Inspection on 18/10/05 for Bright Care

This inspection was carried out on 18th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bright Care 10/10/07

Bright Care 26/07/06

Bright Care 05/07/05

Bright Care 19/10/04

Bright Care 20/04/04

Bright Care 04/11/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Bright Care Ltd 20 Taylors Lane St Mary`s Bay New Romney Kent TN29 0EU Lead Inspector Geoff Senior Announced Inspection 13:00 18 & 19 October 2005 th th Bright Care Ltd DS0000023323.V256916.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 Bright Care Ltd DS0000023323.V256916.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. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bright Care Ltd Address 20 Taylors Lane St Mary`s Bay New Romney Kent TN29 0EU 01797 366 866 01797 366 866 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) Beacon Care Holdings PLC Mrs Sarah Jane Hussey Care Home 6 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three (3) residents with physical disabilities should also have a learning disability. 5th July 2005 Date of last inspection Brief Description of the Service: Bright Care, 20,Taylors Lane is registered as a Care Home for up to six adults with a learning disability (three may also have a physical disability). Bright care Ltd is the registered Provider with the Registered Manager, Ms. S. Hussey in day to day control of the functioning of the Home. At the time of inspection there were four service users accommodated at the home. The home is a single storey bungalow, situated in a quiet road in St Mary’s Bay close to a bus route, local shops, pubs and the beach. All service users are accommodated in single rooms. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was undertaken over a period of 7 hours on 18 & 19/10/05. On the first day the inspector met and spoke specifically with two visiting relatives and with a recently arrived service user. He also spoke generally with all staff on duty. On day two the inspector had the opportunity to speak with the Manager, staff on duty and, in the final hour, the group operations manager who had arrived to conduct a Regulation 26 visit. The inspector also observed staff/service user interaction, viewed a range of records and made an accompanied tour of the premises. As noted at previous visits, the level of functioning of some of the service users precluded the opportunity for any meaningful verbal interaction. However the inspector observed, throughout the visit, the staff’s attention to the service users’ immediately expressed needs, their patient, friendly and respectful manner and their treatment of each service user as an individual. The duty rota indicated a good level of staff during the day for the number of service users. Given the increasing level of dependency and impending admissions to capacity, the night staff levels in particular should be reviewed and addressed. Relatives and service user comment cards and a pre inspection questionnaire for the registered person provided an additional source of information. What the service does well: What has improved since the last inspection? The service continues to develop and improve. The Manager and staff team examine the support and care that is provided and look to innovate and further improve. Work has continued on service user plans and other documents relating to the service users. Staff feel they and the service users are benefiting from a more structured approach whilst retaining a degree of flexibility. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 6 Staff have continued to improve the physical environment in the bedrooms and the garden with items that provide visual stimulus. 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. Bright Care Ltd DS0000023323.V256916.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 Bright Care Ltd DS0000023323.V256916.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): Not assessed at this visit EVIDENCE: Bright Care Ltd DS0000023323.V256916.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): 6,7,9,10. The care planning and report system provides staff with an accessible, clear and consistent vehicle for monitoring the delivery of services. The care plan documentation should include evidence of service user/representative or family consultation in the care planning process. Service user responses to changes in circumstances are noted and acted upon. The arrangements for storage of personal information and property, which previously raised issues of security and confidentiality, have been addressed. EVIDENCE: The amended care plan, recording, monitoring and review system has now been implemented. Two key workers for each client and the manager are responsible for maintaining the documentation. Staff consider the care plan guidelines to be helpful and informative to the delivery of care and support. Daily records cross-reference with the monthly goals and aspirations. These are reviewed and subsequently generate the following month’s goals. Any need for specialist guidance is identified and sought. A service user confirmed that the opportunity for choice and independence is offered within an acceptable risk assessment framework. Staff expressed an awareness of issues of confidentiality and indicated steps taken to ensure it is not compromised. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 10 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): 11,12,14,15,17. Daily routines are flexible and respect service users rights and individuality. Service users are provided with a varied and balanced diet. Staff and service users are benefiting from a more structured approach to providing pastimes and stimulation according to assessed needs and abilities. EVIDENCE: The mobility of the majority of the service users is limited but they may come and go as they please in the communal areas and grounds. The house is a non-smoking, client and staff may use the garden for this purpose. Staff confirmed that the daily routines are flexible and respect the service users rights and individuality. The menu record showed a varied and balanced selection of meals. Staff are aware of service user likes, dislike and preferences and cater accordingly. The meal offered at the time of inspection had plentiful quantities of home cooked food including fresh vegetables. Service users were assisted where necessary. The particular dietary needs of two of the service users were discussed. The manager agreed to ensure that appropriate expert advice, where sought, would be documented and guidelines followed. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 11 Service uses are supported to maintain links with family. Visiting relatives, and written information received, confirmed that the home will consult and inform on any major issues relating to the service users. Activities may be limited by service user ability, application and concentration. Staff have however made efforts to decorate the service user rooms and garden with visually interesting lights and paraphernalia. The previous inspection report noted that there was little evidence of structured activity or stimulating pastimes. There is now a day activity plan in operation which staff feel offers a focus to the day and ensures a more consistent and structured approach. The home has a vehicle available for transporting service users to and from trips out, social venues and home visits Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 12 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): 20 These standards were not fully reviewed. The previous inspection report noted that the storage arrangements for medication needed to be reviewed. This has been addressed. EVIDENCE: Only Staff who have satisfied the manager’s competency assessment are authorised to be involved in medication procedures. Storage arrangements have been reviewed. The home is now utilising a dedicated cabinet. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 13 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): Not assessed at this visit EVIDENCE: Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 14 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): 24,25,27,30 The standard of the décor, furnishings, hygiene and general living environment is good. The service users and staff are provided with a comfortable and homely place in which to live and work. The laundry facility needs to be reviewed in the light of changing client needs. EVIDENCE: The premises appeared to be clean and were free from undue odours. Private rooms are adequately furnished and have been personalised. Toilet and bathroom facilities are adequate for current needs. There is no separate wc facility for staff use and limited space for the storage of their belongings whilst on duty. The laundry facility was discussed with the staff, management and operations manager. It was agreed that the current arrangements would be improved by the provision of a sluice facility and more appropriate machinery. Service users are helped to make use of the enclosed garden and patio area. The slope from the sitting room is to be widened to ease wheelchair use. Staff have made efforts to improve the garden by providing items offering visual stimulation, wind chimes and a gazebo. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 15 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): 32,33. Staff are accessing training courses to enable them to work more effectively with the service users. The staff team is well supported and supervised by the management and is clear about its roles and responsibilities. Low staff levels at night may compromise service users welfare. EVIDENCE: The Manager confirmed that she is aware of the requirements of the NMS in relation to staff training and that the matter of Foundation and NVQ level 2 is still being pursued. Increasing levels of physical dependency require adequate numbers of staff at all times to assist with mobilising and transferring. There is only one member of staff on duty between 20:30 and 07:00. The Manger spoke of her intention to negotiate and implement a minimum of two staff on site overnight. Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 16 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): Not assessed at this visit EVIDENCE: Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 17 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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 2 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bright Care Ltd Score X X 3 x Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000023323.V256916.R01.S.doc Version 5.0 Page 18 yes 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 YA30 YA33 Good Practice Recommendations Laundry facility to be reviewed(see text of report) The home has an effective staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times. Nightime levels to be reviewed in light of increasing needs. Staff have the competencies and qualities required to meet service users’ needs and achieve Sector Skills Council workforce strategy targets within the required time-scales. Staff NVQ requirements to be addressed. 3 YA32 Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Bright Care Ltd DS0000023323.V256916.R01.S.doc Version 5.0 Page 20 - 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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