Inspection on 05/11/07 for Bridge House

This inspection was carried out on 5th November 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bridge House 05/01/07

Bridge House 03/02/06

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 5th November 2007 09:30 Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 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.V360440.R01.S.doc Version 5.2 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.V360440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridge House Address High Street Normanby Middlesbrough TS6 0LD 01642 452365 F/P 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) www.milburycare.com Milbury Care Services Ltd Position Vacant Care Home 7 Learning disability (7) Category(ies) of registration, with number of places Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual who is above the age category is allowed to reside in the home. 5th January 2007 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.V360440.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection covering all of the key standards of the National Minimum Standards for Care Homes for Adults. The Registered Manager was on maternity leave when the inspection was conducted; an acting manager from another Milbury home was covering her absence. During the inspection a tour of the building was conducted, records, policies & procedures and care plans were examined and the inspector spoke to three relatives, the acting manager and members of staff. Weekly fees are £1017. 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. The summary of this inspection report can be made available in other formats on request. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 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.V360440.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. People who use the service experience good quality outcomes in this area. The homes assessment procedure ensured only those whose needs could be met would be admitted. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There had been no admissions to the home for a number of years, however the acting manager said that any future admissions would be preceded by a rigorous pre-assessment procedure involving a multi-disciplinary assessment as well as an extended assessment conducted by staff from Bridge House; any prospective resident would be invited to visit the home on several occasions, including overnight stays, so that his/her compatibility with existing residents could be assessed as well as the homes ability to meet needs. Following admission there would be a trial period before a decision was made as to the long-term suitability of the placement. Each resident had been given a “Service Users Guide” in a pictorial easy-toread format. The guide contained a copy of the homes complaints procedure, a copy of the last CSCI “Easy Read Report Summary” and a contract that showed the weekly fees. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. People who use the service experience good quality outcomes in this area. The homes care planning process ensured resident’s needs were identified and met. Residents were placed at the centre of the care planning process and were supported to make choices and take control of their lives at a level appropriate to their skills and abilities. Risk assessments and risk management strategies were comprehensive and detailed. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A programme was currently being undertaken to upgrade all care plans to bring them in line with a new corporate format; in addition the home had embarked upon a 12 month programme to produce a user friendly care plan for each resident. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 9 Three care plans were examined as part of the inspection process; all contained comprehensive and detailed information about the resident and his/her needs and wishes. Assessments had been conducted and action plans devised covering all areas of daily living and personal need. Risk assessments had been carried out and risk management strategies developed to eliminate or reduce identified risk. Regular monitoring and reviews involving: the resident, appropriate professionals and members of staff from Bridge House ensured changing needs were identified and suitable management strategies developed. Care plans and daily records indicated each resident was encouraged to take part, at an appropriate level, in the day-to-day running of the home and to make choices about everyday things affecting his/her life. Weekly plans showed the domestic activities undertaken by each resident: accompanying staff when shopping for food and household items, helping in the kitchen, tidying their own bedroom etc. Although their degree of disability made it difficult for residents to fully engage in the care planning process and to make decisions, staff had adopted a person centred approach that ensured each resident was involved as fully as possible in the development of a care plan and all matters affecting his/her life. All of the residents had lived at Bridge House for a number of years, and the knowledge of each resident acquired over an extended period had enabled staff to develop strategies to help overcome communication difficulties and to assist residents in the making of decisions. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. People who use the service experience good quality outcomes in this area. Residents were presented with opportunities to lead fulfilling lives. Staff encouraged residents to take part in appropriate leisure activities. Staff encouraged the maintenance of family and friendship links. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff promoted the right of residents to lead a normal and satisfying life and encouraged and supported them to maintain and develop their daily living skills and to achieve as much independence as possible. The close proximity of the home to neighbourhood facilities enabled residents to be part of the local community and to be recognised and made welcome when they visited the local shops and pub. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 11 Individual activity plans showed each resident was offered the opportunity to participate in a range of leisure time activities suited to his/her lifestyle and wishes, both in-house and in the community: TV, listening to music, relaxation/pampering sessions, arts & crafts, visits to the local pub, local clubs e.g. Southlands, trips out to the coast and countryside and other places of local interest. Although the home had its own transport residents were encouraged, where appropriate, to use public transport (accompanied by staff) and the “Dial a Ride” service. Each resident was given the opportunity to have a holiday that suited his/her individual needs and wishes. One resident took regular holidays at “Center Parcs” which also enabled her to visit her sister who lived nearby. There was a flexible approach to menu planning and mealtimes that, whilst ensuring a healthy and balanced diet was provided, enabled residents to choose their preferred meals and to eat at times that suited them. Staff supported those residents requiring assistance with eating. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. People who use the service experience good quality outcomes in this area. Healthcare and personal needs were met by staff who provided support in a sensitive and flexible manner in accordance with the wishes of the individual resident. Appropriate policies were in place to deal with the illness and death of a resident. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Care plans contained information about the resident’s health, dietary requirements and details of any specific ailment or medical condition. General health was monitored by staff at the home and healthcare needs addressed by the individual resident’s own medical practitioner and other community-based professionals such as the District Nursing Service, chiropodists, dentist etc. Staff supported each resident to maintain as much independence as possible in relation to his/her personal care needs; and understood the importance of delivering personal care sensitively, and in the manner preferred by the individual, so that dignity and privacy was maintained. Staffing rotas were arranged so that the two male members of staff worked opposite shifts to each Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 13 other thus ensuring there was nearly always one of them on duty to support the care needs of the male residents. None of the residents had been assessed as being able to control their own medication. All medicines were stored appropriately and administered by members of staff who had undertaken suitable training in the administration of medicines. Medicines administration records were accurately maintained. The home had a suitable policy to deal with the ageing, illness and death of a resident. The philosophy was to provide a “home for life” and, subject to the home being able to meet changing needs, residents would be able to remain at Bridge House throughout their old age and during terminal illness. Resident’s wishes concerning growing older and death were discussed, where appropriate, with the resident and his/her family and recorded in the care plan. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. The home had a suitable complaints procedure and policies and procedures to safeguard residents from abuse. Staff had received training in the protection of vulnerable adults. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home had a suitable complaints policy and a procedure that described clearly the process for making a complaint, who would deal with it, the timescale for the process and what to do if the complainant was not satisfied with the way in which the matter had been handled. A copy of the procedure was included in the service users guide; and relatives and each resident had been provided with an accessible version of the policy “Letting us know what you think.” On an informal day-to-day basis staff assisted residents to express their feelings about the service and to say if they were unhappy about anything; regularly held House Meetings also provided opportunity for residents to talk about any concerns they might have. Examination of the complaints record revealed the home had not received a complaint since the last inspection. Policies and procedures were in place to safeguard residents and to protect them from abuse. A copy of the “No Secrets” adult protection procedure was available to staff who had all received appropriate training in The Protection of Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 15 Vulnerable Adults (POVA). In conversation staff were able to demonstrate knowledge of what constituted abuse and were aware of the procedure to be followed should an incident of abuse be brought to their attention. Three relatives made the following comments: “I am extremely satisfied, my son is well cared for. I am always consulted about his care and kept informed about things that are going on in the home.” “I am very happy about the care given to my brother, especially as he is now getting out more.” “It’s a smashing home with smashing staff, my son is happy and I am happy. I have no complaints.” Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 30. People who use the service experience good quality outcomes in this area. Bridge House provides comfortable, homely and safe accommodation and meets the needs of the people living there. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Bridge House is conveniently situated within easy walking distance of local amenities and is surrounded by a large enclosed garden that provides a good outside recreational area for residents to enjoy. A walk around the home revealed it to be clean, hygienic and free from any offensive odours; the internal and external fabric of the building was maintained in good condition. Décor throughout was pleasant although some communal areas had chipped paintwork that was in need of remedial work. Furniture in the lounge and dining room was domestic in nature and suitable for purpose. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 17 It was observed that the window in the lounge was without curtains. The Acting Manager explained there was a recurring problem with one of the residents repeatedly pulling at them; this had resulted in the curtain rail being pulled down. He said they were currently considering various options and were hopeful that they would quickly find a way to provide window dressings that could not be damaged. Bedrooms were nicely decorated and provided pleasant and comfortable accommodation that reflected the personality and interests of the occupant; each room contained good quality furniture and had been individualised by the inclusion of personal effects such as pictures, photographs, TV, CD player etc. All areas of the home were centrally heated and radiators had been covered with guards to ensure a low surface temperature; it was noticed during the inspection however that many of the radiator guards were loose and could easily be removed. The provider should ensure that all radiator guards within the home are made secure. During the last inspection the following issues were raised: * Problems with low water temperatures throughout the house. * Uneven paving to the front of the house. Both of these issues have now been satisfactorily resolved. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. People who use the service experience good quality outcomes in this area. Residents were protected by a competent staff team and by the homes policies and procedures on recruitment and training. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: During the inspection it was observed that there were sufficient members of staff on duty to meet resident’s needs. Staffing rosters indicated staff were always employed in sufficient numbers to meet assessed needs, including social needs. The home followed Milbury Care Services corporate recruitment policies and procedures that ensured a rigorous selection process was adhered to. Examination of personnel files revealed that all the necessary information required by Schedules 2 and 4 of the Care Homes Regulations 2201 was in place and that prior to commencement of employment the home obtained two Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 19 suitable references and conducted all necessary checks, including Criminal Records Bureau (CRB). Training records and conversation with staff revealed the home had a good training policy and all members of staff were encouraged to undertake training that would aid their professional development and help them meet resident’s needs. Fifteen of the sixteen members of staff had achieved a level 2 NVQ in Care, three had achieved NVQ level 3 and two had completed their portfolio and were awaiting verification. One member of staff held the NVQ level 4 in Care. There was a supervision policy in place ensuring all members of staff received at least six formal supervision sessions per year. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43. People who use the service experience good quality outcomes in this area. A well managed home with a competent staff team. The health, safety and welfare of residents are protected by the homes record keeping and policies and procedures. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The Registered Manager has relevant experience and is the holder of the NVQ level 4 in Care and the Registered Managers Award; she is currently on maternity leave and is expected to resume her post at the beginning of January. Appropriate management arrangements were put in place to cover her absence, with the vacancy being filled by an acting manager seconded Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 21 from another Milbury home. During this period the home has been effectively managed and has continued to deliver a high standard of service. The home had suitable policies and procedures in place covering all aspects of the management of the home; these were regularly monitored and updated, where necessary, to reflect changes in legislation and current good practice guidelines. Records were kept to safeguard resident’s rights and best interests and to ensure the safe and effective running of the home; these were up-to-date and stored appropriately. Members of staff were aware of their responsibilities under health and safety legislation. Regular checks of the building and equipment were conducted and maintenance and servicing undertaken to ensure a safe and comfortable environment. There were various quality monitoring systems in place both formal and informal to measure success in meeting the homes statement of purpose and aims and objectives: Informal feedback from residents and relatives; Service user review; Staff meetings; Staff supervisions and appraisals; Monthly service review conducted by Milbury’s Operations Manager; Development/Improvement Plans following an Annual Service Review by Regional Quality Assurance Manager. The following comments were published in the Annual Service Review: “The staff provide a very high standard of care and work in a very person centred style.” (Community Nurse) “I am very happy with the very high standard of care my brother receives off all members of staff from Bridge House. My brother is happier now that he goes to college and the gym. It is nice that all members of staff treat him like family – for that I would like to say thank you very much.” (Relative) Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 2 Refer to Standard YA24 YA24 Good Practice Recommendations Suitable means of securing curtains/window dressings should be explored to enhance the appearance of communal areas and to ensure privacy. Damaged paintwork throughout the house should be repaired. Bridge House DS0000000109.V360440.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V360440.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!