Inspection on 06/07/05 for Bridge House

This inspection was carried out on 6th 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 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 07/03/07

Bridge House 05/11/05

Bridge House 02/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Bridge House Green Hills Barham Canterbury Kent CT4 6LE Lead Inspector Nicki Dawson Announced 06/07/05 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bridge House Address Green Hills Barham Canterbury Kent CT4 6LE 01227 831545 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) Family Investment (Four) Limited Miss Bernadette Riley Registered Care Home 6 Category(ies) of Young Adults with a learning disability registration, with number of places Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 10th January 2005 Brief Description of the Service: Bridge House provides residential care for 6 adults with a learning disability. It is situated in the rural village of Barham. A shop with a post office, village hall, bowls club and two churches are within walking distance of the home. Buses provide links to Canterbury and Folkestone. The home is owned and managed by Family Investment Limited, and the families of residents may buy shares in the company. Family Investment Limited also operates a day centre, which is within walking distance of the home. The home is on two floors. There are six single rooms, and two have en-suite facilities. There is a bathroom with toilet and shower facilities on each floor. The communal space consists of a main lounge and a kitchen/dinner. Half an acre of gardens surround the home. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 9.30am and concluded at 6.10pm. The majority of this time was spent talking with residents and staff. The registered manager gave the inspector a tour of the day services offered by Family Investments Limited. This enabled her to talk to all of the residents who live at the home. Two support staff were interviewed and time was spent in the office looking at records and speaking with the registered manager. Two of the residents showed the inspector around their home and the inspector shared a meal with one of the residents. The inspector received information about the service, from the registered manager, all of the residents and three relatives, prior to the inspection. The comments from residents and relatives were all positive about the level of care provided by Bridge House. What the service does well: What has improved since the last inspection? What they could do better: Residents should all be aware of the important things that staff write about them. The home needs to look at ways of ensuring that this takes place. The home needs to strengthen the staff induction programme and broaden the staff training programme to ensure that it meets with the National Minimum Standards. The registered provider needs to complete the appropriate paperwork in relation to the extension to the property, so that the Commission can assess the suitability of the extension to the needs of existing and future residents. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 6 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 H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 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 standard(s) EVIDENCE: Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 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 standard(s) 6, 7,8, and 9 Staff understand the individual needs of residents as set out in their individual plan of care. Residents’ are involved in all aspects of life within this home. EVIDENCE: The individual plans of care that were viewed, clearly set out the resident’s assessed needs. They contain a short history of each resident, followed by health needs and current medication, diet, relationships, communication and current activities. The plans are regularly reviewed with any recent changes highlighted at the front of the document. Residents in this home are encouraged to be independent and strategies to take risks have been written in individual plans of care. The level of resident involvement in this process varies. Some residents knew that staff wrote about them, but said that staff never told them the content. Another resident was able to explain the detailed content of a risk strategy involving them and this document was signed and dated by the resident. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 10 Residents and staff described situations in which the residents were offered choices. “It’s all down to (resident) choice”, stated one member of staff. Staff explained that residents’ choices of activities were restricted when there was only one member of staff was on duty. An extra member of staff is being employed one evening a week to partly resolve this situation and all residents are able to travel outside the home independently. Residents have regular meetings where they come together to discuss their home life. Residents are encouraged to take responsibility for their own monies and clear records are kept of all financial transactions. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 11 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 Residents lead active, busy lives in this home. They take part in a variety of leisure, work and educational activities at home and in the community. They are also responsible for undertaking all household tasks. EVIDENCE: Household tasks are shared amongst the residents. Residents are all aware of their responsibilities, which are detailed on a rota on the kitchen wall. One resident explained that these jobs extend to cleaning the car and checking that it has not run out of petrol. Residents were enthusiastic about the many activities and work experiences that they undertake. Family investment Limited runs a day centre where residents create art, needlecraft, and woodwork. On another site there is a working vineyard, pottery and café. In addition some residents have jobs in the community and attend college. There is also time for leisure activities such as swimming, horse riding and bowls. One resident is an active member of the local church. Residents were excited about the forthcoming trip to the Kent County Show and their annual holiday. One resident was also keen to explain that their birthday party was taking place at the local village hall. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 12 Residents are supported to keep in contact with friends and family by letter or by telephone. The residents phone is situated in a hallway. This location does not offer residents privacy. It is next to a staircase and will be a through fair to two resident’s rooms when the home is extended. The residents share all aspects of meal shopping, planning and preparation. One resident had seen a meal they liked in a magazine, cut the article out and was being supported to cook this meal for dinner that evening. The inspector shared lunch with a resident. It was a relaxed occasion with informal conversation. One staff said that at mealtimes people “talk, just like a family would do”. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18, 19, 20 and 21 A supportive staff team meet the physical, emotional and medical needs of residents. EVIDENCE: Residents organise their own personal care and staff give guidance when needed. The health care needs of residents are recorded in their individual plan of care. Staff stated that a written report is made of all medical appointments and residents confirmed that staff accompanied them to these appointments. Staff are aware of the emotional needs of residents and support them to develop strategies to deal with the problems that can occur when a group of people all share one home. Selected aspects of the storage and administration of medication was inspected and found to be in accordance with the homes policies and procedures. The staff interviewed demonstrated that they were competent in administrating medication and first aid. Through discussion, staff showed that they are discrete and sensitive to the needs of residents who are unwell or bereaved. Extra support is offered or accessed in these situations. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24, 25, 26, 27 and 28 Bridge House provides a comfortable and homely environment for the residents who live there. The registered provider should inform the Commission of any changes to the property before they commence. EVIDENCE: Residents were delighted to give a tour of their home. Each resident has a single room. Bedrooms have been decorated according to individual tastes and contain items that are important to the residents. There is a bathroom and toilet on each floor. In addition two of the upstairs rooms are en-suite. Downstairs a large living room leads to a kitchen/diner and separate laundry area. The garden has been laid to lawn, with a patio area and is accessible from the lounge. The kitchen has been newly fitted and decoration is nearing completion. The registered manager explained that residents are in the process of deciding the new colour scheme for the kitchen. Building work is currently taking place to extend the home to provide two additional resident rooms. The current residents are very aware of the process and some of the impact that this will have on their daily lives. The registered provider has not submitted the appropriate paperwork to the Commission in respect of this extension. She stated that she would do so immediately. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Residents are protected by the home’s recruitment practices. Staff understand and communicate well with the residents, both individually and as a team. Mandatory training in induction, adult protection and infection control needs to be undertaken by all staff to ensure the safety of residents. EVIDENCE: Staff have a clear understanding of their main roles and responsibilities when working at the home. They said that these roles were accurately recorded in their job description. Residents spoke highly of the staffs’ qualities. One resident said that they did not have any problems because the staff took care of them, another said that the staff were good ‘companionship. Staff explained that before they were employed in the home they completed an application form and attended an interview. An examination of personnel files indicated that the necessary pre-employment checks had been undertaken. The staff team consists of the registered manger, two deputy mangers and five support staff. The registered manager and one deputy manager also manage another residential home nearby. There is a minimum of one member of staff in the home at all times, rising to two members of staff at some periods. An additional member of staff is being employed one evening a week to ensure that some residents can attend the ‘Special Olympics’. This new member of Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 17 staff was shadowing an existing member of staff as part of their induction during the inspection. Staff receive in-house induction. The National Minimum Standards require that in addition staff are inducted to Sector Skills Council Specification. The registered manager is developing a staff training programme for all staff to ensure that they receive mandatory training. Training in infection control and adult protection had been omitted from this training matrix. Three staff are in the process of completing NVQ Level 2. Staff said staff meetings are regularly held and that they are an effective form of communication. In addition staff communicate the changing needs of the residents by writing in the handover sheets and communication book. Staff receive supervision. The personnel files viewed indicated that the regularity of these meetings fluctuates between staff. However, staff said that ‘Bernadette’s (the registered manager) always got time if you want to talk about something’. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 42 The residents and staff benefit from the open and clear management approach in the home. Systems are in place to ensure the health, safety and welfare of residents. EVIDENCE: Staff said that the registered manager had “good people skills” and this was evident in the sensitive way in which she communicated and supported residents during the inspection. An inspection of records revealed that maintenance of gas, electrical and fire fighting equipment had been undertaken. The fire alarm was activated during the inspection and residents and staff left the building calmly. The registered manager followed the homes procedures in respect of this unplanned fire drill. One member of staff applied first aid to a resident during the inspection and did so competently using the correct equipment. Staff demonstrated through discussion that they knew what to do if an accident took place. Assessments of environmental risks to residents have been undertaken and this includes the current building work that is taking place. Residents’ explained the potential dangers that can occur when building work takes place. Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 19 Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 20 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 x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 2 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bridge House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 21 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 15 Regulation 16 2 (b) Requirement The registered person must write a plan of action and send it to commission, stating how residents will access the telephone in private. The registered person must complete an application form in respect of the extension to the home and send it to the commission without delay. The registered person must ensure that all new staff receive structed induction and foundation training to Sector Skills Council specification The registered person must ensure that all staff receive training in the protection of vulnerable adults The registered person must ensure that all staff receive training in the control of infection Timescale for action 6/9/05 2. 24 26 19/7/05 3. 35 18 c (i) 6/7/05 4. 35 13 (6) 6/1/06 5. 35 13 (3) 6/4/06 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 Good Practice Recommendations H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 22 Bridge House 1. Standard 6 2. 3. 20 35 The registered person should ensure that all residents are involved in the care planning process and that they are informed of the content of important imformation that is written about them The registered person should keep a sample signature of all staff who administer medication The registerd person should ensure all staff induction and foundation training is accredited by the Learning Disability Award Framework Bridge House H56-H05 S23349 Bridge House V226747 060705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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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