CARE HOME ADULTS 18-65
Bridge House Bridge House 115 Grovehurst Road Kemsley Sittingbourne Kent ME10 2TA Lead Inspector
Graham Cummings Unannounced Inspection 4th October 2005 09:30 Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bridge House Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bridge House 115 Grovehurst Road Kemsley Sittingbourne Kent ME10 2TA 01795 479382 care@cartrefhomes.co.uk Mr Robert William Tyler Mrs Brenda Joyce Tyler Mr Christopher John Tyler Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd March 2005 Brief Description of the Service: Bridge House is one of a group of three homes known as ‘Cartref Homes’. Mr R Tyler and Mrs B Tyler are the owners of all three homes. It is a detached property with accommodation being on two floors. The first floor accommodation consists of five single bedrooms all having a washbasins and TV points. Also on this floor is a bathroom with bath and toilet as well as a shower room containing a shower and toilet. On the ground floor there is a large lounge, a second lounge that is used for activities, a games room with pool table, a kitchen/dining room and the laundry. The home offers care to young adults with learning disabilities who wish to be able to enjoy an independent life as possible. The home provides a supportive environment with Service Users sharing the home’s facilities and the responsibilities for running it. There are clear boundaries and procedures in place to enable Service Users to take responsibility for their own lives and to work towards independent living. Services are tailored to meet the needs of the individual offering opportunities of building self-esteem and gaining the skills needed to manage and organise their lives. The home employs ten full/part time care staff who work a rota that ensures the home is adequately staffed during the day and there is one wake night person on duty. A senior staff member and the Registered Manager provide backup as required. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the Unannounced Inspection between 09:30 and 11:45am on the 4th October 2005. The Inspector spoke to the Team Leader on duty Shelley Griggs. The Inspection also consisted of looking at staff files, Service User files and a tour of the home. The Inspector noted that the Registration Certificate on display in the office said the home was registered for 3 however the home has 5 Service Users living there, an application appears to have been put in to the Commission in July 2002 but the paperwork has never changed, this needs to be clarified by the Commission. The home had a good relaxed atmosphere and was light and spacious and the Service Users made positive comments to the Inspector when introduced. Service Users were spoken to with respect and were appropriately praised when they carried out any tasks without prompting. The home is run in the best interests of the Service Users and with their consultation. All of the Requirements from the last inspection have been addressed. The Inspector left the home with no concerns for the health, safety and welfare of the Service Users. What the service does well: What has improved since the last inspection?
The 3 Requirements made at the last inspection have all been addressed. The complaints procedure had been changed to include the CSCI and the Area Office address. Some of the document still had the NCSC initials and these need to be changed to CSCI. Staff supervision has started and the Inspector noted that dates had been put in the homes diary for supervision to take place. The landlords gas certificate was dated 16.6.04 and Portable Appliance testing stickers were seen in the kitchen dated 16.5.05. A self medication policy was seen in the Policy and Procedures manual. A new sofa had been purchased for the lounge and some decoration had taken place.
Bridge House DS0000023825.V255469.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 DS0000023825.V255469.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Service Users have access to information to make an informed choice. Prospective Service User needs are assessed. Prospective service Users are encouraged to visit prior to any placement. Service Users have written contracts. EVIDENCE: The Inspector saw the homes Statement of Purpose and Service User Guide which are available to any prospective service user. Pre Placement agreements were seen on Service Users files, the home encourages any prospective Service User to visit the home before any placement takes place, this would be to try and ensure that both new and existing Service Users meet and agree to the placement. The Inspector noted that the files looked at had contracts and conditions on them. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, Service Users changing needs are reflected in their individual plans. Service Users are part of the decision making process and are consulted and participate in the running of the home. Service Users are supported to take risks as part of an independent lifestyle. EVIDENCE: The Inspector saw 2 Service User care plans and found them to contain clear information that had been evaluated and updated at regular intervals. Service Users have participated in the making of the care plan and signed them to show their agreement. Service User meetings take place weekly where issues are raised and discussed and any views and ideas are listened to and where appropriate implemented. There are clear risk assessments in the care plans that support individuals in progressing their independent living skills. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17 Service Users have opportunities for personal development and take part in appropriate activities in the local community. Service Users have appropriate relationships. Service Users rights are respected and are offered a healthy and nutritious diet. EVIDENCE: Service Users personal development is set out in their care plan and community opportunities include educational, social and personal activities including attending college, Navy Reserves, Judo, card making and Bingo. Service Users have contact with family members and friends with most of the Service Users going home for overnight stays. The Inspector noted throughout the visit that staff spoke and listened to Service Users with respect. The Service Users are encouraged to cook as much as possible for themselves and for the group with support as part of their independent living skills training, the dining room is bright and makes a nice environment to eat meals in. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 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): 18,20 Service Users receive personal support in the way they prefer. Service Users are protected by the homes policies and procedures. EVIDENCE: Service Users are able to carry out personal care themselves and in the way they wish. Following the last inspection the home have produced a policy and procedure that protects Service Users, any medication that is self administered is kept in a locked cupboard in Service Users bedrooms, spot checks are carried out at intervals to ensure that Service Users are protected. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 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): 22,23 Service Users are listened to and protected from abuse. EVIDENCE: Service Users throughout the inspection were able to speak to staff who listened and responded to in an appropriate manner. All staff have attended the Learning Disabilities Award Foundation training and attend local courses as well. Staff on duty were aware the procedures to follow should an adult protection issue arise. A complaints procedure is in place. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 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): 24,27,28,30 Service Users live in a homely environment. Service Users have sufficient bathrooms and toilets to meet their individual needs. Shared space complements individual rooms. The home is clean and hygienic EVIDENCE: The home is comfortable and well furnished, there are 2 separate lounge areas and a games room and a kitchen diner. There is a bathroom and toilet as well as a shower room with toilet. The garden has a seating area if Service Users wish to use it. The home is clean and hygienic and Service Users are encouraged to do their own laundry and cleaning. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 14 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): 31,32,34,35,36 Service Users benefit from a clarity of staff roles and are supported by a competent staff team and the homes recruitment process. Staff have access to training facilities and are well supported and supervised. EVIDENCE: The Inspector looked at staff files and found that they contained the relevant information required including an application form, 2 references, CRB, contract and Job description. The home has a good training record and has staff completing their NVQ level 3 which will bring them to above the 50 requirement before the end of 2005. The Inspector saw individual supervision appointments in the diary. The staff on duty informed the Inspector that they have good support from the management team and they can always get the advice or support they require. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 15 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): 37,41,42 Service Users benefit from a well run home. Records seen indicate that Service Users benefit from the homes record keeping. The health, safety and welfare of the Service Users are promoted and protected. EVIDENCE: The home appears to be well run and managed, the Inspector did not meet with the manager but the staff said that the manager was competent, supportive and always available. The home has weekly management meetings and monthly staff meetings to ensure that there is a consistency of approach to the Service Users. The homes records seen looked to be of a good quality and standard. Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Bridge House Score 3 X 2 x Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 3 X DS0000023825.V255469.R01.S.doc Version 5.0 Page 17 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. Standard Regulation Requirement Timescale for action 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 YA20 Good Practice Recommendations The registered manager and staff encourage and support service users to retain, administer and control their own medication, within a risk management framework, and comply with the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. The registered person ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, or inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policy. Staff should attend an adult Protection training course in the near future to update their knowledge following the introduction of new Local authorities protocols. 2 YA23 Bridge House DS0000023825.V255469.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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