Inspection on 19/09/05 for Bridgewood House

This inspection was carried out on 19th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridgewood House 19/11/08

Bridgewood House 28/11/07

Bridgewood House 30/08/07

Bridgewood House 24/01/06

Bridgewood House 18/10/04

Bridgewood House 14/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Bridgewood House 165 Barnsley Road Denby Dale Huddersfield West Yorkshire HD8 8PS Lead Inspector Alison McCabe Unannounced Inspection 19th September 2005 11:45 Bridgewood House DS0000026322.V251987.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 Bridgewood House DS0000026322.V251987.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. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bridgewood House Address 165 Barnsley Road Denby Dale Huddersfield West Yorkshire HD8 8PS 01484 861103 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) Bridgewood Trust Limited Mrs Tracey Fraser Care Home 23 Category(ies) of Learning disability (23), Physical disability over registration, with number 65 years of age (23) of places Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2004 Brief Description of the Service: Bridgewood House is a care home providing personal care and accommodation for twenty-three people with learning disabilities. It is owned by the Bridgewood Trust, a voluntary organisation providing a range of service in the field of learning disabilities for people in the Kirklees area. The home is situated on the outskirts of Denby Dale, a small community midway between Huddersfield and Wakefield. The home was purpose built for care. It consists of a single level home accommodating nineteen service users and four self-contained bungalows built in the grounds. All but two of the rooms in the care home are for single occupancy. There is a good range of communal facilities in the home. The home has large, well-maintained gardens. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted by one inspector. The inspection took place between 11.45am and 5.15pm. The inspector had the opportunity to talk to three service users, senior support worker, the cook and the service manager. As part of the inspection, records were examined and the inspector looked around the main lounge, dining room and kitchen in the main house and one of the bungalows used for independent living. The last inspection was conducted on 18th October 2004 and a number of requirements and recommendations made at this inspection have been addressed. The inspector did not have the opportunity to assess whether all the requirements and recommendations had been met. Those that have not been assessed have been carried over and will be looked at during the next inspection; these are clearly marked on this report. What the service does well: What has improved since the last inspection? Staff have started using a new assessment tool to record information about service users needs. This will be used to write new care plans. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 6 The staffs’ practice when they are supporting service users with meals has improved; staff are more sensitive to service users needs. Records of food that service users are offered are more detailed. Bathrooms have been refurbished. 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. Bridgewood House DS0000026322.V251987.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 Bridgewood House DS0000026322.V251987.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): 2 Service users’ needs are assessed before they move into Bridgewood House. Re-assessments are carried out with existing service users. EVIDENCE: The Bridgewood Trust has introduced a revised assessment and care-planning tool. The assessment tool had been completed for eight existing service users at Bridgewood House; two were examined. These contained excellent detail about the needs of the service users. The service manager reported that these would be completed for prospective new service users in addition to the Community Care Assessment. Staff have received training in how to complete the assessment tool. The assessment is to be used to develop the revised care plans however at the time of inspection these had not yet been completed and the home was still using the old format. Bridgewood House DS0000026322.V251987.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): 6,7,9 Service users care plans fail to fully meet all their health and welfare needs. Service users at Bridgewood house are supported to make choices. Service users risk assessments need to be more detailed. EVIDENCE: The staff at Bridgewood House are in the process of implementing a new ‘Personal Support Plan Assessment’ that will inform the revised individual care plan. At the time of inspection, eight assessments had been completed however the revised care plans were not in place. The format currently used is a joint care plan/risk assessment, which does not adequately cover all aspects of the service users’ personal, social, and healthcare support needs. It was noted that information gathered using the new assessment tool was not always consistent with the information in the care plan. Individual service user plans should include all the information as set out in standard 2 of the National Minimum Standards and must set out any restrictions on choice, freedom of movement and power to make decisions. Daily records are not being kept for all service users’ to demonstrate that their identified needs have been met. A recommendation regarding this has therefore been brought forward. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 10 There was evidence that service users are supported to make choices. A service user said that he had decided not to attend day services on the day of inspection and staff had supported him in this decision. Staff were observed offering choices to service users about what they would like for lunch. Further development of risk assessments is necessary to provide staff with sufficient detail about the identified risks to service users and the agreed actions to minimize the risks. The service manager explained that a new risk assessment format would also be implemented as part of the revised care planning system. The recommendation in respect of risks assessments made at the previous inspection has been brought forward. Bridgewood House DS0000026322.V251987.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): 15,17 Service users are supported to keep in touch with family and friends. Service users are supported at meal times with sensitivity. The food provided is balanced and varied; service users enjoy the food. EVIDENCE: Service users spoken to confirmed that they are supported to maintain contact with family and friends. A service user said that her family visit her regularly. There is sufficient communal space within the home for service users to see their visitors in private if they choose to do so. Since the last inspection there has been significant improvement in care practice at meal times. Service users who require support at meal times were observed being supported with their meal sensitively. Choices were offered to service users and staff were observed to inform service users what the meal was. Food that needs to be liquidised is done separately so that service users can taste the different flavours and textures of their meal. The cook said that she is in the process of taking photographs of different meals. These will be laminated and used to enable service users with communication difficulties to make choices about what meal they would like. Records of food provided were Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 12 in good order and menus showed that a balanced and varied diet is offered to service users. Service users said that they enjoyed the food provided. Bridgewood House DS0000026322.V251987.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): 18,20,21 Personal support is usually provided sensitively. Individual care plans need to be clearer about how service users prefer to be supported with personal care. Medication is well managed by staff at the home although clear guidelines need to be in place describing when ‘as required’ medication should be administered. Staff handle the illness and death of service users with sensitivity. EVIDENCE: Most of the time service users were provided with personal support in a sensitive manner, for example, staff informing service users before moving them in a wheelchair, talking to service users whilst supporting them with their meals. Care practice in how service users with visual impairments are guided needs to improve as poor practice in this area was observed. This was discussed with the service manager at the time of inspection. Individual care plans do not provide sufficient information about how service users prefer to be supported with their personal care; this should be included to ensure that a consistent approach is used. Suitable equipment is provided to enable service users with physical disabilities to maximise their independence. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 14 Medications checked all reconciled with the records kept. Medication is stored securely at the home. All staff that administer medication have received the appropriate training. Guidelines are in place for some ‘as required’ (prn) medication, but not all. The registered person must ensure that clear protocols for the administration of all prn medications are in place. Information is available in service users records concerning their wishes around funeral planning arrangements. The revised assessment tool covers this area in detail. Since the last inspection, a service user has passed away. Evidence that this was handled with sensitivity was seen in records. Service users and staff were supported appropriately to deal with the death. Bridgewood House DS0000026322.V251987.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 The home has a clear complaints procedure. EVIDENCE: A satisfactory complaints procedure is in place that is also available in symbol format. Service users spoken to confirmed that they knew how to make a complaint and would feel comfortable in discussing any concerns with staff, the manager or service manager of the home. Bridgewood House DS0000026322.V251987.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): Service users live in a clean and comfortable home. EVIDENCE: The main communal lounge, dining room, conservatory and kitchen were seen as part of this inspection. All were clean and furnished to a satisfactory standard. The service manager reported that the bathrooms had been refurbished and redecorated; emergency lighting is due to be fitted in the bathrooms. A service user living in one of the independent living bungalows invited the inspector to have a look around. This was furnished to a satisfactory standard although the service user said that he did not like the décor in the sitting room and had asked if it could be redecorated. This was discussed with the service manager at the time of inspection. The service user also requested that a new carpet be fitted as parts of the carpet were worn through. This was passed to the service provider. The home was clean and free from unpleasant odours. Suitable procedures are in place for the safe handling and disposal of clinical waste. Bridgewood House DS0000026322.V251987.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): EVIDENCE: Not assessed on this occasion. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 18 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): EVIDENCE: Not assessed on this occasion. Bridgewood House DS0000026322.V251987.R01.S.doc Version 5.0 Page 19 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 X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bridgewood House Score 2 X 2 3 Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000026322.V251987.R01.S.doc Version 5.0 Page 20 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 YA2020 Regulation 13(2) Requirement Timescale for action The registered person shall make arrangements for the recording, 31/10/05 handling, safekeeping, safe administration and disposal of medicines received into the care home. Clear protocols for the use of prn medication must be in place. 31/12/04 unmet The registered person shall prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. 30/11/05 2 YA18YA6 15 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 YA40 Good Practice Recommendations The service provider should separate out the policies and procedures concerned with direct service user are from those concerned with the material objects supporting the care. Not assessed at this inspection DS0000026322.V251987.R01.S.doc Version 5.0 Page 21 Bridgewood House 2 3 4 YA6 YA9 YA14 5 YA14 6 7 YA18 YA19 8 YA41 Individual service user plans should include all the information as set out in standard 2 of the National Minimum Standards. Individual service user risk assessments should be reviewed to ensure that specific risks and actions taken to minimize risks are recorded in sufficient detail. The home should explore how the some of the leisure activities currently provided could be replaced with functionally equivalent leisure activities that are appropriate to the age of the service users. Not assessed at this inspection The home should explore how to make information about entertainers coming into the home more accessible to service users. Not assessed at this inspection Further detail about individuals’ preferences about how they are supported should be added to the care plans to ensure a consistent approach. The manager should ensure that all service users’ health needs are monitored and any potential problems identified and dealt with at an early stage. Not assessed at this inspection Daily records should be kept to demonstrate how the individual service users’ needs are being met in line with their individual service user plan. 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