Inspection on 13/11/06 for Bradwell House

This inspection was carried out on 13th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bradwell House 12/11/07

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Southfields

Thorndene

Insight - Eastchurch

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Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Bradwell House 14 Brockhill Road Hythe Kent CT21 4AQ Lead Inspector Wendy Jones Unannounced Inspection 13 November 2006 11:30 Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 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 Bradwell House DS0000066868.V304246.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradwell House Address 14 Brockhill Road Hythe Kent CT21 4AQ 01206 828290 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) www.achuk.com Aitch Care Homes (London) Limited Post Vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Bradwell House is a newly registered home that is owned by Aitch Care Homes Limited (ACH). It is a large detached house located in Hythe that provides care for ten people with a learning disability. The home is close to the high street, supermarkets and the beach. A train station and bus service to local towns is close by. The current core charge for Bradwell House is £1354.77 per week. Additional one to one time with services users is charged extra by the hour. There are also additional charges for personal items, clothing, hairdressing, newspapers and magazines. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and concluded with a site visit to the home between 11:30am and 14:30pm on 13 November 2006. A range of evidence has been used to inform this report and judgements have been made based on this evidence. Evidence used includes any concerns, complaints, allegations and other information received; reports of incidents that have occurred; a tour of the home; inspection of some records; and discussion with residents, staff and the manager. What the service does well: What has improved since the last inspection? What they could do better: A rockery area in the garden presents a risk to residents at present. The rockery wall needs repairing and a small set of steps up to this area has cracked and broken paving slabs. This has been reported and repairs are due to be made. Copies of the induction training new staff have undertaken should be kept on their files to evidence that they have received a thorough induction. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information they need to decide whether Bradwell House can meet their needs. EVIDENCE: The statement of purpose and service user guide are in a form that residents can understand. They include the terms and conditions of the home. The two residents living in the home had only recently moved in. The manager confirmed that the company will issue contracts to them so that they know what the “rules” of the home are. All future residents will receive a contract when they move into the home. The home’s admissions policy states that prospective residents can visit the home on a trial period before deciding whether to move there. This was supported by evidence that a new resident, due to move into the home the next week, had visited previously. Information from these visits and preassessments carried out by the company and the manager of the home were contained in a care plan that was being developed for this resident. Residents’ care plans contained assessments from their care managers and other professionals. These had been used to develop comprehensive assessments of their needs and goals. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that meets their individual needs and choices. Residents make decisions about their lives and are supported to live independently. EVIDENCE: Residents’ care plans were comprehensive and took a holistic approach. Details of all areas of their lives including their likes and dislikes, activities they enjoyed, health, communication etc., were well documented from a person centred perspective. Risk assessments covered activities and the environment and were clear and concise. They covered areas that were a particular risk for each resident. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 10 Care plans and risk assessments are to be reviewed each month and progress recorded. Residents are clearly involved in developing their care plans. The manager explained that residents help with tasks in the home depending on their ability. They are encouraged to do their own washing and ironing. Residents’ money is kept in the home’s safe in individual moneybags. Detailed records are kept of the money put in and taken out. One resident’s finances were sampled and the records tallied with the money in the safe. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-16 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities for leisure activities, work placements and to continue their education. Their rights are respected and they have contact with their family and friends. EVIDENCE: One resident said that they are going to go to College next year and like to go swimming at the local pool. Residents’ care plans contained details of the activities that they have taken part in. These included swimming, walking, shopping, arts and crafts, watching television and listening to music. The home has only recently opened and the two residents have only been there for a short time. It was not possible, therefore, for the views of Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 12 residents, care managers or other professionals to be gathered prior to the site visit. Residents clearly have contact with friends and family. The manager said that a web cam is to be installed on the computer as another way that residents can keep in contact with their families. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal, physical and emotional health needs are met and they are protected by the way the home deals with their medicines. EVIDENCE: Details of each residents’ personal, physical and emotional health needs are recorded in their care plans. Details of referrals to appropriate professionals and other health appointments are also recorded. Details of the medication that residents have been prescribed were seen in their files. Medication records had been accurately recorded and medication was stored appropriately and safely in a locked medication cupboard fixed to the wall. No residents had been prescribed controlled drugs at this time. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 - 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected and their views are listened to and acted on. EVIDENCE: At the time of the site visit no complaints about the service had been received. The complaints procedure gives the timescale the home will carry out investigations in and contact details for complainants to contact the Commission if they wish. Training records showed that staff are trained in adult protection. Staff spoken with were clear about what to do if they suspected someone was being abused and who to report this to. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and safe environment with the equipment needed for their independence. EVIDENCE: The home was clean and free from offensive odours. The dining room and communal areas are well decorated, light and airy. The dining room has enough dining tables and chairs for all residents to eat in the dining room when the home is full. There is a separate lounge with comfortable furniture, TV and music system. There is a separate building in the garden. This will provide a sensory and activities room for residents to use when fully equipped. There is a small, secure and attractive garden. A rockery area in the garden presents a risk to residents at present. The rockery wall needs repairing and a small set of steps Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 16 up to this area has cracked and broken paving slabs. The manager explained that this has been reported and repairs are due to be made. Pictures have been hung around the home, which helps to give it a homely feel. There are six bedrooms on the first floor and four on the ground floor. All bedrooms are en suite shower or bathrooms. All bedrooms have been attractively decorated and contain all furniture to meet residents’ basic needs. The bedrooms of the two residents living in the home contain their personal possessions and are comfortable and individual to them. There is one communal toilet on the first floor and one disabled toilet on the ground floor. There is a modern, well-fitted kitchen with a cooker, microwave, dishwasher, fridge, and plenty of worktops and cupboards. It was clean and tidy. The laundry has one washing machine and one dryer. The manager said that residents are able to use these to do their own laundry. There was a specialist chair in the dining room that had been brought to the home ready for the new resident who was to move into the home the next week. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 - 36 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected by a thorough recruitment programme and supported by a qualified, competent and effective staff team. EVIDENCE: The manager and two support workers were on duty at the time of the inspection. As there were only two residents living in the home this was extremely adequate as it gave them one to one support. The manager explained that currently there is one senior and two support workers on duty during the day and one waking and one sleeping member of staff at night. As more residents move into the home it is intended that this will increase to one senior and four support workers during the day and two waking night staff. As the home has only recently opened all staff were new. The manager and the staff on duty said that they have been able to attend a lot of training and to work together to build up their team. Staff were clear about their roles and responsibilities and how to meet the needs of the residents. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 18 Staff records were seen for two members of staff. These contained evidence that a thorough recruitment process had been followed and appropriate checks made. Records of training staff had attended and was due to take place in the next few months were seen. Subjects included health and safety, first aid, food hygiene, COSHH, manual handling, infection control, epilepsy, learning disability awareness, and adult protection. Records did not contain completed induction programmes for staff. The manager explained that staff keep these themselves. A copy should be kept on staff files to evidence that they have undertaken a thorough induction. Evidence was seen during the site visit that staff receive a thorough induction. A new member of staff was doing the first day of their induction and the induction record for a member of staff who was on duty was seen. This was dated and had been signed by the member of staff and the manager. A blank induction form showed that induction is in stages. It listed subjects to be covered on the first day, first week, 3 months and 6 months. Supervision records and tracking forms showed that staff receive monthly supervision. Staff had also signed a supervision agreement. Records of supervision were seen. Staff spoken with said that they felt there is a good team spirit and things are “going well”. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 - 42 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a well run home. They benefit from the leadership and management approach of the home. EVIDENCE: The manager has the Registered Managers’ Award and has a number of years experience of management in the learning disability field. The manager showed a good understanding of the needs of the residents. Both she and the deputy manager had made good progress in setting up systems and procedures in the home. Management and staff were welcoming and friendly, well organised and had clearly put in a lot of effort towards making sure that the residents needs are met. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 20 The atmosphere in the home was calm and residents were happy and contented. Discussions with management, records seen and staff observed working in the home showed that the home is run with the best interests of the residents in mind. All records are kept securely in the manager’s office. As the home has only recently opened and residents have only moved in over the past few months no quality assurance surveys have been carried out yet. However, residents have a key worker who they can discuss issues with. Regular staff and manager meetings are held where any issues raised by residents or their relatives can be fed back and discussed and any relevant action taken. A current insurance certificate and the registration certificate were displayed in the entrance area of the home. Staff have received training in manual handling and fire procedures. They were clear about the procedure to follow in the event of a fire and said they had been able to practice this thoroughly. Prior to this site visit the manager had sent the Commission details of maintenance and other essential checks that had been carried out. Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 X Bradwell House DS0000066868.V304246.R01.S.doc Version 5.2 Page 22 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 YA24 Regulation 4(a) and (c) Requirement All parts of the home that residents have access to must be, so far as reasonably practicable, free from hazards to their safety. The loose wall and cracked and broken steps to the small rockery area in the garden must be repaired and made safe. Timescale for action 13/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA35.3 Good Practice Recommendations Records of induction training new staff have undertaken should be kept on their staff files. 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