Inspection on 20/06/05 for Bridge House

This inspection was carried out on 20th June 2005.

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 24/11/08

Bridge House 10/01/07

Bridge House 12/01/06

Bridge House 19/01/05

Bridge House 21/06/04

Bridge House 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bridge House Manorside Market Street Flookburgh, Grange Over Sands Cumbria LA11 7JS Lead Inspector Ray Mowat Announced 20 June 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bridge House Address Manorside Market Street Flookburgh Grange Over Sands Cumbria LA11 7JS 015395 58622 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cumbria Care Anthony Lyons Care Home 40 Category(ies) of OP 40 12 (DE)E registration, with number of places Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. A maximum of forty older people (OP40) may be accommodated including twelve older people with dementia (DE(E)12) 3. The staffing levels for the home must meet the Residential forum Care Staffing Formula for Older Adults by 1st April 2004. 4. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available.. Date of last inspection 19 January 2005 Brief Description of the Service: Bridge House is a purpose built residential care home owned by Cumbria County Council and operated by Cumbria Care, an independent business unit of the County Council. Bridge House is registered to provide residential care to forty older people, including up to twelve residents with dementia. The home is divided into three distinct units, Sandgate, which specialises in Dementia care, Applebury and Humphrey Head. There is a passenger lift making all three floors fully accesssible. There are pleasant gardens to the front and rear of the home. The home is situated in the centre of the village of Flookburgh, within walking distance of the local amenities and close to the town of Grange-over-Sands. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 20th June 05. The inspector met with many of the residents during the day, including the “case tracking” of three residents. This involves meeting the resident and the staff that support them and then examining their care plan files. During the course of the inspection, the inspector also spoke to volunteers, families and a district nurse who were all visiting the home. The inspector spent time in all three units, talking to staff, in addition to formally interviewing two staff. The inspector discussed issues arising with the supervisors on duty and the manager throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The key area for improvement for the home was in the development of more detailed care plans, for individuals with specialist healthcare needs, such as diabetes. Information must be in place to support and guide staff, based on good practice and advise from relevant professionals. At present there are limited opportunities for residents to participate on trips outside the home, further opportunities to support such activities should be explored. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 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 F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5. The admission process is effective and provides prospective residents with clear information and the opportunity to make an informed choice, about moving into the home. EVIDENCE: All residents entering the home were offered a service user guide, which contains all relevant information about the home as required by the National Minimum Standards (NMS). This enables resident s and their families to make an informed choice about living in the home. Many of the residents spoken to were familiar with the home prior to moving in on a permanent basis. This was through attending the day service that is run from the home three days each week or from staying in the home for respite care. Residents commented on how these short stays had given them chance to “adjust to the idea of living in residential care”. There are two beds within the home that are “block booked” by Social Services that are used solely for respite care. The home takes referrals from Social Services and private fee payers. The manager or supervisor will always visit any prospective residents’ and complete a comprehensive assessment, prior to admission to the home. This ensures the home is able to fully meet the individual needs of the residents. A Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 9 clear contract of terms and conditions is agreed and signed by the resident or their representative on admission to the home, this clarifies the home’s and the resident’s responsibilities. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. On the whole records relating to resident’s personal and healthcare needs were good and kept up to date, however information relating to specialist healthcare needs must be strengthened. EVIDENCE: Resident’s care plan files were examined by the inspector, these contained very informative personal profiles, which were written in the first person making them more meaningful. There was evidence care plans were kept under review, with monthly monitoring sheets signed by key workers. These documented changes to the care plan and actions required, which is good practice. Manual handling risk assessments were in place in addition to a comprehensive functional assessment that was also kept under review on a monthly basis. Personal and healthcare needs were also documented and monitored within the care plan. All residents were registered with a GP of their choosing. There was also evidence of specialist services being engaged when needs were identified, including regular contact with the district nursing team, intermediate care team and psychiatrist. Although there was reference to specialist or specific care needs and conditions, there was not detailed information to guide and support staff in responding to related issues. Diabetes care was an Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 11 example of this, with a record on file that a person had diabetes and was insulin dependent and supported by the district nurse but no detail about how the condition presents and what action staff should take in an emergency etc. Relevant risk assessments are also required. Daily care notes were completed for each resident to ensure pertinent information was passed on between shifts, these included various monitoring charts related to health and well being such as weight charts, “ABC” monitoring charts for problem behaviours and food intake. The home has developed a robust medication policy, with residents encouraged to maintain their independence. Multi disciplinary risk assessments were in place to support self-medication. Resident’s questionnaires stated that residents felt they were treated with respect and dignity at all times, which was confirmed by discussions with residents and their families during the inspection. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Residents were seen to exercise choice and control over their lifestyle and enjoy access to a range of activities within the home. EVIDENCE: A member of staff has been appointed to take a lead role on facilitating and coordinating activities within the home. She has 1-2 days each week for this role. She has liaised with the local Adult Education service, which has provided a tutor, to facilitate taster sessions such as craft activities and IT, currently they are piloting a reminiscence course, which was proving popular with residents. Each unit within the home has developed an activity file, which records forthcoming events and also an individual record of which activities residents have participated in. This enables staff to monitor the effectiveness of activities and ensure resident’s needs are being met appropriately. It was evident the home provides a good range of organised activities, as well as making resources available for residents to enjoy at their leisure. Families, friends and volunteers also get involved, on the day of the inspection “PAT” dogs (Pets AS Therapy) were visiting the home, which two residents in particular look forward to each week. The weekend prior to the inspection the home had organised a tabletop sale, residents also talked about a coffee morning in the village hall, which had proved popular. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 13 The home has consulted residents regarding activities provided and on the choice and quality of food. Feedback from residents was responded to, with suggestions being incorporated into new menus, these were then discussed at a house meeting. During discussions with residents and staff the issue of day trips/bus trips was raised, at present these are not available to residents, as they do not have access to a vehicle. The feasibility of providing trips should be explored and shared with residents and their representatives. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18. Resident’s are safeguarded and their rights protected by the home’s policies and practice. EVIDENCE: The home has a detailed complaints policy and procedure, which meets the requirements of the care home regulations. The policy was issued to residents or their representatives within the service user guide, giving them clear information. There have been no complaints since the last inspection, although the inspector did examine the investigation record of a complaint received by the home just prior to the last inspection. This had been fully investigated and resolved with the complainant. Residents and visitors spoken to were aware of how to complain. Information about advocacy services were made available to residents or their representatives. However advocates were not routinely used, with residents being represented by family, friends or solicitors. The home manages small amounts of personal finances with clear records maintained of all transactions. Based on discussions with staff they were aware of their responsibilities in identifying and reporting abuse, the policies of the home and had completed appropriate training. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. Bridge House is safe and well maintained and provides a comfortable living environment that meets the needs of the residents. EVIDENCE: On the day of the inspection the home was found to be clean and hygienic, domestic staff are employed, who have a lead responsibility for maintaining the cleanliness of the home. Within the units care staff are involved in cleaning duties related to mealtimes. The home has a suitable programme of repairs and renewal and on the whole the home was well maintained, decorated to a good standard and safe. The manager was aware of the corridor and lounge, which were in need of attention due to chairs and wheelchairs, chipping and marking walls and paintwork, with remedial work planned. There was a cracked toilet seat in a communal bathroom that was in need of replacement. There is a designated smoking area within the home, this is a small lounge on the second floor. It has a fan fitted, however this is being upgraded to ensure the smoke does not get into other parts of the home. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 16 The gardens and grounds were in a good state of repair and were being upgraded with new furniture and a new patio area. On the day of the inspection the residents were in the garden enjoying the good weather. The probation service were supporting young people, who are serving community service orders, to maintain the gardens. This was being managed effectively by the home to safeguard residents at all times. The home has a well-equipped laundry, which was clean and well ordered. There was a colour-coded system to separate laundry from each unit, with the home providing and stitching on nametapes for individual’s clothes to make them easily identifiable. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30. The home has sufficient numbers of suitably trained and experienced staff on duty each day to meet the needs of residents. EVIDENCE: The home had recently appointed staff to all vacant posts giving them a full compliment of staff. It was evident staff were receiving core induction training within the required timescales. At present there were only twelve care staff with the NVQ qualification, which is below the 50 required by the NMS. However staff are working towards the qualification, which should meet the target. The recruitment procedures in the home were in line with current good practice and safeguarded residents with all relevant checks in place. The central training unit send out a training programme for six months ahead, which enables the manager and supervisors to identify appropriate courses for staff to maintain their professional development. Continuous professional development files have been introduced for all staff to record and monitor all training activity. The organisation was in the process of introducing an annual appraisal format for all staff, which will be completed by the end of June 05. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37, 38. The home was well managed, with residents and staff feeling well supported and safe. There was a clear management structure, with the home being run in the best interests of residents. EVIDENCE: The current manager of the home Mr Tony Lyons has been in post for two and a half years and is working towards the registered manager award. Based on discussions with residents and staff they felt well supported by the management of the home, whom they said were “approachable and available at any time”. The inspector examined resident’s questionnaires, which had been completed on a regular basis. These covered areas such as quality of care, respect and dignity, activities and food. Issues arising from these had been discussed either individually with residents or at the resident’s meetings, if this was appropriate and actions agreed in response to points raised. When the Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 19 inspector was talking to a resident about the quality of the service, they described it as the “Flookburgh Hilton”. Staff meetings had been planned for the remainder of the year, every two months, to coincide with the organisations team briefing. The organisation sets an annual budget for the home, which is managed locally by the manager, with monthly monitoring systems in place for all income and expenditure. The home manages small amounts of personal monies at the request of residents or their representatives. These were securely stored and robust monitoring systems in place to safeguard residents and staff. The manager and supervisors provide formal supervision for all staff in line with the NMS, which staff felt was beneficial to them and provided them with support and guidance as required, including training and personal development. The inspector examined records required by regulation and for the safe and efficient management of the home. These were found to be up to date and in order. The home had recently been visited by the fire officer and environmental health department and found to be satisfactory. Health and safety issues were being formally monitored by management, to maintain a safe environment. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 21 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 7 Regulation 15(1) Requirement Clear guidance for staff, in responding to specialist healthcare needs, must be recorded in the care plan. Timescale for action 1st September 05 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. Refer to Standard 14 Good Practice Recommendations It is recommended the home look at the feasability of providing/facilitating trips out for residents. Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bridge House F58 F10 s36506 bridge house v224702 200605 ai stage 4.doc Version 1.30 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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