Inspection on 08/06/07 for Bridge House

This inspection was carried out on 8th June 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridge House 17/01/06

Bridge House 11/01/05

Bridge House 22/06/04

Similar services:

Littledale Hall Therapeutic Community

Bennett House

Padgate House

Mary & Joseph

Westcliffe House

Richards House

Hamer Cottage

Turning Point (Hoole Road)

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

CARE HOME ADULTS 18-65 Bridge House 1 St Lukes Place Preston Lancashire PR1 5DE Lead Inspector Denise Upton Unannounced Inspection 8th June 2007 10:30 Bridge House DS0000010023.V335439.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 DS0000010023.V335439.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 DS0000010023.V335439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridge House Address 1 St Lukes Place Preston Lancashire PR1 5DE 01772 797654 01772 791810 bridgehouse@alcoholanddrugsservices.org.uk 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) Alcohol and Drug Services Miss Kathleen Egan Care Home 16 Category(ies) of Past or present alcohol dependence (16) registration, with number of places Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must only accommodate adults with past or present alcohol dependence (Younger Adult - YA) aged between 18 and 65 years upon admission. The service must only accommodate up to 16 (sixteen) service users. Date of last inspection 17th January 2006 Brief Description of the Service: Bridge House is a residential rehabilitation unit registered for up to 16 adults, whose lives have been severely affected by their misuse of alcohol. Bridge House is managed by Alcohol and Drugs Services (ADS) an established registered charity, the Head Office being in Manchester. The premises, a converted church building, are close to the city centre, with good access to local services and amenities. The accommodation includes 10 single bedrooms on the first floor and 6 self-contained flats on the ground floor, plus a variety of shared living rooms. Therapeutic and client centred interventions form the basis of the service provided. The rehabilitation programme includes a structured therapeutic programme plus individual one to one sessions with a key worker. The team currently consists of an administrative worker, a cleaner, a cook, two project workers, a family and children worker, deputy manager and manager. A two-stage programme is in operation with individuals initially living on the first floor and then moving into one of the self contained flats as they prepare for discharge. Bridge House also offers acupuncture to residents, carried out by qualified staff. A volunteer at the home is also a Reiki Master and some project workers also have a Reiki qualification. This service is offered to people staying at Bridge House and is highly valued. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during a midweek day and an afternoon period of another day. In total, these site visits spanned a total of approximately nine and three quarter hours. At the time of the visits, fourteen residents were living at the home. All of the core standards identified in the National Minimum Standards, Care Homes for Adults (18-65) were assessed along with one other standard. The inspector spoke with the registered manager, deputy manager, a project worker and the children and family project worker. A number of records were examined and a partial tour of the building took place. In depth individual discussion also took place with four people currently living at the home and the inspector also observed an ex residents support group meeting that takes place on a weekly basis. The Commission for Social Care Inspection resident and carer/relative comment cards, made available prior to the inspection provided further information on how one resident and a relative felt that Bridge House was meeting their individual needs and requirements. Information was also gained from a pre inspection questionnaire completed by the deputy manager. The current scale of charges range between £351.50-£388.00 per week. What the service does well: Bridge House has a group of staff that are highly valued by people staying at the home. Comments included “The staff are brilliant, I cannot speak highly enough about the staff” and “A big thumbs up from me, I cannot praise this place or the staff enough” People staying at Bridge House spoke positively about the support they received during the group workshops and their individual one to one meetings and stated that they felt safe and trusted the staff and each other. The atmosphere is open and welcoming and people staying at Bridge House know that their views and opinions are important. The accommodation at Bridge House is homely and well maintained. The accommodation is arranged so that people are supported to become more independent as they progress through the programme. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 6 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 DS0000010023.V335439.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 DS0000010023.V335439.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): 2 Quality in this outcome area is good A well-established and detailed pre admission assessment including relevant risk assessments is in place prior to a person being admitted into the programme. This is to ensure that people are only admitted if their individual needs and requirements could be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bridge House operates an open referral policy however before a resident is admitted to the home funding arrangements have to be in place. This usually involves contact with Social Services. For individuals referred via Care Management arrangements, an initial community care assessment will have been undertaken. The people spoken to had either chosen Bridge House themselves or had it recommended to them by a professional involved in their recovery It is understood that funding made available is becoming more restricted in terms of the time scale of rehabilitation. However this has been acknowledged and the programme is adapting to these changes. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 9 To supplement the initial information provided, Bridge House staff carry out their own comprehensive pre admission assessment that includes the rehabilitation and therapeutic needs of the prospective resident. This is to ensure that individual requirements could be met, the individual is sufficiently motivated to benefit from the programme, and the person must have a level of physical ability and also be able to engage. Part of the pre admission assessment also looks at what the prospective resident feels Bridge House could do and their own perception of recovery. Emphasis is given to how the wants and needs of each resident could be met and carried through. One resident spoken with explained that this is still ongoing during the one to one key worker meetings Once the assessment is completed the prospective resident is offered a halfday visit to the home prior to admission. This gives the prospective resident opportunity to sit in on a group without any pressure to take part and to meet staff and existing residents within the home. For prospective residents who are completing a period of detoxification prior to entering Bridge House, the admission time frame is aimed to tie with completion of this programme. It is clearly evident from discussion with residents spoken with, that peer support is one of the fundamental factors that enable residents to make progress and that resident’s “look out for each other”. From the collated information obtained, an initial care plan is developed in full consultation with the individual resident. One resident spoken with stated that, “residents are fully involved in all decision making whether this is about themselves or the community” At the time of the initial ‘in-house’ assessment, prospective residents are given a copy of the Service Users Guide. This gives a lot of information about the programme and what people can expect while living at the home including the potential restrictions on freedom and choice required by the rehabilitation programme. Bridge House DS0000010023.V335439.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 & 9 Quality in this outcome area is excellent. There is a clear and consistent care planning and risk assessment system in place to provide staff with the information they need to maintain a high quality service. Good opportunities are made available to ensure that people living at Bridge House are involved in day-to-day decision-making. This promotes self worth and influences change. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents at Bridge House have an individual care plan that is regularly reviewed. Residents spoken with confirmed that they are very much involved in the development of their care plan and that any changes are only made following full consultation and agreement between the key worker and the resident. For some people there is also a separate care plan that covers issues regarding children and family. All individuals are provided with a copy of their Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 11 care plan that they are invited to sign as acknowledgement of their understanding and agreement of the content. People have full information about any rules and restrictions and those residents spoken with, clearly understood the reasons for these. Without exception, the people spoken with were all very complementary about the staff group and the support and understanding they provided. One resident said, “Staff are brilliant, amazing, cannot speak too highly about the staff”. A similar comment was mirrored by another person living at the home when he stated, “The staff have changed my life it’s like making a fresh start and I cannot praise them enough”. People also spoke highly about the groups they were part of and the one to one support of their key worker. Good records are kept of both one to one and group meetings. The community at the home was also highly valued with people feeling that their views and opinions were important and that they could very much influence decision-making. An example of this was a recent meeting to discuss smoking within the building. Residents and staff were fully involved in the discussions and an agreement was reached through negotiation. One person said, “ As a community we feel very involved”. Individuals are involved in staff selection, are invited to the annual general meeting and have regular in house community meetings where ideas can be raised. People complete a discharge form as they leave and these give a lot of positive feedback about the service. People living at the home are encouraged to take informed risks as part of an independent lifestyle. Risks are assessed and support plans and risk management strategies in place. One resident said he thought that, staff allowed residents enough freedom while being careful of risks. Certain rules are however in place including when visitors are made welcome and residents visiting their own home. One resident explained that for the first two weeks he could not go out on his own, he could not have his mobile phone, could only have a key to the home after he had been resident for four weeks and that he was expected to be back at Bridge House by a certain time each night. The reason for these restrictions was understood and it was acknowledged that they helped to address certain areas of risk. Over time some of the rules are relaxed especially when people progress to living more independently in one of the flats. It was very evident that peer support is highly valued and that people “look out for each other”. One person said that, “the community looks after each other very well, if somebody has been in their bedroom for a while one of us will go and find out if they are alright”. Another resident said, “All residents support and trust each other”. People spoken with also stated that they felt very safe and very well supported by everybody at Bridge House. Bridge House DS0000010023.V335439.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): 11,12,13,15,16 & 17. Quality in this outcome area is excellent. Excellent opportunities for personal development are built into the programme and this includes support with relationship issues. Links with the community are good that support and enrich resident’s social and educational opportunities. Resident’s rights are respected and responsibilities recognised while remaining mindful of the house rules and restrictions in place. People staying at Bridge House enjoy healthy nutritious meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 13 The personal development of individuals forms the basis of the service provided. This is encouraged through group work and one to one counselling with the individual’s key worker. This helps to promote personal growth and change. The therapeutic group work focus on different issues that include a community group, feelings group, activity group, personal development group, and a specific family group for residents who have children. Certain relationship issues or issues relating to children and families are explored within this group and also through individual one to one key worker sessions. People spoken with felt that that group work sessions were very helpful with one person saying that the group work was very important and it was “where you can learn stuff”. Another resident said that he found the groups had helped in confidence building and he had learned a lot about himself. Another person spoken with who was nearing the end of his stay at Bridge House also felt that the one to one key worker counselling sessions that take place on at least a weekly basis were very helpful. This person also said that resident’s can request additional meetings with their key worker if they feel they need to and members of staff always made time for this as it was seen as a priority. During the course of the visit, an ex-resident’s group was taking place that was observed. This facility appeared to be much valued by the people attending and provided an important link with the service. Paid employment would not usually be a priority, particularly during the early stages of recovery, when the focus is on the therapeutic programme of group and individual sessions. However as people progress through their rehabilitation, opportunities for voluntary work or further education can be discussed with their key worker and negotiated around the priorities of the programme and the best interests of the individual. One person spoken with had commenced a college course and had also applied to undertake some voluntary work. During a resident’s second stage of recovery when living in a flat at Bridge House, an increased level of independence and responsibility is promoted and gradually developed. This includes ensuring people are confident in practical tasks such as budgeting, cooking skills and maintaining a healthy eating pattern. People staying at Bridge House are not always from the local area and as discharge approaches staff provide support and contact details of services, housing and employment in the area they are moving to. Staff are experienced in providing advice regarding benefits, and support people to apply for benefits/grants or re-housing to an area of their choice. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 14 There are set periods of free time at Bridge House that enable residents to assess community services and facilities. Good information is provided about the local area. People access the community according to their individual needs and wishes, bearing in mind risk assessments and the priorities of the programme. A range of social activities is available at Bridge House that include a computer room with two computers and printing facilities, video/DVD, table tennis, darts, football table, pool table and outdoor games. In addition, one half day a week is devoted to a recreational group activity and residents are also funded for additional outside activities such as bowling, pictures, gym, and library, attending a local college or voluntary work. Quiz nights are organised on a regular basis. Various other social events take place throughout the year and an annual holiday in the Lake District was in the process of being arranged. Residents spoken with confirmed that appropriate activities were provided to fulfil their requirements. Information about house rules, rights and responsibilities regarding daily routines and house rules is provided prior to admission to the home. There are clear rules regarding alcohol and drugs, and certain visiting restrictions and relationships restrictions, which form a key part of the contractual agreement. However visitors are made welcome at certain times of the day as evidenced during the course of the visit. Two people staying at Bridge House spoke about the daily routines and their involvement in domestic tasks, which are carried out on a rota basis. Both considered the system to be fair and that it worked well. Certain activities and routines are negotiated within the group such as who is cooking each weekend. During the first stage of recovery residents are required to prepare and cook their breakfast and lunchtime meal. A part time cook makes the evening meal during the week, with weekend meals being made by people staying at the home. The self-contained flats provide good cooking facilities. Nutritional input is monitored especially during the early phase of recovery. People spoken with confirmed that there was always something to satisfy everybody’s taste and there was always “somebody who can cook”. A wide range of foods is provided and people living in the flats sometimes also cook a meal for each other. In addition to the main kitchen, a small kitchen area is also available where residents can make a hot drink for themselves and their visitors. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good People living at Bridge House do not normally require any support to maintain personal care. The physical, emotional and psychological health needs of residents are well met with evidence of good multi disciplinary working taking place. Medication in this home is well managed promoting good health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at Bridge House are self-caring. If an issue of personal hygiene arose, then this would be addressed individually and sensitively within a one to one key worker session Although people living at the home are expected to attend the group work sessions and one to one sessions with their key worker, routines within the home outside of these times are flexible with residents dictating when they Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 16 choose to get up, go to bed and the individual clothes and hairstyle that reflect their personality. Each person has a designated key worker who facilitates one to one sessions and monitors progress within the programme. Certain staff are also trained to provide acupuncture treatment, relaxation techniques and Reiki that is highly valued by the people spoken with who are living at the home. Health information is gathered during the pre admission process. All newly admitted residents are registered with a local General Practitioner (G.P.) practice within the first two weeks and are seen by a G.P and Practice Nurse. Residents are expected as far as possible, to manage their own health care although staff must be made aware of any medication prescribed or over the counter medicine brought into the home. Bridge House has good systems in place to ensure the safe management and recording of medication. Recommendations made at previous inspections have been implemented to good effect. All staff that has responsibility for medication have undertaken medication training that is specific to the home or are currently undertaking this training. Staff that have not completed medication training do not undertake any medication related tasks until the training is completed. At the time of the inspection all people living at the home were self-medicating their own prescribed medication. Medication risk assessments are in place. These are automatically reviewed on a monthly basis by the individual resident and their key worker during the course of the one to one key worker session. Medication is securely stored in individual bedroom/flat accommodation. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is Good Bridge House has a good corporate complaints system and adult abuse policy and procedures for the protection of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection no complaints or allegation of adult abuse has been made. The home’s complaint procedure is compliant with requirements and incorporated in the written information provided to people who are admitted to Bridge House The policy outlines the home’s commitment to providing a written acknowledgement of any complaint received with 24 hours of receipt and to respond to complaints wherever possible within 14 working days. Bridge House provides an open and inclusive atmosphere. People living at the home are encouraged to voice any concerns immediately so that issues can be discussed and addressed. Individuals spoken with were aware of the written formal complaint information and confirmed that their views and concerns are listened to and acted upon. People spoken with also explained that although concerns can be raised at any time, community meetings are also used to share views, concerns and ideas. The home also has a robust policy and procedures in place for protecting people using the service from possible abuse. Discussion with members of staff confirmed a good understanding of issues of vulnerability for this client group. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 18 Staff supervision arrangements provide opportunity for any work performance issues to be addressed. All staff and volunteers undergo Criminal Records Bureau (CRB) clearance at enhanced level. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 19 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 & 30 Quality in this outcome area is Excellent Bridge House has an excellent range of single accommodation that suits the needs and requirements of people living at the home during the different stages of their recovery. Bridge House is clean and well maintained, providing a comfortable and attractive environment for those staying there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bridge House provides very good individual accommodation. On admission people stay in single bedrooms on the first floor. As individuals progress with their recovery and prepare for leaving they move into one of the self-contained flats on the ground floor. The service therefore continues to be able to respond to people’s changing needs and lifestyles, as they work towards moving back into the community. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 20 The building was originally a church and has been sympathetically converted retaining many original features. There is good access to local amenities, transport systems and the city centre. The home is well maintained and decorated. Furnishings are domestic in character and provide welcoming and attractive accommodation. Since the last inspection a number of communal areas and some private accommodation have been redecorated, a new washing machine purchased and a freezer provided to each flat. It was noted that people living at the home are encouraged to have their say about how they would like the accommodation to be decorated and individual accommodation was made more homely by personal possessions and decoration to suit the occupant. People spoken with were very pleased with the accommodation provided. In order to promote independence, residents are required to attend to their own laundry and to be responsible for cleaning their own rooms and the communal areas on a rota basis. Residents spoken with considered this to be fair. Appropriate laundry facilities are provided. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 21 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): 32,34,35 & 36 Quality in this outcome area is excellent. The qualities and skills of the staff team are highly valued by the people staying at Bridge House. Recruitment processes are robust that helps to protect people who live at the home from harm. There is a good programme of staff training to ensure staff have the skills to provide a consistently high service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People spoken with currently living at Bridge House were unanimous in their very positive comments about the staff team and how well supported they felt. One person commented that (Bridge House) “Gets a big thumbs up from me, I cannot praise this place or the staff highly enough”. Another person said, “The staff are all very good, in fact brilliant, they care about us”. People also stated that they felt very safe and trusted the staff and each other. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 22 A relative also wrote on a Commission for Social Care Inspection, relative/carer survey form “I would like to say that Bridge House staff work very hard to improve the new way of life for the residents. They do a wonderful job and I have a great admiration for them all”. When speaking to staff it was clear that individuals understand both their role and the aims of the service. The project workers and deputy manager, carry out individual counselling sessions as does the manager, although currently the manager is also undertaking temporary duties elsewhere within the organisation. The children and families worker has a specific role and refers individuals back to their counselling key worker when appropriate. Residents spoken with very positive about the group work and the one to one key worker sessions and way staff were always available when needed. Although Bridge House is not normally staffed during evenings or at weekends, when an on call support system is in operation, people living at the home felt this arrangement to be quite satisfactory. These arrangements are however flexible, with a staff member holding a return from leave meeting each Sunday and additional staffing arrangements being made if issues of risk have been identified. A resident explained that if anybody wanted to speak with a member of staff outside of the normal working day, a member of staff was always available. This same resident stated that this made people feel secure and confirmed that people do use the on call system and staff would always come if needed. A member of staff also said that sometimes a staff member will ‘pop in’ over the weekend just to make sure that everything was all right. During discussion with staff it was very clear that they were enthusiastic and caring about what they did and genuinely wanted to help and support people through their period of recovery Volunteers within the home are also supported in their specific roles. A degree Social Work student is also currently on placement at Bridge House, working under the supervision of the deputy manager/registered manager. The current policy is that all counsellors should be qualified to diploma level or have at least two years experience and be willing to work towards the diploma. The children and family worker is a qualified teacher. Volunteers attend an alcohol awareness-training course. In addition the registered manager has almost completed a Health and Social Care Degree, the deputy manager has achieved the Registered Managers award and an NVQ Level 4 qualification and a number of staff have completed Reiki and Acupuncture accreditation. These therapies are available to residents and highly regarded by those who participate. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 23 A variety of mandatory training is also a requirement that includes, anti discriminatory practice, working with violent clients, alcohol and drug misuse at various levels, assessment and care planning, cultural awareness as well as training specific to an individual role such as child protection training. Staff also undertake basic health and safety courses, such as food hygiene. A training review takes place as part of the annual appraisal for each member of staff. Since the last inspection, new members of staff have been appointed. Two of these staff files were observed that confirmed that the recruitment practices followed were robust in order to protect people living at the home. Appropriate references and clearances had been obtained and deemed to be satisfactory before the new member of staff commenced employment at the home. As part of the recruitment process, residents at Bridge House are involved in the selection of new staff. Once a member of staff has been appointed, induction training is provided followed by a minimum probationary period of six months. A volunteer policy is in place, with volunteers undergoing Criminal Records Bureau checks and receiving training. Staff supervision arrangements are in place. All staff receive formal one to one supervision on at least a monthly basis covering a variety of topics. In addition, group clinical supervision also takes place on a monthly basis. A new supervision form has recently been introduced. Informal day-to-day supervision as part as the management role is ongoing. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 24 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): 37,39 & 42 Quality in this outcome area is excellent The registered manager is well supported with all staff demonstrating a good awareness of their role and responsibilities. The home regularly reviews aspects of its performance through a programme of self-review and consultation with users of the service and staff. Systems are in place to ensure as far as possible the health and safety of residents, staff, volunteers and visitors. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is very competent and experienced and has obtained a range of qualifications, including the Registered Managers Award (NVQ 4), the Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 25 Advanced Diploma in Counselling and the Practice Teachers Award. As previously stated in this report, the registered manager has also almost completed a Health and Social Care degree and is currently undertaking an additional temporary role within the organisation. Alcohol and Drugs Services, the registered organisation provides good management training opportunities, allowing the registered manager to keep up to date and further develop her knowledge. Effective quality monitoring and quality assurance systems are in place and the home has achieved the ‘Investors In People’ award. The home regularly reviews aspects of its performance through a good programme of self-review and consultation. This includes resident questionnaires and discharge forms to gain feedback about the service. Evaluation sheets are periodically used to gain feedback regarding the effectiveness of the group sessions. Follow up surveys are also provided to ex residents, six months and twelve months after discharge. These also help to inform the internal quality audit. Some of the comments made in the surveys are incorporated in the Residents Handbook. The annual general meeting takes place each November and includes the presentation of the annual review. In addition, a senior manager from Alcohol and Drugs Services undertakes a monthly monitoring visit and produces a report as to the conduct of the home. Bridge House ensures safe working practices are maintained through implementation of the home’s policies and procedures and staff training in respect of health and training issues. All members of staff receive some mandatory health and safety training. Although users of the service are in the main physically able and are expected to take responsibility for their own health, one member of staff has successfully obtained a first aid certificate in order to provide emergency first aid should this become necessary. However it is understood that the organisation is looking closely at this issue and are considering increasing the number of staff who undertake this training. In the past manual handling training has not been a priority. However the registered manager is currently a member of the organisation’s Health & Safety committee and one of their remits is to review Health & Safety training including manual handling training and whether this should be routinely provided. It is recommended that manual handling training be provided to help protect staff. Observation of documentation including maintenance records confirmed that various routine health and safety checks are maintained and environmental Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 26 risk assessments are in place. There is a system in place for recording health and safety issues and it was evident that equipment is regularly serviced and a number of up to date certificates were evidenced that included fire safety equipment and a small appliance testing certificate. However the electrical installation certificate was out of date and the electrical installation system had not been re-inspected for a number of years. This was of concern and could potentially caused a risk to the safety of the building. It is understood that arrangements will be made to address this matter in order to help ensure the safety of the building, residents, visitors and staff. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 27 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 X 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 4 12 3 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 2 X Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 28 NO 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 YA42 Regulation 23(2)© Requirement The electrical installation certificate must be re-inspected as a matter of urgency Timescale for action 31/07/07 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 YA42 Good Practice Recommendations Consideration should be given to providing staff with appropriate manual handling training. Bridge House DS0000010023.V335439.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 DS0000010023.V335439.R01.S.doc Version 5.2 Page 30 - 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. 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