Inspection on 26/07/06 for Bright Care

This inspection was carried out on 26th July 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bright Care 10/10/07

Bright Care 18/10/05

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 Wendy Gabriel Unannounced Inspection 26th July 2006 09:30 Bright Care Ltd DS0000023323.V298483.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 Bright Care Ltd DS0000023323.V298483.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. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 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 (2), Physical disability (4) registration, with number of places Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Four (4) residents with physical disabilities should also have a learning disability. 18th October 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 and the Registered Manager is Ms. S. Hussey. The home provides single bedroom accommodation and is situated in a quiet road in St Mary’s Bay close to a bus route, local shops, pubs and the beach. Fees are currently £907 a week. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the unannounced inspection the Inspector was pleased to observe the very good level of interaction between Service Users and support workers. The home was clean and tidy. Currently the home does not have a senior support worker or a Deputy Manager. The Registered Manager also manages another small local home owned by Beacon Care Holdings PLC and does not have support for being ‘oncall’ and has to be available when on days off, annual leave and sick leave. A requirement is made for this to be suitably addressed by the company. One of the three recommendations made at the previous inspection had not been met and is now a requirement. The home is considering accepting one more Service User with a physical disability as well as a learning disability. This may only go ahead if further suitable day accommodation is provided. What the service does well: What has improved since the last inspection? What they could do better: A suitable sluicing facility must be provided to maintain infection control measures. The Registered Manager must be given senior support worker and management support and the ‘on-call’ system must be reviewed. Although staff training is well under way, staff development is to be maintained to meet the Sector Skills Council workforce training targets. The Registered Manager must be given the facilities to access this and other information either directly and regularly from Beacon Care Holdings PLC or other sources including internet access. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 6 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.V298483.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 Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Information is available to allow the prospective Service User or advocate the opportunity to make an informed choice about living in the home. Service Users needs assessment details specific support requirements as known. EVIDENCE: All prospective Service Users receive a needs assessment before admission. There was evidence of a completed joint assessment profile from the placement authority that detailed needs and health issues. Information is sought from involved Health care professionals. A service user compatibility format is used for the Registered manager to be able to make an informed judgement as to whether the home is suitable for the prospective Service User. Wherever possible the Registered Manager will visit the prospective Service User in his or her own environment and visits to the home will be arranged. Information is available to give the prospective Service User and family the opportunity of understanding the terms and conditions of living at the home. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans detail assessed needs and promote consistent care. Decision making by Service Users is limited but promoted where possible by staff. EVIDENCE: Care plans viewed contained information that identified assessed needs. Daily reporting included details of food eaten that day. The care plans are now less bulky than had previously been noted and files readily available to staff contained only information pertinent to the everyday needs of each Service User. Reviews are undertaken. Pre review information is collated by the Registered Manager and the key worker and sent to health care professionals, family or advocate and the community nurse or social worker involved with individual Service Users. A copy of the findings of the review is then given to all who attended and for the staff to read. This is good practice and promotes continuing and consistent care. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 10 During the course of the inspection the staff were noted to be proactive in ensuring dignity and privacy for Service Users. Risk assessments are ongoing. One Service User was observed discussing different choices he was making for that days and future activities. This included plans he and the Registered Manager were making to play a joke on the rest of the staff. This made the Service User laugh and there was confident, friendly and appropriate rapport between he and the Registered Manager. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service Users are supported by staff to maintain their individuality and rights. Activities are limited only by the assessed needs of Service Users. Service Users benefit from a varied and balanced diet that may be enhanced following discussion between the Registered Manager and company for an increase in budget. EVIDENCE: Most of the current Service Users have limited communication and education opportunities are not suitable for the people living in the home. Several members of staff were able to speak about the activities undertaken. These are fairly limited because of the Service Users complex needs. One support worker said that the local community was friendly and welcoming and recognised Service Users, for example if they went into shops or the pub. Also, that some people in the community did not realize the premises was a Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 12 residential care home, as it did not ‘stick out from other bungalows in the road’. There was evidence of sensory items around the home and in the garden. An aromatherapist visits the home every fortnight. One Service User accesses ‘sensory sessions’ in a specialist unit. The home has its own transport and popular drives out include trips to places where there is a café and especially where there are animals for the Service Users to see. Daily routines are flexible and meet the needs of the Service Users. At the time of the inspection one Service User was in bed. A member of staff said that the Service User had already been up but had decided to return to her bed. Others were in the process of getting up and some were ready for the day. There is a ramp from the lounge in the back garden that is wide enough for a wheelchair. Music was played at times during the day but was not constant or too loud and reflected the choice of Service Users as understood by the support workers. Families are welcomed to the home. The kitchen was clean and tidy. Menus are balanced and are chosen mainly by staff who observe whether Service Users enjoy certain foods or not. There was a variety of fresh food in the home and the fridge and freezer were full. The Registered Manager agreed to discuss her concerns over the food budget with the company with regard to one Service User and to speak to the placing social worker about assessed needs regarding diet. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans identify Service Users needs and support healthcare initiatives. Medication administration is supported by procedures and policies. Specialist support is available as required. EVIDENCE: Health care needs are identified and specialist information is included in care plans. The Registered Manager pointed out comprehensive information and a new charting system detailing information about seizures. Staff record appointments to or by Health care professionals. Medication is secure and policies and procedures are in place. No Service User self administers their own medication. A nominated shift leader holds the keys to the medication facility. The Registered Manager stated that staff who have received medication administration training undertake a competency check every six months. A member of staff was clearly able to discuss the personal support required by the Service User she is key worker to. As previously indicated, staff were seen Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 14 to actively promote privacy and dignity when undertaking daily personal care routines with the Service Users. Some specialist equipment has been identified and provided by the occupational therapist. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Policies and procedures ensure that complaints will be listened to and that Service Users may be protected from abuse. EVIDENCE: The home promotes training to be aware of adult abuse and there are policies and guidelines regarding abuse and whistle blowing. The Registered Manager stated that a prospective employee would be made aware as early as at the job interview that they would be expected to report any instance or suspected instance of abuse. Training around understanding abuse begins during induction. There are policies and procedures for complaints. The Registered Manager agreed to include a section on the complaint-recording format for outcomes of any complaints made. No complaints had been made since the previous inspection. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is clean and attractive and is a pleasant environment to live in. A sluicing facility is required to maintain infection control measures. EVIDENCE: Staff take a great deal of pride in the decoration of the home especially in obtaining items for visual stimulation including lights. Key workers choose the bedroom décor for the Service User they are responsible for. Although one bedroom was clean, tidy and suitable, a key worker said she wants to add to the decoration when she is more able to ascertain the likes and dislikes of the Service User who has very limited communication. It was apparent that much thought had been given to individual likes and dislikes and bedrooms ranged from very pretty and feminine for female Service Users to sports and family interests for male Service Users. A recommendation made at a previous inspection for a sluicing facility to be provided has not been met and is now a requirement. The laundry is kept clean and tidy and well organised by the staff but has only a domestic style Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 17 washing machine. Without a sluicing facility it does not meet infection control guidelines. The home would otherwise have received a higher rating if this had been in place and it is a shame that the care and attention given to the rest of the home is undermined by lack of suitable investment for this facility. A shower room does not have a ‘walk in’ facility and this makes safe moving and handling very difficult. A recommendation is made for this to be reviewed. As previously stated, the property is in keeping with the local community. The communal facilities are adequate for the current Service Users. Should the home wish to provide for another Service User with physical disability and in a wheelchair; further suitable day space will have to be provided. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Service Users will benefit by increased supervision and support given to the Registered Manager by Beacon Care Holdings PLC. Service Users are supported by the homes recruitment policy. Staff training is ongoing but would improve by the home better understanding the Skills Sector Council. EVIDENCE: A previous recommendation for two staff to be on duty at night has been met. One staff file was viewed and included evidence of suitable recruitment and employment details including CRB check and terms and conditions of employment. The staff team is well supported by the Registered Manager their supervision is regularly undertaken. The Registered Manager receives supervision from the companies’ operations manager, but stated that this often have to be cancelled or interrupted due to pressures of work both sides. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 19 Currently the home does not have a senior support worker or a Deputy Manager and the Registered Manager also manages another small local home owned by Beacon Care Holdings PLC. The Registered Manager is under great pressure to maintain standards in the home and the fact that she is able to do so is due to the skill and good will of both herself and the staff. On the day of the inspection an off duty support worker came into work to accompany a Service User she is key worker for to an appointment. Although this is a very caring action by the support worker Beacon Care Holdings PLC must not rely on the good will of staff but must provide adequate support to the Registered Manager. The Registered Manager does not have support for being ‘on-call’ and has to be available when on days off, annual leave and sick leave. The Registered Manager also stated she has been called into the home when on sick leave. A requirement is made for the Beacon Care Holdings PLC to provide adequate support to the Registered Manager to address these issues. Out of eleven staff, nine are currently undertaking NVQ2 and one has obtained NVQ2. This level of training has been addressed since the previous inspection and is good practice. Staff have undertaken or are booked to complete or update the National Minimum Standards mandatory training. Although staff training is well under way, staff development is to be maintained to meet the Sector Skills Council workforce training targets. A recommendation is made that the Registered Manager must be given the facilities to access this and other information. This may be either directly and regularly from the company or from other sources including internet access where up to date information may be found from different sources such as Sector Skills Council and the Commission for Social Care Inspection sites. Bright Care Ltd DS0000023323.V298483.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service Users benefit by the staff and Registered Managers approach to the ethos of the home. Quality assurance audits may safeguard Service Users rights and best interests. EVIDENCE: The Registered Manager has begun quality assurance audits for the home in advance of the Commission for Social Care Inspection standards that commence in September 2006. This includes questionnaires to families and professionals involved with individual Service Users. Staff meetings are held regularly and staff receive annual appraisals in addition to supervision. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 21 The Registered Manager and staff promote health and safety in the home and this will be enhanced by investment in a suitable sluicing facility. A health and safety audit is undertaken monthly. Until the Registered Manager receives adequate support from Beacon Care Holdings PLC in the form of a deputy and by access to up to date information regarding other agencies regulations there is the risk that the home may be compromised if the current management system breaks down and no suitable support is available. The fire safety book was in date as were annual maintenance checks. Staff said the Registered Manager was approachable and supportive. Bright Care Ltd DS0000023323.V298483.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 X 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 2 25 4 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 1 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 23 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 YA36 Regulation 12 & 18 Requirement Suitable support must be given to the Registered Manager and that on-call arrangements be reviewed and supported. A suitable sluicing facility must be provided to meet infection control measures. Timescale for action 30/10/06 2 YA30 13 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA24 YA36 YA17 Good Practice Recommendations The shower room is to be reviewed with a view to supporting safe moving and handling. The manager must be given the facilities to access up to date information regarding management of the home including details of the Skills Sector Council. Registered Manager is to discuss the food budget regarding special needs with the placing social worker and Beacon Care Holdings PLC. Bright Care Ltd DS0000023323.V298483.R01.S.doc Version 5.2 Page 24 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.V298483.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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