Inspection on 15/02/06 for Bridge House

This inspection was carried out on 15th February 2006.

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

Bridge House 04/12/08

Bridge House 08/01/07

Bridge House 08/09/05

Bridge House 14/03/05

Bridge House 22/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Bridge House 2 Bridgwater Road Taunton Somerset TA1 2DS Lead Inspector David Kinder Announced Inspection 15th February 2006 09:30 Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 DS0000039957.V277794.R01.S.doc Version 5.1 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. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bridge House Address 2 Bridgwater Road Taunton Somerset TA1 2DS 01823 331712 01823 353691 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) Home First & Foremost Ltd Miss Sarah Louise Fry Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Bridge House is a large property located within walking distance of Taunton town centre. The service user accommodation is provided over two floors. All service users bedrooms have an en-suite bathroom. There are two lounges, a dining room and kitchen within the home. The garden to the rear of the property is an attractive space made secure and accessible for service users. The Registered Manager is Sarah Fry, and the Registered Provider is Voyage Ltd. Bridge House is registered with the Commission for Social Care Inspection to care for up to eleven people with learning disability. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over one day (7 Hours) and was conducted by two inspectors. The Inspectors would like to thank the service users and the staff team for their hospitality and for making the Inspectors welcome at the home and for their contribution to the inspection process. The Inspectors viewed most parts of the home, viewed records in relation to care and support plans. Also viewed were records regarding Health and Safety, staff recruitment and risk assessments. The Inspectors spoke to nine service users and four staff members, three of these staff in private. The inspectors observed the staff team interacting with service users in a professional, caring and sensitive manner. As part of the inspection process Voyage notified all parents/relatives, care managers and placing authorities of the inspection and sent out questionnaires, which were forwarded to the inspectors. The inspectors received 8 replies from relatives, 1 reply from a care manager and 1 reply from a social worker. All replies were extremely positive and many commented on the kindness and helpfulness of the staff. Communication between staff and relatives is very good and all are satisfied with the environment. Some comments were made regarding the request for more activities for service users and the registered manager is currently addressing this. As a result of this inspection the home had no requirements and three recommendations. What the service does well: Bridge House provides a homely environment that is very well presented and maintained. The service users appear settled, comfortable and well looked after. The home is furnished and decorated to a high standard and has a comfortable and homely atmosphere. Every effort appears to be made to provide all service users with meaningful leisure and social activities. A further recommendation to continue to develop a suitable monitoring, recording and evaluating method of recording these activities has been requested to support the good practice of the home. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 6 The home benefits from a positive staff team who support and encourage all service users in a kind and gentle manner. Staff have skills in alternative methods of communication. The Registered Manager provides clear leadership and has created a calm and direct approach to the running of the home. The home continues to demonstrate detailed care and support plans with regular review updates. The risk assessments are clear, concise and regularly reviewed. All bedrooms reflect the individual preferences and lifestyles of each service user. 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. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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): These standards were not assessed, as there have not been any new admissions to the home since 30.04.2002. EVIDENCE: Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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, 8, 9, 10 The home has detailed care plans that are reviewed regularly. The risk assessments are also contained within the care plans. These are detailed and regularly reviewed. Service users are encouraged to make decisions as much as possible. EVIDENCE: The Inspector viewed three care plans. All where detailed and comprehensive and all had been reviewed recently and signed by the Registered Manager. The care plan files included a personal profile, records of health care and professionals contact, management of behaviours and monthly summaries. The care plans also contained detailed risk assessments and evidence of relative’s involvement in the care plan process. However, one care plan seen showed evidence of what could be deemed as misleading information. The inspectors discussed this with the Registered Manager. Service users are encouraged to air their views as much as possible. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 10 All documents relating to service users are stored securely, in accordance with the Data protection act 1998. The home has a confidentiality policy. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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): 12 13 14 15 16 17 The home continues to provide a wide range of activities for all the service users. However, further steps need to be taken to meet the previous recommendation for more suitable recording of these activities. The home promotes contact with family and friends. Menus seen show a varied and healthy diet with specialised diets being catered for when needed. EVIDENCE: During the inspection service users where seen participating in a variety of activities both within the home and also activities in the community. Evidence was seen of a planned programme of activities, these included a programme of goals and outcomes tailored to the needs of each service user. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 12 A more extensive recording system was discussed with the Registered Manager, Operational Manager to ensure that all staff is aware of what constitutes an activity and a simple method of recording. It was evident from the care plans reviewed and staff members spoken to that the home encourages and promotes contact with relatives and friends. Service users spoken to commented that they enjoyed the food and that they have choices if they do not like the meal that is offered. The home has a planned menu. The inspectors noted that the food cupboards were well-stocked and fresh fruit and vegetables were available. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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): 19 20 The home ensures that service users have access to a variety of health care professions. The home has clear practices for the storage, dispensing and recording of medication. EVIDENCE: The home operated a key worker system. The records the inspectors used clearly evidenced that the home involves other health care professionals. These include GP’s, speech and language therapist, dentist, opticians, psychiatry and psychology services. There are currently no service users independently managing their own medications. The inspectors viewed the MAR sheets and the medication system all of which are very well organised and maintained. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 The home has a robust complaints policy. The home has an effective complaints procedure in place. The home promotes good practice in relation to the management of behaviours. EVIDENCE: Voyage has a complaints policy and a complaints record, this was viewed at inspection and no complaints had been made since the previous inspection. A whistle blowing policy is in place within the home relating to the Protection of Vulnerable Adults and staff spoken to where aware of its contents and usage. Voyage has implemented a training programme of agreed physical intervention and breakaway techniques for all staff. Records of financial transactions involving service users finances where not viewed at this inspection. The Inspectors had discussions with the Registered Manager and the Operational manager with reference to service users holding small meetings to support this standard. These meetings would include decisions such as menu setting and activity planning. The Registered Manager and Operational Manager confirmed that this would be given further consideration. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 25 26 27 28 30 Bridge House appears to be clean, hygienic and decorated to promote a homely atmosphere. Service users bedrooms reflect individual lifestyles and tastes. EVIDENCE: Bridge House is located on a main road within walking distance of Taunton town centre. The service user accommodation is provided over two floors with a further two lounges and a dining room which will comfortably seat fourteen people. There is a patio area and an attractive rear garden .The kitchen has recently been refurbished to a high standard and a new carpet has been fitted in one bedroom and one corridor. There are plans for a further two carpets to be replaced. The home is furnished and decorated to a high standard and has a comfortable and homely atmosphere. The bedrooms are decorated in a manner that reflects each service users personality and many photographs and personal belongings where evident. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 16 One service user had a thermos in their bedroom to increase independence. Each bedroom has its own en-suite bathroom facility. The refurbished kitchen was seen and is much improved. On the day of inspection the home was very clean, hygienic and tidy. There are adequate laundry facilities within the home and it appears well managed. Service users have access to the laundry area with staff support. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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): 32 33 34 35 At the time of inspection the home appeared adequately staffed. The staff spoken too appeared well supported and settled. The home operates a robust recruitment policy. EVIDENCE: Staff are currently receiving a training programme for behavioural changes. Staff records show that 50 of staff has completed the NVQ 2 and a further 15 are registered to commence the course. The Registered Manager commented that staffing levels are currently appropriate at this time but further recruitment is to take place. Some of the staff spoken to by the inspectors from staff would support that further staffing would support the increased activity for service users programme. Two staff have been employed since the last inspection, the inspectors viewed the files. The files contained all the appropriate documentation as listed in Schedule 2 of the Care Homes Regulations 2001. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 18 Staff members commented that there are usually six staff on each morning and evening and this is suitable to allow for activities to take place and still maintain safe staffing levels. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 38 39 42 The Registered Manager has a clear and effective management style, which promotes a positive atmosphere within the home. The home has comprehensive policies and procedures and strives to promote health and safety. EVIDENCE: Bridge House benefits from an effective Registered Manager who exhibits a positive leadership style. Staff are comfortable with the style of management and were happy to approach the Registered manager with any problems they may have. Minutes of staff meetings were seen and show a clear direction and attitude towards the running of the home. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 20 The inspector viewed the documentation in relation to health and safety .All fire records were up to date and from records viewed it appears that staff is receiving regular training. Visual checks of the emergency lighting and fire extinguishers were checked weekly with an annual check of the emergency lighting on 13.09.05. All environmental risk assessments were regularly reviewed. Records of fridge and freezer temperatures were satisfactory and new kitchen equipment had also been purchased. It was noted that all the food stored in the fridge was covered and dated. One en-suite sink was cracked and needs replacement and the radiator cover in the dining room needs minor repair. The inspectors noted that the laundry facilities were well maintained and appropriate to the service users needs. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 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 X 2 X 3 X 4 X 5 X 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 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 3 3 3 X 3 3 X Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA13 YA22 YA42 Good Practice Recommendations The home should further develop methods of recording, monitoring and evaluating service user activities. The Registered Manager should consider implementing service user meetings with records kept. The Registered Manager should consider a sink in one ensuite bathroom to be replaced and a radiator cover in dining room being repaired as part of the refurbishment programme. Bridge House DS0000039957.V277794.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 DS0000039957.V277794.R01.S.doc Version 5.1 Page 24 - 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. 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