Inspection on 14/05/07 for Bridgewood Mews

This inspection was carried out on 14th May 2007.

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

Bridgewood Mews 22/08/06

Bridgewood Mews 12/12/05

Bridgewood Mews 15/06/05

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOME ADULTS 18-65 Bridgewood Mews 38 Bridge Road Tipton West Midlands DY4 0JW Lead Inspector Mrs Amanda Hennessy Key Unannounced Inspection 14th May 2007 10:00 Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridgewood Mews Address 38 Bridge Road Tipton West Midlands DY4 0JW 0121 522 5780 0121 522 5781 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) Exemplar Homes Ltd Kathleen Felton Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22nd August 2006 Brief Description of the Service: Bridgewood Mews is a purpose built home and can accommodate up to 20 younger adults who are physically disabled and may require nursing care. Accommodation is on two floors, each floor having a lounge, dining room and a further quiet lounge. Resident’s bedrooms are on both floors. There is access to the first floor by a passenger shaft lift. All bedrooms are single occupancy each with en-suite facilities consisting of toilet, hand basin and shower. The main kitchen is on the ground floor with the laundry on the first floor. The home is privately owned by Bridgewood Mews Healthcare. The home is situated a mile from Great Bridge and is easily accessible via public transport route to local areas, Dudley and West Bromwich. The home has an experienced Manager. There is a registered nurse on duty on each floor twenty-four hours a day assisted by a team of care staff. Fees vary between £683 and £1537 and are dependant on the needs of the service user. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by one inspector. The inspection was carried out between 10.00 and 18.30. The inspection included a tour of the home, talking to service users and staff and a review of service users questionnaires, which had been returned to the Commission for Social care and Inspection prior to the inspection. A review of information supplied by the Manager (pre inspection questionnaire) was also undertaken and expanded upon during the visit. Care records were reviewed as part of the “case tracking” of six service users and six staff. The Inspector was also very fortunate to meet the Advocate of service users who are deaf and dumb who provided invaluable information about their life in the home. The home has been open since January 2005 and is now fully occupied. All requirements have been addressed. No requirements were made at this inspection and there are just two good practice recommendations. The Inspector would like to thank the Home Manager, Care Manager, staff and service users for their assistance and hospitality during the inspection. What the service does well: The home is clean and welcoming and meets peoples’ needs. Comments from service users were positive and included: “The home is kept clean and tidy at all times. ” All service users have a comprehensive assessment of their health needs prior to their admission to the home. They receive sensitive care with staff exploring their preferred likes and dislikes such as preferred gender of staff, time getting up and going to bed, type of bed, bed linen, food preferences and whether they prefer a bath or shower and how frequently. People are enabled to access the local community either in the homes mini bus or out on foot or in wheelchairs with staff. People are able to maintain and develop relationships both with their families and friends. The home has a good relationship with advocacy service with required information available to enable residents to contact advocacy and supporting residents to contact advocacy service when required. Residents also feel enabled to raise contact and are confident that they will be acted upon. The Manager has published the findings of the service user survey, which are available for service users and all interested parties. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 6 The home has robust recruitment and selection policies and procedures that safe- guard its service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that their health needs will be assessed prior to their admission to the home, required information about the home is available and staff have the necessary skills to meet their needs. EVIDENCE: People are admitted following a comprehensive assessment of their needs undertaken by a senior member of staff. Prospective residents and or their representative are involved in the assessment of their needs. A letter is given prior to admission confirming that assessed needs can be met by the home. Prospective residents and their families are encouraged to visit the home before making the decision to come and stay with some service users coming to stay for a meal or over night, sadly other service users due to their health are unable to visit. The home has one bed that is fully used for people who require respite care. It was nice to see and hear how staff and residents build up relationships with people having respite stays and that they “look forward” to their stay at Bridgewood Mews. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning is undertaken when possible with residents and represents their needs, capabilities and choices. EVIDENCE: All service users have a plan of care, which identifies their needs and gives staff instructions on how their needs will be met. Staff support residents choices and decision making whenever possible. Staff support and facilitate peoples right to make decisions over their life unless a restriction in choice or personal freedom is identified by a risk assessment. It was really good to meet the Advocate Worker of two residents who are deaf and dumb. He said that he found staff helpful and willingly to work with him to assist in improving the quality of life of those residents. There is also information on advocacy services prominently displayed on the main notice board should other residents wish to contact advocacy services independently. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 10 Other residents who have Huntingdon’s Disease and Multiple Sclerosis have specialist workers who visit them and advice staff on their care and needs. It was pleasing to hear that the home has several service users who manage their own money with other service users supported by staff and their families to manage their own finances. The home try to ensure that its residents maintain their independence and quality of life for as long as possible such as their ability to walk, go out without staff or eat normal foods. Risk assessments identify any limitations to their life and these are discussed so that residents and their carers understand these risks and when required restrictions or limitations that are identified. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People, who live in the home are encouraged to exercise choice and control over their lives, access the local community and maintain and develop relationships with their families and friends. EVIDENCE: Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 12 People, who live at the home are able to take part in age, peer and culturally appropriate activities. The homes mini bus is in use daily taking residents out. The Friday before the inspection four residents went to Blackpool for the day with further trips to Blackpool planned for other residents. One relative spoken said that she was looking to going and with her son. There was also a trip planned “ Ladies Day” shopping to Telford on the Friday after the inspection. Residents also regularly go to football matches at West Bromwich Albion with staff. Other regular trips out are to the cinema, pubs and church as well as family visits and other shopping trips to local cities and towns. The advocate of some residents confirmed that residents attend the deaf club in the mini bus and that carers go with them. One of the lounges has been developed into a sensory room for those service users who are unable to or do not wish to go out of the home. Family and friends are welcomed to the home and are confirmed that they are encouraged to continue to be involved with their loved ones. Staff and service users spoken to confirmed that service users regularly visit their families and are able to choose who they see. A quiet room is available should they wish to see their visitors in private. There were positive interactions between residents and staff with staff treating residents with kindness and understanding of their very challenging and distressing symptoms of their illnesses. Staff do not enter peoples bedrooms without their consent and were observed to knock before entering. Bedroom door keys are available with a number of people holding their own keys. The dining room is pleasantly furnished with tables laid with lovely crockery. It is surprising that at meal times the table clothes and nice crockery are removed and other plates and dishes are used and no tablecloths are used. Whilst some residents due to distressing features of their illness and problems swallowing do make a mess when eating it would be nice if staff considered other options to promote residents dignity. Staff were observed to feed those residents requiring feeding. The home has a three week menu and provides special diets such as diabetic and soft diets of varying consistencies dependent on the resident and their swallowing capabilities. Residents do have a choice of what they like to eat although several felt that the menu needs expanding and would like meals to reflect their culture. One resident required halal meat although had just been receiving a vegetarian diet, the manager said that she was addressing this. People said: “It can improve in the food area” and “Would like more choice when it comes to meal times.” The home has successfully achieved their second gold award for food safety from Environmental Health and was very proud of this achievement. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at the home receive sensitive care that meets their personal and healthcare needs and is person centred. There are appropriate policies and procedures for the safe keeping and administration of medication to promote residents’ health and wellbeing. EVIDENCE: People who live at the home receive care that is person led, their personal support is flexible, consistent and is able to meet their changing needs. Care records comprehensively identify service users preferences such as preferred gender of care staff, preferred style of clothing and preferred colours of clothing such as “likes casual clothing”, use of toiletries, preference of and frequency of a bath or shower, preferred time of going to bed and getting- this varied greatly between all the service users accommodated from 9.00 to one resident who liked to get up at twelve alongside residents cultural needs. Staff spoken to were able to identify residents individual needs and ensure that they are met. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 14 Staff ensure that there is consistency of care with the use of key workers who work closely in partnership with the resident and their family. The home has good links with other Health professionals and specialist organisations such as the Huntington’s Society, Multiple Sclerosis Nurse Specialist, Tissue Viability Nurse Specialist, Speech Therapists, Physiotherapists and GPs. Staff also ensure that service users have required specialist equipment that both supports their independence whilst also protecting their health. Records demonstrated that staff monitor residents condition and refer them to their GP when appropriate. The home appropriately and safety administers and stores residents medication to safeguard residents health and well being. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust and effective complaints procedure, and are protected from abuse, neglect and self-harm. EVIDENCE: The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. One relative spoken to said that she felt that any concerns she had were appropriately dealt with staff and that her relative was well cared for in a staff and understanding home. The home display their complaints procedure on the main notice board in the reception area of the home and it is also in the service user guide. The home has received thirteen complaints with all concerns proactively managed with complainant’s assured of appropriate actions and required actions undertaken when required. The home has appropriate policies and procedures to safe guard residents from harm and potential abuse and ensure that referral is made to the required agencies. Staff have all received recent training in the identification, awareness and action to be taken if abuse is alleged. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, homely and safe environment that meets service users needs. EVIDENCE: The home is well maintained and provides for the needs of people who live at the home. The home has bedrooms, lounge, dining room and a quiet lounge on each floor. All bedrooms are single and ensuite. People who live there may choose either a double or single bed and are encouraged to bring in treasured items from home. All areas of the home seen were clean, welcoming and free from any offensive odour. The home has a wide variety of specialist equipment to care for dependent people whilst also maximising their independence. There is a bathroom on each floor with both having an assisted bath. All bedrooms have an ensuite with a large walk in shower that can be used by people in a chair if required and also there own toilet. Staff undertake a comprehensive assessment of service users, which includes an assessment of equipment required, to ensure Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 17 that ensure all required equipment is made available to them. A passenger shaft lift enables service users access to both floors. There are appropriate infection control systems in place. The laundry and laundry systems meet infection control guidance. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff at the home are skilled and are available at required times and in sufficient numbers to meet service users needs. EVIDENCE: There is at least one registered nurse on each floor supported by a team of care staff. The skill mix of the staff on duty generally meets service users needs however records identify that staff may not always recognise the needs, which revolve around choice for younger adults. The manager confirmed that she can allocate staff flexibly to fit around residents needs. She gave the example of additional staff being available to enable residents to go on their trip to Blackpool as she needed to ensure that there were sufficient staff in the home and also to accompany those residents who went to Blackpool leaving before 8.30 in the morning and not returning until after 10.30 at night. She also said that when residents go to the evening football match they frequently did not return until after midnight. The home usually has two “Life skills coaches” whose role is predominantly centred around ensuring that service users social needs are met but Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 19 unfortunately both have been on long term sick until recently with support staff taking on this role. Staff receive regular training to ensure that they are aware of features of the service users illness, understand their challenging needs and ensure that care is given on a “person centred” basis. The home has recruitment and selection procedures that are robust and protect vulnerable people. The home has 7 of its 29 (24 ) care staff with a minimum of National Vocational Qualification (NVQ) level two or above. The home has needed to recruit new staff since the ground floor has been occupied and as a result its percentage of qualified staff has decreased. The manager needs to identify a strategy to support and encourage staff to undertake their NVQ level 2 care qualification- the current requirement is for a minimum of 50 of care staff with NVQ or above. The Care manager confirmed that staff do receive induction training and demonstrated the booklets that she uses. No evidence that staff had completed their induction as they retain their booklets. The Care Manager has organised a programme of supervision but unfortunately as staff retain their records this could not be evidenced. It was advised that staff know that their supervision records may be and are available to be reviewed as part of the inspection process. Staff have at least five training days each year with a training and development plan which links to the homes aims and service users needs. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are listened to and people can be assured that the home protects and promotes their health, safety and welfare. EVIDENCE: The home has an effective management team. There is an experienced Home Manager and Care Manager who are both registered nurses and have several years care home management experience. The Home manager has managed the home since it opened and demonstrates a good understanding of the needs of younger people. Staff and visitors all say that both managers are approachable and they can discuss any concerns with them. The manager conducts monthly audits of accidents, complaints and pressure sores. A service user survey has been undertaken with a report available of its Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 21 findings, which is available for all interested parties including the Commission for Social Care Inspection. The home and its staff act on advice given by the Commission for Social Care Inspection and consequently has addressed all requirements. The home has good health and safety support from its head office, who also undertake checks of the home and provide the Manager with advice when required. Procedures to protect service users include regular and required checks on the fire alarm, emergency lighting, fire extinguishers, nurse call points and hot water. Records identify that staff regularly attend mandatory training in fire safety, moving and handling, food hygiene, first aid, health and safety, infection control and protection of vulnerable adults. Maintenance records and contracts were reviewed and were found to be up to date. Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 4 28 x 29 4 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 3 x x 3 x Bridgewood Mews DS0000062330.V330799.R01.S.doc Version 5.2 Page 23 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. 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 Refer to Standard OP32 OP32 Good Practice Recommendations The home should have 50 of its care staff with NVQ level 2 or above. Staff should have regular supervision that is recorded. 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