Random inspection report
Care homes for adults (18-65 years)
Name: Address: Bridlington House 4 Bridlington Avenue Hull East Yorkshire HU2 0DU one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Angela Tew Date: 2 8 0 7 2 0 0 9 Information about the care home
Name of care home: Address: Bridlington House 4 Bridlington Avenue Hull East Yorkshire HU2 0DU 01482217551 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Akintola Oladapo Dasaolu Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 22 The maximum number of service users who can be accommodated is: 22 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Mental Disorder, exluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Bridlington House is a care home providing accommodation and personal care for 22 persons who have enduring mental health problems. An individual privately owns the care home. The building is a detached property and it is situated within walking distance of the City Centre, shops, and local community centres, churches other places
Care Homes for Adults (18-65 years) Page 2 of 14 Brief description of the care home of interest are also nearby. The home has 6 single and 8 double rooms; four of the single rooms and two double rooms have en-suite facilities. The home has four bathrooms, one assisted and 12 communal toilets. There are two lounges and a dining room. There is a garden to the rear and a small parking area to the front of the property. The weekly fees are currently #278.50 - information supplied by the manager during the inspection visit on 07.04.08. The registered manager stated that all residents are given a service user guide and this contains the last inspection report. The registered manager also stated that prospective residents are offered a copy of the home?s statement of purpose and service user guide. Care Homes for Adults (18-65 years) Page 3 of 14 What we found:
During the random inspection visit it was identified that a person had recently moved into the home without an assessment of need being undertaken either by the Local Authority, who were funding the placement or by the home. The manager told us that this was an emergency placement and that the social worker had telephoned and within the hour the person had arrived with minimal paperwork. The manager agreed to take this person without knowing what the needs of the person were. It was confirmed by Hull Social Services that the person has complex needs and although they do have a mental health problem, the primary need was currently alcohol related and would have their needs better met if they were placed somewhere that specialised in substance or alcohol misuse. The manager confirmed that staff do not undertake any specialist training or have the skill sto deal with alcohol related issues. Therefore the home agreed for the person to come and live there without knowing whether they could meet those needs and manage the risks. Staff do not individually or collectively have the skills and experience to deliver the services or care required for people who have more complex behaviours including alcohol misuse. We looked at sample of files which belonged to people living in the home. We saw that each person had a care plan that was basic in style and content and did not give sufficient detail about the needs of the individual. The plans are not person centred or written in a way that included the person or their views. One care plan was dated August 2008 and this person had recently come to live in the home and although the care plan covered past life and mental health problems including self harming behaviours, it did not give clear guidance about intervention or how staff should offer support. The plan lacked detail and direction and had not been updated even though a series of events had occurred resulting in the previous placement breaking down. Some of the paperwork looked at included managing risk. However, these varied and there appeared to be little consistency in their presentation. The majority of the risk management plans gave an indication of the level of risk, but not how to reduce the risk. For example, one person when their mental health was deteriorating would refuse their medication. Although this was written in the plan it did not state what the actual risk was or what the staff must do and when they would need to contact other agencies for support or seek urgent medical advice. We looked at the food stock in the dry store, freezers and the kitchen confirming that there was sufficient food in the home to maintain a varied diet. People said they were happy with the food offered and surveys received at the previous key inspection confirmed this. Two staff members said that they felt the food stock was consistent and there was petty cash available if they run out of anything. One staff member said, it is better now and there is sufficient food and petty cash if we run out of anything. It was observed that not all food was dated when opened. The Environmental Health Department had visited the previous week, however the home was awaiting their report on the cleanliness and hygiene within the kitchen. During the visit we looked at the complaints records and it was identified that a complaint had been made by a person living in the home in January 2009 and not completed. The
Care Homes for Adults (18-65 years) Page 4 of 14 previous manager had discussed the complaint with the person and commenced the investigation as this involved the staff and how they delivered care. There was no outcome recorded or what action would need to be taken. A discussion occurred with the current manager who agreed to follow the complaint up and relay the outcome back to the complainant. There have been four safeguarding referrals made to the Local Authority since the last key inspection and these are currently under investigation. A tour of the building was undertaken and the standard of cleanliness was poor and in some parts of the building there were offensive smells in some bedrooms. Since the last key inspection the cleaning hours have remained at 30 per week, however at weekends the care staff have to undertake the cleaning tasks in addition to their care duties. The main entrance carpet has been replaced with non slip flooring and this has improved the presentation. The registered provider submitted a refurbishment plan to CQC that details any refurbishment, repairs and maitenance for 2009. This will be assessed at the next key inspection as to whether this has been implemented. The carpet in the hall, stairs and landing is in poor condition having cigarette burns, stains and is poorly fitted and may pose a trip hazard. Some of the bedrooms remain in poor condition requiring redecoration, new carpets and bedding, this would ensure that people live in a place that is homely and maintained to a good standard. We looked at the staffing rota for the next two weeks and the manager confirmed that the staffing hours had remained as they were at the previous key inspection on 8.4.09. During the visit it was evident that little or no activities take place and staff do not undertake one to one support with people. The home currently has 376 care hours per week, however the Residential Forum recommend that for the number of people and level of need it should be 425 per week. At the previous inspection a recommendation had been made for the home to review the staffing hours and as this has not been addressed, therefore this will become a requirement that the care hours are reviewed and increased to ensure that all of the needs of people living in the home are met. The manager told us that since the previous inspection the staff files have been reorganised and all existing staff have a current criminal records bureau (CRB) check in place and two references. We saw written evidence confirming that existing staff have appropriate checks in place and one new member of staff has been recruited in a safe way and the correct checks were in place. However, due to the lack of compliance in previously in relation to recruitment, it was felt that the requirement will remain outstanding and will be fully assessed at the next key inspection. At which point there may have been other staff appointed and consistency could be measured. We looked at the training records for staff and it was confirmed that the majority of the mandatory training has been booked or staff have undertaken some courses. The manager said, Social Services came and discussed our training needs, we have identified areas that required urgent attention and these courses have been booked. Some of these
Care Homes for Adults (18-65 years) Page 5 of 14 were safeguarding, infection control, first aid, food hygiene and health and safety. The manager also said, I have undertaken a full audit of the training needs of staff and discussed this with them in their supervision. Evidence was also seen to confirm that regular supervision has been offered since the last inspection took place. Although the mandatory training has been organised and booked, there is little in the way of specialist training and the home has people living there with a whole range of difficulties including alcohol or substance abuse, complex mental health needs and challenging behaviour. The home needs to ensure that specific need can be met by staff that have been trained. The manager told us that she had been in post since March 2009 and is currently not registered with CQC. She confirmed that a CRB check has been undertaken at the CQC Leeds office and when that is returned an application for registered manager will be submitted. The manager also told us that since the last inspection the registered provider has visited on a regular basis. She said, the owner has been supportive to me and I receive 1-1 supervision when he comes to visit, we have discussed the report and prioritised areas that required urgent attention. The owner has been forwarding the required reports to CQC when they have taken place. The manager told us that there are sufficient funds made available to maintain the building, purchase food and other items when required. During a tour of the building we noticed that some people are smoking in their bedrooms and ashtrays full with cigarette ends were left on beds. The metal bins provided contained plastic bags and other flammable items and from looking at the written records it was clear that the fire risk assessment for the building had not been updated for sometime. It was also observed that some staff had not undertaken fire safety training for several years. The manager also told us that one person had, set fire to his mattress by accident. During the visit the Fire Department was contacted and the concerns above were passed on resulting in the Fire Officer visiting the home on 4.8.09. The home is not maintaining the health and safety of the people living there and is not taking adequate precautions against the risk of fire. The manager was unaware of the requirement to report incidents such as the person setting fire to their mattress or when staff are subject to disciplinary procedures. What the care home does well: What they could do better:
Care Homes for Adults (18-65 years) Page 6 of 14 People do not always have their needs assessed before they move in and this means that the home is offering a placement to someone whose needs they cannot meet. Care plans are basic in style and content and did not give sufficient detail about the needs of the individual. The plans are not person centred or written in a way that included the person or their views. The majority of the risk management plans gave an indication of the level of risk, but did not give clear direction to staff about how to reduce or manage the risk. During the visit we looked at the complaints records and it was identified that a complaint had been made by a person living in the home in January 2009 and although the complaint had been looked into it had not been completed. At the previous inspection a recommendation had been made for the home to review the staffing hours and as this has not been addressed, therefore this will become a requirement that the care hours are reviewed and increased to ensure that all of the needs of people living in the home are met. Although the mandatory training has been organised and booked, there is little in the way of specialist training and the home has people living there with a whole range of difficulties including alcohol or substance abuse, complex mental health needs and challenging behaviour. The home needs to ensure that specific need can be met by staff that have been trained. Staff had not undertaken fire safety training for several years. The manager also told us that one person had, set fire to his mattress by accident. During the visit the Fire Department was contacted and the concerns above were passed on resulting in the Fire Officer visiting the home on 4.8.09. The home is not maintaining the health and safety of the people living there and is not taking adequate precautions against the risk of fire. The manager was unaware of the requirement to report incidents such as the person setting fire to their mattress or when staff are subject to disciplinary procedures. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 7 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 12 Risk management plans must 21/07/2009 be followed and implemented. To ensure that people have risk reduced to a minimum and are protected. 2 23 13 Staff must undertake the safeguarding vulnerable adults training. To ensure that staff have received training and know how to refer to safeguarding when needed. 21/07/2009 3 34 19 New, existing staff and the manager must be recruited in a safe way, ensuring that a full CRB check and references are in place before the person commences employment. To make sure that people are supported by staff who have been appropriately vetted, ensuring they receive support in a safe way. 21/07/2009 4 42 26 The registered provider must 21/07/2009 undertake regulation 26 reports on a monthly basis, ensuring that the requirements detailed in this report are referenced to and
Page 8 of 14 Care Homes for Adults (18-65 years) Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action detailing what training staff have undertaken. To ensure that information is forwarded to the commission about how staff are being recruited and trained that would ensure peoples safety. 5 42 12 Staff must receive training in 21/07/2009 relation to maintaining the health and safety of people living in the home, including moving and handling, fire safety, first aid, infection control, safeguarding vulnerable adults, health and safety and food hygiene. Other records must be made available such as fire officer report, environmental health department report. To ensure that staff have undertaken the necessary mandatory training in order to maintain the health and safety of people and other regulators requirements are complied with. Care Homes for Adults (18-65 years) Page 9 of 14 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 2 14 People must have their 30/09/2009 needs assessed before being offered a place to live. To ensure that the home can meet all of the assessed needs of the people living there. 2 6 15 Care plans must be descriptive and give clear direction to staff about what the needs are and what support is required and when. These must also be person centred and include preferences and choice. To make sure that staff understand what the needs of people are and what is required of them and when. 30/09/2009 3 9 13 Risk management plans must 30/09/2009 be clear about what the risk is, give signs, symptoms and triggers, how the risk can be reduced or managed and give direction to staff about when they need to intervene or contact other agencies.
Page 10 of 14 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action To ensure that risk is managed in a robust way. 4 22 22 Complaints must be dealt with appropriately, investigated and the outcome given to the complainant. To ensure that complaints are dealt with in accordance to the homes complaints procedure and feedback is given to those making complaints. 5 24 23 The refurbishment 30/09/2009 programme must be implemented and the home comply with other regulators requirements and recommendations. To ensure that people live in a safe and well maintained place. 6 33 18 The staffing levels must be 30/09/2009 reviewed and be sufficient to meet the needs of all of the people living there. To ensure that peoples needs can be met by sufficient numbers of staff. 7 34 19 New staff must be recruited in a safe way, ensuring that a full CRB check and references are in place before the person commences employment. 30/09/2009 30/09/2009 Care Homes for Adults (18-65 years) Page 11 of 14 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action To make sure that people are supported by staff who have been properly vetted. 8 42 37 Incidents that affect the well 30/09/2009 being of the people living in the home, or any allegation of misconduct about a person working in the home must be reported to CQC and recorded. To ensure that management are aware of their responsibilities and people live in a safe and well run home. 9 42 23 Staff must undertake fire safety training, the fire risk assessment needs updating and smoking in bedrooms must be addressed with the fire department. To ensure that people live in a safe home and adequate precautions are taken to prevent fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 30/09/2009 1 3 Staff should undertake specialist training including alcohol or substance misuse, as this would ensure that they have the knowledge and skills to deal with people. Food should be labelled when opened, ensuring that produce is not kept past the use by date and is safe to use. The registered provider should implement the smoking
Page 12 of 14 2 3 17 24 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations recommendations made by the Environmental Health Department. To ensure that people live in a home where they have the choice not to sit in a smokey environment. 4 35 Mandatory and more specialised training should be offered to new and existing staff on a regular basis. To ensure that people received support from safely from a well-trained staff group. Care Homes for Adults (18-65 years) Page 13 of 14 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 14 of 14 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
