Inspection on 26/09/05 for Bridge Reach

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Reach 27/07/09

Bridge Reach 17/01/07

Bridge Reach 30/06/05

Bridge Reach 14/03/05

Bridge Reach 08/02/05

Bridge Reach 04/04/03

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

CARE HOME ADULTS 18-65 Bridge Reach 3 Tern Crescent Rochester Kent ME2 2RE Lead Inspector Lucy Ansell Announced Inspection 26th September 2005 09:30 Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bridge Reach Address 3 Tern Crescent Rochester Kent ME2 2RE 01634 318283 01634 328140 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) Mrs Kim Scott-Telford Mr Herbert James Smith Scott-Telford Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Bridge Reach is a small care home providing support to three people with learning disabilities. The residents live very much as part of the family. The home is a three bedded semi-detached house situated in a quiet residential area. It has three single bedrooms, bath and toilet upstairs and a cosy lounge, kitchen and conservatory used as a dining room on the ground floor. There is also an office/sleeping in room on this floor. There are no obvious aids and adaptations around the home as all residents are able-bodied. The home has front garden and off-road parking and garden to the rear of the property. The home is situated on the outskirts of Rochester/Strood with good bus and rail links situated nearby, and within walking distance of local shops. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection at Bridge reach Care Home took place on 26th September 2005 by one inspector Lucy Ansell. The Inspector agreed and explained the inspection process with the Registered Owner and discussed the ethos and values of the home. Documentation and records were read, including care plans. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises was undertaken. The focus of the inspection was to assess Bridge reach in accordance to the National Minimum Standards for Young Adults and principally on resident’s views of the home. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full and the last report should be read in conjunction to obtain a full picture. What the service does well: What has improved since the last inspection? The home streamlined the care plans held for all residents, monthly reviews are monitored more closely and ensure that care plans are used as a working tool to enable clearer, and consistent support to service users by care staff. The home has been producing a shopping list for the residents with pictorial references to enable service users to go and independently help with the homes shopping. It has also been working on a pictorial board with all the residents’ chores and what day they are on. To enable clear understanding of what they are required to participate in around the home. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 6 Further work has been done on developing a new induction programme, which includes the staff handbook to ensure consistent and clear guidelines for all staff. The home is continuing with its programme of training and supervision and one of the owners has become a trainer for Adult Protection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Residents have enough information to make an informed decision about moving into the home, and are confident the home can meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users Guide had been reviewed/rewritten in May 2005 and now contained the required information. It is clear and concise with all relevant information included. The home at the moment are working on making the service user guide into a pictorial format with easy reading so it is suitable for their residents. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contract in the care plans, which were very detailed. Residents are admitted following a full assessment by the homes owner; the newest resident will have been with the home nearly three years and the other resident’s fourteen and seven years. The owner was able to explain the preassessment process and how it was staged over several weeks. This included assessment and trial visits to get to really know the client and see if they matched the home and the service could meet their needs. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8,10 Residents can be confident that their individual needs and choices are well met by the plans of care. Residents can be confident that they will be consulted and participate in all aspect of life in the home. Residents benefit from information about them being handled appropriately and confidentiality maintained. EVIDENCE: The new care plans were seen these are now compact versions of the old care plans, which hold only necessary information. These were very detailed documents that contained, updated risk assessments; individual plans for daily living, support plans and health needs. The monthly and six monthly reviews were all up to date as where the risk assessments. The old care plans are now used as archive files and hold the old reviews, yearly assessments and any non-vital medical information. The staff still signs Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 10 to see this information as per the old system and in keeping with Data Protection, however new files do not use this system. The information held by the home is excellent and shows the staff have a complete knowledge and understanding of the residents needs. The home continues to be person centred in its practice and the residents are consulted on all decisions and participate fully in the home. The home still needs to ensure that the daily writes up detail the time, are signed by the respective staff, with no spaces / gaps are not left between each recording. The manager also has several different ways of recording daily incidents and it was recommended that this was looked at and changed to be incident specific. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 the following standard(s): 11-17 Residents benefit from being encouraged to make choices about all aspects of their daily lives, through the support of a range of activities in the home and local community. Residents’ opportunities for personal development are good with ample chances to maintain and develop independent living skills. EVIDENCE: The care plans and direct observation clearly evidence that residents are encouraged to learn, maintain and develop practical life skills to the best of their abilities. One resident spoken to on the day attend college and one has a work placements; they were already at work at the children’s nursery and is really well supported by the staff there, and this perfectly meets her needs. The other resident attends The Balfour Centre and works there for a couple of days a week. The third resident has been unwell but is now getting better and is hoping to resume college after Christmas. It was apparent through discussion with the owner and the resident’s that they had control over the activities they did or did not participate in. The residents accessed the local community to do their shopping, go to the local shopping centre, and use the cinema, pubs and restaurants. The Residents at the weekends go out on activities with the staff or their own Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 12 family. This year there have been trips to the Ice show at Brighton, Earls Court to see Kylie, Brighton, Hasting and Herne bay and Margate. Evidence was seen in the care plans of a range of leisure activities that they choose to participate in. The owner explained that they have family contact or visits when they wish and risk assessments had been undertaken to assist staff in supporting resident’s maintain appropriate personal relationships. The residents had just had a week’s holiday in a local caravan site. This appeared to be successful and the owner and residents are looking at the type of holiday that might be enjoyed for next year and Disneyland Paris was high on the residents list. The home is looking to negotiate with a local charity to help fund this. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20 Residents can be confident that their personal and health care needs will be well met. Residents are protected by the home’s medication policies and procedures. EVIDENCE: The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. One of the residents is very independent with her personal care needs so is offered guidance and supervision, and the other resident who needs more assistance, is offered this in as sensitively way as possible. The home promotes and maintains residents health through supporting and facilitating medical appointments as required. The Manager stated that all service users are registered with a GP of their choice. Care plans showed that speech and language assessments had been obtained for residents as required. There was also clear evidence of medication reviews happening and optician and dentist appointments. The home policies and procedures on medication has improved its procedures around checking medication stocks and can now cross reference with the administration sheets. The medication administration sheets were seen these were all filled in correctly need to have a photo and known allergies on the sheet. The procedure for giving out PRN medication was good with space to Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 14 put how many given and at what time. The cupboard was tidy and no excess medication was being held. The home has no clients on controlled medication. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents are protected from abuse and benefit from having access to a clear complaints procedure. EVIDENCE: The home has a clear step-by-step complaints procedure that meets the requirement of the regulations. The residents know the complaints procedure and were able to tell me quite clearly whom they would tell if they had any concerns, but the home has received no complaints since the last inspection. The home is looking at producing a pictorial complaints procedure for all the residents to have in their room. The home is using the Kent and Medways new Adult protection policy as the homes guidelines. Staffs spoken to were clear on the procedures to follow and the owner has completing a course to enable him to teach the staff Adult Protection. The home will continue to send new staff on their induction, on to an outside agencies course on adult protection so they can have a wider view on the subject. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28,30 Resident’s benefit from living in a safe, well maintained, clean and homely environment in which the standard of décor, furnishings and fittings are high. EVIDENCE: The home’s location and layout is suitable for its stated purpose; it provides a homely environment for the residents. The home was decorated and furnished to a high standard and the resident’s room was personalised to their own tastes. The home is domestic in nature and has one lounge and dinning room and kitchen along with three bedrooms for the residents and a sleeping in room for staff on the ground floor. The home has very high standards of cleanliness and no odours were detected anywhere in the house. The home tests the water for temperatures and legionellas, and thermostatic valves have been fitted. Laundry facilities were sited within the kitchen, this was appropriate for the style of service as domestic in nature. Hand washing facilities are prominently sited with paper hand towels available. Policies and procedures are in place for infection control, disposal of clinical waste. Protective clothing is available if required. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 The residents benefit from being cared for by a staff team who are well supported and supervised. The residents are protected by the home’s good recruitment and induction procedures. EVIDENCE: The home has lost two staff members and is currently recruiting to replace them. The existing staff team is made up of a large percent of family members but this helps ensure consistency of care and a family environment. The home at present only has one male carer to two male residents and needs to consider this when recruiting. Regular staff and house meetings take place and senior staff have weekly and monthly checklists to ensure all required administration and day to day running is carried out. The home being aware of needing new staff has invested time and resources into ensuring the induction process is reviewed and is as good as it can be before having to use it. The home has also reviewed and rewritten the staff handbook and this will be given to all staff. All existing staff will also be tested to ensure they are familiar with all the elements in the induction and can provide the correct information to new staff. The homes manager is also a Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 18 Topps induction trainer. The home is to be commended on exceeding this standard. All staff at the home are up to date with this years training and have undertaken more training on challenging behaviour, Understanding Learning disabilities which staff have found very useful. The home has a current training matrix, which enables the manager at a glance to see all staff training needs. All staff receives supervision and support however this is not written on one format it is written over three different ones and the system is adhoc when you receive it. Agreed with the manager to look at the recording formula to include: the homes aims and philosophy, work with individual clients, support and professional guidance and training and development needs. The manager to ensure a record is kept of all supervision and a date is made for the next one at the end of the session. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The and . The and residents benefit from a well run home with good transparent leadership they can be confident that their views are listened to residents’ best interest and rights are safeguarded by the homes policies procedures. EVIDENCE: The owner is experienced and competent to run the home as has over 20 years experience with clients with learning difficulties and has also set up a second home for residents who live semi-independently. She has now enrolled on the NVQ 4 and will be hopefully finishing this at the end of the year. The owners need to ensure periodic training is undertaken to maintain and update skills and knowledge. The resident’s benefit from the management approach of the home and an open and inclusive atmosphere is created. The processes of managing and running the home are open and transparent and the residents live very much as part of the family. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 20 The home does have a quality assurance and monitoring system in place and annually surveys the residents. However the home has to produce the results and outcomes for all interested parties to see. The home received six comments cards back from family and health and social care professionals all praising the service and care received. The home does have all the policies and procedures required, and yearly updates and reviews them. The policies seen had all been dated with the reviews and signed. The records required by regulation for the protection of residents and for the effective and efficient running of the home are all maintained and up to date. The home is registered with the Data Protection and this is due to be renewed this November. The owners ensures as far as is possible the health safety and welfare of the residents. Their moving and handling training is up to date, they are current with fire safety equipment and procedures and testing. They hold current first aid certificates, food hygiene and infection control training, which is all current. The home has safe storage for hazardous substances and COSHH sheets have been obtained. The home has fitted a valve to regulate the water temperatures, and risk assessments for the property have been carried out. There is a current development plan for the home and their priorities are two new staff and fix the outside drive. The home is financially viable and finances are spent on improvements as are needed. Insurance cover for the home was seen. Lines of accountability are clear and well evidenced. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 x 4 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bridge Reach Score x 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000028854.V253588.R01.S.doc Version 5.0 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. 1 2 3 4 Refer to Standard YA1 YA6 YA7 YA36 Good Practice Recommendations It would be good practice to ensure that the service users guide is available in a format suitable to them. It would be good practice to ensure daily record recording are accurate and signed It would be good practice to change the name of contact sheets to Incidents sheets, as that is what is being recorded. Staff receive the support and supervision they need to carry out their jobs on a two monthly basis. Bridge Reach DS0000028854.V253588.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Reach DS0000028854.V253588.R01.S.doc Version 5.0 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. 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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