Inspection on 24/07/06 for Bridgeside Lodge Care Centre

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Bridgeside Lodge Care Centre 04/07/07

Bridgeside Lodge Care Centre 13/09/05

Bridgeside Lodge Care Centre 04/05/05

Bridgeside Lodge Care Centre 16/11/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Bridgeside Lodge Bridgeside Lodge 61 Wharf Road Islington London N1 7RY Lead Inspector Ms Pippa Treadwell-Smith Unannounced Inspection 24th July 2006 10:00 X10015.doc Version 1.40 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 Bridgeside Lodge DS0000061535.V287283.R02.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 Older People. 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. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bridgeside Lodge Address Bridgeside Lodge 61 Wharf Road Islington London N1 7RY 020 7250 0156 020 7490 8027 carmen.warner@foresthc.com 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) Blackberry Hill Ltd Carmen Arlithia Warner Care Home 64 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (58), Physical disability (6) of places Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Bridgeside Lodge is owned and operated by Blackberry Hill Ltd, which is a subsidiary of Forest Health Care. Although the home is registered to admit service users over the age of 65 years, in the category of general nursing care, some of the service users can be aged 60 years. The home is a modern purpose built home. It occupies a site overlooking the canal. The nearest underground station is The Angel and the home is within reach of many bus routes. Bridgeside Lodge is a care home with nursing for 64 people. This large property stands in its’ own grounds and vehicle as well as pedestrian access is through large gates. Car parking is available at the front of the building. The current scale of charges is from £563.00 to £850.00. The ground floor houses the main kitchen, laundry and the remainder of the space has been redeveloped to provide accommodate for a further 12 service users. Six of these beds are designated for younger people with physical disabilities and six for older people with physical disabilities. Accommodation for the older service users is located on the first, second and third floors. The first floor houses the Dementia Care Unit. Each floor is self-contained and staffed separately. A shaft lift gives access to all floors. Terraces are available on the third floor to enable service users to have access to outside space and there are opportunities to view the canal from the patio at ground level. All bedrooms have ensuite facilities, which include a toilet, shower and walk-in shower. Each floor has a nurses’ station, two lounges and a separate dining room. There are two assisted bathrooms on each floor and single toilets. Each floor provides a pantry/kitchenette, which can also be used by visitors to make drinks. The home and grounds offer disabled access. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the course of two consecutive days. The visits lasted a total of 14 hours. The Registered Manager was on leave so the Deputy Manager and the Administrator assisted the inspection along with additional input from the Operations Manager. Records such as care plans, daily logs as well as accident and incident logs were examined. A tour of the building was made with attention to the rooms of the service users being case tracked. Some service users were asked for their views of the running of the home and what their experiences were living there. Relatives also contributed their comments. Staff were observed carrying out their duties and were involved in general discussion with the inspector. Prior to the inspection the manager returned a pre-inspection questionnaire. Three service users and five relatives returned questionnaires giving their views about the home. Feedback was given to the Operations Manager at the end of the second day. A comment card about the inspection process was left to be completed and returned to the Commission for Social Care Inspection (CSCI) What the service does well: The home provides all good-sized single rooms with ensuite facilities. In the new units, Miriam and Regent on the ground floor, the ensuite includes a shower suitable for service users with physical disabilities. The home is good at providing or securing appropriate aids and adaptations to ensure comfort and independence for service users. The current service users say that they like living in the home and feel well looked after. They describe the staff as “caring”, “patient” and “responsive”. The ethos of the home is to welcome relatives and visitors. One relative commented, “I cannot fault the care”. There are arrangements in place to meet the health care needs of the service users. The company has always shown an interest in developing and training staff. Relevant training opportunities are available for the staff. The manager is said to be supportive and approachable by both relatives and staff. Representatives of the company have regular contact. They demonstrate a very active interest in developing the quality of the service for service users. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The staff are using the same care-planning format for all service users residing in the home. A more flexible approach is needed for service users living in the Dementia Care Unit and in the new Physical Disability Unit. For service users in the Bradbury Unit (dementia care) the home should provide a dementia specific assessment and care planning process. Although a popular activities programme is available, more consideration needs to be given to providing service users with dementia with a more individual programme; one that is drawn from the ongoing information gathered through the assessment and care planning process. The home provides a well balance diet and choices are available for service users. There could be improvements in how the menu is presented and whether pictorial menus will aid choice. During the two-day visit, the inspector observed situations, which did not promote and protect the dignity and privacy of service users. Both incidents have been fed back the manager will be looking into the matter. Service users should not be changed into their nightclothes before the teatime meal unless it is the informed choice of the service user. The home provides a pleasant environment for service users however it could be enhanced for some service users if pictorial signs are used to denote toilets, bathrooms, lounges and dining rooms. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 7 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. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality in this outcome area is considered to be good. This judgement has been made using available evidence, including visits to the service. Service users are supported to make an active choice to move into the home. Their needs are assessed, but more detail in relation to their social care needs would focus the delivery care better. EVIDENCE: The home has both an updated statement of purpose and service user guide. Relatives confirmed that contracts had been received. On the day of the inspection a prospective service user was being shown around the Miriam Unit and was offered information about the service as part of that visit. At the time of the inspection five service users were occupying interim beds. The care records of eight service users were looked at. Four of these had been admitted since the last inspection. Community care assessments were available and there was clear evidence that the home had completed their own assessment prior to admission. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The quality in this outcome area is considered to be adequate. This judgement is made using available evidence, including visits to the service. The company has identified that the care planning process needs to improve to provide a person centred approach. The health care needs of the service users are being well met. The systems for the administration of medication are good with clear and comprehensive arrangements were in place to ensure service users’ medication needs are being met. EVIDENCE: In total, eight care plans were looked at and seven service users contributed their views. Care staff were observed interacting with service users whilst carrying out their duties. The daily records were looked at. On the day of the inspection a GP was reviewing service users’ medication needs on one of the units. The pre-inspection information provided details on how service users have access to health and remedial services, inclusive of a weekly GP surgery held in the home on a Tuesday or visits as and when required. All service users have a care plan, which is being reviewed on a monthly basis and are allocated a key worker. The care plan follows standard activities of Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 11 daily living format. This standardised approach means that all relevant areas are covered but the care plans do not take a person centred approach. This is particularly relevant for the Dementia Care Unit (Bradbury). This unit needs a care planning process that is ongoing and responsive. One that should be enabling for a person with dementia and is informative for staff. All the information gathered about a person from the initial assessment and the subsequent things that staff learn about a service user, contribute to enabling the service user to have as much autonomy as possible. The person centred approach is appropriate for the remainder of the units in the home but in particular the Miriam Unit for younger people with physical disabilities. At present the care plans are generalised and the content of the social profiles is poor. Discussions with the Operations Manager highlighted that this is an area that the company has identified as an area for improvement and a plan of action has been put together. Please see requirement 1. The collaborative notes on each service user file show that the service users have access to external health care services. There is clear evidence that service users have been seen by a dietician, chiropodist, community psychiatric nurse (CPN), occupational therapist (OT), tissue viability nurse and a physiotherapist. However it is not clear whether instructions from health care professionals is incorporated into the care plan. In one instance a care record showed input from a physiotherapist and an OT regarding the introduction of stretching exercises but there is no clear evidence from the care plan or daily records that this is being carried out. The GP holds regular surgeries in the home and discussions with staff highlighted that medication reviews are organised. Such a review was happening during the inspection. The Camden Primary Care Trust NHS, “Local Heat wave Action Plan” was on display in the home together with the CSCI “Heat wave Advice for Care Homes”. Staff knew where to gain access to this information. Fans are available, water dispensers are located in lounges, jugs of juice were available and staff were observed ensuring that service users were getting adequate fluids in the hot weather. Fluid charts were being maintained for the vulnerable service users particularly those who were bed fast. As much ventilation as possible was being circulated although a couple of areas in corridors were found to be stuffy. Service users said that they were doing the best job possible to keep them cool. A full pharmacy inspection was carried out by CSCI on 19th August 2005 and at that time the Pharmacist found that the home was managing medication well. A small audit on medication was done on two floors. All medication is administered by nursing staff that continue to work to an efficient medication policy, which is supported by NMC procedures and practice guidance. Arrangements for the disposal of medication is in line with updated guidance and is disposed of as clinical waste. The training programme includes further training for nurses on the administration of medication. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 12 The service users said that the “Staff were very kind and caring”. Other comments included that the home provides “A good environment and the staff are pleasant”; “I am happy here and looked after quite well”. Generally they felt that staff respected their privacy and dignity. Care plans also reflected the values of privacy, dignity and choice. Staff were observed speaking to service users in a sensitive and caring way. However the inspector observed one of the service users attired in pyjamas at 16.00 hours in the afternoon. The care plan did not reflect that this was a choice. Information from two visitors to the home also confirmed that they have seen service users in nightclothes before the teatime meal. One family confirmed that they had to insist the staff stop this practice for their relative and it no longer occurs. This practice is more in keeping with staff convenience and an institutionalised practice rather than service user’s choice. This was discussed with the Operation’s Director, who agreed to follow it up. Please see requirement 2. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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, 14 & 15 The quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. For some service users the lifestyle in the home matches service users’ expectations and preferences. Family and friends are welcomed into the home. Service users have a choice in well-prepared meals but improvements could still be made to the menus. EVIDENCE: The pre-inspection information included a programme of activities. The home has an activities organiser. Feedback from the service users confirmed that there is always activities going on and that they can join in if they choose to. There was evidence of service user’s artwork on display. However an inspection of the social activity sections on assessments and care plans revealed sparse details about the past hobbies and interests of the service users. This kind of background knowledge is important especially to enable key workers to provide more spontaneous individual activities. For those service users living in the Dementia Care Unit then this information is also necessary to provide content for the development of life history/life-story books. The development of such books helps staff in getting to know the whole person and thus be able to support their interests. Daily records of activities are kept in care records however in some instances once the big Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 14 sporting events such as the World Cup and Wimbledon were finished, there was little recorded about social activities. A requirement has been made. Discussions with relatives highlighted that they are made to feel welcome in the home. One relative commented that, “Staff are wonderful, very welcoming and very responsive.” Another relative confirmed that her husband is well looked after. A further comment from a relative was “The home is very welcoming and accommodating and try their utmost at all times”. The manager organises residents and relatives meetings. A list of pre-arranged dates was on display and minutes of the last meeting was available. The comments cards returned proper to the inspection and discussion with the service users during the inspection highlighted that they are able to follow their preferred routine. Staff confirmed that they deploy themselves in accordance with service users’ wishes at busy times of the day. During the inspection staff were heard offering service users choices. Nutritional assessments are completed and where it is appropriate service users are weighed on a regular basis. A menu was supplied with the preinspection information, but this did not reflect the practice seen in the home over the two days of inspection. The chef meets with service users on admission to find out about likes and dislikes and any special requirements. This information is not retained, except for special diets, on care records but in the kitchen. Staff were observed offering service users choices for their breakfast including items that were not on the main menu. These were requested and sent up by the catering staff. Service users are offered a choice at lunchtime. The choice is selected the day before. Staff were not seen reminding service users of what choice they had made. The menu records that it is soup and sandwiches each teatime. There are alternatives available but these are not recorded. Overall service users said that the food served in the home is very good. On both days of the inspection the menu on display did not correspond to the menu on the tables. The format and presentation was not always accessible for some service users. A recommendation has been made. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality in this outcome area is good. This judgement has been made using available evidence, including visits to this service. Service users are protected by the home’s response to complaints and potential abuse. EVIDENCE: Complaints records were examined. Staff were asked about their understanding of adult protection and what were their responsibilities in relation to potential abuse. The home has been subject to complaints made through the CSCI. These have been investigated by the registered manager and the reports are comprehensive. The reports have shown how the investigation has been carried out, who has been involved and has included supporting evidence to underpin the conclusions. Where areas of the complaint may have been partially of fully substantiated, then remedial action has been taken. Service users said that they felt comfortable about telling staff if they were unhappy with any aspect of their care. This was also echoed by the relatives, who confirmed that staff had been open and responsive if they had made a complaint. The procedure is on display on each floor of the home and is available in the service user guide. An inspection of the minutes of residents and relatives meetings clearly show that they have been informed of the ethos of the home is that all concerns are brought to the attention of the management. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 16 The in-house policies and procedures on adult protection and whistle blowing are contained within the home’s operational policy. A copy of the local authority adult protection procedure is also available. Discussions with staff confirmed that they had received training in the protection of vulnerable adults. Training records verified this. They understood the concepts of what constitutes abuse and were clear in their responsibility for reporting any suspicions or allegations. At the time of the inspection there is a current investigation by the Local Authority into concerns raised by a relative of an exresident. At this is still an on-going investigation no conclusions have been reached. The home has co-operated fully and professionally with this investigation through attending a strategy meeting and producing all the written documentation necessary for scrutiny. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The standard of the environment within this home is good providing service users with an attractive and spacious place to live. The overall appearance of the home is clean, well presented and free from offensive odours. EVIDENCE: The home was toured, including visiting the bedrooms of the service users who were being case tracked. This was done with their permission. One of the lifts was out of order but this was being attended to on the same day. The Miriam & Bradbury wings are the newest units to be developed and the accommodation is still in excellent order. All the bedrooms in the home are single occupancy with ensuite facilities; and in the new units this includes a shower. The home has assisted baths and communal toilets all designed to MP3 standards. There is access to outside areas at both ground floor and at Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 18 upper levels. The upper floors have access to balconies and on the third floor there are two balconies. A relatives report that during the hot weather there has been insufficient ventilation, the cleaning has not been very good, the bedroom smells and a lounge is not welcoming. Another relative reports that the lift is too small and it makes it difficult to take her husband out. There are stretcher chairs available on each of the upper floors to enable service users to be evacuated in the event of an emergency. A relative recorded that “The home is very pleasant and any “accidents” are quickly seen to and dispensed by the caring staff”. Service users commented that the home is usually fresh and clean; they find their accommodation comfortable and have access to appropriate equipment. On both days of the inspection there were several areas of the home that were stuffy due to the oppressive heat. Fans and cooling drinks were available. Those bedrooms checked were found to be clean and tidy with a selection of personal items to individualise the rooms. Where this personalisation was not apparent it was the service user’s choice. Lounge areas and bathrooms were noted to be practical rather than inviting and homely. A recommendation has been made to use pictorial signs for bathrooms, toilets, lounges and dining room. Staff follow cross infection policies and procedures. Protective clothing such as gloves and aprons are available. COSHH training is available. Hand towels and soap dispensers were available in all communal toilets and in each ensuite that was checked. Overall there were no offensive odours although underlying smells were noted in some rooms but there is a procedure in place to ensure that carpets are clean regularly. Contracts are current for the collection of clinical waste. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in the outcome area is considered to be good. The judgement has been made using available evidence, including a visit to the service. Staff are deployed in sufficient numbers to meet the needs of the service users. The provider has a history of investing in staff training and development. EVIDENCE: Staff were observed carrying out their duties, service users were asked for their views and training records and rotas were looked at. There is a clear management structure with a manager, deputy and a sister-incharge assigned to each floor with a team of staff nurses, senior carers and care staff. There are dedicated catering, laundry and domestic staff. Feedback from service users and relatives is mixed as to whether staff are always available when needed. Service users were complimentary about the staff and felt that staffing levels were suitable. One service user said, “The young ladies are very kind and caring”. However feedback from relatives is that there is not sufficient staff on duty. One commented “Bridgeside Lodge is a good environment and staff are pleasant but I do find there sometimes not enough staff on duty to cover for all the types of clients that live in the home” An inspection of the rotas showed that the home is deploying staff in accordance with the staffing schedule. Two floors in particular were looked at. On one floor there was one nurse, three care staff and an adaptation nurse who is supernumerary for sixteen service users. The same staffing levels were apparent on a floor for eighteen service users. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 20 The training list for 2006 was available for inspection. It showed that 43 staff are scheduled for POVA training. The list covers the statutory training requirements including manual handling, health and safety, fire awareness, basic food hygiene, COSHH and prevention of cross infection. It was highlighted from the pre-inspection information that 34 of the care staff have NVQ 2 as opposed to the 50 , which is expected. Since the pre-inspection information was sent in, the percentage of staff with NVQ 2 has risen to 45 . The training plan identifies that 6 further staff are due to start the NVQ 2 training. It was not possible to determine whether staff had undertaken dementia care training or whether the activities organiser is trained in supporting people with dementia so that she can be developing activities appropriate for varying levels of dementia and supporting staff to be involved. A recommendation has been made, A sample of recruitment files were looked at. The manager is supported by a Human Resources Department. The Commission is satisfied that the company continues to operate a thorough and robust recruitment and selection process. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38 The quality in this outcome area is considered to be good. This judgement is made using all available evidence including visits to the service. The home is being effectively managed. Arrangements are in place to promote the health, safety and welfare of service users. A system is in place for self-monitoring through formal as well as informal means. EVIDENCE: The home is managed by an experience and suitably qualified manager who is supported in the home by a management team and receives back up from the parent company. The home has circulated anonymous satisfaction surveys last year and it is usually an annual event. The home organises service users and relative meetings and minutes are available to show that views and opinions are clearly expressed. The CSCI can request the latest quality assurance report and a requirement is made to this effect. A representative of the company visits the home regularly and has been sending the Commission the Regulation 26 Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 22 reports about the conduct of the home. The inspector would draw the company’s attention to new guidance on the completion of these reports and request that more detail in included. There are policies on handling service users monies and valuables. The manager or provider does not act as appointee for any of the service users. The pre-inspection information shows that the home manages the personal allowance for 15 service users. Three are subject to power of attorney. Savings, of those service users who do not handle their own personal allowance, are invested in an account in the name of “Residents of Bridgeside Lodge” A sample of financial records were looked at and found to be accurate. Where service user’s monies are retained for safekeeping, there are two senior people who are responsible for keeping the accounts. Accounts are kept to allow for an audit trail. There are secure facilities available for service users to store valuable items. Suitable and appropriate insurance cover is in place. The company allocates budgets in line with a business plan. The home has a health and safety policy in place and staff undertake appropriate training. A training programme is on display. Records show that equipment is serviced and there is a system in place to report repairs. During a tour of the premises there were no hazards observed. Medical Device Alerts are circulated and infection control measures are posted. Water temperatures are regulated but there is also a system in place to take random samples throughout the home. Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(1) & (2) (a)(d) Requirement Care plans must contain all the relevant information to ensure that a service user’s needs are to be met. This is particularly relevant to the Dementia Care Unit. The care planning process needs to have a more person centred approach. This requirement is being partially re-stated The registered person must ensure that the home is conducted in a manner, which respects the privacy and dignity of service users. The practice of changing service users into night attire for their tea time meal must be stopped; unless the home can demonstrate through consultation, assessment and care planning that the service user has made a clear choice. The assessment process must include collecting information about the service users, hobbies, interests and preferred activities. The registered person must supply the Commission with a DS0000061535.V287283.R02.S.doc Timescale for action 30/10/06 2 OP10 12(4)(a) 30/09/06 3 OP12 4(1)(c) & 14 24(1)-(3) 30/10/06 4 OP33 31/12/06 Bridgeside Lodge Version 5.2 Page 25 report following the service user, relative and stakeholder survey. 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 OP12 Good Practice Recommendations It is recommended that the activities organiser and care staff attend training in providing suitable activities for service users with dementia and physical disabilities It is recommended that the menus are made more accessible to service users. Consideration needs to be given to the size of the font, the colour of the print and paper. The menu should contain all the options available. It is recommended that pictorial signs be used on the Dementia Care Unit to denote toilets, bathrooms, lounges and dining rooms. It is also recommended that bathrooms are made more pleasant and homely. OP15 3 OP19 Bridgeside Lodge DS0000061535.V287283.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Bridgeside Lodge DS0000061535.V287283.R02.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. 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