CARE HOMES FOR OLDER PEOPLE
Bradley Resource Centre Lord Street Bradley Wolverhampton WV14 8SD Lead Inspector
Ian Harris Unannounced 7 July 2005 08.00
th 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 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 E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Bradley Resource Centre Address Lord Street, Bradley, Wolverhampton, WV14 8SD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01902 553543 01902 553448 Wolverhampton City Council Elizabeth Heathcote Older People 23 Category(ies) of Mental Disorder (23) registration, with number Old Age (23) of places Physical Disability (23) Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1) Age 50 and over. 2) 14 rehabilitation beds and 9 respite care. Date of last inspection 11/01/2005 Brief Description of the Service: Bradley Community Resource Centre provides a range of services for older people. The home is managed by the city council’s 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 E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced 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:
Bradley Lodge Resource Centre continues to provide a very high standard of care. The Care Manager and staff are to be commended on their efforts to encourage the residents to maintain their independence through social activities within the home. The provision of a Mini bus is a great asset to the home, which allows the residents easy access to the community. The residents key-worker system is working well and ensures, that residents’ wishes are being met. Observations during the inspection saw very attentive staff providing for the individual needs of the residents. A number of residents confirmed that the Staff are very supportive and caring. The home has a very good staff- training programme, which all staff are involved in, this ensures that they are improving their knowledge and skills. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 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 standard(s) 3 and 6 Appropriate assessments of need are in place and are carried out. Residents that are in the rehab unit have a good programme that maximises and encourages independence. EVIDENCE: There is evidence on the files that all the residents undergo a full multidisciplinary assessment prior to admission. All the residents in the rehab unit have a detailed care plan, which is designed to help they regain and develop their independence and have access to occupational and physiotherapist. It was noted that last year 80 of the residents attending the unit were able to return home. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8.and 9 Each resident has a comprehensive individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration and recording of medication are good with clear and comprehensive arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a regular basis. The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that these services are provided by
Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 10 local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered, by means of a monitored dosage system in most cases. The residents in the rehab unit are encouraged as part of their care plan to self medicate under supervision. The system appears to be working very well. The home receives good support from the local pharmacist. All Senior Staff have been trained to use the system before they are allowed to administer medication. The home has very good draft policies and procedures, which are used as guidance and are an integral part of the care staff induction programme. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12 and 15 The home provides a stimulating experience for the residents where they are encouraged to maintain their independence as much as possible The home provides a range of social activities within the home designed to the capabilities of the residents The meals in the home are good, offering both choice and variety and also catering for special dietary needs EVIDENCE: The Team leader stated that the residents are consulted regarding the day-today running of the home through residents’ meetings reviews, questionnaires and by feedback from their key-worker. The routines and activities within the home are flexible and are built around the needs of the residents. The home has a Staff members designated to organised social and leisure activities and identify interests that the residents wish to pursue. This has proved very successful in promoting and encouraging participation in the wide range of activities programme. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 12 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 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 not received any formal complaints since the last inspection 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 N.V.Q. training, which the Staff is undergoing. There have been no incidents that have needed to be recorded or reported. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19 and 26 The standard of the environment within the home and the garden is very high providing the residents with attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home has been established for many years and has undergone major alterations three years ago in order to improve accommodation for older people. The home is maintained to a high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. 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 E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. 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, Positive Approaches to Dementia Care and Safe Handling of Medication, Ageism, Risk assessment and Managing Safety. The home operates an acceptable procedure and the Local Authority is registered in order to complete the appropriate checks on staff. However there was no evidence within the home that all the checks are being carried out. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,37, and 38 The home is a well managed one, where residents interests and welfare are well protected and promoted. EVIDENCE: The routines and activities within the home are flexible and built around the needs of the residents’. There was also evidence to show that staff, consult with the residents’ regarding the choice of meals and activities within the home. There are regular resident unit meetings where residents are consulted about menus and entertainment etc. Also the Key-Worker system in operation is designed to ensure residents’ wishes are responded to. The home is operating a good system to assist residents’ with the safe handling and keeping of their personal finances and good records are being kept of all transactions made. All the records and administrative procedures within the home that was, inspected were found to be well ordered and maintained.
Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 16 The home has a good heath and safety policy and all staff are aware of their responcibilities regarding these issues and all of staff have received training. Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x 3 3 Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 18 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 OP 29 Regulation Schedule 2 Requirement A method of recording references, medicals and CRB checks must be developed as files are kept centrally off site (Timescale of 31/03/05 not met) Regulation 26 visit must take place as required by the regulations (Timescale of 01/02/05 not met) Timescale for action 01/08/05 2. OP 33 26(2)(b) 01/08/05 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. Refer to Standard Good Practice Recommendations Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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
© 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 Bradley Resource Centre E56 000035751 Bradley RC v234892 AI 070705 Stage 4.doc Version 1.30 Page 20 - 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!