Inspection on 17/01/06 for Bridge House

This inspection was carried out on 17th January 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 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

Bridge House 08/06/07

Bridge House 11/01/05

Bridge House 22/06/04

Similar services:

Littledale Hall Therapeutic Community

Bennett House

Padgate House

Mary & Joseph

Westcliffe House

Richards House

Hamer Cottage

Turning Point (Hoole Road)

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

CARE HOME ADULTS 18-65 Bridge House 1 St Lukes Place Preston Lancashire PR1 5DE Lead Inspector Lesley Plant Unannounced Inspection 17th January 2006 11:30 Bridge House DS0000010023.V259802.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 DS0000010023.V259802.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 DS0000010023.V259802.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bridge House Address 1 St Lukes Place Preston Lancashire PR1 5DE 01772 797654 01772 791810 kate.egan@alcoholanddrugsservice.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) Alcohol and Drug Services Miss Kathleen Egan Care Home 16 Category(ies) of Past or present alcohol dependence (16) registration, with number of places Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must only accommodate adults with past or present alcohol dependence (Younger Adult - YA) aged between 18 and 65 years upon admission. The service must only accommodate up to 16 (sixteen) service users. Date of last inspection 2nd June 2005 Brief Description of the Service: Bridge House is a residential rehabilitation unit registered for up to 16 adults, whose lives have been severely affected by their misuse of alcohol. Bridge House is managed by Alcohol and Drugs Services (ADS) an established registered charity, the Head Office being in Manchester. The premises, a converted church building, are close to the city centre, with good access to local services and amenities. The accommodation includes 10 single bedrooms on the first floor and 6 self-contained flats on the ground floor, plus a variety of shared living rooms. Therapeutic and client centred interventions form the basis of the service provided. The rehabilitation programme includes a structured therapeutic programme plus individual one to one sessions with a key worker. The team currently consists of an administrative worker, a cleaner, a cook, three project workers, a family and children worker, deputy manager and manager.A two-stage programme is in operation with individuals initially living on the first floor and then moving into one of the self contained flats as they prepare for discharge. Bridge House also offers acupuncture to service users, carried out by qualified staff. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 11.30 am and took place over five hours. The inspector spoke individually to two of the 14 people staying at the home, with seven of the group completing comment cards with their views of Bridge House. Information was also gained from discussions with the registered manager and the family worker. A tour of the premises took place, records were inspected and an inspection questionnaire completed by the deputy manager provided additional information. Key standards not assessed at this inspection will have been addressed at the previous inspection on 2nd June 2005. What the service does well: What has improved since the last inspection? The system for recording medication received and disposed of has been improved. Each bedroom now has lockable storage for medicines and more people are being supported to self-administer their medication. Certain staff are qualified to provide acupuncture and this treatment is again being offered to people at the home. New national occupation standards are being introduced for the drug and alcohol work sector and the provider organisation is currently mapping their training programme against these new standards. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 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. Bridge House DS0000010023.V259802.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 DS0000010023.V259802.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): None of the above standards were assessed at this inspection. EVIDENCE: Bridge House DS0000010023.V259802.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): 7 Individuals make decisions about their lives and good information about external support is available. People understand that any restrictions are in their best interests. EVIDENCE: Staff provide individuals with good information regarding local support groups, other agencies and advocacy services. Peer support forms an important part of the therapeutic programme at Bridge House, with the people spoken to confirming the value of these group sessions. Any limitations or restrictions are consistent with the purpose of the service, and individuals confirmed that they are made aware of any restrictions prior to admission to the home. These restrictions include people only being given a front door key four weeks after admission and specific arrangements for visitors to the home. People staying at Bridge House are involved in making decisions about the running of the service. A group discussion had recently taken place to look at the budget for food and provisions, and certain changes were agreed. Evaluation forms have been used to gain views about how activities are arranged, giving everyone opportunity to have their say. Individuals manage their own finances. Increased independence is promoted as people move into the self contained flats and take more responsibility for meals and budgeting. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 10 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 and 16 People are able to take part in appropriate activities in the community. Rights and responsibilities are respected, forming part of the rehabilitation programme for each person. EVIDENCE: Paid employment would not usually be a priority, particularly during the early stages of recovery, when the focus is on the therapeutic programme of group and individual sessions. Some individuals are involved in voluntary work or further education, with this being discussed with their key worker and negotiated around the priorities of the programme and the best interests of the individual. As people progress through their rehabilitation, opportunities such as these are individually addressed. People staying at Bridge House are not always from the local area and as discharge approaches staff provide support and contact details of services, housing and employment in the area they are moving to. Staff are experienced in providing advice regarding benefits, and support people to apply for benefits/grants or refer them to Welfare Rights or the Benefits Agency as appropriate. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 11 Good information regarding community services and facilities is provided. People access the community according to their individual needs and wishes, bearing in mind risk assessments and the priorities of the programme. There are set periods of free time during the week as observed at the time of this inspection. Seven people completed comment cards for the inspection, with the majority confirming that appropriate activities are provided. Bridge House is classed as a temporary address and therefore individuals remain on the electoral roll at their home address. Bridge House is not normally staffed during evenings or at weekends, when an on call support system is in operation. However, these arrangements are flexible, with a staff member holding a return from leave meeting each Sunday and additional staffing arrangements being made if issues of risk have been identified. Information about rights and responsibilities regarding daily routines and house rules is provided prior to admission to the home. There are clear rules regarding alcohol and drugs, and certain visiting restrictions, which form a key part of the contractual agreement. Each person has a key to their room/flat and is given a front door key after four weeks of residency. Two of the people staying at Bridge House spoke about the daily routines and their involvement in domestic tasks, which are carried out on a rota basis. Both agreed that this system is fair and works well. Certain activities and routines are negotiated within the group, such as weekend leave and who is cooking each weekend. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 12 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 Individuals do not require assistance with personal care. The key worker system ensures consistency and continuity of progress. EVIDENCE: The people staying at Bridge House do not require any direct support with personal care. If an issue of personal hygiene arose, then this would be addressed individually and sensitively within a one to one key worker session. Individuals choose their own clothing and there are no set times for going to bed or getting up. Each person has a designated key worker who facilitates one to one sessions and monitors progress within the programme. Certain staff are qualified to provide acupuncture and this treatment is again being offered to people at the home. Although not fully assessed at this inspection, the registered manager is continuing to look at ways to improve medication systems, to ensure that realistic procedures, relevant to the needs of individuals, are in place. Previous advice given by the CSCI pharmacist has been taken on board and advice has also been sought from the local primary care trust. The system for recording medication received and disposed of has been improved. Each bedroom now has lockable storage for medicines and more people are being supported to self-administer their medication. One person who does not administer his own medication stated that he was happy with his individual arrangement, whereby staff come to his room to access his medication on his behalf. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 13 Bridge House DS0000010023.V259802.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): 23 Policies, good practice and the open atmosphere at Bridge House promote the protection of those using the service. EVIDENCE: Staff sign to confirm that they have read the abuse guidance policy and the registered manager is planning to carry out in house training regarding the protection of vulnerable adults (POVA) procedures. Discussion with a member of staff confirmed a good understanding of issues of vulnerability for this client group. The staff member stated that there is an open atmosphere at Bridge House, with both staff and residents being encouraged to discuss any concerns and that the excellent staff supervision arrangements provide opportunity for any work performance issues to be addressed. All staff and volunteers undergo Criminal Records Bureau (CRB) clearance at enhanced level. The seven people who completed comment cards all responded that they feel safe at Bridge House and one person commented, “It is a comfortable and caring environment, with a feel good vibe.” Bridge House DS0000010023.V259802.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 and 30 Bridge House is clean and well maintained, providing a comfortable and attractive environment for those staying there. EVIDENCE: The home is well maintained with good quality furnishings and fittings. The building was originally a church and has been sympathetically converted retaining many original features. There is good access to local amenities, transport systems and the city centre. The provider organisation has appointed a handy person for the area, who carries out maintenance jobs at Bridge House. Other maintenance issues would be reported directly to the housing association landlord. Internally, there is an ongoing programme of decoration and refurbishment, which means that a good standard of decoration is always maintained. Since the last inspection several areas have been redecorated. People staying at Bridge House are involved in choosing colours and furnishings for communal areas. The premises are clean and hygienic. At present a volunteer worker cleans the staff areas of the building, with people staying at the home being responsible for cleaning their own rooms and the communal areas. Two people spoken to explained that there is a cleaning rota, which works well and is considered fair. Appropriate laundry facilities are provided. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 16 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, 34 and 35 The qualities and skills of the staff team are highly valued by the people staying at Bridge House. Recruitment is well organised and there is a good programme of staff training. EVIDENCE: Much positive feedback about the qualities of the staff at Bridge House was gained from comment cards and talking to people staying at the home. Comments included; “ It is the best place to be. The staff are excellent.” And “They listen and seem to really care.” People spoke highly of the staff team, their commitment and personal qualities, such as, being genuinely interested in their work and in the progress of individuals. One person praised the involvement of the children and family worker who had helped him to progress his relationship with his children and supported him during court hearings. The current policy is that all counsellors should be qualified to diploma level or have at least two years experience and be willing to work towards the diploma. Four of the five staff who provide counselling are qualified at Diploma level, with the fifth team member having achieved NVQ level 2 in counselling. The children and family worker is a qualified teacher. Volunteers attend an alcohol awareness-training course. A social work student is currently on placement at Bridge House, working under the supervision of the registered manager. There is an organised and well-established recruitment procedure in place. The staff file viewed showed that appropriate checks, including evidence of Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 17 qualifications and criminal records bureau clearance take place. All staff undergo a six-month probationary period followed by an appraisal, which then takes place annually. A volunteer policy is in place, with volunteers undergoing Criminal Records Bureau checks and receiving training. The individual training record for one member of staff was viewed. The organisation provides a rolling programme of mandatory training, which includes; anti discrimination, working with gay and lesbian service users and cultural awareness. Staff also undertake basic health and safety courses, such as food hygiene. A training review takes place as part of the annual appraisal for each member of staff. Staff are also able to apply for external courses relevant to their role. The children and family worker is soon to attend a course on alcohol and parenting. Some of the team are qualified to perform acupuncture and two staff are currently involved in reiki training, with a view to offering this therapy to people at Bridge House. New national occupation standards are being introduced for the drug and alcohol work sector and the provider organisation is currently mapping their training programme against these new standards. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 18 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, 39 and 42 The home is well managed. Quality monitoring takes into account the views of people who use the service. Policies, good practice and training promote the health and safety of people both working and staying at Bridge House. EVIDENCE: The registered manager has obtained a range of qualifications, including the Registered Managers Award (NVQ 4), the Advanced Diploma in Counselling and the Practice Teachers Award. Alcohol and Drugs Services, the registered organisation provides good management training opportunities, allowing the registered manager to keep up to date and further develop her knowledge. The registered manager is involved in working groups and projects, which enhance personal and professional development. An example of this being inclusion in the working group which is reviewing job descriptions within the organisation. There are internal and external quality assurance systems in place. A senior manager from Alcohol and Drugs Services carries out monthly monitoring visits, with a report being sent to CSCI. Regular meetings take place with the Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 19 people staying at the home and the programme’s group sessions also provide opportunity for views to be shared. There is also a regional group, which is attended by representatives from Bridge House. Questionnaires and discharge forms are used to gain feedback about the service provided. The inspector discussed unplanned discharges with the registered manager. There are various reasons why some individuals choose to leave the programme and the inspector advised that this could be looked into more closely as part of the quality monitoring at Bridge House. Evaluation sheets are periodically used to gain feedback regarding the effectiveness of the group sessions and there has been a recent review of activities. The annual general meeting takes place each November and includes the presentation of the annual review. The organisation has achieved the Investors in People Award. The organisation arranges health and safety training such as food hygiene and some team members are qualified first aiders. The registered manager plans to introduce further health and safety training, using learning packs. The records viewed showed that regular safety checks take place, fire drills are held and fire equipment is maintained. The handyman for the organisation is now responsible for the annual check of portable electrical equipment. A record of any accidents is kept. The registered manager was advised to use the new Health and Safety Executive (HSE) accident recording sheets for all accidents, as at present there is a separate accident book relating to people living at the home and the new record sheets are only used for staff. This HSE record complies with data protection and is considered good practice. Appropriate health and safety policies are in place. There is currently no individual from the provider organisation registered as Responsible Individual with the CSCI. This must be addressed. Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 20 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 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X 3 X X 3 X Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 21 NO 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 YA43 Regulation 7 (2) © Requirement An application must be made for a responsible individual to be registered with the CSCI. Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bridge House DS0000010023.V259802.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 DS0000010023.V259802.R01.S.doc Version 5.1 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. 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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