Inspection on 02/12/08 for Bradley House

This inspection was carried out on 2nd December 2008.

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

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.

Other inspections for this house

Bradley House 04/12/07

Bradley House 03/08/06

Bradley House 27/02/06

Bradley House 03/10/05

Similar services:

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Snydale Care Home

Hawkhills

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Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bradley House Bradley Road Grimsby North East Lincs DN37 0AJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rob Padwick     Date: 0 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Bradley House Bradley Road Grimsby North East Lincs DN37 0AJ 01472878373 01472277548 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dryband One Ltd Name of registered manager (if applicable) Christine Angela Erbil Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Bradley House is situated close to the village of Bradley and is approximately one mile from the centre of Grimsby. The home has a view of the surrounding countryside. The home is registered to provide residential and nursing care for older people including those with dementia, physical disability over 65 years and physical disability over 18 years. In addition the home provides respite and day care services for up to six people. The home consists of two storeys, the upper floor accessed by both stairs and a passenger lift. There are thirty six single rooms, twelve of which are ensuite and a further four large rooms situated on the first floor which can be shared or used as single. Care Homes for Older People Page 4 of 27 care home 44 Over 65 4 44 2 0 0 2 Brief description of the care home The gardens to the front and side of the building are spacious and contain mature trees, shrubs and flowerbeds. The home has a small internal courtyard accessible from two separate corridors. There is also a patio area with garden furniture. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home is also available from the manager. Information given by the manager indicated the current fee ranges from 361.00 pounds to 408.18 pounds per week, depending on the type of care that is required. Additional top up fees are charged for a single or en-suite room, or a single room with a lounge area. There are additional charges for hairdressing, private chiropody treatment, toiletries and newspapers and magazines. A full list of prices for these additional services is available from the manager. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since its last key inspection, which took place on 10th Care Homes for Older People Page 6 of 27 December 2007 and includes information gathered during a visit to the home. As part of the inspection process,we sent an a self assessment document that the registered person must complete and return to us. This should show how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the manager and information from this used as part of the inspection process. Other information used, included direct feedback from people living in the home, together with responses gained from relatives and professional staff, and official notifications received by the Commission for Social Care Inspection. This information helps us reach judgments about the service provided. The site visit took place on 2nd December 2008 and lasted for 7 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to her, we talked staff who were on duty and people living in the home. We looked round the building, including bedrooms and shared areas and we inspected the records of peoples care, staff files, health and safety documents and other records that were kept by the service. What the care home does well: What has improved since the last inspection? What they could do better: Confirmation the service can meet the needs of people moving into the home should be provided to ensure they can be formally assured of this and care plans should be further developed, to help staff meet the individual strengths of people living in the home as well as their needs. Training on the Mental Capacity Act should be provided to help staff support people living in the home to take sensible risks and the manager should ensure staff have the right skills to help them engage with people to maximise their opportunities for individual choice and self control. Complaints about the home should be clearly recorded so that outcomes from these are clear and transparent and new care staff should only allowed to start work after a full and satisfactory CRB and POVA check has been received for them. Staffing levels should be further reviewed to ensure enough of them are available to meet the needs of people living in the home at all times. Management and administrative systems should be further developed to help support Care Homes for Older People Page 8 of 27 the manager to encourage the involvement of staff with people living in home and the frequency of meetings with staff and people living in the home should be increased to make sure there are good channels of communication and enable direction and leadership to be provided. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available to help people thinking about moving in to the home to make an informed decision about it and the needs of people living in the home are assessed to ensure the service can meet them appropriately. Evidence: The provider had developed information about the home to help people who are thinking about using the service to make an informed decision about it, as was previously required. Information provided by the manager stated Families are made to feel welcome and given time to not only look around the home but time is spent discussing (various) problems. A relative confirmed this and told us Although we had no previous knowledge about the home, I feel we were lucky in our choice, the support of the staff was exceptionally sympathetic (with) all questions being dealt with in a caring manner. Case files belonging to people living in the home, contained information about their needs which the manager had obtained before they had moved Care Homes for Older People Page 11 of 27 Evidence: in, to ensure the service could meet these appropriately. However, there was no written evidence that prior confirmation of this had been provided and a recommendation is made, to ensure people can be formally assured their needs will be met before they commit themselves to a placement at the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were appropriately supporting the health and personal care needs of people living in the home to ensure that their individual wishes and feelings about these are respected. Evidence: People living in the home indicated their individual health and personal care needs were being met and case files contained care plans for these, to ensure their personal wishes and feelings could be respected. The care plans inspected covered details about a range of needs, together with information on how staff should support people with these. The care plans were detailed with records and charts and there was evidence they were being regularly monitored and reviewed to ensure they remained accurate and up to date. People living in the home and their relatives confirmed they were involved in reviews of their care and one relative told us whenever asked for medical help (staff) are always there to help you. The self assessment for the service indicated a holistic approach is adopted so support can be individual and person centered, however, it is recommended care plans are further developed to enable greater Care Homes for Older People Page 13 of 27 Evidence: opportunities for individual strengths of people to be maximised as well as their needs. Following our last visit to the home, we made requirements and recommendations to ensure a human rights based approach was further developed for the service and we saw evidence of progress with this, with staff currently taking a course about dementia as previously required. Staff told us they supported people to be as independent as possible and there was evidence of good key worker involvement in one file of good key worker involvement, in order to help learn more about peoples individual wishes and feelings. We saw evidence people living in the home had been assessed for a variety of known risks, together with strategies for the management of these. The manager has previously attended a course about the Mental Capacity Act, however a recommendation is made that further training on this is provided, so that staff can support people better to take sensible risks and take as much responsibility for these as is possible. We made requirements and recommendations previously about the recording of medication given to people living in the home. We checked the records for these and saw evidence of appropriate action to implement these and that they were now being accurately recorded. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are generally provided with opportunities to experience a lifestyle that meets their needs, however further development of these would enable their well being to be better met Evidence: The home has a part time activities organiser and we saw evidence of various events planned to take place over the coming month. On the day of our visit, Christmas decorations were being put up and the activities worker came in to organise a clothes party, so opportunities could be provided for people to buy presents and gifts. Whist there was evidence in the records of regular events that had taken place in the home, some comments received from people and their relatives indicated this aspect of the service could be further developed. One relative commented, Activities are arranged but my husband is unable to take part and we observed a number of people looking listless and bored. The group of people living at Bradley House have variety of needs and a significant number have dementia or visual impairments. A requirement was made that appropriate activities are developed for this group of people the last time we visited, and whilst there was evidence of work carried out to implement this; with key worker input, dementia training and plans to increase further opportunities for Care Homes for Older People Page 15 of 27 Evidence: them, a recommendation is made that the manager ensures staff have the right skills to help them engage more actively with people with dementia and help them to maximise opportunities for greater individual choice and self control. Relatives confirmed they were able to take part in the life of the home and a number visit very regularly to maintain links with their loved ones and assist in their care. Relatives spoke positively about the caring nature of staff and one told us she was 110 satisfied with the care provided. We observed staff supporting people sensitively at mealtimes and relatives confirmed the food was of good quality. Information provided by the manager indicated improvements had been made to the menus following consultation with people living in the home and this was confirmed by one person who stated the food was much better now as the menu has recently been changed. There was evidence in the case files that nutritional needs of people living in the home are appropriately monitored and menus inspected provided evidence of a healthy and varied diet. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The concerns of people living in the home are taken seriously and staff training is provided to ensure they can safeguard them from abuse. Evidence: The service had a comprehensive complaints procedure to ensure the concerns of people living in the home are taken seriously and a copy of this was displayed on a notice board in the service. The self assessment for the service indicates this procedure is given to people when they move in to the home and those who we spoke to confirmed they were aware of what to do should they have any concerns. People told us staff listened to them and the homeowner had met with them about previous concerns. We received a complaint about the service since the last time we visited, which the homeowner investigated and we subsequently received evidence of satisfactory action taken to resolve. The complaints log contained evidence of nine complaints received by the home, together with action to resolve these within given timescales. Some follow up actions about these however were clearer than others and a recommendation is made about this. The service had policies and procedures to ensure people living in the home are safeguarded from abuse and we saw evidence of staff training carried out about this as was previously required. At the time of this visit, the Local Authority was investigating a safeguarding referral, however the outcome of this had not yet been reached. Care Homes for Older People Page 17 of 27 Evidence: Information provided by the manager indicated aspects of adult abuse were discussed in individual staff supervision sessions and staff who we spoke to demonstrated appropriate understanding of this. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are provided with a environment that is comfortable safe and well maintained Evidence: The building was warm and homely and had a welcoming atmosphere and was in the process of being decorated for Christmas. Relatives were generally positive about the environment provided, although some indicated there were times when cleaning could be improved. A person living in the home told us I feel the cleaning is adequate but its impossible to be 100 all the time. On the day of our visit the building was clean and hygienic and we saw evidence of regular work carried out to ensure it was kept free from unpleasant smells. Bedrooms were individually decorated and adaptations in place to help maximise the independence of people living in the home. The communal areas were spacious in nature and provided people with a variety of comfortable areas and the manager told us about plans to develop the gardens. The service shares a full time maintenance worker with other homes owned by the Provider and we saw evidence of a programme of routine repairs to ensure the building was appropriately maintained. The laundry was neat and tidy there we saw evidence of work carried out to provide staff with further infection control training as was previously required. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst staff are provided with training to help them to do their jobs, improved recruitment practices would ensure people living in the home are safeguarded better and that new staff are safe to work with them Evidence: People living in the home and their relatives were very positive about the caring nature of the staff and told us The staff are always warm and friendly and they are Always helpful, whilst a comment card stated,The carers are always fantastic with me, I cannot fault them at all. We observed staff interacting with people in a sensitive manner and those staff who we talked to were positive and committed to their work. Some people however, indicated times when staff availability needed improving and that Sometimes they may be short staffed because of illness, so we have to wait a little longer. The manager indicated staffing levels are monitored against the needs of people living in the home, however a recommendation is made these are further reviewed to ensure sufficient staff are available to meet the needs of people living in the home at all times. The last time we visited a requirement was made that staff training is developed to ensure staff have the right skills and we saw evidence of good progress to implement this and that training needs were identified and updated regularly. The self assessment for the service stated Staff work in a culture that training is essential to their job role and staff confirmed this and stated We have lots Care Homes for Older People Page 20 of 27 Evidence: of training, everything we learn stipulates dignity and respect. Staff files inspected contained evidence of appropriate induction and mandatory training, together with certificates for a range of courses and confirmation of supervision and appraisals to ensure their continued career development. The service had recruitment procedures and policies to ensure staff are safe to work with people living in the home. Whilst staff files contained evidence of checks of identity and Protection of Vulnerable Adults checks (POVA First) carried out, the files of recently employed members of staff indicated they had been allowed to start work before a full Criminal Records Bureau check had been received. The manager was reminded this practice should only be allowed in exceptional circumstances and a recommendation is made about this. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the service was being generally well managed, improved administrative and management systems would enable the needs of people living in the home to be better met and ensure that their health and safety is protected and promoted. Evidence: People living in the home indicated the service was being generally well run and we saw evidence of this in the records kept in the home. The manager is appropriately qualified and there was evidence she is committed and takes an open and hands on approach. Staff comments confirmed this and a relative told us The Matron and staff are always available, the Proprietor by appointment and independent of staff. Quality Assurance systems were in place to enable the service to be monitored against its aims and objectives and people living in the home and their relatives confirmed they were able to contribute ideas to help influence the running of the home. We saw evidence of questionnaires issued to people living in the home and their relatives, together with actions resulting from these developed centrally by the Provider. Whilst Care Homes for Older People Page 22 of 27 Evidence: there was evidence of meetings with people living in the home and the staff, these were not always being held frequently, and it is recommended the frequency of these is increased. The manager had moved her office recently and whilst administrative systems were in place, it was not always easy to find some things that we needed. A recommendation is made about this to enable the manager to encourage the further involvement of staff with people living in home. Regular checks of various aspects of the service were being carried out and records of finances belonging to people living in the home were accurately kept. Maintenance records contained evidence of regular checks of equipment together with a range of up to date certificates to ensure the safety of people of living in the home was promoted. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 4 The Registered Person should ensure confirmation that the service can meet the needs of people who are thinking about moving into the home is provided to them to ensure they can be formally assured of this before they commit themselves to a placement at the home. The Registered Person should ensure care plans are further developed to enable greater opportunities for the individual strengths of people to be maximised as well as their needs. The Registered Person should ensure training on the Mental Capacity Act is provided to staff to help them support people living in the home to take sensible risks and take as much responsibility for these as is possible. The manager should ensure staff have the right skills to help them engage actively with people living in the home in order to help them to maximise their opportunities for individual choice and self control. The Registered Person should ensure actions from complaints made about the home are clearly recorded so that outcomes from these can be clear and transparent. The Registered Person should ensure staffing levels are further reviewed to ensure sufficient staff are available to Page 25 of 27 2 7 3 7 4 14 5 16 6 27 Care Homes for Older People meet the needs of people living in the home at all times. 7 29 The Registered Person should ensure that new care home workers are only allowed to start work in the home when a full and satisfactory CRB and POVA check has been received for them. The Registered Person should ensure the management and administrative systems for the home are developed to support the manager and enable her to encourage the further involvement of staff with people living in home. The Registered Person should ensure the frequency of meetings with staff and people living in the home are increased to ensure good channels of communication and enable direction to be provided. 8 31 9 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!