Inspection on 04/07/05 for Bridge House

This inspection was carried out on 4th July 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 28/11/05

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 Announced 4 July 2005 th 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 F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bridge House Address Topping Fold Road Bury Lancs BL9 7NQ 0161 764 1736 0161 797 5045 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) European Care (UK) Limited Manager not registered with CSCI at time of inspection. CRH PC - Care Home Only 34 Category(ies) of OP Old Age - 34 registration, with number of places BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. Date of last inspection 13th October 2004 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 F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the home’s first of two annual inspections for the inspection year 2005 to 2006. The inspection took place over seven hours. The inspection included discussion with residents and their supporters, a tour of the premises, inspection of care and other records maintained at the home, and discussion with management and staff. The home was well-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. What the service does well: What has improved since the last inspection? A number of improvements to the environment of the home have been instituted – in particular a large number of windows have been replaced. Resident’s care records have been reviewed and reorganised – this enables staff to access records more easily and therefore understand the needs and preferences of residents as individuals. Staff training has been reviewed and a BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 6 programme of appropriate training has been implemented that is aimed at improving the service resident’s receive at the home. 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 F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 Prospective residents and their supporters are enabled to make informed choices about the home. EVIDENCE: The home provided a statement of purpose and service users guide that was readily accessible to all potential and existing residents and their supporters. Inspection of these documents revealed that they provided appropriate information in respect of the services provided by the home. These documents were readily accessible to residents and their supporters. Those spoken to found the information easy to understand and were of the view that they fairly reflected the service provided. Inspection of the contract of terms and conditions issued to residents by the home indicated that this document was appropriate and has been reviewed and appropriately amended. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 9 Inspection of care records revealed that all prospective residents undergo a formal pre-admission assessment that is conducted by a senior member of staff from the home. Records of assessment revealed that all the relevant activities of daily life were assessed appropriately and any areas of need in these areas identified. Such an assessment ensures that the home identified precisely what prospective resident’s needs are and that the home will be able to provide the care that individual requires. Discussion with residents, management and staff, and inspection of care records indicated that the care and accommodation provided were meeting residents assessed needs. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 Residents care records have been completely reviewed since the last inspection. The health and personal care needs of residents at the home were being assessed and addressed appropriately. The arrangements for the management of resident’s medicines were appropriate and staff were observed to interact and assist residents sensitively and appropriately during the inspection. EVIDENCE: The health care records of 5 residents 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 appeared to address the health, personal and social care needs of residents and were formally evaluated on a regular basis. 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. The arrangements for resident’s medicines were secure and BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 11 appropriately documented. These arrangements are operated by senior staff at the home all of who have undergone appropriate training in the management and administration of medicines. 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 always polite and willing’, ‘they help me willingly’, ‘my privacy is respected’ and ‘I am well looked after’. Residents also indicated in their comments, and this was supported in discussion with staff and inspection of care records, that residents 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 F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 Social and leisure activities were organised and varied providing stimulation and interests for residents. 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 were satisfied with the personal choices and freedom they were able to exercise. Comments regarding this included ‘I am able to choose when I get up in the morning and when I go to bed’, ‘I go out with my family when I want’ and ‘I go to my room when I want to and staff speak to me properly’. They were also mainly satisfied with the range of activities, entertainments and outings provided. However a number of residents were of the view that more activities/outings could be enjoyed if more staff were on duty. A programme of activities was prominently displayed in the home – this enables residents to be aware what is available and to choose what activities they wish to participate in. This programme of activities is supplemented by an entertainer occasionally coming to the home, and a range of outings, that BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 13 provide appropriate opportunities for residents to experience life and leisure outside the home. 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 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. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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) 16,18. Appropriate arrangements had been made 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. EVIDENCE: Discussion with residents and inspection of responses in pre-inspection questionnaires and the service users guide issued, 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 and record 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, discussion with staff and inspection of staff training records 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. The inspector gave advice on accessing training for staff that relates to the protection of vulnerable people. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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. 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 well-maintained rear garden. Adequate and suitable WC and bathing provision was accessible to service users – however 1 of the bathrooms on the ground floor adjacent to the lounges was still in need of refurbishment and redecoration. The inspector was informed that this issue was schedule to be addressed in September 2005. 12 resident’s bedrooms were inspected on this occasion – these were clean, appropriately/adequately furnished and very personalised. However not all rooms were provided with a lockable space or door lock. 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 BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 16 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. One bedroom carpet was in need of replacement. All 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 at the time of this inspection. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 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 management at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. However a number of residents commented that sometimes they had to wait some time for staff to assist them – particularly in the mornings. Others felt that more activities/outings could be enjoyed if more staff were on duty. Inspection of 2 recently employed staff personnel files revealed that these 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 not been completed. Inspection of training records demonstrated that staff at the home were provided with appropriate training in care and related issues – including NVQ training. Discussion with staff revealed that they felt they were able to access appropriate training and were encouraged and supported by the manager in doing so. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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) 31,32,33,35,36,37,38. 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: Residents and their relatives were very positive about the manager being accessible and approachable. They were of the view that their concerns were addressed promptly and in a manner that made them comfortable in expressing their views and concerns. The arrangements for the management of residents personal allowance monies (where these are managed by the home) were secure and appropriately documented. Residents confirmed to the inspector that they were able to access monies when they required them. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 19 Discussion with staff, inspection of staffing records, and inspection of staff supervision and training records indicated that staff were properly supervised whilst caring for residents. Records in respect of fire safety equipment, fire drills, gas safety, electrical safety, lifting equipment, waste removal, and the regulation of water temperatures were inspected. These were found to be satisfactory. However an up to date fire safety risk assessment was not available for the inspector. BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 3 2 BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 21 yes 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 19 Regulation 23 Requirement That a written action plan that details of when the redecoration/refurbishment of the ground floor bathroom is to be completed is submitted to the CSCI. That a copy of the fire safety risk assessment that has been conducted by the registered persons (including confirmation that any issues identified have been addressed) is submitted to the CSCI That the registered peresons confirm in writing to the CSCI that CRB checks have been completed on all staff working within the home That staffing provision within the home is reviewed in response to the views of residents expressed in the staffing section of this report and that the CSCI is informed in writing of the outcome of this review. That the worn floor covering in bedroom 28 is replaced Timescale for action 30th of September 2005 2. 38 23 31st of August 2005 3. 29 19 31st of August 2005 31st of August 2005 4. 27 18 5. 19 23 30th of September 2005 BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 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. 2. Refer to Standard Good Practice Recommendations BRIDGE HOUSE F56 F06 S8412 Bridge House V222499 040705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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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