Inspection on 07/03/07 for Bridge House

This inspection was carried out on 7th March 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 05/11/05

Bridge House 06/07/05

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 Key Unannounced Inspection 7th March 2007 13:40 Bridge House DS0000023349.V300668.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 DS0000023349.V300668.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 DS0000023349.V300668.R01.S.doc Version 5.2 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 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) Family Investment (Four) Limited Post Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th November 2005 Brief Description of the Service: Bridge House provides residential care for up to eight 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 buy shares in the company. The day centre (Fifth Trust Work), Elham Valley vineyards, pottery and teashop form an integral and significant part of the lives of the residents. The home manager, Annette Norton, has applied to become the registered manager. The home is on two floors. There are eight single rooms, of which five 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. The fee level is £484.86 per week. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, which means that nobody knew that the inspector was coming to the home. The inspection started at 1.40pm and took six hours. Time was spent in the office looking at records. The inspector spoke with residents and care staff. She joined everyone for dinner. The inspector looked around some of the rooms in the home. The home manager was not at the home on the day of the inspection. She was contacted by telephone afterwards. What the service does well: What has improved since the last inspection? All of the things that needed to be done, since the last inspection, to make the home better for residents, have been done. Residents have helped to write the Service User Guide. It is easy for residents to understand what is written in it. There is a procedure in place so that residents can make telephone calls in private. Residents’ care plans have been written in a way that staff find easy to understand. This helps staff to do their job better. There are good checks in place to make sure that residents are given the right medication. A number of policies and procedures are now up to date. This helps staff to do their job the right way. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 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 DS0000023349.V300668.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents are given information about the home that is easy to read and their needs are fully assessed, before they move to the home. EVIDENCE: The home has a ‘statement of purpose’ that sets out the aims, objectives and philosophy of the home, together with the services and facilities provided for residents. This document is kept up to date. The ‘service user’s guide’, clearly sets out for residents, the services and facilities that they can expect if they move to the home. This has been written in an easy to read format, using pictures. It is a very good piece of work. The home has assessed two potential resident’s suitability for living in the home, since the last inspection. Detailed assessments are written for each resident. Staff said that they were helpful in ensuring that resident’s care needs are met. All potential residents have opportunities to visit the home, including overnight stays, before deciding whether the home meets their needs. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 9 A resident contract was sampled which sets out the terms and conditions of residence at the home. New contracts now include the weekly residential home fee. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ participate in all aspects of life in the home and their individual needs and choices are promoted. EVIDENCE: Residents’ care plans have improved since the last inspection. They contain all the information that staff need to support residents. The plans are kept up to date and any changes are highlighted. Staff said that care plans are easy to understand and use on a daily basis. Residents are involved in any changes to their care needs. Residents say that they are able to make choices as part of their everyday lives. Staff gave examples of how they help residents to make choices. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 11 Residents take part in all aspects of home life. They are able to make their views known at residents meetings. These take place once a month and are recorded. There are clear records kept of all residents’ monies. Residents are encouraged to save money for activities, holidays and transport so that everyone has enough money to take part. It was recommended at the inspection that this agreement between residents and the home be written in the home’s policy and procedures. The manager actioned this immediately after the inspection. Residents are supported to take risks and these are clearly recorded in individual risk assessments. To minimise the risk for the resident, there is a checklist which staff use before the activity is undertaken. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 12 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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home supports residents to live fulfilling lives. EVIDENCE: Staff encourage residents to take part in their share of the household tasks and develop their independent living skills. Each resident is allocated one day at home a week to attend to their household tasks and any shopping. Family Investment, through the Fifth Trust, has developed a range of day opportunities for residents. There is a pottery, vineyard and teashop in the Elham Valley and a workshop in Barham. The residents are actively involved in these activities and say that they are happy with their activity programmes. Some residents have jobs in the community and others are working towards NVQs. At one time during the inspection, all of the residents and staff were out of the home, at the activity centres or shopping with staff. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 13 Residents have opportunities to take part in a wide range of leisure activities. There are some leaflets of different events on the resident’s notice board and residents are able to put their name by the event/s they want to go to. On the evening of the inspection some residents went out to gym and swim. One resident said that they had celebrated their birthday by going bowling. Another resident talked enthusiastically about a trip to the cinema. Residents have a holiday once a year, which they look forward to. Residents are encouraged to develop and maintain relationships with friends and family. Some residents spoke about the friends they had made that live at other Family Investment houses. Residents said that their relatives are able to visit the home when they wished. Residents, who wish, have a key to their room to maintain their privacy. In the evening residents are able to take part in the activity that they choose. On the day of the inspection, some residents went out, others went to their rooms, some sat in the lounge and others did household tasks. The inspector joined the residents for their evening meal. Staff and residents sat down together to eat like a large family and the inspector was made to feel part of the occasion. Some residents prepared the meal; others helped to clear the table and others to wash up. Residents are given choices at mealtimes and have a well-balanced diet. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs are fully met. EVIDENCE: Residents’ personal support needs are monitored. Staff make sure that residents regularly visit the dentist, chiropodist and optician. All health care appointments and the outcomes are clearly recorded. Any issues identified are clearly recorded in the individual’s care plan. The home has a comprehensive policy on the administration of medication. The way that staff record the medicines that they give to residents has improved since the last inspection. There is now a system in place to ensure that the records are completed correctly. Staff are trained in giving medications to residents and know what to do if an errors are made. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ feel confident that their views are listened to and acted upon. Staff have the ability to protect adults from abuse and neglect. EVIDENCE: Historically, there have been no complaints about this service. Staff are familiar with the home’s complaints procedure and said that they would encourage discussion and action before a concern developed into a formal complaint. Residents said that staff listen to any concerns they have. Complaints and concerns are recorded, together with the action taken to resolve the issue. Staff are trained how to protect vulnerable adults from abuse. Staff said that they would take any suspicion of abuse seriously and report it to the home manager. The home has a ‘whistle blowing’ policy and staff said that they felt confident to use it. Bridge House DS0000023349.V300668.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, 26, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bridge House is home for the residents who live there. EVIDENCE: Bridge House is in the rural village of Barham. It has public transport links to Canterbury and Folkestone. The home has its own minibus. The inspector was invited to look at some resident’s bedrooms. Each resident has a single room and five of the residents have ensuite toilet and shower facilities. Bedrooms are decorated according to individual tastes and to a good standard. Rooms contain items that are important to the residents. Downstairs there is a living room a kitchen/diner. The lounge has recently been redecorated. Resident’s said that they have chosen new carpet for the hall and living room. There is a large garden to the rear of the home. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 17 The home was clean, bright and inviting on the day of the inspection. Staff have been on a training course about how to minimise the spread of infection and they demonstrated that they have good knowledge in this area. Bridge House DS0000023349.V300668.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, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a trained and competent staff team. EVIDENCE: Throughout the inspection staff showed that they are good listeners and communicate with residents in a sensitive way. The National Minimum Standards are that 50 of staff, including bank staff are trained to NVQ level 2. The home is taking steps to ensure that this standard is met. The home manager said that she has audited staff files to ensure that all the relevant staff information is kept in the home. Staff confirmed that they have the appropriate checks before being employed by the home. There is a rolling training programme to ensure that all staff are trained in the necessary areas. The home manager said that new staff are inducted using the ‘skills for care’ programme as recommended by the National Minimum Standards. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 19 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well run and well managed home. EVIDENCE: The home manager, Annette Norton has managed the home for 17 months. Shortly after the completion of the inspection, she was successful in her application to become the registered manager. She has worked in care settings for people with mental health and learning disabilities for many years. She has obtained the City in Guilds Advanced Management for Care. Residents and staff praised the management approach of the home manager. “Things work well and run smoothly”, said one staff member. People said that Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 20 she was approachable and supportive. The home manager has a clear sense of direction in which to lead the home. The home uses various methods to gain the views of residents, staff and stakeholders about the quality of care provided at Valley House. Staff meetings are held and the home’s policy states that there are shareholders meetings and an annual general meeting. Residents said that their views are sought and listened to during regular meetings and in addition they complete a quality service questionnaire yearly. The current quality assurance questionnaire is overdue. The home manager is active in ensuring that all maintenance in the home is up to date. Policies and procedures are in place to minimise the health and safety risks to residents and staff. There is a rolling programme of staff training to ensure that all staff are trained and receive refresher training in fire, first aid, food hygiene, infection control and moving and handling. Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 21 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 X 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 4 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 4 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 3 X X 3 X Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Bridge House DS0000023349.V300668.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000023349.V300668.R01.S.doc Version 5.2 Page 24 - 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. 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