Inspection on 02/02/06 for Bridge House

This inspection was carried out on 2nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 29/06/07

Bridge House 04/10/05

Bridge House 22/03/05

Bridge House 13/05/04

Bridge House 29/01/04

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

CARE HOME ADULTS 18-65 Bridge House Bridge House 115 Grovehurst Road Kemsley Sittingbourne Kent ME10 2TA Lead Inspector Sarah Montgomery Announced Inspection 2nd February 2006 10:15 Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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 DS0000023825.V268315.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 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 DS0000023825.V268315.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bridge House Address 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) Bridge House 115 Grovehurst Road Kemsley Sittingbourne Kent ME10 2TA 01795 479382 care@cartrefhomes.co.uk Mr Robert William Tyler Mrs Brenda Joyce Tyler Mr Christopher John Tyler Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Bridge House is a registered care home offering 24-hour support to 5 service users. It is a detached property with accommodation on two floors. Accommodation is provided in 5 single bedrooms, all of which have TV points. The home employs a manager, a team leader and 10 care staff, all of whom work a rota, which includes one person working at night on waking duty. A further senior staff member is available on call if needed. The home offers services for young adults with learning disabilities who aspire towards more independent living. The home provides a supportive ‘house share’ environment with clear boundaries enabling service users to take risks and to take responsibility for their own lives and behaviour with the aim towards independent living. Services are tailored to meet the needs of the individual offering opportunities and choice, to facilitate experience, enhancement of self esteem, and to enable service users to manage their lives with minimal support and assistance. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this announced inspection on February 2nd 2006. The inspector spoke with the manager, support staff and service users. Information was gathered from a range of sources, this included reading care plans, assessments, quality assurance documents, activity records, and daily evaluation notes. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that service users are able to use the complaints procedure. Bridge House DS0000023825.V268315.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 DS0000023825.V268315.R01.S.doc Version 5.0 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 DS0000023825.V268315.R01.S.doc Version 5.0 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): 2 Prospective service users benefit from having their individual needs and aspirations assessed. EVIDENCE: Assessment documentation for one service user was inspected. It was evident that the pre assessment process was detailed and thorough, with the pre assessment containing details of the service user’s strengths and needs, and identifying care and support needs. Evidence within the pre assessment is gathered from a variety of sources, and always include the service user. Care plans and risk assessments are developed following the pre assessment, and these documents were closely linked to information contained in the assessment. Bridge House continues to assess service users once they are living in the home, and the initial care plans are reviewed within six weeks, or earlier if required. The inspector asked a service user about moving to Bridge House. The service user described the assessment process, and how his skills, strengths and needs were all important factors in whether or not he moved there. He was aware of risk assessments and care plans, and informed the inspector that he talks about these with his key worker and the manager. The service users added that he feels supported at Bridge, and feels that staff understand what he wants to do with his life, and that they support him to get where he wants to be. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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 and 7. Service users can be confident that their assessed and changing needs and personal goals are reflected in their individual plans. Service users are supported to make decisions about their lives. EVIDENCE: Care plans inspected evidenced a clear and focussed system entirely based on the needs of service users. They are fluid working documents, which are responsive to changing needs. The manager has devised several quality assurance documents to ensure that care plans are truly reflective of current service user need. These documents include; a task book for key workers in which tasks are set at the beginning of the week and expected to be completed by Friday; a discussion section within each care plan, detailing discussion with the service user about how the care plan is going, and a conclusion sheet attached to each care plan detailing how the care plan has been achieved. Files read contained evidence of frequent discussions with service users. These discussions are either recorded in the discussion section of the care plan, or on contact sheets when the discussion is more general and not linked to a particular care plan. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 10 Service users discussed their care plans with the inspector. They displayed awareness of their care plans, and of their risk assessments. They praised the staff and indicated that they felt understood and supported. Service users also spoke of how the care plans help them focus, and that it felt really good when a goal had been reached and another was set. They spoke of being encouraged to move forward, and said that this didn’t feel ‘pushy’, but felt that people ‘cared about what they do with their lives’. When asked about their input into care plans and decisions about their lives, service users said they were fully included, even if this meant that decisions were difficult. Service users explained to the inspector that all care plans and risk assessments are written in full consultation with them. As one service user pointed out to the inspector – ‘if I don’t agree with it, I’m not going to do it, am I?’ Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 16 and 17. Service users have opportunities for personal development, are part of the local community, have their rights respected and responsibilities recognised, and can be assured of benefiting from a healthy diet. EVIDENCE: All service users living at the home have assessments, which detail their strengths and needs in areas of personal development. Individual care plans focus on these more closely, and development of skills is goal orientated within a care plan. Independent living skills have particular focus at Bridge House. All service users are working towards obtaining skills necessary to move onto greater independence. The home excels in this area, providing service users with individual teaching plans linked to assessment and care plans. Service users are supported to work through the goals, and will only move onto the next stage if they feel confident and competent that they have attained the current goal. Conversations with service users evidenced that they are part of the local community, and are knowledgeable about local facilities and amenities. Access to the community can be supported by staff or be independent. Risk assessments detail precise levels of support service users need. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 12 Service users are expected and encouraged to have responsibilities in the home. The service user guide and individual contracts both clearly state group and individual responsibilities. Discussion with service users evidenced that responsibilities for themselves and other people they live with are understood and taken seriously. All service users take part in cooking meals. This is done on a rota basis, and each evening one service user cooks for the house. In addition to this, each evening one service user cooks for themselves. One service user is completely independent in this area and budgets, shops and cooks all his meals. Menus for the house are decided on by all (apart from the service user cooking for himself). Staff ensure that service users are provided with sufficient information to ensure menu choices are nutritional and balanced. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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): THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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. Service users cannot be sure their views are listened to and acted upon. EVIDENCE: Although the home has a complaints procedure, conversations during the inspection with service users indicated that they were not confident about using it, and did not appear to be knowledgeable about their rights to complain. Concerns were raised by service users to the inspector. When asked whether they had raised these issues with staff at the home, or had awareness of the complaints procedure, the service users indicated that they didn’t know how to raise a complaint. The inspector discussed this issue with the manager, and suggested that service users receive ‘training’, possibly through house meetings, about the complaints procedure and how to use it. Complaints raised by service users during the inspection are being addressed by the home. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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 Service users benefit from living in a home that is homely, comfortable and safe. EVIDENCE: All communal areas were inspected. These presented as homely, comfortable and safe. Service users expressed to the inspector that living in a home that is nicely decorated and tidy makes them feel good. Bedrooms were not inspected. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 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. Service users are support by staff who are competent and qualified. EVIDENCE: The staff team comprises of a Manager, a Team Leader, 7 Support Workers, and 3 Waking Night staff. The rota viewed indicated that sufficient staff are on duty to ensure all needs of service users are met. Conversations with staff evidenced that they are knowledgeable about their roles and of individual support needs of service users. Service users spoke highly of the staff team, indicating that they felt supported and understood by all staff, and were particularly satisfied with the individual support received from key workers. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 17 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. Service users benefit from living in a well run home. EVIDENCE: Stuart Byrne has been in post as manager since June 2005. He is in the process of completing the RMA and has applied to be the Registered Manager. Conversations with the manager, and inspection of key documents (care plans, assessments, risk assessments) indicated a management approach that is committed to positive outcomes for service users. This has been achieved by being clear about expectations with the staff team, setting goals and targets for keyworkers, and by gaining an in-depth knowledge of the support needs of service users. Staff and service users described the manager as being approachable. Bridge House DS0000023825.V268315.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 X X X Standard No 22 23 Score 1 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X X X X X X LIFESTYLES Standard No Score 11 4 12 X 13 3 14 x 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 4 X X x X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bridge House Score X x X X Standard No 37 38 39 40 41 42 43 Score 4 X X X X X X DS0000023825.V268315.R01.S.doc Version 5.0 Page 19 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 YA22 Regulation 22(2) Requirement The complaints procedure shall be appropriate to the needs of service users. 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 DS0000023825.V268315.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000023825.V268315.R01.S.doc Version 5.0 Page 21 - 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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