Inspection on 19/09/07 for Bradstowe Lodge

This inspection was carried out on 19th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Bradstowe Lodge 12/07/06

Bradstowe Lodge 12/01/06

Bradstowe Lodge 22/10/04

Bradstowe Lodge 28/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Bradstowe Lodge Bradstowe Lodge 22 Victoria Parade Broadstairs Kent CT10 1QL Lead Inspector Christine Lawrence Key Unannounced Inspection 19 September 2007 10:40 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 Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradstowe Lodge Address Bradstowe Lodge 22 Victoria Parade Broadstairs Kent CT10 1QL 01843 861962 01843 604672 enquiries@radstowelodge.org.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) Kent Old People’s Housing Society Limited Vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12 July 2006 Brief Description of the Service: Bradstowe Lodge is a large older style property, which has twenty-one single bedrooms. Every room has a call bell and TV point. There is a small shaft lift in the home. The home caters for men and women over the age of 65 years. It is located on Broadstairs’ seafront, within walking distance of the centre of town and therefore close to all amenities. There is a small paved patio area to the rear of the premises, together with a paved area to the front of the premises. Both areas are maintained for the use of residents. On the road parking is limited to one hour around the vicinity of the home. Information from the home on the day of the inspection indicates that the fees range from £345.00 to £375.00 per week. A copy of the last inspection report is kept by the front door and there is a website at www.bradstowelodge.org.uk which provides information about the home and encourages people to contact them directly for more information. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit to Bradstowe Lodge was unannounced and I was there from 10.40 till 14.40. I spoke to the head of care and other staff and to the coordinator of the management committee. I made observations of staff supporting and caring for residents and I observed lunch being served. I spoke to several residents and made a tour of the building with a senior member of staff. Residents completed eleven surveys and relatives completed ten surveys and information from them is used in this report. There were also four completed by health professionals (three GPs and one community nurse) and two completed by staff at the home. The registered manager has very recently left but she provided further information by completing the Annual Quality Assurance Assessment (AQAA) form. Information from the previous inspection is also used for this report. What the service does well: What has improved since the last inspection? The care plans have been improved to reflect that they are monitored and reviewed regularly. The medication administration procedures are also improved. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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 Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs. EVIDENCE: There is clear evidence that a detailed assessment – including a visit to the prospective resident - is carried out by the manager or a senior member of staff before a decision is made that the home will be able to meet the needs of the resident. This includes gathering information from the individual, their relatives if appropriate and any other professional involved. The head of care was clear about seeing people as individuals and this is reflected in the initial assessment. The assessment allows for information to be gathered regarding ethnicity, religion, age and gender. Information about any disability would be covered throughout the assessment. There is not yet a question regarding sexual orientation. This information is used to compile a care plan (see standard 7) which gives clear guidance to staff Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: The care plans seen contained all the relevant information relating to the identification of individuals’ social and health care needs and how they should be met. The care plans are considered working tools and are kept up to date. They are clearly written and contain assessments of any risk. The records showed that health care professionals are involved as and when required. I observed medications being given out during lunchtime. This was appropriately managed. The records seen were all properly completed and the storage was satisfactory. Only senior staff give out medication and they have received training. One member of staff said that medication was very Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 10 important and you had to make sure you did it properly. There is no designated, private space for residents to meet with their relatives. Some bedrooms are big enough to entertain guests but others are not. The dining area can be used outside of mealtimes but this is also close to the staff workstation. The ‘conservatory’ area is not a particularly welcoming area and is also the throughway to the rear patio. The head of care and other staff confirmed that dignity and privacy are an important part of the care provided at Bradstowe Lodge. Medical examinations would take place in the residents’ own room and personal care would be in own rooms or bathroom areas. The chiropodist sees residents in the ‘conservatory’ area but it is not clear if residents are choosing that place or if it is just what has been established. Residents should be asked about their preferences. It might also be possible to offer the use of the hairdressing room if not being used for hairdressing. I observed respectful and polite interactions between staff and residents. The care plans reflect residents’ preferred name. Some comments included in surveys were - …staff are caring, polite, respectful, kind and gentle…- …I like the respectful atmosphere…- …she is treated with the respect she deserves…-…I believe Bradstowe Lodge treats everyone on an individual basis…-…they treat residents with respect. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to as far as possible and that they will be enabled to maintain contact with friends and family. Residents are given opportunities to make choices, therefore allowing for some level of control over their lives. The meals in this home offer both choice and variety and catering for special needs. EVIDENCE: Of the ten surveys completed by relatives 4 answered ‘always’ to the question “Does the service support people to live the life they choose?” and 4 answered ‘usually’. Residents’ responses to the question “Are there activities arranged by the home that you can take part in?” were 4 ‘always’, 3 ‘usually’ and 3 ‘sometimes’. The home has recognized that although improvements have been made with regard to activities, outings and general stimulation, there is still a need to keep this under review. There are no designated staff to undertake formal activities, they just have to be fitted in when staff are able. It would be better if the rota was devised to ensure that activities were properly and reliably scheduled. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 12 It is clear from talking to residents, reading the surveys and talking to staff, that residents are supported to maintain contact with friends and relatives. There were lots of examples of residents making choices and decisions about what they wished to do. The meal observed looked and smelt appetizing. There was a great deal of praise for the food provided at Bradstowe Lodge. Of the eleven residents who completed surveys 8 answered ‘always’ to the question “Do you like the meals at the home?” and 2 answered ‘usually’. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents/their representatives can be confident that any concerns will be taken seriously and responded to. Staff spoken to were very clear about their responsibilities relating to protecting residents. There are policies and procedures in place which include whistle blowing and systems relating to protecting residents’ finances. EVIDENCE: The home’s procedure for complaints was reviewed in January 2007. All the surveys from residents and relatives indicated that everyone knows how to make a complaint. However, one relative included the comment that there was a complaints book by the entranceway. This book is not an appropriate way for people to express a concern or complaint, as it does not allow for confidentiality. As it is not clear from the survey responses if any other people think this is the way to make a complaint the home should undertake to make things clear. The information in the AQAA completed by the registered manager before she left indicates that the ethos within the home was very much about trying to deal with any small issues before they become of concern to anyone. This was confirmed in discussion with members of staff and residents. Staff spoken to were very clear about their responsibilities relating to protecting residents. There are policies and procedures in place which include Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 14 whistle blowing and systems relating to protecting residents’ finances. External trainers are used for adult protection and this is reinforced in house on a day-to-day basis. Both the manager, in the AQAA and the administrator during the site visit, confirmed that the procedures for dealing with residents’ monies is stringent. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home which is homely, clean and hygienic. They would further benefit from improved facilities and décor. EVIDENCE: Improvements to the home have been planned for a while now. Some decoration has taken place in the last 12 months and some flooring has been replaced. Some new furniture has been purchased. There is no definite date for any work to be started. Some areas of the home will need attention in the interim and this needs to be planned to ensure that standards are reasonably maintained until the planned extensive work begins. One relative said “…the home is always clean and tidy…” and residents were positive in their comments about cleanliness and freshness. A new washing machine, with a ‘sluice’ facility has been purchased. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: The surveys completed by both residents and relatives were a mixture in terms of the questions relating to sufficient staff and meeting needs. Most of the responses from relatives and residents were a mixture of ‘always’ and ‘usually’ but there was one resident who answered ‘sometimes’ in response to the question asking “Do you receive the care and support you need?” and there were two residents who answered ‘sometimes’ in response to the question “Are staff available when you need them?” One resident commented that …staff seem too busy to help or are not available… The staff surveys completed included one comment saying that sometimes “…we are short staffed…” and to the question “Are there enough staff to meet the individual needs of all the people who use the service one answered ‘usually’ and one answered ‘sometimes’. Staff spoken to and who completed surveys were positive about how the staff team developed under the management of the manager who has just left. Overall there seems to be sufficient staff but this needs to be carefully monitored, especially in the absence of a registered manager. There is a mixture of skills and experience within the staff team. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 17 More than half of the care staff have national vocational qualifications (NVQ) level 2 or above. Staff spoken to and who completed surveys confirmed that checks were carried out prior to their appointment and the recruitment procedure includes application forms, terms and conditions of employment and references being sought. Induction and ongoing training is provided. This was confirmed by staff and in the AQAA. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have benefited from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: As previously noted the manager has recently left. A new manager has been appointed and is due to start work in early October. The co-ordinator of the management committee, who is also the ‘responsible individual’ representing the provider, is currently assuming management responsibility in the short term. There is also a head of care and a number of senior carers. Information provided in the AQAA by the registered manager prior to leaving, as well as written and spoken comments from staff members, indicates that the staff Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 19 team are working well together and providing a good service to residents. The management structure of registered manager, head of care and senior carers works well. The provider needs to ensure that the good practice established is not lost in the changeover of managers. All professionals need an element of support and supervision, including managers. It may be difficult for a manager to receive appropriate supervision, particularly in a small company. It may be helpful for the provider to access a mentor or another professional for support and supervision of the new manager in relation to professional practice. I was informed that regular audits take place and questionnaires are sent to relatives. Residents are listened to and their opinions are discussed within the staff group and with the management committee. One resident gave me an example of how something changed within the home after it had been raised. As previously noted, the systems for managing residents’ finances are stringent. This was confirmed by senior staff, information provided through the AQAA and by the administrator. The maintenance and servicing contracts are appropriate and up to date. Training regarding health and safety is provided to staff. Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23 Requirement A plan should be made of what work needs to be done in the next 12 months to ensure standards are maintained prior to any refurbishment. Timescale for action 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Bradstowe Lodge DS0000023329.V348577.R01.S.doc Version 5.2 Page 23 - 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. 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