Inspection on 10/12/08 for Bradfield House

This inspection was carried out on 10th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bradfield House 119 Heene Road Worthing West Sussex BN11 4NY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Palmer     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Bradfield House 119 Heene Road Worthing West Sussex BN11 4NY Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Jemma Dinwoodie Type of registration: Number of places registered: Broadham Care Ltd care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 10. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Bradfield House is a 10 bedded home for adults with a learning disability on the outskirts of Worthing. The home, which offers 24 hour support and care is owned by Broadham Care and was opened in June 2008. The home has 6 bedrooms on the first floor and 4 on the ground floor. All have an en-suite shower or bath room. The accomodation provides a kitchen, main lounge, dining room, visitors lounge and sensory room. There is also a utility room where people can be supported to do their own laundry. The home has its own transport and is also in walking distance of shops and other local amenities. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 10 Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The information used to write this report was obtained in the following ways: We looked to see if we had received any complaints about the home and saw that we had not. We also looked at any information the home had given us about what might have happened since the home opened. We used some information the provider gave us in the form of an Annual Quality Assurance Assessment (AQAA). This is a form we ask the home to fill in every year to tell us what they are doing to make sure they are giving the people who use the service the care that they want. We received this when we asked for it and it gave us most of the information we needed. A five hour visit was made to the home by one inspector to carry out a key unannounced inspection. Some people in the home have limited verbal communication, so time was spent observing Care Homes for Adults (18-65 years) Page 6 of 27 staff practice and the interactions between people who use the service and staff. There was also an opportunity to get the views of three members of staff who worked in the home. Time was also spent discussing the managers plans for the home and looking at the environment. A random selection of documents was viewed. Three people who use the service were case tracked. This means their records were looked at to see how the provider identified their needs and made sure they were met. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 suitable information for people to make an informed choice about the home. People who use the service can be assured that their individual needs and aspirations would be assessed prior to moving to the home. Evidence: The home provides a statement of purpose and service user guide to inform prospective residents and their relatives/advocates of the care and facilities provided in the home. These need to be updated as they still include the name of the previous registered manager. Initial assessments were looked at for three of the people living at Bradfield House. These were detailed and clear and gave enough information for a judgement to be made about whether or not their needs could be met in the home. Close relatives, care managers and other professionals were involved in this process, as and when appropriate. Care Homes for Adults (18-65 years) Page 10 of 27 Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have individual care plans and risk assessments that are detailed and clear. People who use the service and their representatives are involved in their care plans and involved in decisions about their every day life. Evidence: Three care plans were looked at. These were clear, specific to the individual and kept under regular review. Care plans are accessible to the people for whom they are drawn up for. They include pictures, photographs and are person centred. There was evidence that people who use the service are involved in this process, as are their relatives, care managers and other relevant professionals. Information such as important relationships likes and dislikes and how to support individuals are written in the plans. Communication needs are detailed for individuals to ensure that those supporting them can understand their needs and wishes. For those who use signing and specific gestures, these are detailed. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Also included are emotional and health needs and evidence of concerns being followed up was seen. People who use the service are supported to take risks and risk assessments are in place and regularly reviewed. Risk assessments are drawn up on an individual basis and the emphasis on independence and positive outcomes supports people to achieve their goals and aspirations. Examples promoting independence and supporting individuality were seen in the care plans. One staff member spoken to said they thought the care plans were more up to date, thorough and accessible since the new manager has been in post. An email from a relative said they were very impressed with their relatives care plan that had recently been reviewed. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to access a range of educational, social and community activities. Healthy and varied meals are provided with the preferences of people who use the service taken into account. Evidence: From the three care plans looked at, talking to staff and observing service users it is evident that people are supported to make choices about how they spend their time. They are supported to access a range of activities based on their assessed needs and individual preferences. Some go to college, others stay at home and are supported by staff to access the local and wider community. One person is supported to go to church on Sundays and worship in the home in a way that they wish. Another person has recently joined a local snooker club. During evenings and weekends a range of activities are offered and records showed that people are active and busy. Care plans Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: detail peoples preferences and their regular social activities. Evidence was seen to show that people are encourgaged to do the things they like and try new things. People are supported to use the local shops, pubs, cafes and restaurants. Evidence in care plans showed that people are supported to keep in touch with their families. Some are supported to use the telephone, others have email contact with their relatives or staff do this on their behalf and individual arrangements are in place for this. Evidence of people being supported to keep in touch with relatives abroad was seen. One care plan stated a residents preference for cycling and outlined plans for this to take place. Records showed evidence of one cycling trip with their parents. Staff spoken to said they had not as yet supported this person with this. This was discussed with the manager who agreed to put into place a plan for this to happen on a regular basis. In the daily records we saw entries which referred to residents as being naughty or behaved well. This was discussed with the manager who was aware of some staff using this language and agreed this language did not afford people dignity and respect as adults. She said she had addressed this through training and further training is scheduled. In their AQAA, the home tells us that the residents are encouraged to be involved in menu planning, and meat and fruit and vegetables are locally sourced from suppliers with a preference for organic produce. Meal times are a social occasion and staff and service users eat together. Staff confirmed and residents were observed on the day being supported to make their lunch and eating together in the dining room. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences.They are protected by the homes policies and procedures for storing, recording and administering medication. Evidence: The individual needs and preferences of people who use the service regarding their health and personal care are recorded in their care plans. Care plans detail how people prefer their personal care and details peoples favourite toiletries, creams and perfumes. Care plans and daily records show that people get the support they need and that staff act when they believe a persons health or well being is effected. Evidence in care plans shows that emotional and psychological needs are considered individually and the home will seek advice and support from other professionals who can offer advice and support. Each person is supported to maintain their health and well being by being registered with a local General Practitioner (GP). Evidence seen showed that the home will contact GPs if they have any concerns and action is communicated to staff to ensure everyone is aware of any new procedures or changes Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: to medication. Records of outpatients appointments were seen along with evidence that people are supported to attend these. People are also assisted with dentist, outpatient and podiatry appointments. Currently one resident in the home is taking prescribed medication. This was seen to be safely stored and accurate records kept. Procedures and records for this were sampled and found to be secure and accurate. No controlled drugs are currently used in the home, however there is suitable storage should this be needed at any time. It was noted that several over the counter medicines and creams are used in the home. one was recommended by a GP without a prescription. The manager agreed to consult the guidance given in The Administration and Control of Medicines in Care Homes and Childrens Services, produced by The Royal Pharmaceutical Society of Great Britain. The manager stated that a national pharmacy would be providing training to all staff in January 2009. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home and their families are able to express their views and make complaints. Procedures for reporting incidents are being improved to better protect the people living in the home. Evidence: People who use service and their relatives have all been provided with a copy of the homes complaints procedure. The homes AQAA tells us that residents are encouraged to build therapeutic relationships with the staff team so that they feel enabled to discuss any concerns and that these concerns will be listened to and responded to. Any complaints logged are dealt with within a standard framework and records of these are kept. One complaint from a relative has been logged. The manager responded in a timely manner and the correspondence for this was seen. It was evident that appropriate action had been taken within the home. The complaint related to a matter of physical assault from one resident to another. The manager had not referred this for independent review under the West Sussex Safeguarding Adults procedure. The manager had not understood that these types of incidents needed to be referred in this way. She had however, taken appropriate action within the home to minimise the risk of this happening again. Including informing the care managers involved, informing the Commission and putting strategies in place to support both the residents involved. The manager is now clear about her responsibilities under the West Sussex Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: Safeguarding policies and since the inspection has shown us evidence of this. The staff spoken to had received Adult Protection training, apart from the newest member of staff who is still on induction. All those spoken to showed a good understanding of protecting people and reporting events although they were not sure what happened after they had followed their responsibility of reporting and recording incidents. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a clean, homely and safe environment to live in. Evidence: During the inspection the lounge, visitors lounge, dining room, office, two bedrooms and one bathroom were seen. All these areas are clean and homely and suitable for the people who use them. Bedrooms were personalised to reflect the people they belonged to. The option to lock their room is available to people to offer them privacy. One person chooses to lock their room while they are out. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here are supported by adequate numbers of trained and competent staff. Recruitment records must be available for inspection. Evidence: Staff in the home are still undergoing their induction programme. The manager oversees this. The members of staff spoken to during the inspection were confident and competent. They said they enjoyed their work and showed sound knowledge of the individual needs of people who use the service. They spoke about people in a sensitive and positive manner. People who use the service were observed interacting with staff. Where a 1:1 protocol was in place, this was seen to be carried out. Staff said there are always enough people on duty to meet the needs of residents, this includes the opportunity for each person to go out every day. Rotas showed at least 4 staff are on duty each morning and evening shift. The manager stated that this is increased according to the planned needs and wishes of residents. The recruitment files of four staff were looked at. Three of the four were seen to contain all the required documentation, including, an application form, two written references and a Criminal Record Bureau (CRB) check and Protection of Vulnerable Adult (POVA first) check. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The file of the newest member of staff contained an application form only. The manager stated that the rest of the paperwork was currently at head office. The staff member stated she had undergone a CRB and POVA first check. The manager stated she was currently working under the supervision of other staff members. The member of staff confirmed she was shadowing other staff. The manager agreed to ensure that all recruitment records are available for inspection. All staff spoken to said they receive regular supervision which they found usefull and supportive. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 is well run by a qualified and experienced manager. There are effective systems in place to ensure the health and safety of people who use the service in most areas. Consultation with West Sussex Fire and Rescue will ensure they are protected against fire. Evidence: Bradfield House was registered with us in June 2008. The registered manager for this service left in September 2008. In October 2008 a new manager was appointed to the service. She is currently in the process of registering with the Commission. She has an NVQ4 and the Registered Managers Award and has an A1, NVQ assessors award. She has previously been a registered manager and has experience of running a care home. Staff say there have been positive changes since the new manager arrived and that she is open and approachable. Regular monitoring visits take place by the organisation, as required under regulation 26. These were seen to highlight areas for improvement, for example, the induction of staff, which are then followed up by the manager. The home involves close relatives Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: and other professionals in the decision making process. In some cases, where a resident may not be able to speak up for themselves, these opinions are relied upon. The homes AQAA states they plan to develop the in-house quality assurance assessments as the home develops. Staff are trained in First Aid, Health and Safety, Food Hygiene, Manual Handling and Fire Safety to ensure the health and safety of people living in the home. Fire records were sampled and it was noted that the weekly testing was two weeks overdue. An updated fire risk assessment was seen to be in place. West Sussex Fire and Rescue service were due to visit in October 2008 to approve this, however this has not happened yet. The manager said she would contact them to arrange this. A requirement has been made by us. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 23 In line with regulation 23 (4) 09/02/2009 the registered person must consult with West Sussex Fire and Rescue Service and ensure that the home takes adequate precautions against the risk of fire and this must include an up to date fire safety risk assessment that meets current legislation. To protect people who live and work in the home against the risk of fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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