Inspection on 05/07/05 for Bright Care

This inspection was carried out on 5th July 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 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

Bright Care 10/10/07

Bright Care 26/07/06

Bright Care 18/10/05

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 Marys Bay New Romney, Kent TN29 0EU Lead Inspector Geoff Senior Unannounced 5 July 2005 10:30 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 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 Stationary 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 H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bright Care Ltd Address 20 Taylors Lane, St Marys Bay, New Romney, Kent, TN29 0EU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01797 366866 01797 366866 Beacon Care Holdings PLC Mrs Sarah Jane Hussey Care Home only 6 Category(ies) of Learning Disability x 6; Physical Disability x 3 registration, with number of places Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1.Service users with PD should also have LD Date of last inspection 19/10/04 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 H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on 5/7/05 between 10:30 and16: 35. The inspector met and spoke generally with all staff and more specifically with the senior support worker. The Manager was on sick leave. The level of functioning 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. The Inspector viewed the premises and inspected a range of records; care plans, daily records, staff files and training records. What the service does well: What has improved since the last inspection? The home has addressed the requirements and recommendations of the last inspection report. They have been met or have actions planned. Administrative systems and records have been reviewed and are in the process of being amended /replaced where appropriate. Staff have endeavoured to improve the physical environment in the bedrooms and the garden with items that provide visual stimulus. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 6 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 H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) 1,2, 4. The statement of purpose and service user guide provides prospective service users and their representatives with details of the service the home aims to provide, thus enabling a reasonably informed decision about admission to the home. Potential admissions are subject to pre placement assessment. This should include a compatibility assessment to ensure the placement is mutually beneficial EVIDENCE: The statement of purpose generally addresses the requirements of the standard. The manager has reviewed the company format and supplied additional information to reflect the extent, limit and individuality of the service at Brightcare. Referrals to the home arrive via the marketing department’s assessment. The manager then meets with potential client and undertakes further care needs assessment. There is a need to include an assessment to ensure compatibility with existing service users. The admission process includes the opportunity to visit the home to meet and spend time with the existing service users and staff and view the accommodation. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,10. The care planning and report system is adequate but does not provide staff with an easy accessible, clear and consistent vehicle for monitoring the delivery of services. There was no 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 current arrangements for storage of personal information and property raise issues of security and confidentiality. EVIDENCE: Two Service user files in current use were viewed. They contained information relevant to the support needs of the individual. They were bulky and included information that, whilst relevant, was not essential to the day-to-day working document. Care plans with an improved level of information in a more user friendly and informative format are to be introduced. Service users with limited communication skills are encouraged by staff to express a choice or preference wherever possible. Staff interacted with the service users in a friendly and non-patronising manner and made efforts to include them in any interactions. Risk assessments were not viewed at this visit. Files are kept in cabinet in lounge. This was not locked. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15,16,17 Daily routines are flexible and respect service users rights and individuality. Service users are provided with a varied and balanced diet. Service user activity is limited. Staff may benefit from more guidance/leadership in providing pastimes and stimulation according to assessed needs and abilities. This may include input from external agencies. EVIDENCE: There is little interaction with the immediate neighbourhood. The service users make limited supported use of the local amenities and services. Two visit the local shop. The home has a vehicle available for transporting service users to and from trips out, social venues and home visits. The service users mobility is limited but they may come and go as they please in the communal areas and grounds. The house is non-smoking 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 Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 11 meal offered at the time of inspection had plentiful quantities of home cooked food including fresh vegetables. Service users were assisted where necessary. Service uses are supported to maintain links with family. Activities are limited by service user ability, application and concentration. Staff have made efforts to decorate the service user rooms and garden with visually interesting lights and paraphernalia but there was little evidence of structured activity or stimulating pastimes. Any activity should be linked to care needs and based on advice from OT etc. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) 18,19,20. Staff have a good understanding of individual support needs. This was evident from the positive relationships formed between the service users and staff. Personal support is provided in such a way as to promote privacy and dignity. The arrangements for medication administration are generally good. Storage arrangements need to be reviewed. EVIDENCE: Staff are aware of issues relating to privacy and dignity when offering personal support and care.. Systems are in place to monitor ongoing healthcare needs. Staff support Service users to attend external healthcare appointments. Staff spoke of training received in respect of medication administration, recording and storage. Only those who have satisfied the manager’s assessment are authorised to be involved in medication procedures. Current storage arrangements need to be reviewed. The home is in possession of a dedicated cabinet but it is not being used. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) These Standards were not assessed at this visit EVIDENCE: Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 standard(s) 24,25,26,27,28,29,30. 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. EVIDENCE: 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. The premises appeared to be clean and 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. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32,33,34,35,36. Recruitment practices provide for the protection of service users. 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: Staff were noted interacting with service users in a friendly and non patronising manner. Service users were seen responding to staff without inhibition. 3 staff confirmed they have been offered NVQ level 2 training and are due to enrol once funding is finalised. Staff files viewed showed appropriate checks had been undertaken prior to appointment or unsupervised access to service users. Staff files contain a competency assessment to be used in the annual appraisal and development programme. Staff confirmed that they receive regular one to one supervision. 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. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 42,43. The home is well managed and provides a caring and supportive service. Staff consider the promotion of service user health and welfare as paramount EVIDENCE: The service users and staff appear to benefit from the open and inclusive approach of the home’s manager and are clear about their respective roles. They have opportunity to express views and opinions in formal and informal forums. The CSCI receive regular internal audit reports in accordance with Regulation 26. Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bright Care Ltd Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 2 3 H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 18 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 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. 3. 4. 5. 6. 7. 8. Refer to Standard YA6 YA10 YA14 YA20 YA28 YA32 YA33 YA42 Good Practice Recommendations Staff awaiting instruction from line management re implementation of new care plan and daily record format Personal information Storage arrangements in loungemay compromise security seek specialist advice re stimulating and beneficial activity. Utilise dedicated medication cabinet Staff facilities to comply with requirements of the standard. Staff to complete NVQ training Staff levels to be reviewed in light of increasing dependency levels. Night levels in particular. see YA33 Bright Care Ltd H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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 H56-H05 S23323 Bright Care Ltd V226045 070605 Stage 4.doc Version 1.30 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. 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