Inspection on 19/06/07 for Bridge House

This inspection was carried out on 19th June 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bridge House 23/11/05

Bridge House 29/06/05

Bridge House 16/03/05

Bridge House 21/10/04

Bridge House 03/02/04

Bridge House 15/01/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Bridge House 43-45 Bridge Street Barnsley South Yorkshire S71 1PL Lead Inspector Rob Padwick Key Unannounced Inspection 19th June 2007 11:00 Bridge House DS0000018224.V329135.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 Bridge House DS0000018224.V329135.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. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridge House Address 43-45 Bridge Street Barnsley South Yorkshire S71 1PL 01226 208101 none none 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) Mrs Janet Barlow Mrs Janet Barlow Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registration includes 3 beds at 43 Bridge Street, 3 beds at 12 Bridge Gardens and 3 beds at 45 Bridge Street. 23rd November 2005 Date of last inspection Brief Description of the Service: Bridge House is one of a group of services operated by Mrs. Janet Barlow and comprises three domestic properties at 43 Bridge Street, 45 Bridge Street and 12 Bridge Gardens. The houses are in a residential area within walking distance of the town centre of Barnsley. Each property has one shared and one single bedroom and can accommodate three people. Whilst Bridge House is registered as a care home for a maximum of nine people with mental health needs, elements of the service provision are of a supported living nature. The standard fee charged by the home is currently £296.96 with additional charges made for hairdressing, taxi fares and holidays. Bridge House provides information to residents about its facilities in its Statement of Purpose and Service User Guide. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A Pre Inspection Questionnaire asking for information about the service was sent to the manager before this visit and information from this was included as part of the inspection process. Other information used, included feedback from questionnaires sent out to people living in the home, staff working in the service and professional staff in the community who know the people living in the home well. The responses from those returned generally expressed high levels of satisfaction with the service. No other information about the service had been received since the last inspection. The inspection visit for this service lasted for 6 hours and during this period, time was spent talking with people living in the home and observing their daily lives. Other time was spent looking at their care plans and other records and talking to staff. The inspection visit also included a tour of the properties. What the service does well: The manager ensures she has clear information about the needs of prospective residents, in order to confirm that the service is able to meet their needs. The home’s policies and procedures ensure admission to the service is a part of a staged and gradual process, involving visits to the home to meet other people living in the home and the staff, progressing to day visits and overnight stays. People living in the home are encouraged and supported to live as independently as possible. Daily routines are flexible in order to enable people living at Bridge House to follow their own routines. People living in the home confirmed that they were supported to take part in a good range of activities on a daily basis, which include social groups; day centres and visits to places within the local community either independently or with staff. The owner and staff were observed to have positive and professional relationships with people living in the home. Staff are well motivated and provided with training to ensure they can meet the needs of people living there. The properties are clean and well maintained, which promotes a safe and homely environment. People living at Bridge House indicated they liked the home and said “Its lovely” and “I enjoy living here”. The registered manager/owner has many years experience within the caring profession and communicates a clear sense of leadership. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Bridge House DS0000018224.V329135.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 Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 People who use this service experience excellent outcomes in this area. People living in the home had been involved in decisions about moving in to the service. The needs of people living in the home had been assessed prior to their admission, in order to ensure that the service was able to meet them satisfactorily. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed that they had been actively involved in the process of moving into the home. The case files of the two most recently admitted people contained information about their individual needs, which had been obtained by the home’s manager before they had moved in, so that she was able to make an informed judgement about the suitability of the service for them. People living in the home stated that they were consulted about future admissions to the service, in order to ensure compatibility. Case files inspected indicated that the admission process was a gradual and graded one, involving trial visits and overnight stays. Evidence was seen in the case files inspected of good liaison with professional staff in the community who were involved with the people living in the home. Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service experience excellent outcomes in this area. People living in the home were being supported well by staff to make responsible decisions about their lives, in order that their individual needs and wishes could be appropriately met. This judgement has been made using available evidence including a visit to this service. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 10 EVIDENCE: People living in the home stated that they were able to make decisions about their lives and that staff supported them in this process. Case files inspected contained person centred plans of support, which focussed on the strengths of the individual’s living in the home, together with the actions needed to achieve the goals identified as part of their annual development plan. The support plans inspected covered a range of issues relating to the health, social and emotional needs of the people living in the home and evidence was seen that they had been consulted about the development of their plans. Evidence was seen that the support plans were being evaluated on a monthly basis to ensure that any changes were incorporated into them and daily recordings in the case files indicated that the needs of the people living in the home were being monitored by staff, with liaison with members of the wider Community Multi Disciplinary Teams as appropriate. A comment received from a mental health professional in the community stated “ Staff are very cooperative, observant and professional.” “All clients are treated as individuals”. Aspects relating to the management of identified risks to people living in the home were contained within the case files that were inspected, together with information for staff on what to look out for and do in these matters. Staff demonstrated good insight into the support required to assist people living in the home in making informed decisions, based on their individual rights and responsibilities. Records of meetings held with people living in the home confirmed that they were involved in making choices about their lives. Throughout this inspection visit, staff were observed assisting people living in the home in a friendly and supportive manner and discussion with individuals living at Bridge House confirmed that they were encouraged to fulfil their wishes and goals and be as independent as possible. Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 People who use this service experience excellent outcomes in this area. People living in the home were being encouraged to maintain and develop their social and independent living skills in order that their lifestyle needs and wishes could be appropriately met. This judgement has been made using available evidence including a visit to this service. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 12 EVIDENCE: People living in the home confirmed that they were able to make decisions about their lives and that they could choose to take part in a variety of activities according to their individual wishes and tastes. The group had a range of support needs and from discussion with them, it was apparent that some chose to be highly involved in various activities, whilst others chose to be less so. Case files documented the involvement of people living in the home in attending day centres, college courses, social clubs and other meaningful activities such as paid employment and, from observation, it was clear that people living at Bridge House had their own preferences and likes that they were able to follow. The home’s routines were flexible and people living there indicated they were supported to take responsibility for household jobs, such as baking, cleaning and doing their washing, in order to build their selfconfidence and develop their independent living skills. Generally staff in the home prepare meals that are served, however discussion with people living at Bridge House confirmed they participated in decisions about the choice of food provided. Inspection of the associated records for these indicated that the dietary provision in the home was healthy and nutritious. The home had a visiting policy and procedure and people living in the home confirmed they were able to see friends and stayed over with them or their relatives on a regular basis. Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service experience good outcomes in this area. Staff were supporting and encouraging people living in the home to ensure their health and personal care needs were appropriately met. This judgement has been made using available evidence including a visit to this service. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 14 EVIDENCE: People living in the home were mostly independent with regard to their personal care and discussion with them indicated that staff encouraged them to take an interest in this aspect of their lives, in order to promote their well being and personal dignity. Support plans contained information about the wishes and preferences of the people living in the home together with guidance to staff about particular issues to be aware of. Case files documented various aspects relating to health needs of people living in the home and discussion with them confirmed they were supported to attend medical check ups and other health appointments as necessary. Positive feedback from health professionals in the community indicated good liaison with the home’s staff “They always keep recovery services fully informed of any changes in the client’s condition”. There was a medication policy and procedure to ensure that staff adhered to this aspect of practice safely. People living in the home confirmed they had been consulted about assistance with their medication needs. Risk assessments were contained within the case files, which identified where individuals were able to administer their own medication, together with evidence of support from staff to ensure they were complying with their responsibilities in this regard. Staff confirmed they had received training on the safe use and handling of medication and a random inspection of the home’s medication records confirmed these were being satisfactorily maintained. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience good outcomes in this area. The concerns of people living in the home were being taken seriously and they were being safeguarded from abuse by staff that had been trained in this aspect of practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service had policies and procedures to ensure that the concerns of people living in the home were taken seriously and that they were safeguarded from abuse. The Commission for Social Care Inspection had received no complaints about the service since the last inspection visit to the home and discussion with people living at Bridge House indicated they felt staff listened to their views and they knew how to make a complaint, if this was needed. The home’s complaints log contained no entries since the last inspection and positive feedback received from professionals associated with the home was contained in the home’s quality assurance records. Staff files provided evidence of training relating to the protection of vulnerable adults and discussion with those on duty confirmed that they were aware of the home’s policies and their responsibilities in these matters. People living in the home are encouraged to manage their own finances and discussion with one individual confirmed they were able to spend their weekly allowances how they chose. The records of money held on behalf of the people living in the home were randomly checked and found to be satisfactory. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience good outcomes in this area. The home was being well maintained and was clean and comfortable, so that people living in the home had an environment that could safely meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bridge House comprises three domestic properties situated in Bridge Street and Bridge Gardens and inspection of them all confirmed they were clean and being well maintained. Records relating to the upkeep of the service indicated that action was being taken to ensure that the environment was safe and homely. The doors on the bedrooms were not fitted with locks, but people living in the home confirmed that they had been provided with secure storage facilities for the storage of valuables and documentation in their case files indicated that they had been consulted about this. All of the people living in the home indicated that they enjoyed living at Bridge House. Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use this service experience good outcomes in this area. Staff had received training to ensure that they could support the needs of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed that staff supported them to meet their needs. Strong relationships were observed to exist between these two groups, with staff providing friendly advice and assurance where this was needed. Comments received from staff questionnaires indicated good levels of understanding concerning the needs of the people living in the home and staff files inspected contained evidence of a training and induction programme, to ensure that staff were equipped with the necessary skills to do their jobs. Whilst staff files contained evidence of annual personal development appraisals, some gaps were identified in the regularity of the supervision taking place, however staff members confirmed that this did occur on a very regular but informal basis. Information provided by the manager indicated that 75 of the staff team had obtained an NVQ at level 2 or above which is above the minimum recommended and is therefore commended. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 18 The home had a recruitment policy and procedure in place to ensure that staff employed were safe to work with the people living in the home. Inspection of the files of the two most recently employed staff members indicated that this was being appropriately followed, with evidence of Criminal Records Bureau and Protection of Vulnerable Adults (POVA First) checks being carried out and references obtained. Other checks confirming staff identity had also been carried out. Bridge House DS0000018224.V329135.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service experience good outcomes in this area. The conduct and management of the service ensures good record keeping and involvement with people living in the home, in order that their health, safety and welfare is promoted and protected. This judgement has been made using available evidence including a visit to this service. Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has many years experience within the caring profession and is currently undertaking her Registered Managers Award. A deputy manager has recently been appointed and discussion with him confirmed that he is a qualified registered mental health nurse and is enrolled on a diploma in management course. Both staff and people living in the home expressed confidence in the management’s leadership style and evidence of good communication was seen in the minutes of regular meetings held with them, in order to ensure that both staff and people living in the home could participate in decisions about the home. Evidence was seen of close management support systems and, whilst the managers visit the service on a very regular basis, people living at Bridge House confirmed that they were also able to contact them at other times and that they were quick to respond to requests for support. Quality assurance systems had been developed to ensure that the service was meeting its aims and objectives and feedback obtained from both professional staff and people living in the home was very positive in nature. The home’s records inspected were well organised and plans had been developed relating to the business, staff training and the upkeep and maintenance of the home. Information provided by the manager indicated that regular checks were being carried out in order to ensure the health and safety of staff and people living in the home. A random check of the home’s records confirmed that up to date certificates relating to fire, gas and electricity were in place. Bridge House DS0000018224.V329135.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 X 2 3 3 4 4 4 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 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Bridge House DS0000018224.V329135.R01.S.doc Version 5.2 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. Refer to Standard YA36YA36 YA37YA37 Good Practice Recommendations The registered manager should ensure that staff receive regular formal supervision The registered manager/owner should complete her Registered Managers Award. 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