Inspection on 28/11/05 for Bridge House

This inspection was carried out on 28th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bridge House 25/02/09

Bridge House 03/09/08

Bridge House 09/10/07

Bridge House 11/07/06

Bridge House 04/07/05

Bridge House 13/10/04

Bridge House 05/05/04

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 Topping Fold Road Bury Lancs BL9 7NQ Lead Inspector Mike Murphy Unannounced Inspection 28th November 2005 09:30 X10015.doc Version 1.40 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 DS0000008412.V268716.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 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 DS0000008412.V268716.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bridge House Address Topping Fold Road Bury Lancs BL9 7NQ 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) 0161 764 1736 0161 797 5045 European Care (UK) Limited Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 4th July 2005 Date of last inspection Brief Description of the Service: Bridge House is owned by European Care (UK) Ltd. The home provides care and accommodation for up to 34 older people. Bridge House is an attractive detached house situated in a residential area of Bury. The majority of bedrooms are on the ground floor. There are twenty eight single bedrooms and three doubles. Twenty of the single rooms are en suite. There are well kept gardens accessible to service users. In addition to care staff, the home also employs cooks, kitchen assistants, domestic staff, a maintenance worker and an administator. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the home’s second of two annual inspections for the inspection year 2005 to 2006. The inspection took place over four hours. The inspection included discussion with residents and their relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with the manager and staff. The home was being appropriately managed and provided residents with a clean and comfortable environment in which to live. Residents were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. A number of issues were identified in relation to care plans, risk assessments, floor coverings, CRB checks and issues identified in the fire safety risk assessment conducted by the home. These issues are addressed within this report. What the service does well: What has improved since the last inspection? The programme of staff training that was identified in the last inspection report has been implemented and staff have received a wide variety of appropriate and updated training that addresses the health and welfare needs of residents and helps staff deliver care more effectively. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 DS0000008412.V268716.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 the following standard(s): 3,4,5. An appropriate method of assessment is used by the home manager to ensure that potential resident’s health and social needs can be met by the home. The home also seek to ensure that they provide the right type of information to enable potential resident’s and their supporters to make informed choices about the suitability of the home for them. EVIDENCE: Inspection of 3 residents care records revealed that a pre admission assessment had been conducted on all 3. These assessments included consideration of prospective residents physical, psychological and social needs. The assessments had been done by the home manager. These assessments were supplemented by others conducted by various health and social care professionals such as doctors, nurses and social workers. Discussion with residents indicated that where possible they had been able to come to the home for trial visits to the home prior to their admission. They felt this was a good thing because it made them more in control of their own lives Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 9 as well as enabling them to make an informed choice regarding their future. Further discussion with residents also indicated that the home was meeting their needs appropriately. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10,11. The health and personal care needs of residents at the home were being assessed and addressed appropriately. However some issues were identified relating to care records. The arrangements for the management of resident’s medicines were appropriate. And staff interacted and assisted residents sensitively and appropriately during the inspection. These are important matters in ensuring residents receive appropriate care and treatment. EVIDENCE: The health care records of 7 residents who live at the home were inspected on this occasion. These were found to contain care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans in the main addressed the health, personal and social care needs of residents and were evaluated fairly regularly – however some care plans lacked detail in respect of what actions staff were to take in meeting resident’s care needs and a number of care plans had only been formally evaluated erratically. Whilst it is acknowledged that a new system of recording care plans Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 11 has been introduced that remedies the problems identified, this needs to be extended to all resident’s care records. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including weight monitoring) and other relevant areas. However some were evaluated irregularly- it is recommended as good practice that risk assessments should be formally evaluated at least monthly. The arrangements for resident’s medicines were secure and appropriately documented. Discussion with residents indicated that staff at the home treat them with respect and seek to maintain resident’s dignity and privacy particularly when personal care is being provided. Examples of such comments are ‘ the staff are pleasant and kind’, ‘they care for me well here’, ‘ I can go to the lounge or stay in my room as I choose’, ‘ my family are able to visit at any time’. Residents also indicated in their comments, and this was supported in discussion with staff and inspection of care records, that they are able to access health care services appropriately, this included access to opticians, dentists, and chiropodists. Clearly this assists residents in maximising their health and well being. All residents were registered with a local GP. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 the following standard(s): 12, 15. The organisation of social and leisure activities has deteriorated since the last inspection. Meals provided a balanced and varied diet. Both these are important areas for residents as they are central components of how they describe their satisfaction or otherwise with a home. EVIDENCE: Discussion with resident’s indicated that they continue to be satisfied with the personal choices and freedom they were able to exercise. Comments regarding this included ‘I can choose what time I get up in the morning and when I go to bed’, ‘I am able to go out for the day with my friends and visit my family’ and ‘I go to my room when I want to and staff speak to me with respect’. They were however not satisfied with the range of activities, entertainments and outings provided. No programme of activities was displayed in the home and the last entry in residents care records in respect to their diary of social activities was for July 2005. This contrasts with the findings at the last inspection when residents were generally quite satisfied. The manager informed the inspector that she has recruited an activities organiser to work 20 hours per week to address this problem. Residents spoke very positively in respect of the food provided at the home, choice of meals and dining areas provided. Comments made included ‘ the food Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 13 is very good’, ‘I can have something else to eat if I wish’. Menus were varied, balanced and provided extensive choice. Inspection of the kitchen revealed that it was clean, well stocked and adequately equipped and managed. Staff served and assisted residents appropriately and sensitively with their lunch on the day of inspection. This was a hot, substantial and well presented meal. The dining room was clean appropriately furnished and provided a pleasant environment for residents to take their meals. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 the following standard(s): 16, 18. Appropriate measures have been taken to provide an environment where residents and their supporters feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are crucial to the protection of resident’s in a care home, many of whom are extremely vulnerable. EVIDENCE: Discussion with residents and their relatives indicated that there was a general awareness and information provided that enabled people to make a complaint if they desired. A detailed and accessible complaints procedure was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Resident’s spoken to felt comfortable and confident enough to raise a complaint if they felt it necessary to do so. Inspection of policies and procedures operated at the home and discussion with management indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. Regular training has been provided for all staff in the important area of protecting vulnerable adults. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25,26. The home appeared to be structurally well maintained and to provide an appropriate environment for residents to receive personal care and accommodation. EVIDENCE: An ongoing programme of refurbishment and redecoration was in operation at the time of this inspection. All areas of the home designated for resident’s use were accessible to them – including a substantial garden and large well maintained grounds. Adequate and suitable WC and bathing provision was accessible to service users – including a refurbished shower room on the ground floor.9 resident’s bedrooms were inspected on this occasion – these were clean, appropriately/adequately furnished and very personalised. However it remains the case that not all rooms were provided with a lockable space or door lock. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 16 The inspector was informed that lockable spaces were eventually going to be provided in all rooms as furniture was replaced, however one would be supplied on request if desired. The inspector was also informed that an appropriate door lock would also be provided if desired. The arrangements regarding lockable spaces and door locks should be clearly detailed in the service users guide in the home and individual residents preferences noted in their care records. Two bedrooms floor coverings were in need of replacement. Residents spoken to expressed their satisfaction with their bedrooms and stated that they were able to go to their rooms when they chose to. Lounge and dining areas within the home are spacious and provided a comfortable and homely environment for residents – who can choose from a number such areas in which to sit, with some areas being quieter than others. The home was clean and free of odour. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29, 30. Staffing arrangements at the home appeared to be appropriately managed and suitable to meet the assessed needs of residents at the home. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with the home manager indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s at the home. Inspection of 1 recently employed staff personnel file revealed that this contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training. However the inspector was informed by the manager that that a Criminal record check on some staff employed at the home for a long time have still not been received – this issue had been identified at the last inspection in July 2005. Inspection of training records revealed that staff were provided with appropriate training in care and other related issues – including NVQ training. Discussion with staff revealed that they felt they were encouraged and supported in obtaining appropriate training by the manager. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 38. The home was being appropriately managed at the time of this inspection. This is important as residents need to have confidence in and access to competent managers. EVIDENCE: At the time of this inspection the home manager was going through the process of registration with the CSCI. This is a legal requirement for all care homes. The inspector was informed that the home manager, who is very experienced in the care of the elderly and who has worked at the home for many years in a senior capacity, is due to start studying for an NVQ4 in care and management. Discussions with resident’s, their relatives, staff and inspection of recording systems in the home indicated that the home is Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 19 managed in a positive and open way. Management was said to be accessible and responsive to issues raised. Records in respect of fire safety equipment, fire safety training for staff, fire drills, gas safety, electrical safety and lifting equipment were inspected. These were found to be satisfactory. A fire safety risk assessment had been conducted in respect of the premises in July 2005. The CSCI need to be informed how the issues identified in the fire safety risk assessment have been addressed. Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A 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 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X 3 X Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15 Requirement That all residents care plans are completed in sufficient detail that clearly identifies how each resident’s needs in respect of their health and welfare are to be met That the CSCI is informed in writing of what actions have been taken to address the fire safety risk assessment conducted in respect of the home on the 19th of July 2005 That the registered persons confirm in writing to the CSCI that CRB checks have been completed on all staff working within the home Outstanding requirement That the worn floor covering in bedroom 4 is deep cleaned or replaced That the worn floor covering in bedroom 28 is replaced Outstanding requirement Timescale for action 31/01/06 2. OP38 23 31/01/06 3. OP29 19 31/01/06 4. 5. OP19 OP19 23 23 31/01/06 31/01/06 Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 22 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 8 Good Practice Recommendations That risk assessments conducted in respect of resident’s health and welfare are formally conducted on a monthly basis Bridge House DS0000008412.V268716.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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