CARE HOMES FOR OLDER PEOPLE
Bradley Resource Centre Lord Street Bradley Wolverhampton West Midlands WV14 8SD Lead Inspector
Mr Ian Harris Announced Inspection 24th October 2005 08:00 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 Bradley Resource Centre DS0000035751.V259606.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 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. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bradley Resource Centre Address Lord Street Bradley Wolverhampton West Midlands WV14 8SD 01902-553543 01902-553448 helen.heathcote@wolverhampton.gov.uk 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) Wolverhampton City Council Mrs Elizabeth Helen Heathcote Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23), Old age, not falling within any of places other category (23), Physical disability (23) Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Age 50 and over 14 rehabilitation beds and 9 respite care Date of last inspection 7th July 2005 Brief Description of the Service: Bradley Community Resource Centre provides a range of services for older people. The home is managed by the city councils Social Services Department and supports older people and their carers in the south east of the city. It provides a rehabilitation unit with 14 single bedrooms, Rehabilitation is usually provided for a six-week period by a team of rehabilitation assistants, occupational therapists and physiotherapists based at the centre. A Respite Unit with nine single bedrooms provides short-term care for older people. It also provides carers with a break from their role as carers. A day care service which is not inspected and a Home Support Service which is inspected and is addressed in a separate report also operate from the centre It is close to a bus route and the metro. Nearby are shops and a public house. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 4 hours. The main purpose of the inspection was to check the progress made by the home regarding the recommendations and requirements made in the last inspection report. This home has a history of meeting and exceeding national minimum standards and providing a good service for people; consequently on this occasion only those standards identified as “key” by CSCI have been inspected. The fullest co-operation was given to the inspection officer by the Care Manager staff and residents. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 9 of the 36 care staff were on duty, and 10 of the 23 residents were spoken to. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable and safe with contented residents. What the service does well: What has improved since the last inspection?
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 6 Since the last inspection considerable amount of work has been carried out within the home they include replacement double glazed windows to the ground floor, replacement rear door to the garden and a new porch. Also the main entrance, staffroom, Kitchen, Duty Office, Two Dining rooms and lounges have been redecorated. 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. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 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 Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 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 and 5 The home provides clear and accurate information to prospective residents on the services provided, enabling them to make a properly informed choice about the home. All residents are given a written contract on admission to the home. EVIDENCE: The home provides clear and accurate information to prospective residents on the services provided, in the form of a brochure and a service users guide enabling them to make a properly informed choice about the home. The service users guide has recently been updated and a copy is placed in all of the bedrooms. Each resident is provided with a detailed service users guide and statement of terms and conditions when they move into the home. This statement contains the required information. The statement is clear on what the fees do and do not cover. There was evidence on resident’s individual files to show that all the residents are provided with a statement of terms and conditions of residence at the time of admission.
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 9 Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 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): 10 and 11 The Staff are sensitive to the individual needs of each service user and meet these in a professional manner EVIDENCE: All residents have single rooms. No personal care interventions take place in communal areas. Observed practice on the day of inspection was appropriate and showed respect for the residents. Consultation with health care and social care professionals is carried out within the resident’s bedrooms. Visitors are able to meet residents in their bedrooms. Residents and visitors spoken with were keen to inform the inspector that the staff are very caring, supportive and always willing help them with their care needs. As Bradley resource Centre caters for respite and rehabilitation and has no permanent residents deaths are usually unexpected. . The home has clear policies with regard to dying and death and staff have received loss and bereavement training. The Care Manager and Care Staff are conscious of the need to provide extra support to the residents in their final days at the home. All the Staff are very aware of the need to be particularly sensitive, caring and attentive to the residents needs prior to their death. The care manager is also aware of the
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 11 support the staff should provide to relatives and colleagues. Resident’s relatives are encouraged to be fully involved in the residents care at this particular time. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 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): 14 and 15 Individuals are enabled to exercise choice and control over their lives wherever possible balancing the rights and risks with each individual The meals in the home are good homely type offering both choice and variety and also catering for special dietary needs. EVIDENCE: Service Users and staff stated that the Service Users are consulted regarding the day-to-day running of the home through unit meetings, reviews and by feedback from their key-workers. The key-workers also identify interests that the service users wish to pursue. The observations made, examination of menus and the comments received from the service users and their relatives confirmed that particular attention is given to the service users’ individual preferences. All of the comments made by service users regarding the quality, quantity and variety of food provided are complimentary. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 13 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 and 18 The home has a good complaints procedure with some evidence that residents’ views are listened to and acted upon. The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, copies in every bedroom and a notice on the notice board in the hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has received one formal complaints since the last inspection this and all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in an in house training programme and the homes induction programme and N.V.Q. training, which the Staff is undergoing. There have been no P.O.V.A. incidents that have needed to be recorded or reported. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 14 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 and 26 The standard of the environment within the home is high and there is a rolling programme of maintenance providing the residents with a very attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. The garden needs to be maintained to a higher standard. EVIDENCE: The home has been established for many years and has undergone major alterations in order to improve accommodation for older people and provide a rehabilitation unit and respite unit. The home is maintained to a high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. Since the last inspection considerable amount of work has been carried out within the home they include replacement double glazed windows to the ground floor, replacement rear door to the garden and a new porch. Also the main entrance, staffroom, Kitchen, Duty Office, Dining rooms and lounge have been redecorated.
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 15 The home was found to be clean and tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received training in food hygiene and Infection Control. All staff appeared to be conscious of the dangers of cross infection. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 16 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, and 30 The home is well staffed with adequate numbers and skill mix of staff. The staff have a very good understanding of the residents’ support needs. The home has good policies and procedures regarding the recruitment of staff. There is a very good training programme in place that ensures that the staff are competent to do their job. EVIDENCE: The inspection of staff rotas and discussions with staff indicated that the home is well staffed at all times and has a low turnover of staff. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. The Care Manager and staff are committed to developing their knowledge and skill through training. The home has a good induction programme and training programme, which meets the T.O.P.S.S standards. In addition to the N.V.Q training programme staff have attended training courses on the following subjects. Manual Handling and lifting, Fire prevention, First Aid and Basic Food Hygiene, Intermediate Food Hygiene, Managing safety, Disability equality, Cultural Awareness, loss and Bereavement, Safeguarding Vulnerable Adults Positive Approaches to Dementia Care and Safe Handling of Medication, Wound Care, Ageism, and Risk assessment. The home operates an acceptable recruitment procedure and the Local Authority is registered in order to complete the appropriate checks on staff.
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 17 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, 34 and 36 The manager has very good leadership skills and has a clear development plan and vision for the home, which he has effectively communicated to the residents’, staff and relatives. The Residents’ finances, are being handled appropriately by designated senior staff EVIDENCE: The Care Manager is qualified in both practice and management and has considerable experience in caring for older people in residential homes There are clear lines of accountability within the home and is very supportive of both staff and residents. Observations made and discussions with residents and staff indcated that the Care Manager is very approachable and operates an open door policy. The staff and residents who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. .
Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 18 All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. It was noted that formal supervision is taking place on a regular basis. Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 19 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 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X 3 X X Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bradley Resource Centre DS0000035751.V259606.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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