home

Ashlea Mews Residential Home

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

CARE HOME ADULTS 18-65 Bradbury Wing The Minories Rosebery Crescent Jesmond Newcastle Upon Tyne NE2 1EU Lead Inspector Janet Thompson Key Unannounced Inspection 8th May 2007 10:30 Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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 Wing DS0000000394.V338086.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 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 Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradbury Wing Address The Minories Rosebery Crescent Jesmond Newcastle Upon Tyne NE2 1EU 0191 281 7996 0191 281 7102 info@london.leonard-cheshire.org.uk www.leonard-cheshire.org.uk Leonard Cheshire 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) Mrs Anne Stocker Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: The Bradbury Wing is situated in a residential area of Jesmond. It is a single storey building, which provides both nursing and residential care for 20 younger people with a diverse range of disabilities. Leonard Cheshire in Northumberland runs the home, however the building is leased from the City of Newcastle upon Tyne and they remain responsible for the maintenance of the building, grounds and gardens. Resident bedrooms are all single occupancy and have large en-suites including showers and ceiling track hoist systems. There is a range of adapted specialist bathrooms and toilets throughout the home. There is a large lounge and separate dining room. Dining facilities are shared with the adjoining day unit. Service users are able to access the courtyard gardens as they wish and are supported to use all local amenities. There is limited car parking to the front of the home. Further information about the home is available in the service users guide and previous inspection reports. These are available from the home. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over one day. The Registered Manager, Mrs Ann Stocker was on duty during the visit. There were 18 service users at the time of the visit. Staffing levels were checked. Time was spent looking around the home to check the cleanliness, maintenance and decoration during the visit. Prior to the inspection questionnaires were provided to service users and relatives. Service users completed six questionnaires. Relatives and visitors completed three questionnaires. Service users shared their views during the inspection. Time was also spent observing the contact between the service users and staff. Care plans were examined. Arrangements for the administration and management of medication were checked, staff recruitment, NVQ training, catering and quality assurance were also examined. What the service does well: Comments from service users suggested that all felt that staff treated them well, their privacy was respected, they felt safe and liked living at the home. Service users said they could not comment on complaints because they had none to make. Relatives thought the home was “better than anywhere previously experienced” The food was very good. Service users said they liked the food on offer. Service users bedrooms are all personalised, clean and comfortable. The staff are well trained and specialist training is provided to meet the needs of the people cared for. The health care needs of people are understood and met. Care plans clearly set out service users needs. They were up to date, comprehensive and easy to read. The home is well equipped to meet the needs of service users. Service users are involved in the running of the home in that they participate in staff interviews and are involved in some staff training. The management of medications was satisfactory. Service users are protected through good and thorough staff recruitment procedures. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 6 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 Wing DS0000000394.V338086.R01.S.doc Version 5.2 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 Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have their individual needs assessed before entering the home. EVIDENCE: Three case files were examined. They showed that service users needs had been assessed before they came into the home. That assessment helped to form the initial care plan. The assessment took account of information provided by other professionals. The assessments were clear and easy to follow. They identified needs and ability of residents as well as the help required to meet those needs. The manager stated that the service users key worker and named nurse are on duty the day the person is admitted. This ensures that there is a rapport built immediately and helps staff to get to know individuals quickly. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual needs and goal were reflected in plans. Service users are encouraged to make decisions about their lives. Service users are supported to take risks. EVIDENCE: Three care plans were examined. Two were case tracked. The care identified did reflect the actual needs of the residents. All needs and goals were clearly set out. Care plans had been reviewed. All aspects of care were covered. Care plans clearly reflected service users choices. Service users are encouraged to participate in the general running of the home as well as deciding on their own routines. Service users rooms were highly individual and reflective of their personalities, preferences and interests. Service users are encouraged to be as independent as possible. This includes going outside of the home and participating in outings. Risk assessments are in place where appropriate. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users take part in appropriate activities. Service users are part of the local community. Service users have appropriate personal relationships. Service users rights and responsibilities are recognised. Service users are offered an adequate diet. EVIDENCE: Due to the complex disabilities of some service users, individual access to the community varies. The Bradbury wing caters for a number of people requiring a high degree of nursing input and end of life care. Service users share the services of a voluntary organisation that take people out and set up sport and leisure activities. Some service users socialise locally and join in the activities in the day centre. Care plans clearly set out service users social needs and abilities. This included relative involvement. It was observed that relatives and visitors to the home were made welcome and appeared relaxed there. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 11 The service users commented in their questionnaires that they liked the food and that it was usually good. The inspector tasted the food on offer. It was tasty, hot and well presented. The portion size was good. The manager is currently reviewing food to promote healthier living, i.e. meals with less salt and fat. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive their support as they prefer. All service users health needs are met. Service users are protected by good medication policies and practice. EVIDENCE: Service users wishes regarding healthcare were recorded in their care plans. Service users said that they are consulted about their healthcare and kept informed of changes. Service users needs are very well identified in care plans. The home has been equipped with a wide range of aids to meet those needs. Staff work closely with health professionals to meet the needs of service users. This was well documented in care plans. Many service users hare very dependant on staff for their care and have complex nursing needs. All service users looked clean, comfortable and well cared for. Staff spoken to were very knowledgeable regarding services users needs, likes and dislikes. Medication records were examined and were fully completed. The storage, ordering, administration and disposal of medication were satisfactory. A pharmacist audits medication every six months. Controlled drugs were stored, administered and recorded correctly. Two amounts of controlled drug wee checked and found to be correct. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel they are listened to and their views acted on. Policies are in place to protect service users from abuse. EVIDENCE: Steps are taken to involve service users in the running of the home and seek their views. Complaints are recorded and acted upon. Service users spoken to said they would not complain, as they had no cause to. In questionnaires service users said they would be confident that their complaints would be dealt with. One relative requested a fuller action plan following complaints; the manager agreed to review this but in the absence of specific information was not sure what exactly was required. The complaints procedure was examined and was satisfactory, therefore no recommendations or requirements have been made. There had been one referral to the Adult Protection Team this was instigated by staff to protect a service user and did not involve staff members. This demonstrates that staff do act to protect service users and promote their best interests. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is homely, comfortable and safe for service users to live in. Service users needs and lifestyles are reflected in their bedrooms. The home is well equipped to meet service users needs. The home was clean but not fully hygienic. EVIDENCE: The home appeared very comfortable. The large amount of medical and mechanical equipment needed did not detract from the homely atmosphere. Some areas were looking a little worn but a programme of refurbishment has just been agreed. Service users bedrooms were all very well personalised. They were very different from each other in décor and content. Service users were able to choose their own décor. Some bedrooms contained items to boost sensory perception. All bedrooms were comfortable and clean. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 15 The home is very well equipped with hoists and other equipment to meet the needs of the service users. Most bedrooms are supplied with overhead tracking. Rooms are adapted depending on their occupants needs. All areas of the home were clean. Storage, as in most homes, is in short supply but the home was as tidy as possible. The laundry and linen areas were clean but very small. It was impossible to separate clean and dirty laundry; in event of an outbreak of infectious disease this would cause a problem. Some hand washing areas did not have regulators on the hot water taps. The water was too hot for staff to wash their hands adequately. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent and qualified to support service users. The staff team could be more effective at night to meet the needs of service users. The home’s recruitment practices support and protect service users. Staff are appropriately trained. EVIDENCE: Regional Learning and Development officers are employed to ensure that the training needs of the staff team are met. There is an excellent training matrix in place. This enables the training officer to see, at a glance, which staff are due to receive statutory training and how much vocational training has been provided. Staff were up to date with statutory training. Training has also been given in palliative care, multiple sclerosis, mental capacity, medication, tissue viability, infection control, recruitment and supervision. The staffing for the home is currently provided at: Two nurses between 8am and 5pm. One nurse after 5pm. Seven carers until 5pm plus two carers allocated as one to one with two residents between the hours of 8am to 5pm. Four carers after 5pm and two carers at night. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 17 The inspector was concerned that the night time staffing is too low. The manager has been asked to review this. Four staff recruitment files were checked. These included staff from all grades. All files showed that good recruitment procedures were followed. Where possible service users are involved in staff recruitment. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well run. Service users views underpin the management of the home. The health and safety of service users is promoted in the home. EVIDENCE: The home runs smoothly. The manager has been at the home for seven and a half years, five of these have been as the manager. There are clear lines of accountability in the home, which ensures that it runs as smoothly in the absence of the manager. Staff spoken to were knowledgeable about the needs of service users and the systems within the home. Service users are consulted in all aspects of the running of the home. They are consulted as individuals regarding their personal management and bedroom spaces and as a group regarding menus, social life and routines. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 19 Health and safety records were examined. Safety checks and tests were up to date. These included checks on hoists, call bells, beds, wheelchairs and other equipment. Checks on the fire fighting equipment had been carried out. External checks on the water systems, gas and portable electrical appliances were also up to date. The manager reported that the electrical systems had been checked in 2004, this lasts for five years. The certificate was not available for inspection because it was kept at the head office and she did not have a copy. Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 X 27 X 28 X 29 4 30 2 STAFFING Standard No Score 31 X 32 4 33 2 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 x LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 4 X X 2 x Bradbury Wing DS0000000394.V338086.R01.S.doc Version 5.2 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 13(3) Requirement Review the laundry facilities and provide a policy for the separation of clean and dirty laundry. Ensure that staff are able to wash their hands under running water at all hand wash basins. Provide evidence that the electrical systems have been tested and certificate issued. Timescale for action 01/07/07 2. YA42 13(4)(a) 01/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA33 Good Practice Recommendations Review the numbers of staff on duty through the night. 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