Inspection on 16/10/06 for Bryony Lodge

This inspection was carried out on 16th October 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 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

Bryony Lodge 03/09/07

Bryony Lodge 06/09/05

Bryony Lodge 19/04/05

Bryony Lodge 24/01/05

Bryony Lodge 17/06/04

Bryony Lodge 13/02/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Bryony Lodge 19 St Mary`s Road Hayling Island Hampshire PO11 9BY Lead Inspector Mr Roy Bega Unannounced Inspection 16th October 2006 10:00 Bryony Lodge DS0000028547.V312751.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 Bryony Lodge DS0000028547.V312751.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. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bryony Lodge Address 19 St Mary`s Road Hayling Island Hampshire PO11 9BY 023 9246 0358 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) Mr A Rutter Mrs J V Rutter Mr Shaun David Brough Care Home 9 Category(ies) of Physical disability (9) registration, with number of places Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user (date of birth 27/09/65) in the LD category may be accommodated at the Home. 6th September 2005 Date of last inspection Brief Description of the Service: Bryony Lodge is a large modernised house, furnished and decorated in a contemporary style, and is set in a quiet residential street on Hayling Island. The home is registered to accommodate nine younger adults with physical disabilities including one service user with a learning disability. The people who live at this service make use of the local shops that are within walking distance, and use public transport or the homes mini bus. The home is able to accommodate service users who use wheelchairs. All service users have ensuite bathrooms and these contain assisted bathing facilities. Current weekly fees range from £450 to £1,000 per week with additional costs being made for hairdressing, newspapers, and sundries. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for adults 18-65 were being met. Evidence has been collated from the service’s history file and this site visit. This visit took place on 16 October 2006 between the hours of 9-30 a.m. and 4-30 p.m., a total of seven hours. Opportunity was taken to look around the home view records, observe the working environment and speak with management, staff, residents and relatives. There were not any requirements raised as a result of this visit. What the service does well: What has improved since the last inspection? The service has further developed its quality assurance and quality monitoring systems, based on seeking the views of residents, relatives and associated professionals to measure success in achieving the aims objectives and statement of purpose. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 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. Bryony Lodge DS0000028547.V312751.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 Bryony Lodge DS0000028547.V312751.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): 2. Quality in this area is excellent. This judgement has been made using available evidence including a visit to the service. Prospective residents benefit from good pre admissions assessment/ procedure and being fully involved in the process. EVIDENCE: Records were seen for the most recently resident admitted to the service. The inspector had the opportunity to speak with the resident who readily stated they and their family were fully involved in the process. The assessment focused on achieving positive outcomes for the person including ensuring the facilities, staffing and specialist services provided by the home could meet the diversity needs of the individual. Other residents spoken with informed the inspector that they were fully involved with the assessment process and took opportunity to visit the service before making a decision whether it was the right place for them. They were also provided with appropriate information, which helped them understand, what specialist services the home provides. On admission, an individual member of staff was allocated to them to provide information and support in helping them to settle in. Staff spoken with informed the inspector they are involved in the assessment/admission process, where their views, opinions, and comments are listened to and fully debated, before agreement is give for the admission. An Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 9 individual member of staff is allocated in agreement with the resident post admission to give them information and to help them understand how the home is organised and run and the facilities and services available. . (See also section “Individual needs and Choices” of this report). Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 10 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 and 9. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Care plans provide staff with good information on the needs of the residents, who are encouraged to make decisions about their lives and who participate fully in all aspects of life in the home. EVIDENCE: The service has a strong belief that it is essential to involve residents in the planning of care that affects their lifestyle and quality of life. Management and staff understand the importance of residents being supported to take control of their own lives, and to encourage and enable them to exercise their rights and make their own decisions and choices. The service promotes the person centred approach to care planning (PCP) where the resident is at the centre of making decisions about what they want out of their life. A random sample of three up to date care plans were seen and case tracked as part of the visit. Plans reflect what is important to each resident, their capacities and support they need including methods of communication. They also reflect what is possible and not what is available. For example, being assessed for a possible move to supported living, college Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 11 and personal interest such as football, theatre and church. It was noted plans are reviewed monthly involving the resident and, where agreed, their families and action taken to respond to any changes. This was reflected in discussions with residents. Residents informed the inspector that they are supported by staff to do what they want and when they want. For example going to watch the local premiership football team and going to college. Management acknowledged however, having the facilities for making their own drinks would enhance residents’ independence and choice. For example, an appropriately adapted kitchenette, adjustable work tops in the current kitchen or facilities in their own rooms. Residents commented this would be a welcomed addition. Up to date risks assessments and reviews have been completed that coincide with residents’ chosen and agreed activities and lifestyle. Staff spoken with informed the inspector that they find this way of planning resident care very positive in that the resident is put first. It is regarded as a working tool to assist them in supporting residents to achieve their desired outcomes. Relatives spoken with had nothing but positive remarks and classified the service as being wonderful and more like a hotel than a residential home. (See also the section “Life Style” of this report). Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16 and 17. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Care plans provide staff with good information on the needs of the residents, who are encouraged to make decisions about their lives and who participate fully in all aspects of life in the home and community. EVIDENCE: Discussions and observations indicated the service has a strong commitment to enabling residents to develop their skills, including social, emotional, communication, and independent living. Management acknowledged however, having the facilities for making their own drinks would enhance residents’ independence and choice. For example, an appropriately adapted kitchenette, adjustable work tops in the current kitchen or facilities in their own rooms. Residents commented this would be a welcomed addition. Records seen and discussions with residents indicated individuals are supported to identify their goals, and work to achieve them. Residents informed the inspector they have the opportunity to develop and maintain important personal and family relationships. Discussions with residents also Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 13 indicated staff help them to maintain their rights and make informed choices with daily living. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. Discussions indicated they have been fully involved in the planning of their lifestyle and quality of life. They are enabled to access and enjoy the opportunities available in their local community, e.g. using public transport, library services, the local pub, and local leisure facilities. The service is committed to the principles of inclusion and promotes, and fosters good relationships with neighbours and other members of the community. Discussions with residents and staff indicated where appropriate residents are involved in the domestic routines of the home, they take responsibility for their own room, menu planning and the preparation of meals, making sure that they are able to enjoy the food they prefer and like. The menu is varied with a number of choices including a healthy option. It includes a variety of dishes that encourage individuals to try new and sometimes unfamiliar food. The meals are balanced and nutritional and cater for the varying cultural and dietary needs of the residents. It was seen care staff are sensitive to the needs of those residents who find it difficult to eat and give assistance when required. This was reflected in discussions with residents. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 14 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): 18, 19 and 20. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents receive support to ensure their physical and emotional needs are met and are protected by the home’s good procedures in the management of medicines. EVIDENCE: Observation and discussions indicated staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Staff were observed to manage instances of unacceptable behaviour with sensitivity and a calm manner therefore, decreasing the level of stress for all those present. Care plans seen and discussions showed that residents’ health care needs have been assessed, and appropriate procedures put in place to ensure they are carried out. Records and discussions indicated that residents visit their doctor and other health related services as required. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Attention is given to ensuring privacy and dignity when delivering personal care and staff are sensitive to changing needs Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 15 of residents. Where possible residents are supported and helped to be independent and responsible for their own personal hygiene and personal care. The home works to an efficient medication policy supported by procedures and practice guidance. Staff follow robust systems to make sure medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Records of medication retuned to the pharmacist were seen and well documented. Evidence was seen that staff who administer medication have received appropriate training by a recognised organisation. Residents who have the capacity are encouraged and assessed to manage their own medication. Appropriate facilities are provided for residents to keep their medication. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 16 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): 22 and 23. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents are safeguarded by the home’s policy, procedures, dissemination of knowledge and training with regards to complaints and adult protection. EVIDENCE: The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. It can be made available on request in a number of formats) to enable anyone associated with the service to complain or make suggestions for improvement. The complaints procedure is widely distributed, and has a high profile within the service. Residents and others associated with the home understand how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. Residents informed the inspector the service always responds within the agreed timescale. The Commission has not received any concerns regarding the service in the preceding year. The policies and procedures regarding protection of individuals are of a high quality and are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. Management acknowledged training of staff in the area of protection requires updating and agreed to give the matter immediate attention. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 17 Observations and discussions indicated the service has an open culture, which enables residents to express their views, and concerns in a safe and none blame environment. Residents and others associated with the service state that they are very satisfied with the service provision, feel very safe and well supported by an organisation that has their protection and safety as a priority. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from a well maintained and clean homely environment. EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the residents who live there. The well-maintained environment provides specialist aids and equipment to meet the needs of the residents. The home is a very pleasant, safe place to live. The bedrooms and communal rooms meet the National Minimum Standards or are larger. All bedrooms have en-suite facilities adapted to meet individual needs. Residents are encouraged to personalise their bedrooms. All the homes fixtures and fittings meet the needs of the individuals and can be changed if their needs change. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 19 People who use the service say that there is plenty of hot water and the temperature in the home can be changed, on request. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy; they seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the homes’ policy to reduce the risk of infection. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 20 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, 34 and 35. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from good recruitment procedures. Staff benefit form training provided by the organisation. EVIDENCE: Residents have confidence in the staff that care for them. Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. Staff members undertake external qualifications beyond the basic requirements. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. People who use the service report that staff working with them are very skilled in their role, and are consistently able to meet their needs. The service ensures that all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. This training can be small scale and individualised if necessary in order to promote the delivery of person centred services. Staff spoken with informed the inspector that they feel well supported in receiving appropriate training. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 21 The service has a good recruitment procedure that clearly defines the process to be followed. Staff confirmed they went through a rigorous recruitment process where management made it clear about what was required at all stages. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 22 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 area is good. This judgement has been made using available evidence including a visit to the service. Residents and staff benefit from the registered manager’s open door approach to management. Residents’ health, safety and welfare are protected by the home’s safe working practices. EVIDENCE: The Manager has the required qualification/s and experience and is competent to run the home. He works to continuously improve services and provide an increased quality of life for residents. There is a strong ethos of being open and transparent in all areas of running of the home. The manager is person centred in their approach, and leads and supports a strong staff team who have been recruited and trained to a high standard. The manager is aware of current developments both nationally and by the Commission and plans the service accordingly. During the visit, the inspector had the opportunity to speak with staff who commented positively on the support they receive and the “Open Door” approach adopted to manage the home. It was evident during the visit that Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 23 there are positive relationships between the registered manager, staff and residents. The atmosphere was relaxed indicating an environment where resident’s abilities and aspirations are being promoted. A quality assurance system based on seeking the views of residents, relatives, service purchasers and professionals is in place. Minutes of monthly resident and staff meetings were seen which form part of the quality assurance process. Staff have received appropriate training with regards to Care of Substances Hazardous to Health. Hazardous substances are kept in a locked cupboard to promote the welfare and safety of residents. The home has up to date maintenance certificates for the boiler, fire equipment etc. Fire drills and required fire safety precautions are carried out and recorded promoting the health and safety of residents. The most recent inspection report from Hampshire Fire and Rescue Service dated 10 April 2006 was seen which indicated there were not any concerns. Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 24 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 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 25 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Bryony Lodge DS0000028547.V312751.R01.S.doc Version 5.2 Page 27 - 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!