Inspection on 28/02/06 for Bridgemead

This inspection was carried out on 28th February 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bridgemead 21/11/08

Bridgemead 05/12/06

Bridgemead 07/11/05

Bridgemead 03/03/05

Bridgemead 02/11/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bridgemead 81 St John`s Road Bathwick Bath Bath & N E Somerset BA2 6PZ Lead Inspector Wendy Kirby Unannounced Inspection 28th February 2006 09:30 X10015.doc Version 1.40 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 Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 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 Older People. 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. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bridgemead Address 81 St John`s Road Bathwick Bath Bath & N E Somerset BA2 6PZ 01225 484904 01225 466486 bridgecare@freeola.com 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) Bridgecare Limited Ms Pamela Vanessa Bourton Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 24 Persons over 50 years of age requiring nursing care May accommodate up to 16 persons aged 65 years and over requiring personal care. Manager must be a RN on parts 1 or 12 of the NMC register Staffing notice dated 03/03/2000 applies Date of last inspection 7th November 2005 Brief Description of the Service: Bridge Care is a Christian trust and is a registered charity. It is the founder of Bridgemead. Bridgemead is registered as a care home for a maximum of 32 service users, accommodating up to 24 service users requiring nursing care. The home also provides day care Monday to Thursday for up to 8 service users. The house is considered a home for life and all physical health care needs would be met, including terminal care. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted one day. During the inspection the inspector spent time in discussions with the manager, and examined a number of records, including four residents care plans, and records relating to the day-to-day running and management of the home. The inspector spent time observing the residents in the home throughout the course of the visit and spoke with several at length. Members of staff were observed on duty and two were consulted individually. What the service does well: What has improved since the last inspection? The home has demonstrated compliance to the two requirements from the last inspection. Records of all financial transactions and valuables relating to residents money is now recorded appropriately. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 6 Some bedrooms have been redecorated and carpets replaced. Last year the home enrolled on a two-year pilot scheme whereby care staff receive training in basic nursing skills. New skills they are acquiring have provided a holistic approach to the care they deliver and has enabled staff to provide consistency and continuity to the resident. 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. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Prospective residents or their families have all relevant information to make a decision about the nature of the home. Prospective residents needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met. Trial visits give prospective residents an opportunity to assess the nature of the home. EVIDENCE: A statement of purpose and resident guide is available, in loose-leaf format and presented as a whole document in a folder. This document is made available to prospective residents/families and has been issued to all current residents. Copies are also available from reception. The home caters for older people with continuing social, health and nursing needs and has no other speciality. The staff are trained and experienced in providing care for the resident group. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 9 The prospective resident, family and carers are involved in the pre-assessment and all information is used to determine the suitability of the placement. Where possible the manager had also obtained comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. Admissions are taken mostly from local hospitals and the community. The specific admission criteria is that residents must live within a 10–mile radius of bath. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.10,11 The service had good systems for meeting and monitoring residents’ health and personal care needs in consultation with residents Staff have a good awareness of individuals needs and treat the residents in a warm a respectful manner, which means that they can expect to receive care and support in a sensitive way. Plans are being developed with regards to resident’s wishes when dealing with acute illness and making plans for end of life. EVIDENCE: The home uses the Standex system of documentation for assessing, planning and evaluating care based on the activities of living. The documentation available was comprehensive and overall completed to a satisfactory standard. Risk assessments were in place with detailed information to ensure safe procedures for example, manual handling, the correct use of bed rails and pressure sore assessments. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 11 Last year the home enrolled on a two-year pilot scheme whereby care staff receive training in basic nursing skills under the direction and supervision of the trained nurses. Assessment of the training is carried out by staff from Bath and North East Somerset Council Training Department. The manager stated that the home was motivated and spoke positively about the new skills they are acquiring and how through learning these skills they will be able to implement them effectively within the home to the residents. Through this training the care staff will be able to meet basic health needs including venepuncture, taking observations and specialist feeding. This holistic approach to care will enable the staff to provide consistency in delivering care to the residents without involving resources within the community e.g. district nurses and GP and subsequently may avoid possible hospital admissions. Records of the General Practitioner visits/contact with residents and the outcomes were also available. The home had access to pressure relieving equipment and this was documented in the plan of care. Specialist referrals and visits from other professionals were evidenced in care files including Community, Chiropodists, opticians and Dentists. The Inspector was informed that each resident was referred to a GP of his or her choice on admission to the home and an initial first visit was then set up. Although only one local GP conducts a fortnightly visit to the home, good working relationships with other GP’s and District Nursing teams have been formed and will visit on request. The GP conducts six-monthly medication reviews for each resident and also requests regular blood tests on the residents as part of their health screening. The manager is currently developing care plans for resident’s wishes for end of life and is taking part in a survey organised with a local Consultant Geriatrician with regards to dealing with acute illness in nursing homes. This will be examined at the next inspection in more detail. Staff were witnessed knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times. All rooms have a telephone point from which residents can make and receive calls. Private telephone lines can be installed. A portable pay phone is available and can be moved from room to room. A payphone is available on each floor. The atmosphere in the home on the day of the inspection was relaxed. Staff, the manager and residents were observed to have good relationships. Staff responded to residents in a sensitive and professional manner. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents maintain family contact and staff encourage family and friends to join in with activities and any outings. Residents receive a varied and wholesome diet that they are able to influence. EVIDENCE: From discussion with manager and the residents it was clear that the home has a flexible approach to residents wishes about the pattern of their day. A vacancy currently exists for an activity coordinator. The home is fortunate to have approximately twenty volunteers taking an active part in the home including the trolley shop where residents can buy a range of useful day-to-day items, including toiletries, sweets and a selection of greeting cards. The volunteers also assist with the mobile library, tea and coffee mornings, help with the day-to-day activities, and provide quiet time for fellowship, fifteen minutes daily. A programme of events is produced each week and each resident receives a copy. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 13 Activities are targeted to individuals who require one to one work as well as group activities. Residents are involved in activities such as gentle exercise to music, story telling, arts and crafts and poetry. Visiting entertainers include a pianist, classical guitar, harpist and magician. A record of resident participation is made along with recorded comments from the residents. As the warmer weather arrives the home provides monthly trips to places of interest including National Trust Parks, garden centres and local events. The home also organises fundraising events for example a “Street Party” which residents, families and people in the local community support, providing an enjoyable social feel. Sunday services and monthly communion are held. The home has a monthly residents meeting which are well attended and minutes are taken. A monthly newsletter is also produced and circulated to residents and families. The home operates an open door policy for visitors. Residents were able to see visitors in the privacy of their rooms and there were several semi-private seating areas around the home. The size and layout of the dining room made it possible for all residents to enjoy the social advantages of dining together. Staff had used their expertise and knowledge of the residents, personalities, preferences and ability to eat independently, when seating them for lunch. The dining room was light, spacious and the tables were attractively laid with tablecloths. Residents that required assistance with eating their meals were supported by staff members, this was performed in a respectful, sensitive way, for example without rushing the residents and staff were sat at the same level as the resident. Staff were seen to be polite and helpful when serving the meals The inspector spent time with the cook and her assistant. The cook was able to demonstrate an awareness of individual requirements and needs of the residents, including special dietary requirements and personal preferences. The 4-week menu rota displayed traditional meals and choice was available at each setting. The menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. When residents have a birthday, to celebrate the day they are asked to choose the menu for the whole day to include all of their favourites. The kitchen was very clean and spacious. Stores exhibited a good range of foods. Food hygiene training was up to date for staff. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 14 Documentation was provided to show the inspector that required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked before serving. Risk assessments were in place and up to date. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 There are robust and comprehensive policies in place to manage complaints or allegations of abuse. There are good arrangements in place for staff training and awareness of protection of vulnerable adults. EVIDENCE: A copy of the complaints procedure is on display in a well-frequented part of the home, which means people will know how to obtain the required information if they want to make a complaint. The complaints policy and procedure is detailed and contains all the required information. There had been no complaints received since the last inspection. There are procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse’ including the Local Authority “No Secrets” document. The staff handbook and induction training provides education on topics for whistle blowing, management of aggression and bullying. The availability of this information should increase staff awareness and understanding of their role in protecting vulnerable adults who live at the home. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 16 The policy and procedure for holding residents pocket money was examined and three individual accounts were looked at. At each Sunday service there is a money collection. After three months the money is totalled and residents discuss at their meeting where they would like to donate the money. Last year the residents chose to send animals to Africa, they were able to fund a hive of bees, apple trees and sheep. It was evident that good accounting methods are adopted which account for all transactions documented and receipts for sundries were available to see. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 The home is clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the resident’s needs. EVIDENCE: The home was purpose-built to care for elderly people. The gardens were attractive and designed to the needs of the residents. The residents spoken with were very complimentary about the home and the garden areas. The home is on three floors, with level access to all via a passenger lift. The inspector walked around the inside of the home and viewed, most of the bedrooms, all bathrooms and the communal living areas including the dining room, several lounges and a large conservatory. Room sizes are generally adequate for their stated purposes, particularly the lounges and conservatory and some of the bedrooms. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 18 Rooms have en suite facilities provided and communal bathing areas; showers and toilet facilities are located throughout the home. All areas of the home were tastefully decorated, clean and well maintained. Great attention has been given to ensure that all areas are homely. Residents had been supported to personalise their bedrooms with pictures and ornaments and residents are able to bring items of furniture should they wish. Residents were making full use of these areas and their bedrooms on the day of the inspection. A number of residents said how much they liked the views of the river, trees and wildlife from their bedroom windows. One resident said how much she enjoyed her own company and the sanctuary in her own room and that she also had the opportunity to meet up with fellow residents in various lounge areas throughout the home when she so desired. The home was clean and free from unpleasant odours. The home employs domestic staff on a daily basis. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Residents are supported and protected by the homes recruitment policy. EVIDENCE: A robust recruitment policy and procedure is in place and the files inspected showed all the appropriate documents and checks were in evidence. CRB disclosures are being retained until they have been examined by the inspector. Nurse PIN’s are validated annually. On recruitment staff are given a handbook, which contains, many of the homes policies and procedures including manual handling, health and safety and first aid. The inspector spent some time throughout the day sitting in the communal areas observing staff carrying out their duties and assisting residents. Staff were respectful, warm in manner, good humoured and sensitive towards the residents within a relaxed, calm environment. The inspector spoke to several residents who expressed very positive views about staff and the care they receive providing comments like, “I am so lucky to be here” and “I am well looked after” Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,38 Residents’ needs and best interests are central to the management approach in the home. The health and safety of residents, staff, and visitors is protected. EVIDENCE: The home continues to consistently demonstrate good, effective leadership and management that relates to the aims and purpose of the home. The home’s registered manager Mrs Bourton has over four years managerial experience working in Bridgemead and is well qualified both in management and training. Some of the Health and safety records in the home were examined. Documentation showed that all relevant checks were maintained correctly and Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 21 at the required intervals including fire alarms and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services, and manual handling equipment. Fire safety training for staff is given on induction at then at the recommended given intervals. Fire drills had been carried out however records did not clearly identify that all members of staff had been present during the drills. Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 23 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. 1. Standard OP38 Regulation 17, schedule 4 23(4) Requirement Ensure records accurately reflect that staff have received the recommended annual fire drills. Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Bridgemead DS0000020299.V284061.R02.S.doc Version 5.1 Page 25 - 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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