Inspection on 30/06/05 for Bridge Reach

This inspection was carried out on 30th June 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridge Reach 27/07/09

Bridge Reach 17/01/07

Bridge Reach 26/09/05

Bridge Reach 14/03/05

Bridge Reach 08/02/05

Bridge Reach 04/04/03

Similar services:

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Insight - Eastchurch

Southfields

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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 Unannounced 30 June 2005 9:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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 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 Nil Care Home 3 Category(ies) of PC Care Home only registration, with number of places Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Nil Date of last inspection 14 March 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 H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 carried out by one inspector Lucy Ansell who was in the home from 09.30 to 13.00 on the 30th June 2005. During the inspection the owner/manager represented the home, and a member of staff was also present for some of the time. Documentation and records were read, including care plans. A tour of the premises was undertaken. The inspectors spent time talking with 2 residents, to ensure standards are being met and a good quality of life is being enjoyed by the residents. One resident is unwell and in hospital up in London, the home has been able to have staff with them every day, meet the requirements from the last inspection and take residents on a week’s holiday. The home needs to be commended on ensuring that every ones needs are meet in what has been a difficult time. What the service does well: What has improved since the last inspection? Since the last inspection the home has improved the checks it carries out on a daily and weekly basis, fire alarms, water, fridge and freezer temperatures. The home has also improved its procedures around checking medication stocks and can now cross reference with the administration sheets. Supervision and training has also improved with all staff now undertaking or having at least NVQ 2. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 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 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. 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 H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 9 Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Resident’s individual needs and choices are well met. Residents are well supported to take risks as part of an independent lifestyle. EVIDENCE: Two residents care plans were looked at. These were very detailed documents that contained, updated risk assessments; individual plans for daily living, support plans and health needs. If anything there was too much information and it was suggested that the file for daily use only contain current risk assessments, care plan and monthly reviews. The other file, which is signed in and out to protect resident’s confidentiality, could be used for all other information. It was evident through reading the plans and discussion with the owner that resident’s care plans were drawn up in joint agreement from all concerned individuals. Regular individual reviews are taking place. However the home were not aware that monthly reviews also needed to be taking place. The care plans should reflect long and short-term goals being set for residents that are achievable and within their scope. The care plans viewed showed clear guidance on how to care for the resident, where rights to make decisions are limited, and clear evidence of making informed decisions. Residents are treated as part of the family. Daily writes up require should detail the time, be signed by the respective staff, with no spaces / gaps are not left between each recording. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 11 Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 Resident’s are 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. Resident’s 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. Both residents spoken to on the day attend college and have work placements; one works in a 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. 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 family. 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 Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 13 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. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 21 The personal and health care needs of residents are well met, promoting and protecting resident’s privacy, dignity and independence. EVIDENCE: It was evident from speaking to the owner and looking through the documentation that they are very aware of the needs of their residents. The owner indicated that all support offered was aimed to maximise the resident’s independence. The manager described how routines of the home were flexible to suit the needs and wishes of the residents; this was backed up by the documentation. The health needs of residents are well met with evidence of good multi-disciplinary 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 owner was observed indirectly throughout the inspection, and was seen to interact in a positive and respectful manner with clear affection and genuine regard from both parties. One resident gave positive feedback during the inspection about the approach of the home, commenting, Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 15 “I love it here”. One resident at this time is unwell and is spending a lot of time in hospital up in London. The home has had staff go every day to the hospital to sit with him and also offer his parents support as needed. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents are protected from abuse and have access to a 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 using the Kent and Medways new Adult protection policy as the homes guidelines. Staff spoken to were clear on the procedures to follow and the owner is completing a course to enable him to teach the staff Adult Protection. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 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 homes 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 sufficient toilet and bathroom facilities for the number of service users. The rooms were all clean and well decorated. Bedrooms have sufficient space to accommodate the required furniture. Both the residents showed me their rooms, which are decorated in their own choice of colours. The home has very high standards of cleanliness and no odours were detected anywhere in the house. Laundry facilities were sited within the kitchen, this was appropriate for the style of service as domestic in nature. Residents are encouraged to tidy their room and do their own washing in line with ordinary living principles. The home has an infection control policy. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 18 Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 36 The resident’s benefit from an effective staff team who are well supported and supervised, with good clarity of roles and responsibility. EVIDENCE: The owner stated all staff had clearly defined job descriptions and understood their roles and responsibilities. The staff had helped to create the job descriptions when they were rewritten to ensure accuracy. The staff team is made up of a large percent of family members but this helps ensure consistency of care and a family environment. The manager and a senior staff member are both completing NVQ 4, two other staff are working to complete NVQ 2 and two staff already hold NVQ 2. This will mean they are soon able to reach over the 50 required. Supervision is now taking place every eight weeks, and the manager also documents any informal supervision that takes place. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This was not assessed on this inspection. EVIDENCE: Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 4 4 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bridge Reach Score 3 4 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 22 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. 2. Standard YA6 YA6 Regulation 15(2)(b) 18 Requirement To ensure care plans are reviewed as required To ensure daily record recording are accurate and signed Timescale for action sept 2005 sept 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA6 Good Practice Recommendations It would be good practice to ensure that the service users guide is available in a format suitable to them. Good practice recommendation if paperwork not avaiable from care managers put a sheet in the file recognising this. Bridge Reach H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent, 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 H56-H06 S28854 Bridge Reach V229394 300605 Stage 4.doc Version 1.30 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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