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Inspection on 29/09/07 for Bradfield Residential Home

Also see our care home review for Bradfield Residential Home for more information

This inspection was carried out on 29th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Bradfield is a family run business with a friendly, homely and positive management approach. Staff said, "The manager and family are all very nice, if I have any problem I just go to them and they are willing to help". A visitor commented, "The management are a very nice family". Service users` privacy and dignity are respected at all times and they have choices in all aspects of their daily lives. A service user said, "They always treat us with respect". The home is clean, comfortable and well maintained and has accessible gardens. A service user comment card stated that cleanliness was `Extremely Good`. A team of caring staff supports the health and personal care needs of service users. A resident said, "The staff are very, very good". A visitor said, Meals at the home are well balanced and nutritious. A visitor commented, "Meals are very good, I have my lunch here when I come, I eat every morsel"Service users know that they can raise concerns, however small, at any time and that they will be listened to and their concerns will be addressed. A service user comment card included, `You are told to speak to whichever one of the four proprietors are on duty, you only have to say to a carer that you`d like to see one of them`. General comments from Health Care Professionals about the home include, `This is an excellent care home. It is one of the best residential home`s with whom I have the pleasure of working`. `Personal care from staff who know their clients` `I like the atmosphere. Its cheerful, clean, and clients look content and the carers appear caring and well informed. I always enjoy going there and would recommend it highly` `Happy to live there when I get to that stage`.

What has improved since the last inspection?

The home has developed its own formal quality assurance systems and as a result of service users requests the following items have been purchased; a larger T.V., D.V.D. and Freeview; a new pathway in the garden making it more accessible; vertical blinds in main lounge; the tea-time chef now goes into the dining room during the meal and checks that all service users are enjoying their meal; a wider range of choice has been introduced at evening tea. A formal activities programme has been arranged and the equipment purchased to achieve this. Environmental improvements include total refurbishment of 7 bedrooms; provision of double glazing in porch and UPVC internal front doors; the porch has been redecorated; a new carpet has been laid on top floor landing; all radiators have been cleaned through by a Corgi contractor and have also been repainted; more fire prevention equipment has been installed; and a new drugs fridge has been purchased. Staffing improvements include more training resulting in 50% of staff now trained or working towards NVQ 2 training, and staff have attended dementiatraining; a teatime chef has been introduced; and staff files have been updated.

What the care home could do better:

There are no requirements or recommendations made on this report. The home now needs to continue with the planned staff training in NVQ and mandatory subjects.

CARE HOMES FOR OLDER PEOPLE Bradfield Residential Home Hawksdown Road Walmer Deal Kent CT14 7PW Lead Inspector Chris Woolf Key Unannounced Inspection 28th September 2007 09:15 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 Bradfield Residential Home DS0000023330.V348552.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. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradfield Residential Home Address Hawksdown Road Walmer Deal Kent CT14 7PW 01304 360960 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) Mr David James Johnson Mrs Brenda Eileen Johnson Mrs Brenda Eileen Johnson Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Bradfield is a large, detached house situated in a quiet residential area of Walmer near Deal. The home is close to Walmer Castle and local shops. The home was extended to its current size some years ago. The house and gardens are very well maintained; accommodation is provided for up to 21 older people. A passenger lift is available for access to the two upper floors. All but two of the rooms have en-suite toilet and shower facilities and some of the upper rooms also have the advantage of sea views. Building of an extension to provide accommodation for a further 8 service users is in progress. Mr. & Mrs. Johnson own and run the home together with their daughter. Mrs. Johnson and her daughter have both qualified for the Registered Managers Award. The current fees for the service at the time of the visit range from £303.11 £425.00 per week. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. There is no e-mail address currently available for the home. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information for this report is based on information gained from an annual quality assurance assessment (AQAA) completed by the providers; comment cards completed by 9 residents, 3 relatives, and 3 health and social care professionals; and a site visit to the home lasting just under 6 hours. The site visit was unannounced which means that neither the staff nor the residents were aware that it was going to take place. It included talking with the residents, visitors, staff, and the management. A tour of the premises took place. A variety of records were inspected including care plans, staff files, medication records and the complaints register. Observations were made of the meal being served at lunchtime, an activity that was taking place in the afternoon, and the interactions between residents and staff. Where the initials AQAA are used in this report this refers to the Annual Quality Assurance Assessment that has been completed by the providers. What the service does well: Bradfield is a family run business with a friendly, homely and positive management approach. Staff said, “The manager and family are all very nice, if I have any problem I just go to them and they are willing to help”. A visitor commented, “The management are a very nice family”. Service users’ privacy and dignity are respected at all times and they have choices in all aspects of their daily lives. A service user said, “They always treat us with respect”. The home is clean, comfortable and well maintained and has accessible gardens. A service user comment card stated that cleanliness was ‘Extremely Good’. A team of caring staff supports the health and personal care needs of service users. A resident said, “The staff are very, very good”. A visitor said, Meals at the home are well balanced and nutritious. A visitor commented, “Meals are very good, I have my lunch here when I come, I eat every morsel” Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 6 Service users know that they can raise concerns, however small, at any time and that they will be listened to and their concerns will be addressed. A service user comment card included, ‘You are told to speak to whichever one of the four proprietors are on duty, you only have to say to a carer that you’d like to see one of them’. General comments from Health Care Professionals about the home include, ‘This is an excellent care home. It is one of the best residential home’s with whom I have the pleasure of working’. ‘Personal care from staff who know their clients’ ‘I like the atmosphere. Its cheerful, clean, and clients look content and the carers appear caring and well informed. I always enjoy going there and would recommend it highly’ ‘Happy to live there when I get to that stage’. What has improved since the last inspection? The home has developed its own formal quality assurance systems and as a result of service users requests the following items have been purchased; a larger T.V., D.V.D. and Freeview; a new pathway in the garden making it more accessible; vertical blinds in main lounge; the tea-time chef now goes into the dining room during the meal and checks that all service users are enjoying their meal; a wider range of choice has been introduced at evening tea. A formal activities programme has been arranged and the equipment purchased to achieve this. Environmental improvements include total refurbishment of 7 bedrooms; provision of double glazing in porch and UPVC internal front doors; the porch has been redecorated; a new carpet has been laid on top floor landing; all radiators have been cleaned through by a Corgi contractor and have also been repainted; more fire prevention equipment has been installed; and a new drugs fridge has been purchased. Staffing improvements include more training resulting in 50 of staff now trained or working towards NVQ 2 training, and staff have attended dementia Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 7 training; a teatime chef has been introduced; and staff files have been updated. 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. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 8 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 Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, & 4. Standard 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users receive sufficient information prior to admission, their needs are properly assessed and they can be confident that the home will only admit them if they can meet those needs. EVIDENCE: The service user guide and statement of purpose have been updated during the year to reflect the current situation in the home. Service user comment cards confirmed that they had received sufficient information about the home, prior to admission and included the comments, ‘Children from Australia were Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 10 involved too and son assisted move into Bradfield’, ‘A friend came to view first’, and ‘They also suggested visit prior to moving in’. Each service user is issued with, and signs, a contract/statement of terms and conditions with the home. Contracts are detailed and include the fees payable, the number of the room to be occupied, details of any additional charges, and the rights and responsibilities of each party. All service user comment cards received confirmed that they had received a contract and one included the following statement, ‘Concise, also recommends it should be read by not only next of kin, but other near relatives’. The manager and her deputy undertake a comprehensive assessment at a time and place convenient to the prospective service user prior to admission. As well as physical and mental health and personal care needs the assessments also include any equality and diversity needs. The home’s AQAA states, ‘We recognise that all service users have different needs, we aim to identify specific needs at the time of the initial assessment so we can action how we are going to meet them’. A visitor commented, “He came here for a look and Brenda did an assessment whilst we were here”. This home does not offer intermediate care which is a specialised service with rehabilitation facilities and equipment to maximise service users independence, normally on discharge from hospital, prior to return to their own home’s. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ health and personal care needs are clearly documented in their plan of care, and are met by the home supported by a multi-disciplinary health care team. Service users can be confident that they will be treated with dignity and that their privacy will be protected. EVIDENCE: The home produces a comprehensive, individualised and holistic care plan for each service user based on the initial pre-admission assessment. Care plans are drawn up with the involvement of the service user or their representative Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 12 and include a variety of relevant risk assessments. They are updated by the manager or deputy manager monthly, or more often if needs change. Sufficiently detailed information is included in the care plan to ensure that the staff are able to give the necessary care to service users. A staff member commented, “I am always going back to the care plans because things are always changing”. A folder with a record of visits from health care professionals is stored with the care plan. The health and personal care needs of service users are met by the home supported by a team of health care professionals. District nurses formally review service users health with the managers every 6 months to identify any change in need, equipment required, and any need for further investigation or review. These reviews include tissue viability pressure chart, manual handling and nutritional assessments. Any changes in service users’ health needing professional input in the meantime are referred to the G.P. or District nurse at the time. A staff member commented, “I help the nurses when they come in”. Service users said, “I am well cared for”, and “I am well looked after”, and A visitor said, “The care is very, very good”. Comment cards from service users, visitors, and health care professionals confirm that the home always or usually meet the health care needs of the service users. Visiting professional comment cards included the statement, ‘Personal care from staff who know their clients’. Visitor comment card included, ‘I am totally satisfied with the care and attention my mother receives. I am not aware of any areas requiring improvement’, ‘The staff are helpful and anticipate many clients needs, which are very varied’, and ‘ I think they handle all her day to day needs very well’. Medication policies and procedures in the home are sound, and protect the service users from harm. Recording of receipt, administration and disposal of medication is sufficient to allow an audit trail. Storage is appropriate and will be further improved by the new medication room that is being provided in the new extension. All staff that administer medication have received training for this role. A dedicated drugs refrigerator has been purchased since the last inspection The manager and deputy are very focused on ensuring that the service users are treated with dignity and that their privacy is maintained. Staff are trained in the importance of maintaining the privacy, dignity and respect of service users during their induction and the management closely monitors this. The home is very proactive in ensuring that service users equality and diversity needs are recognised and respected. The home’s AQAA states ‘Past and present service users have had a range of diverse needs including following different religions, being born into different cultures, being of varying ages and gender and some who have suffered with disability, however whatever the diversity of peoples needs everyone is treated with the same respect, privacy and dignity’. When service users do not respect each other’s privacy and dignity the management quickly step in to deal with any issues through education and monitoring. Bradfield Residential Home DS0000023330.V348552.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): 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to lead a life which meets their needs and expectations; they have choices in all aspects of their lives, are encouraged to maintain contact with their family and friends, and receive attractively served, wholesome and nutritious meals. EVIDENCE: Since the last inspection a formal activities programme has been arranged and the equipment needed to achieve this has been purchased. The programme of leisure, social and cultural activities is displayed on the service user notice board and service users are reminded of events closer to the time. Afternoon staff set up the activities and record which service users have taken part in which activities each day in the activities file. Activities vary from arts and Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 14 crafts to armchair exercises; manicures to walks, and bingo to annual bar-bque with family, friends, and staff. There is also an external entertainment programme. A staff member commented, “They enjoy the activities”, and a service user said, “We are playing skittles today”. Service user comment cards confirmed that there are normally activities arranged by the home that they can take part in and comments included, ‘notices are put on the board adjacent to dining room, but residents are also told verbally by staff’, and ‘I take part when I feel like it’. Visitor questionnaires include, ‘There are some activities my mother has no interest in, others she takes part in wholeheartedly’, and ‘Residents who are not bedridden are encouraged to join in functions that are arranged, i.e. musical entertainment by guitar player and singer of assortment of older songs and even 1960’s etc., whist drives, and other games’. At present thre different churches visit the home once a month for Holy Communion. In addition service users who wish to attend are taken to the local churches on a Sunday and for events such as church luncheons. Contact with other denominations is organised by the home according to service users cultural needs and wishes. Service users are encouraged to maintain their links with the local community as they would in their own homes. This includes seeing visitors in private and when they choose also choosing whom they wish to see and not see. Visitors are made welcome in the home at any time and commented, “They always make me welcome”, and “I come in regularly”. A staff member commented, “I have a good relationship with visitors”. One visitor comment card included the comment, ‘visitors are welcome too’. Service users are given choices in all aspects of their daily lives. The home’s AQAA indicates, ‘The manger and assistant manager encourage and assist service users to exercise choice and control over their lives though individual daily meetings and including them in the drawing up of care plans and any future changes. Also as part of the service user guide and on the resident notice board all service users are encouraged to know their rights and express them independently or with help through advocates such as family members, friends, solicitors and through the staff and management at Bradfield’. One service user wants to change rooms and commented, “I’m going to move to a new room before Christmas, Brenda is organising it for me”. Although there are set mealtimes which most service users choose to follow mealtimes are at the convenience of service users. Service users choose whether to take their meals in the spacious dining room or another place of their choice. The home’s AQAA states that, ‘Snacks including sandwiches, cake, fruit and extra drinks etc are available throughout the day at the request of service users’. The home operates a four-week turn around menu, which is changed depending on the season. The AQAA says, ‘Service users can choose anything they wish which is not on the menu as long as we have it in stock Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 15 that day. Service users are encourage to request foods we do not normally have in advance so they can be ordered from our supplier or we make a quick visit to the shops for them’. The home caters for special dietary requirements as needed. If a service user needs to have their food pureed it is served in an appealing way to show the differences in food, colour and texture. The cook commented, “I always make sure that pureed food is colourful”. Service users who require assistance with eating and drinking are assisted discretely, and sensitively and independent eating is encouraged as long as possible by the use of appropriate aids. All service users are monitored discretely for changes in their food and drink intake, which may lead to a review of their health needs. Any continued unexplained weight loss is investigated by the GP and an action plan implemented in their care plan. Service user comment cards indicated that service users usually like the meals served in the home a comments on one card where the service user had been assisted by his relative included, ‘Main meal lunch, well presented, always very hot, as are the plates etc. Dining room is a pleasant room. My husband tells me he enjoys his breakfasts - these are always served in their bedrooms, cereal, fruit, toast & marmalade, also cooked if they wish i.e. egg & bacon etc. Choices are given to residents regarding high tea, types of sandwiches to choose from, fish fingers, eggs etc. fruit or cake’. A visitor comment card included, ‘Meals served are tastefully prepared, and freshly cooked’. Since the last inspection the Department of Health food safety file now being used, and a tea time chef has been introduced. The home’s own quality assurance identified that, on a few occasions, some of the service users had not enjoyed their evening meal. The teatime chef now goes into the dining room during the meal to check if all service users are enjoying their meal, and a wider range of choice at evening tea has been introduced. This has included the high demand for kippers, and for scones with strawberry jam and whipped cream. Service users said, “I have no criticism at all of the meals”, and “I enjoyed my lunch”. Visitors commented, “I have my lunch here when I visit. Having sampled the food three times a week I’m very impressed. I eat every morsel”, “They have breakfast in bed”, and “They cut up xxx food for him”. Bradfield Residential Home DS0000023330.V348552.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): 16, & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their concerns and complaints will be listened to and acted upon and that they will be protected from abuse. EVIDENCE: The home has a clear and accessible complaints policy. A copy is in the Service User Guide which is issued to all prospective service users, and a copy is also on display on the notice board in the hallway. All service user and visitor comment cards received confirmed that they knew how to make a complaint and included the statements, ‘You are told to speak to whichever one of the four proprietors are on duty, you only have to say to a carer that you’d like to see one of them’, ‘Just look in the contract if you need to refresh your memory’, and ‘My mother would raise any concerns through myself’. The home records all complaints and concerns however trivial they may appear, as they are important to the person raising the concern at the time. During the last year 24 concerns have been recorded, all were dealt with Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 17 promptly and satisfactorily, and the outcomes were also recorded. One complaint was raised direct to CSCI; this was referred back to the home for investigation. This complaint was not upheld. Service users are protected from abuse. The home’s recruitment process include checking all new staff against the Protection of Vulnerable Adults register prior to them commencing work in the home. Staff receive training about abuse during their induction and most have also recently undertaken an ASSET course in Dementia care which included a large section on abuse and protection. The managers have attended POVA training and have made themselves aware of their responsibilities under the local multi agency adult protection protocols and guidance. Bradfield Residential Home DS0000023330.V348552.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, 21, 24, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is clean, fresh, well maintained, and comfortable, with rooms that are personalised to meet their needs EVIDENCE: Bradfield is a large, well-maintained, detached property in a quiet cul-de-sac. The home is set out over 3 floors and there is a shaft lift to provide access to all floors. An extension was added several years ago and a further extension to provide 8 more rooms is currently in the process of being built. The home is Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 19 situated roughly half way between the shops and seafront of Walmer, and some of the upper bedrooms benefit from sea views. The grounds are well maintained and accessible, and all of the bedrooms in the existing ‘extension’ have direct access to the gardens. Since the last inspection improvements to the environment have included total refurbishment of 7 bedrooms, double glazing in porch, fitting of internal UPVC front doors, redecoration of the porch, new carpet on top floor landing, radiators cleaned through by Corgi contractor and all radiators repainted, and additional fire prevention equipment has been installed. Following the home’s own Quality Assurance improvements have been made at the request of residents. These include purchase of larger T.V., D.V.D. and freeview, laying of a pathway in the garden to make it more accessible, and the fitting of vertical blinds in the main lounge and one bedroom to eliminate glare. Visitors commented, “It’s a nice home”, and “I am going to join him when they have a vacancy”. The home has the benefit of several communal rooms, including a small quiet lounge on the second floor, and a separate spacious dining room. This enables service users to make choices as to where they sit, or eat, and whom they wish to sit with. All furnishings and fittings are appropriate to the needs of the service users. In addition to the en-suite facilities in the majority of bedrooms, the home also has one assisted bathroom and one easy access shower room. Sufficient toilet facilities are available to meet the needs of the service users. Bedrooms are comfortable, well maintained and personalised to meet the needs and wishes of the service user. It is the service users choice as to the position of their bed in the room, and they are encouraged to bring in pieces of their own furniture if they wish. All rooms are fitted with a nurse call system and extensions are available wherever needed. The majority of service users have their own telephone line and the home has a ‘walk about’ home that is available for use for others. All but two of the bedrooms are fitted with ensuite facilities. Service users commented, “I have got separate living and sleeping areas in my room”, “I still have my bird”, “I have a lovely room”, “I painted that picture”, “On a nice day I have a good sea view”, and “most of this furniture is my own”. The home is clean and odour free throughout and two cleaners are employed each morning to maintain this standard. The home’s quality assurance includes formal weekly cleaning, and fixtures and fittings checklists. The home has robust infection control procedures. Hand wash facilities are available throughout. Personal protective equipment is available for staff. Gel hand cleaner is placed at various places in the home, and in the entrance hall and visitors are all encouraged to use this before entering the home. Service user comment cards all confirmed that the home is always clean and fresh and one commented, ‘Extremely Good’. A member of staff said, “Brenda is very strict on cleanliness and procedures”. Bradfield Residential Home DS0000023330.V348552.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): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies and procedures for staffing levels, recruitment and training give protection service users. EVIDENCE: Sufficient staff are on duty at all times to meet the needs of the service users. Two of the existing care staff are about to be promoted to Senior Carers and will be undertaking NVQ 3. One said, “I am really looking forward to being a Senior Carer, I am pleased to have the opportunity to do this”. Comment cards indicate that staff are available when needed Service user cards included the comments, ‘I can use the alarm bell’, and ‘very much so’, and a visitor card included, ‘The home is remarkably good, my friend xxxxx has no patience and is inclined to pull the emergency cord for the slightest thing, which would drive me mad! No irritation is shown by staff at all’. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 21 The home currently has 50 of its care staff either trained or training towards NVQ 2 in care. Staff commented, “I have NVQ 2”, “I am doing NVQ 2”, and “I am going to start NVQ 3 soon”. The home operates robust recruitment procedures which include an equal opportunities policy. No new member of staff is employed until 2 satisfactory references have been received, an enhanced disclosure has been submitted to the Criminal Records Bureau and a satisfactory check of the Protection of Vulnerable Adults register has been received. If employment commences prior to receipt of the disclosure the member of staff is supervised at all times. All new staff receive a statement of terms and conditions of employment and a copy of the General Social Care Council Code of Conduct on their first day of employment. The home has a planned training programme and all staff have either attended mandatory training or this is planned. New staff receive induction training and the home are in the process of changing to the Skills for Care based induction. Staff recently undertook an ASSET course in dementia care and adult protection was a key part of this training. Staff members said, “I did the dementia training recently, it was good”, and “I did the medication training on Wednesday, it was really interesting. We learnt the 5 rights on medication. If domestic staff show an aptitude to caring they are encouraged to change their roll, and are given the appropriate training. One staff member said, “I used to be a cleaner, if it wasn’t for Brenda and xxx(Deputy Manager) I would not be caring, they encouraged me”. General comments from staff included, “I enjoy it very much”, “We have a good group of staff”, and “I am happy with everything”. A visitor commented, “All the staff are very nice”; a service user said, “The staff are very, very good”; and a health professional comment card included, “The carers appear caring and well informed”. Bradfield Residential Home DS0000023330.V348552.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): 31, 32, 33, 35, & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a positive management ethos and is run in the best interests of the service users. The health, safety and welfare of service users and staff is protected. EVIDENCE: Bradfield is a family run business with Mr & Mrs. Johnson, and their daughter and her partner all being involved in their own areas of the day to day running Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 23 of the business. The registered manager Mrs Brenda Johnson has been running the home for over 12 years. She is supported by her daughter who is the assistant manager, and who has been working full time in the home for 6 years since completion of her business degree. Both the Manager and Deputy have achieved their registered managers awards and update their own skills and knowledge base along with their members of staff. One of the business objectives of the home is to actively encourage the promotion of equality and diversity within the home through policies and procedures and monitoring situations for service users and staff. The management approach to the home creates an open, positive and inclusive atmosphere. The manager and her deputy work the floor with the care staff and continually monitor standards. They give support and guidance to both service users and staff. The deputy manager has recently had a baby and she is a regular visitor in the home, and is a great pleasure to the service users. Service users said, “Brenda is very good”, “xxx (the Deputy Manager) is very good”, “I’m very fond of xxx , he is very nice”. Staff said, “If I have any problem I just go to them and they are willing to help”, “When my mum was ill they just let me have time off immediately to go to see her”, “There is a lovely atmosphere”, and “I get a lot of support”. One service user comment card included, ‘(They are good at) Making the residents feel at home and relaxed, in addition to looking after their material welfare’. Since the last inspection a formal quality assurance programme and an annual development plan have been implemented. Questionnaires have been circulated to service users, families and visiting professionals, an an analysis of results is to be produced. Regular audits are now taking place. Quarterly staff meetings and residents meetings have also recently been started. Service users or their representatives look after their own financial affairs. Where the management team look after service users pocket money and pay for small items on their behalf each service user has their own accounting file. All transactions are recorded and reciepts kept. Next of kin and solicitors are invoiced for service users money along with a receipt of all transactions. The registered manager and management team ensure the health, saftey and welfare of service users and staff so far as is reasonably practical by having safe working practices in moving and handling, fire safety, first aid, food hygiene and infection control and staff receive training in these working practices. Written policies and procedures and risk assessments are also in place. All accidents are recorded and monitored. All safety checks of appliances are up to date. Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 24 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 X X 3 Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 25 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 Home’s 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. Refer to Standard Good Practice Recommendations Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Bradfield Residential Home DS0000023330.V348552.R01.S.doc Version 5.2 Page 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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