Inspection on 12/01/06 for Bridge House

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bridge House 24/11/08

Bridge House 10/01/07

Bridge House 20/06/05

Bridge House 19/01/05

Bridge House 21/06/04

Bridge House 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bridge House Manorside, Market Street Flookburgh Grange over Sands Cumbria LA11 7JS Lead Inspector Ray Mowat Unannounced Inspection 12 January 2005 09:00 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 Bridge House DS0000036506.V259114.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. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bridge House Address Manorside, Market Street Flookburgh Grange over Sands Cumbria LA11 7JS 015395 58622 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) Cumbria Care Mr Anthony Lyons Care Home 40 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (40) of places Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The staffing levels for the home must meet the Residential forum Care Staffing Formula for Older Adults by 1st April 2004. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. A maximum of forty older people (OP40) may be accommodated including twelve older people with dementia (DE(E)12) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 20th June 2005 Date of last inspection Brief Description of the Service: Bridge House is a purpose built residential care home owned by Cumbria County Council and operated by Cumbria Care, an independent business unit of the County Council. Bridge House is registered to provide residential care for up to thirty nine older people. The home is divided into three distinct units, Sandgate, which specialises in Dementia Care for up to 10 people, Applebury and Humphrey Head. Each unit contains a dining room with kitchenette, two communal lounges, accessible toilets and bathrooms and the resident’s bedrooms. There is a passenger lift making all three floors fully accessible. There are well kept gardens to the front and rear of the home. The home is situated in the centre of the village of Flookburgh, within walking distance of the local amenities and close to the town of Grange-over-Sands. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this inspection I spent the majority of my time within the three units talking to residents, their family or visitors and staff, including lunch with the residents in the Sandgate unit. I spent time with the manager and supervisor on duty and examined records relating to residents and the running of the home. I also met formally with three care staff on duty. What the service does well: What has improved since the last inspection? What they could do better: It is important that all staff respect the residents and do not talk about them when they are there, unless they are talking to them. The home must be kept warm and make sure people can control the radiator temperatures in the rooms. Information about people’s life history should be kept in their files. Resident’s files should be looked at, at least every month, to make sure all the information is up to date. What residents eat and how much they weigh is important information and should always be written in their files. The home should check the quality of the food and ask residents about it, when the regular cook is not working. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 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. Bridge House DS0000036506.V259114.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 Bridge House DS0000036506.V259114.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): These standards were assessed and met at the last inspection. EVIDENCE: There have been no changes to the admission procedure to the home and all relevant information is supplied to residents in line with the National Minimum Standards. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 10,11. The recording of personal and healthcare needs was inconsistent. The dignity of residents was not respected consistently. EVIDENCE: The home was in the process of changing the format of their care plans so the content was inconsistent. On the whole the care plans were detailed and gave staff an insight to individual’s personal and healthcare needs and preferences. At the last inspection the care plans contained informative personal profiles, which ‘brought the care plan to life’ and provided staff with a valuable insight to the individual and their life experiences and expectations. It is recommended the profiles are retained within the care plan file. A comprehensive functional assessment is contained within the care plan file, which is used to monitor people’s needs on a monthly basis and record any changes. The completion of these was inconsistent with some people not being assessed on a monthly basis. It is recommended all care plans are reviewed at least once a month and updated to reflect changing needs. Weight charts were also not being completed on a regular basis as required. It is recommended a record is maintained of nutrition, including weight gain and loss and any action taken. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 10 Daily diary notes are recorded at the end of each shift, on the whole these were detailed and passed on valuable information between staff. However some entries referred to “usual care given”. This was discussed with the manager who was aware of the need to ensure more detailed notes were being recorded and had raised the issue with staff. During the inspection there were two examples of staff talking about a resident to one of their colleagues whilst the resident was present and aware of the conversation. In one instance the resident reacted to the staff comments. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15. On the whole residents enjoy a good quality of life participating in activities both in the home and in the community. EVIDENCE: Through both the care plan reviews and residents meetings individual needs and preferences in relation to interests and social activities are monitored and recorded. Based on discussions with residents they were enjoying a range of activities including reminiscence sessions, concerts, chairobics exercises, social gatherings in the home to celebrate events and day trips. Staff spoken to confirmed the popularity of the activities and said how they stimulate conversation and interest in people. Some people enjoy a more sedentary lifestyle enjoying listening to music, watching television or joining in a tabletop activity such as dominoes. Each unit maintains a record of activities undertaken. I read the minutes from the last residents meeting, which had a wide ranging agenda including discussions about, activities, menus, heating, day trips and plans for Christmas festivities. Residents meetings and one to one consultation ensure residents are able to exercise choice and control over their lives. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 12 It was evident from my discussions with residents that the quality of the food is excellent when the regular cook is working, however when the vacant cooks position is filled by agency cooks the quality is inconsistent and people were not happy with the quality of the meals provided. The manager was aware of issues and is currently advertising for a second cook to fill the vacant post. It is recommended the home monitor the quality of the food when agency staff are working and consult with the residents regarding their satisfaction. This will ensure any problems are identified and resolved. Bridge House DS0000036506.V259114.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): 16,18. The home’s policies procedures and practice safeguard residents and staff and ensure concerns and complaints are responded to appropriately. EVIDENCE: The home has a suitable complaints procedure, which is displayed in the home and made available to residents. Staff were aware of their role in supporting residents to raise a concern or complaint. There had been no complaints since the last inspection. Based on my discussions with staff they had received appropriate training relating to identifying and reporting mistreatment or abuse and were aware of the home’s policies and procedures and the need to safeguard residents. Bridge House DS0000036506.V259114.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, 20, 21, 22, 25, 26. The home is well maintained and on the whole provides a safe and comfortable environment. Enabling the residents to control the temperature in the home to maintain their comfort must be addressed. EVIDENCE: On the whole Bridge House is decorated and maintained to a good standard. The home has an ongoing programme of repairs and renewals with timescales agreed for individual projects. I raised the following issues with the manager as being in need of attention, Applebury kitchen units, Sandgate decoration and replacement of some chairs. These had been identified on the programme to be completed this financial year. This will be assessed at the next inspection. From 1pm onwards as I moved around the three units residents commented on the cool temperature in the home. I checked radiators in each unit and from this time until 5.30pm the radiators were cold. I discussed this with the manager and the handyman, who happened to be visiting the home. They both said there was some form of central thermostat that controlled the Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 15 temperature in the home, which overrides the individual controls on each radiator. This prevents people from controlling the temperature in their rooms or the communal areas of the home and must be addressed. Bathrooms were well equipped with suitable aids and adaptations to support residents. Moving and handling equipment was also in place and well maintained. All parts of the home were found to be clean and hygienic. Bridge House DS0000036506.V259114.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, 30. The home has sound recruitment policies and procedures and enjoys the benefits of having a stable and experienced staff team. EVIDENCE: The home provides 779 care staff hours per week including night shift, in addition to 124.5 ancillary hours and 147 management and supervisory hours. This provides each unit with two care staff throughout the day and evening with a third member of staff sharing their time between the three units as required. In addition there is a supervisor on duty during these periods. The home has a full compliment of staff, with only 15 hours being vacant, which are new hours. There is a bank of relief staff that ensure staff absences are appropriately covered and a continuity of care maintained. I met with two relief staff who had both received a thorough induction to the home and were receiving suitable training and supervision. Staff files were examined that confirmed the home was following good practice guidelines with regard to the recruitment of staff. Contracts and job descriptions were issued and all necessary checks completed. Each member of staff has a continuing professional development file that is used to monitor and record all training activity. From this the manager compiles a training plan for the home to prioritise training and development needs of staff. Staff said the training provided was “good and helped them in their role”. Bridge House DS0000036506.V259114.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, 33, 36, 37, 38. The management team provide sound supervision and support for both staff and residents. EVIDENCE: It is evident the manager is experienced and knowledgeable and is respected by staff and residents. He has a good awareness of the needs of the residents and all aspects of the management of the home. Feedback from residents and staff suggest they would like to see more of him on the units within the home, which the manager agreed was something he was planning to do. Through the regular resident’s meetings and both the formal and informal consultation with residents, the management team ensure the home is run in the best interests of residents. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 18 Staff said they got “good support” from the manager and supervisors both informally on a daily basis on the units and formally through regular supervision and appraisal. There were no obvious hazards noted during the inspection with the manager and supervisors monitoring accident reports and notifications for potential hazards or reoccurring incidents. There was evidence of the home liaising with specialist services for advice and guidance when required. Bridge House DS0000036506.V259114.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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X 2 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 3 3 X X 3 3 3 Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 20 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 2 Standard 10 25 Regulation OP12 OP23 Requirement The home must ensure that staff respect the dignity of residents at all times. Residents must be able to control the heating in their rooms and communal areas of the home must be adequately heated. Timescale for action 19/01/06 01/02/06 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 2 3 4 Refer to Standard OP7 OP7 OP8 OP15 Good Practice Recommendations It is recommended personal profiles are retained in the care plan file. It is recommended all care plans are reviewed at least once a month and updated to reflect changing needs. It is recommended a record is maintained of nutrition, including weight gain and loss and any action taken. It is recommended the home monitor the quality of the food when agency staff are working and consult with the residents regarding their satisfaction. Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Bridge House DS0000036506.V259114.R01.S.doc Version 5.0 Page 22 - 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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