Inspection on 03/02/06 for Bridge House

This inspection was carried out on 3rd February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridge House 05/11/07

Bridge House 05/01/07

Bridge House 03/10/05

Bridge House 02/02/05

Bridge House 12/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Bridge House High Street Normanby Middlesbrough TS6 0LD Lead Inspector Ray Burton Unannounced Inspection 3rd February 2006 10:00 Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bridge House Address High Street Normanby Middlesbrough TS6 0LD 01642 452365 01642 452365 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) londonroad@tiscali.co.uk Milbury Care Services Limited Mrs Diane Mary Croves Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual who is above the age category is allowed to reside in the home. 3rd October 2005 Date of last inspection Brief Description of the Service: Bridge House is a large old house located in a quiet cul-de-sac within easy walking distance of local shops and other community facilities. All accommodation is provided in single bedrooms. Externally there is a large and pleasant garden. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on 3rd February 2006 and was the second of two statutory annual inspections required to be carried out under the Care Standards Act 2000. What the service does well: 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. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 6 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 DS0000000109.V273393.R01.S.doc Version 5.1 Page 7 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): These standards were assessed during the inspection conducted on 3rd October 2005. EVIDENCE: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 8 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): These standards were assessed during the inspection conducted on 3rd October 2005. EVIDENCE: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 9 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): 16,17 Resident’s rights were respected and staff encouraged them to be as independent as possible. A varied and balanced diet was in place. EVIDENCE: It was apparent from conversation with members of staff and observation of staff/resident interaction that there was a relaxed and friendly atmosphere in the home and that resident’s rights and privacy were respected. Routines were flexible and accommodated the needs and wishes of individual residents. Staff encouraged residents to be as independent as possible and supported them to exercise choice and make simple decisions within the framework of their individual plans and risk assessments. A comment card received from the sister of a resident stated: “I feel my sister’s individuality is well regarded and that the care at Bridge House has helped her to develop and emotionally grow in recent years.” Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 10 Residents were able to access all areas of the house and grounds subject to any restrictions that had been agreed on health and safety grounds and as recorded in their individual plans. Examination of the menus showed residents were offered a varied and balanced diet. Alternatives were always available should someone not wish to have the dish of the day. Meals were generally served at set times in the dining room, although there was flexibility to allow for individual activities. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 11 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 assessed during the inspection conducted on 3rd October 2005. EVIDENCE: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 12 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): These standards were assessed during the inspection conducted on 3rd October 2005. EVIDENCE: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 13 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): Bridge House provides comfortable and homely accommodation and meets the needs of the people living there. Some maintenance issues from the previous inspection report remain outstanding. EVIDENCE: These standards were assessed during the inspection conducted on 3rd October 2005. A walk around the building on this occasion revealed a continued improvement in the general environment - communal areas and bedrooms were comfortably and appropriately furnished and the home was, in the main, nicely decorated. It was pleasing to see the newly decorated dining room and to note the homely touches such as ornaments and pictures that made this, formerly austere, room pleasant and welcoming. Unfortunately several issues highlighted in the previous inspection report, and which were outside of the control of the manager or staff, remained outstanding: Renewal of flooring in the entrance hall and general upgrading in the entrance hall, staircase and landing areas. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 14 Paving to the front of the house remained uneven. Floor covering in the first floor bathroom was badly stained and required replacing. Working surfaces in the kitchen were marked and in need of replacement. It is acknowledged that these issues are part of a rolling programme of improvements planned for the home, however as they are longstanding issues it is important that the provider addresses them as a matter of priority. In addition the following issue was identified on this occasion: A door closer and hold open device should be fitted to the dining room door (as indicated in the report from Cleveland Fire Brigade). Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Staff demonstrated a suitable knowledge of individual residents and received appropriate training to enable them to meet their assessed needs. The home had an appropriate recruitment policy and procedure, but not all required information was kept in the home. EVIDENCE: The home adhered to Milbury’s corporate recruitment policies and procedures that ensured a rigorous selection process was followed. Examination of personnel files revealed all required documents were in place, however the Criminal Records Bureau information held at the home was not sufficiently comprehensive. All new members of staff undertook a one-week orientation period to familiarise them with the home, systems and residents. An appropriate induction training course had to be completed within six weeks of commencing employment, followed by LDAF training to be completed within a further six weeks. All members of staff were encouraged to undertake ongoing training courses that would aid their personal development and help them to meet resident’s needs. Courses undertaken during the last twelve months included: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 16 First aid; Food Hygiene; Safe Handling of Medicines; Protection of Vulnerable Adults; Epilepsy Awareness; Autism; Moving & Handling; Introduction to Learning Disabilities; Report Writing & Record Keeping; Person Centred Planning; Dementia Awareness; Healthy Eating. Seven members of staff were the holders of the NVQ Level 2 in Care. The remaining 50 were currently undertaking the course. All senior care workers were working towards achieving the NVQ Level 3 in Care. In conversation the manager and members of staff displayed an in-depth knowledge of each resident and his/her needs and aspirations. They spoke with understanding of the difficulties faced by each individual in matters such as communication and self-help skills and were able to demonstrate how they could provide support to enable residents to optimise their potential and lead fulfilling lives. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 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): 37,39,42 EVIDENCE: The home had appropriate policies and procedures that complied with current legislation and recognised professional standards. Records were kept to safeguard resident’s rights and best interests and to ensure the safe and effective running of the home. These were well maintained, up-to-date and stored appropriately. Because of their level of disability none of the residents was able to tell the inspector bout their experience of living at Bridge House or to express an opinion about the running of the home, however comment cards received from relatives indicated satisfaction with the service provided. The sister of one of the residents said: Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 18 “The care that my brother receives from the staff at Bridge House is first class. The time and consideration given to him and the family is beyond reproach.” The home had various systems both formal and informal to measure success in meeting its aims, objectives and statement of purpose and to ensure residents rights and best interests were safeguarded: Regular review meetings to which all appropriate interested parties were invited; monitoring and updating of care plans; monthly audit conducted by Milbury Care Services Operations Manager; annual service review; informal discussions with residents relatives. It was apparent from conversation with members of staff that morale was high and that the manager and all members of staff worked well together as a team to ensure the smooth running of the home and to promote a good lifestyle for the residents. When interviewed staff expressed confidence in the manager and said that she was enthusiastic, approachable and was a good motivator. The manager is the holder of appropriate qualifications in both management and care. Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 3 x 3 x x 3 x Bridge House DS0000000109.V273393.R01.S.doc Version 5.1 Page 20 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 YA34 Regulation 19 Requirement CRB disclosures/information held on staff personnel files must demonstrate the level of the disclosure and the client group for which the disclosure was obtained (i.e. demonstrate POVA checks) Repainting and decorating must be carried out to the staircase. The uneven paving on the patio must be made safe. The provider must fit a door closer and hold open device to the dining room door as per the letter received from Cleveland Fire Brigade. Timescale for action 31/03/06 2 YA24 23(2)(d) 01/11/04 3 YA24 23(2)(d) 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 DS0000000109.V273393.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 DS0000000109.V273393.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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