CARE HOME ADULTS 18-65
Bradford House Bradford House 74 Ellington Road Ramsgate Kent CT11 9SX Lead Inspector
Brenda Pears Unannounced Inspection 09:30 17 March 2005
th Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 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.V271690.R01.S.doc Version 5.0 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.V271690.R01.S.doc Version 5.0 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.V271690.R01.S.doc Version 5.0 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. 16th August 2005 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. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 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 of service users living in the home. The methods of inspecting the home included speaking to the proprietors, staff, service users and observations of the environment and discussing the routines of the home. This report reflects the findings at this and at the previously announced inspection. Any requirements not completed or assessed from the previous inspection are repeated at the end of this report. What the service does well: What has improved since the last inspection? What they could do better:
Discussions were undertaken regarding medication storage. While medication is appropriately stored, this area is subject to severe changes in temperature and therefore medication must be moved to a more suitable area. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 6 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.V271690.R01.S.doc Version 5.0 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.V271690.R01.S.doc Version 5.0 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 Individual goals and aspirations are set for each service user to encourage development and life fulfilment. EVIDENCE: Thorough assessments are undertaken and discussions with each service user and family/advocate/care manager to ensure needs are met and goals are set. Any wishes expressed by a service user are noted and subsequently worked towards. Both short or long-term goals are developed and supported. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 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): 10 Records are stored appropriately and with the knowledge of each service user, ensuring privacy and inclusion. EVIDENCE: Personal care plans are appropriately stored and locked. Daily diaries are kept up to date to describe how each day is spent and what events have impacted on daily lives. Activities are chosen by each service user and supported by staff. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14 Service users take part in local groups, enjoy local amenities and develop skills to encourage independence and achievement. 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. 5 service users were just leaving to go to the day centre and the remaining service user was attending college. Activities enjoyed at college by service users include crafts and cookery. One service user has been successful in achieving a City and Guilds level 2 in cookery. A photograph of the presentation of this award was on display in the dining area. Following discussions with all service users, a holiday was 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 themselves dancing and joining in competitions and making new friends. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 11 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): 18,20 All health care needs are met and appropriate policies/procedures are in place to support service users with regard to medication. EVIDENCE: 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. Discussions were undertaken regarding medication storage. While medication is appropriately stored, this area is subject to severe changes in temperature and therefore medication must be moved to a more suitable area and internal and external medication stored on separate shelves. One service user currently has insulin injections and the district nurse was previously giving injections. Following training and assessments by the district nurse, staff are now competent to administer insulin. The district nurse carries out these routines on Monday as qualified staff are not on duty and this also gives an opportunity for assessment and evaluation. Blood sugar levels are checked and recorded regularly. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 12 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 Service users are protected in the home and they are listened to and supported at all times. 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. 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. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 13 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 Each individual room is comfortable, personalised and promotes independence. 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. Work is still being undertaken to complete the internal redecoration of the home and currently, some external work is being undertaken. There is currently scaffolding to the front of the property, as some roof tiles need to be replaced. While the scaffold is in place, some work will be undertaken to the front of the building. Work was also being carried out in the garden at the time of this inspection to ensure this can then be used by service users when the good weather arrives. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 14 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): 31,32 Staff work together to support service users and are fully aware of their roles and responsibilities, ensuring continuity and teamwork. EVIDENCE: Most staff working at the home have been recruited locally, through either knowing the manager or being recommended by other members of staff. The staff team is small, due to the independent nature of service users, but everyone knows their job roles and responsibilities. At the time of this inspection there were 2 staff on duty to support service users getting prepared to go to the day centre. Staff expressed a good knowledge of both service users and staffing arrangements, what hours and days staff work and routines of each service user. Training that is planned to be undertaken includes care planning, first aid, infection control and ongoing NVQ training. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 15 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 The home is run in the best interests of the service users at all times. EVIDENCE: 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. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Bradford House Score 3 X 2 x Standard No 37 38 39 40 41 42 43 Score 3 X X X X X x DS0000023197.V271690.R01.S.doc Version 5.0 Page 17 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation Requirement Timescale for action 30/04/06 YA12,13,23 Medication to be stored in a suitable area to provide a stable temperature at all times. 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 Refer to Standard YA42YA41 YA42 YA24 Good Practice Recommendations That staff files are reviewed to ensure all necessary paperwork is in place and in an orderly condition. That an environmental risk assessment is undertaken. That the redecoration programme continues until all areas have been addressed. Bradford House DS0000023197.V271690.R01.S.doc Version 5.0 Page 18 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
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