Inspection on 14/12/06 for Bradford House

This inspection was carried out on 14th December 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bradford House 10/12/08

Bradford House 17/03/06

Bradford House 16/08/05

Bradford House 15/02/05

Bradford House 25/11/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Bradford House Bradford House 74 Ellington Road Ramsgate Kent CT11 9SX Lead Inspector Brenda Pears Key Unannounced Inspection 14th December 2006 10:00 Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradford House Address Bradford House 74 Ellington Road Ramsgate Kent CT11 9SX 01843 580026 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 Graham Charles Whatley Mrs Susanne Jane Whatley Mr Graham Charles Whatley Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit two (2) Services User whose dates of birth are 26/08/1940 and 03/01/1940. 19th December 2002 Date of last inspection Brief Description of the Service: Bradford House is a large property situated in Ramsgate close to local shops and amenities. Bus routes are close by and the home is not far from the local railway station and sea front. The home is currently registered for 7 service users and provides a relaxed and welcoming atmosphere with service users at the centre of all care given. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, depending on the level of support required and the staffing numbers provided. The average fee levels, as a guide at this time, are between £323.00 and £456.00 per week. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life for service users living in the home. The methods of inspecting the home included a visit to the home and discussions with the manager, service users and staff. A tour of the building and observations of both staff and service users at this time are reflected in this report and evidence outcomes. What the service does well: What has improved since the last inspection? Decoration has been completed in the upstairs lobby, one service user room and in the lower hallway. The front of the building has been painted, as has the porch area. Individual staff files have been developed and these now contain all the required information. An environmental risk assessment has been completed to ensure the full safety of service users at all times. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with the information they need about the service. They have a full assessment of their needs and know that these needs will be met by the home. EVIDENCE: All initial assessments are undertaken with multi agency participation, including care managers, service users, families/advocates if chosen by the service user. Assessments include risk assessments, full assessment of needs, what the service user wants to achieve and a detailed support plan. Any wishes expressed by a service user are noted and subsequently worked towards, both short or long-term goals are developed and supported. Current service users are also fully involved in any placement into the home, only after ensuring everyone is comfortable and happy, does a placement become permanent. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are reviewed and service users make decisions about their daily life, supporting independence and appropriate care. Service users are supported to make decisions and be involved in the running of the home, but some people with no family would benefit from having an advocate. Reasonable risks are taken where this is seen as appropriate to fully develop life experiences in a safe way. EVIDENCE: Individual care plans and goals to be attained are clearly recorded and completed after discussions with each individual living in the home and any family member or advocate chosen. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 10 Activities are chosen by each service user and supported by staff. Observations at this time, discussions with service users all confirm that due consideration is given for independence and choice. Service users are supported to take reasonable risks to allow them to undertake the activities they wish to. All risk assessments are kept under review. Service users’ personal information is kept secure. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Choices are encouraged and supported to ensure service users engage in appropriate leisure activities in the local community. Service users enjoy a balanced and healthy diet with snacks available at any time. EVIDENCE: Every day is started with each service user choosing what they will do and one service user had decided to stay in the home at the time of this inspection. Five service users attend the day centre, two go to college and two people undertake work experience. Activities enjoyed at college by service users include crafts and cookery. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 12 Following discussions with service users, a holiday was again enjoyed at Camber Sands in a caravan. This enabled walks, entertainment on site, arcades and encouraged the use of daily living skills. Photographs of this holiday showed how everyone enjoyed a variety of activities. Outings and activities are chosen by the service user and appropriately supported by staff. Photographs and records of activities and outings enjoyed by service users confirm service users enjoy local amenities and keep contact with family and friends. All relationships that are important to service users are encouraged and ongoing contact is supported. Events in the home are undertaken with involvement and support from friends and family wherever possible. Observations at this time confirm that service users choose their own activities and daily routines. Service users were seen to be enjoying visits to the local shops and deciding what they wished to do during the late afternoon. Service users in the home at this times were fully included and appeared relaxed and confident when taking part in the inspection. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18.19.20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff do ensure healthcare needs are met, consider the dignity of service users and treat individuals with respect. Medication is administered and stored appropriately. EVIDENCE: There is a policy on the administration of medication, all staff are trained and assessed prior to dispensing. Information is clearly recorded on MAR sheets and all medication files have full information regarding the reason for medication being taken and any side effects that may occur. All service users have access to appropriate healthcare professionals and visits are recorded in care plans. Any change in mediation is set out on a new MAR sheet to avoid any incorrect administration. Records clearly state appointments made and outcomes of all health support that is given. Full reviews are undertaken and the home has good support from the local doctor and community nurse. Medication is securely and appropriately stored with all record sheets that were up to date and clearly Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 14 completed. Discussions have been undertaken regarding insulin storage with the local nurse and this is now stored in a medication fridge. Temperatures of this fridge are monitored but must be recorded to ensure full compliance with requirements. All information regarding side effects of medication is kept on each service user file. Service users’ health needs are fully met and service users are protected by the home’s procedure for managing their personal care and medication. Families are kept fully informed of any incidents that affect service users. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines and practices in the home support and protect service users. EVIDENCE: There is an open and transparent working environment within the home. Respect is demonstrated for the needs of others by both staff and service users. There is a clear policy and procedure on abuse and these are updated as training is undertaken by staff. There is also additional KCC information on file with guidelines regarding dealing with abuse. Discussions with service users enforce these policies and support individuals in their daily lives. Pictures and certificates are on display to recognise the achievements of those living in the home. Service users have informal discussions when everyone is together. This enables everyone to be included and not feel too formal, while encouraging comments and discussion about all issues in the home. All matters concerning individuals are taken seriously and appropriate support is given. The home ensures reviews are regularly carried out with care managers and family/friends and this again, encourages open discussion and multi working relationships that supports service users. Families work closely with staff to support service users, ensuring continuity and appropriate support is agreed. Staff have regular contact with families by telephone. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 16 Money is stored safely and records are kept up to date and contain all receipts obtained. Service users have their own bank accounts that they manage with support as required. One service user also has an appointed solicitor. Service users have a lockable space in their rooms and the home tries to ensure that acceptable amounts of money are retained, this supports and encourages life skills and independence. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a relaxed, spacious and clean home. EVIDENCE: The home is clean and hygienic with a very homely and relaxed feeling. Service users have a very large lounge and dining room area to share and all rooms are also large with high ceilings and ample personal space. The outside of the building has now been fully painted and this presents a bright exterior to the building. Other work that has been completed includes decoration to the upstairs lobby, one service user room and in the lower hallway. Each room is very individual and reflects the personality of the service user. One person enjoys collecting various items and has put hooks around the room to put these things on display. Each room is very much an individual space and is respected as such. Any tidying is undertaken with the permission of the Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 18 service user and no items are removed without the agreement of the individual and while they are in the room. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff undertake appropriate training, are competent and qualified to work in the home. The home’s recruitment policy and practices protect service users. EVIDENCE: The staff team is small, due to the independent nature of service users, but everyone knows their job roles and responsibilities. Previous discussions with staff have evidenced a good knowledge of both service users and staffing arrangements, what hours and days staff work and the routines of each service user. Training that has been undertaken includes fire awareness and courses are booked for next year in food hygiene, health and safety, medication and challenging behaviour. Two staff are taking NVQ level 2, one person has gained NVQ level 2 and one person has NVQ level 3. The manager has level 4 in management and is also to undertake ‘Training the Trainer’. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 20 Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff and routines in the home protect service users and promote their safety and well being at all times. EVIDENCE: The home is managed in an inclusive way that ensures everyone, both service users and staff, are aware of what is happening at any time. Observations and discussions confirm that service users are comfortable and included in all discussions and plans that are made. This gives ownership to service users and makes Bradford House their own home. The well being and safety of service users is ensured through recruitment and training. Health and well being is ensured through support from appropriate professionals and up to date training being undertaken. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 22 Discussions were previously undertaken regarding toiletry products that are in bathrooms. There are now risk assessments for all these products on service user files, ensuring and supporting the health and wellbeing of service users The safety, health and well being of service users is considered at all times and the home works in a relaxed and inclusive way. Staff are trained in core skills that support service users needs and well being. Life skills and goals are supported by staff and the routines in the home are dictated by service users needs and wishes. The manager stated that staff do work well with service users, considering their safety and quality of life at all times. Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 4 X X 3 x Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA20 Regulation YA12 Requirement That the temperature of the medication fridge is regularly recorded Timescale for action 08/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Bradford House DS0000023197.V307107.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!