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Inspection on 08/08/06 for Bradfield Residential Home

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

This inspection was carried out on 8th August 2006.

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

Information for what the service does well The home is clean, comfortable and well maintained. Service users needs are recorded in individualised and holistic care plans. The manager and her deputy are very visible in the home and are well known to all of the service users. The staff maintain service users privacy and dignity, and they have choices in all aspects of their daily life. The homes policy of recording and investigating all complaints, however minor they may appear, is commendable. Service users commented, "I chose to do this on my own volition, If you were to choose a care home this is one of the very best", "I have been very happy here, its my home", and "It`s the best thing we could have done".

What has improved since the last inspection?

The requirements made on the last inspection report have all been met, a variation has been approved for increase of registration to 21 service users, staff have received training in protection of vulnerable adults, and fire doors are no longer wedged open - Self closing doorguards have been fitted to 2 internal doors. Internal painting has taken place of the staircase, all lower skirting, and the lift lobby area. New double-glazing and balcony has been fitted to one bedroom. New parts have been fitted into the boiler. A new sink, toilet, flooring, and wall tiles have been fitted in the staff toilet. In the interest of infection control hand sanitizer has been placed on all floors and at the entrance and all visitors asked to use this. A new garden path has been provided. A new carpet has been laid on the top floor landing. New flooring has been laid in the first floor bathroom. A CORGI engineer has cleaned through all radiators. New porch windows and doors have been fitted and the front entrance door has been opened up.

What the care home could do better:

Following the recent diagnosis of 2 service users as having dementia a variation to registration should be sought to enable the home to continue to care for these service users. Although currently the home do not have any drugs that require refrigerated storage a dedicated lockable drugs fridge should be available. Staffing levels need to be continually reviewed and staff training in NVQ`s should continue as planned. Although the home have quality assurance strategies these are informal and should be developed in a more formal manner. Cleanliness in the home is good but there is one room with a slight odour which the home need to continue to work at clearing.

CARE HOMES FOR OLDER PEOPLE Bradfield Residential Home Hawksdown Road Walmer Deal Kent CT14 7PW Lead Inspector Chris Randall Unannounced Inspection 8 August 2006 09:20 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.V293926.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.V293926.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.V293926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th October 2005 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. Planning permission has recently been granted for an extension to provide accommodation for 8 or 9 service users with Dementia. 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. The e-mail address of the home is currently not available. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this report has been obtained from a pre-inspection questionnaire completed by the providers; comment cards received from service users and visiting professionals; and a site visit to the home of 6.25 hours. The site visit included a tour of the building; talking to service users, visitors, and staff; discussions with the manager and deputy; observations; and inspection of records. What the service does well: What has improved since the last inspection? The requirements made on the last inspection report have all been met, a variation has been approved for increase of registration to 21 service users, staff have received training in protection of vulnerable adults, and fire doors are no longer wedged open - Self closing doorguards have been fitted to 2 internal doors. Internal painting has taken place of the staircase, all lower skirting, and the lift lobby area. New double-glazing and balcony has been fitted to one bedroom. New parts have been fitted into the boiler. A new sink, toilet, flooring, and wall tiles have been fitted in the staff toilet. In the interest of infection Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 6 control hand sanitizer has been placed on all floors and at the entrance and all visitors asked to use this. A new garden path has been provided. A new carpet has been laid on the top floor landing. New flooring has been laid in the first floor bathroom. A CORGI engineer has cleaned through all radiators. New porch windows and doors have been fitted and the front entrance door has been opened up. 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. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have sufficient information to make an informed choice about admission. Prior to admission they are assessed, and the home ensures it can meet their needs, there is also a three-month trial period to confirm this. A variation to registration is needed for two existing service users who have recently been diagnosed with dementia. EVIDENCE: A copy of the homes statement of purpose and service user guide is issued to all service users prior to admission. These documents are in the process of being amended to include reference to the proposed extension. If more than one room is available at any time the service user is able to choose which room they will occupy. A service user commented, “My daughter waited for Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 9 this room for me”. All service user comment cards received confirmed that they had sufficient information before moving into the home. All service users are issued with a contract and the service user comment cards received confirmed this. Signed copies of the contracts are kept in the home and were viewed during the site visit. The home carries out a full assessment of all prospective service users prior to admission. Joint assessments are also obtained for service users who are care managed. A service user plan of care is formulated from the assessments. The home will not accommodate service users unless they are confident of being able to meet their needs. During a recent visit from the psychiatrist two existing service users were diagnosed as having vascular dementia, the psychiatrist indicated to the home that she was happy with the care they were receiving at the home. It is therefore necessary for the home to apply for a variation to their registration to enable these service users to continue to live in the home. The variation will need to include relevant documentation to indicate how the home is meeting the service users assessed needs. A recommendation made about the variation. At present work has commenced with the building of an extension to house service users with dementia. Staff working in the unit will be appropriately trained to meet their needs. The first three months of all service users occupancy is classed as a trial period. This gives the service user the opportunity to see if they like life in the home; and the home the opportunity to ensure that they can fully meet the service users needs. This home does not offer the facility of intermediate care Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 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 the home, supported by a multi-disciplinary team, will meet their health and personal care needs. Medication storage would be enhanced by the purchase of a dedicated drugs refrigerator EVIDENCE: The home has an individualised care plan for each service user. Care Plans include, Personal details, information on medication, medical history, details of visits from health care professionals, risk assessment for mental health, personal care needs, risk assessment for pressure sores/changes in skin care, nutritional requirements/likes dislikes, monthly recording of weight, moving and handling requirements, risk of falls, risk to carers, record of accidents, continence needs, communication needs, leisure and recreation, and general risk assessments. All care plans are reviewed monthly. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 11 Service users health care needs are met by the home supported by the multidisciplinary team including doctors, nurses, chiropodist, and eye clinic. All comment cards received confirmed that service users consider they receive the medical support they need. Service users commented, “ I have been to the dentist 3 times recently, xxx took me, he was so kind, helped me in and out of the car, the wheelchair, and the dentist chair”, “Of course they are looking after me. I love it here, been her nearly 6 years”, and “They do so much for us, even taking us to the hospital when we need to go. I’m very happy”. Service users were observed to be showing signs of well being and generally appeared happy and content. A comment card received from a General Practitioner confirmed that he was satisfied with the overall care provided and commented ‘I would be happy to live there when my time comes’. The manager and her deputy are currently the only people to administer medication in the home although 2 other members of staff have been trained to undertake this task. One service user commented, “I get my pills when they are due”. There are some service users who prefer to administer some or all of their own medication and risk assessments are undertaken regarding this. Although currently there are no drugs requiring refrigerated storage medication storage would be enhanced by the purchase of a lockable drugs refrigerator with minimum and maximum thermometer, and a recommendation has been made regarding this. Service users privacy and dignity are upheld. Staff always knock on doors before entering. When asked if the staff maintained their dignity service users answered, “Yes”, “Yes – very kind, very good. They keep an eye and if we need extra help they give it”, “privacy and dignity is very good”, and “yes they maintain my dignity”. A staff member commented, “The residents are all treated as individuals, they are all happy” Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily life and social activities provided at the home meets the needs and expectations of the service users; they are encouraged to maintain contact with their families and friends; they have choices in all aspects of their lives; and they receive a wholesome appealing and balanced diet. EVIDENCE: Service users are happy that the home meets their social, cultural and religious needs. Currently they receive regular visits from 4 different churches, and there is a monthly Church of England service. One comment card received had the comment ‘I am able to have Holy Communion once a month – greatly appreciated’. A service user commented, “The vicar comes to see me and we have services here”. Activities in the home include, knitting, colouring, puzzles, Scrabble, Bingo with prizes, card games arranged by the service users, and staff chat and do nails. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 13 The home holds an annual Barbeque, and the Music Man visits 4 times a year. Service users are taken out once a week in the homes own mini bus – normally to the cliffs to see boats or to Deal centre for the retired for a cup of tea and chat with their peers. Service users commented, “We have Bingo, they take us on the cliffs, they are very good about it. We make the best of it. I think you should always do things that are planned or they might not happen again”, “We always have a nice Bingo”, and “We are having a barbeque next week, some of my friends are coming”. Staff comments included “They can go out if they want to”, and “We go out for walks with them, go out in the bus, play cards, music, T.V. they have Bingo once a week, and we do 1:1’s Service users are encouraged to maintain contact with the family and friends, when asked if visitors are made welcome service users commented, “very”, “Oh Yes”, and “Yes, very welcome and always offered a cup of tea. My friend comes most days”. A visitor Commented, “Its been very good indeed, I am very satisfied”. Service users are given choices in all aspects of their lives. They commented, “Its all very casual, we please ourselves”, “we can have breakfast where we want and can do things in our own time. Its very good the way they cope”, and “I don’t like tea so I have coffee with milk instead”. A staff member commented “they have choices in everything, where they sit, toileting, time of getting up, they can stay in or go out, they choose the food they eat, everything”. Meals at the home are wholesome, nutritious, balanced, and attractively served. Special diets are catered for when necessary, at present the only special diets are one allergy and two service users needing a soft diet. Soft meals are liquidised and served separately and nicely presented on a plate to look like a normal meal Service users commented, “Meals are very good, if you don’t like it they bring something you do like”, “Its like being at boarding school”, “I always enjoy my food”, and “I am very fussy, not keen on cooked meals. I ask for a salad nearly every day and I get exactly what I want. I also have a choice of sweets”. A staff member commented, “The food is really nice – they always get a choice”. Meals can be taken in the spacious dining room or in service users own bedrooms. Service users commented, “I have meals in my room I prefer to eat alone”, and “I eat in my room because I can’t see very well”. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 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 complaints will be listened to and investigated; and that they will be protected from abuse. EVIDENCE: The home has a clear complaints policy and a copy is on display in the hallway. All complaints however minor are recorded, together with the outcome of the investigation. Service user comment cards completed confirmed that they would know who to speak to if they were not happy and would know how to make a complaint. Service users spoken to commented, “I have not got any complaints”, “if I had a complaint I would go to Brenda”, and “No complaints”. A visitor commented, “I am very satisfied” Service users are protected from abuse. Since the last inspection the home has received the Kent and Medway Adult Protection protocols. All staff have received video training on abuse, and 4 staff have attended an external course, with a further two booked for the next course. All new members of staff are checked by the Criminal Records Bureau and checked against the Protection of Vulnerable Adults register before commencing work. Staff confirmed that they would know what to do if they suspected that a service user was at risk of abuse. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25, & 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 clean, comfortable, homely environment with bedrooms that meet their individual needs EVIDENCE: Bradfield is an extended large detached property in a quiet cul-de-sac. Both the home and the grounds are attractive and well maintained. A staff member commented, “Its like a hotel”. Since the last inspection the practice of wedging open fire doors has ceased, two door openers, that close automatically when the fire alarm rings, have been fitted and more are planned The home has a large lounge, a smaller television lounge, sitting areas in the main and link hallways, and a small lounge on the second floor. There is a Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 16 separate spacious dining room. Furnishings and fittings in the communal rooms are appropriate. There is level access to the garden where service users can enjoy the fresh air and sunshine. One service user commented, “I’ve got a room I can walk straight out into the garden”. In addition to the en-suite facilities in all but two of the bedrooms, the home also has one assisted bathroom and 1 easy access shower room. Sufficient toilet facilities are available to meet the needs of the service users. Service users rooms are attractively decorated and furnished and they are encouraged to bring their own bits and pieces to personalise them. Some of the upper rooms have sea views. Service users commented, “I have my own convenience and shower”, and “ I’ve got a nice room. Its all my own bits in here”. A visitor commented, “Mother has a very nice view” All rooms are naturally ventilated and window restrictors are fitted. Where radiator covers are not fitted appropriate risk assessments are in place. Pre inspection questionnaire indicated that appropriate checks are carried out for water heating and compliance with Legionella. The home is clean, hygienic, and free from offensive odours with the exception of a slight odour in one room, which the home is actively addressing. In the interests of infection control the home have introduced the use of alcohol gel hand cleaner and all visitors are asked to use this prior to entering the home. Service users comments about cleanliness included, “Its very good, the cleaners are excellent, kind nice and fun”, “Beautiful. They come in every day Hoover, dust and polish”, and “ Its very, very clean”. Staff commented, “Its nice and clean”, and “The room with the odour is being dealt with, the carpet is cleaned almost every day”, and “The cleaning is very good”. A recommendation has been added that the home continues with their vigorous efforts to get rid of the odour in the one room. Planning permission has recently been granted to build an extension to house service users with dementia. When asked what they thought about the proposed extension service users commented, “I don’t really know”, “I think it will work out alright”, “I think it will be jolly good. People do need that sort of home”, and “Very happy to have the new wing”. A member of staff commented, “The new extension will be good and will suit individual needs”. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported and protected by the staff of the home and an appropriate recruitment procedure. Staffing levels are appropriate but need to be kept under review and planned training needs to continue to ensure service users needs continue to be met. EVIDENCE: Staffing levels on the day of the inspection visit were appropriate as some of the previous higher dependent service users are no longer in the home. However the information received with the pre-inspection questionnaire indicated that there are times when staffing levels may not be sufficient. A recommendation is therefore made that the staffing levels are kept under review to ensure they meet the minimum standard as set out in the Residential Forum Guidance and meet the needs of the service users. Currently 38.46 of staff are trained to NVQ Level 2 or above with a further three waiting to start their training. One member of staff has NVQ level 3 and another is just starting this level. A recommendation has been made that NVQ training continues as planned to ensure a minimum of 50 of staff are trained. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 18 Recruitment procedures are appropriate. Staff do not commence work in the home until 2 written references have been received, a criminal records bureau enhanced disclosure has been submitted and a satisfactory check has been received against the Protection of Vulnerable Adults register. All new staff undertake induction training and this is just being updated to comply with the new Skills for Care common induction standards. All staff have had the appropriate mandatory training. Training has already commenced in dementia care ready for the opening of the new wing. General comments from service users about the staff included, “They are very considerate and very caring here”, “I cant say there is one of the staff I can complain about, they are all good”, “They all treat me well”, “xxxxxx is full of fun”, and “The staff are nice”. A member of staff commented, “ Its an excellent home. Its somewhere you want to work. The residents are happy”. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both the manager and her daughter who is currently the deputy have completed their NVQ level 4 in care and Management, and have the relevant experience to manage the home. The ethos of the home is open and positive. The manager and her daughter, (the deputy manager), run the home on a day-to-day basis. Currently one or the other, or often both of them, are on duty at all times during the day and on call at night. This situation gives the service users a feeling of confidence in Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 20 the home. Service users commented, “Brenda is very good”, and “Rebecca is absolutely marvellous”. Although the home has quality assurance strategies in place at present it is on an informal basis. As already mentioned management are always on duty and see all residents daily, they also see all visitors, and have meetings with the staff on duty each day. The home has a development plan in place. Monthly maintenance checks are carried out plus additional checks as needed. Menus are reviewed regularly and discussions held on a 1:1 basis with residents to see if they would like anything else added to the menu. The home has received a letter from CSCI about quality assurance stating that further information would follow and they were waiting for this to arrive before a further developing their strategies. A recommendation made that Quality Assurance Strategies are developed in a more formal manner All monies held on behalf of service users are properly recorded and balanced with receipts retained. Staff supervisions and appraisal are carried out at least 6 times a year. The health, safety and welfare of service users and staff is protected by the home. Statutory training of staff is up to date and relevant. Safety certificates viewed on the day of the inspection site visit were all in date. Risk assessments are carried out for service users, the environment and safe working practices. All accidents and injuries are properly recorded and investigated General comments received on service user comment cards stated, ‘I have put my sons name down for a room. I am very happy’, and ‘So much extra is done if we require it’. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 21 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 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 3 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 4 5 6 Refer to Standard OP4 OP9 OP26 OP27 OP28 OP33 Good Practice Recommendations The home should apply for a variation to registration for the 2 service users recently diagnosed with dementia The home should purchase a dedicated drugs fridge with minimum and maximum thermometer The home are encouraged to continue with their efforts to minimise and eradicate the slight odour problem in one bedroom Staffing levels should be regularly reviewed to ensure they meet the minimum levels set in the Residential Forum Guidance and meet the needs of the service users Training should continue as planned to ensure a minimum of 50 of staff are trained to NVQ 2 or above The homes quality assurance systems should be developed in a more formal format. Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bradfield Residential Home DS0000023330.V293926.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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