Inspection on 04/07/07 for Bridgeside Lodge Care Centre

This inspection was carried out on 4th July 2007.

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

Bridgeside Lodge Care Centre 24/07/06

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 Pippa Canter Unannounced Inspection 4th July 2007 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.V333590.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 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.V333590.R01.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.V333590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th & 25th July 2006 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 £1382. 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. Further 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 are single occupancy and 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.V333590.R01.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 one day, which lasted from mid-morning until early evening, about seven and a half hours in total. The manager was available and assisted the inspector along with additional input from staff on duty, visitors and people living in the care home. Records such as care plans, assessments and menus were examined. The care plans were also cross-referenced with other records, such as complaints and accident and incident reports. A partial tour of the building was made. Six service users were asked for their views of the running of the service and talked about their experiences of being in the home; though some were unable to give them due to their level of disability. Staff were observed fulfilling their roles and responsibilities and were involved in general discussion with the inspectors. Service users and staff were spoken to during both, and lunch was observed being served during one of the unaccompanied tours. Some staff were asked about aspects of care, and of their experience of working at the home. Staff recruitment, supervision, and training records were examined. Prior to the inspection we looked at all the information we had about the home, including notifications of accidents or serious incidents, monthly reports about the conduct of the home sent by the provider and previous inspection reports. The manager had returned a pre-inspection questionnaire, which confirmed some useful information about the service. Comments cards for service users and relatives were left for collection in the home. Other surveys were sent out to Care Managers and a GP surgery. Any feedback received is reflected in this summary as well as the main body of the report. We reviewed all the evidence and it has allowed us to form a judgement about the outcomes for people living in the home. At the end of the inspection, general feedback was given to the manager and an email has also been sent A feedback form will be sent along with the draft report so the manager can let us know how she felt about the inspection process. What the service does well: Bridgeside Lodge provides a safe, warm, and welcoming environment for the people who live there. It is well maintained and furnished and decorated in a homely fashion. All bedrooms are of a good size allowing personal possessions to be accommodated. Each room has an ensuite toilet, shower and wash hand Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 6 basin. There are also communal, assisted, baths on both floors for people who prefer a bath. The design of the building, separating the services into separate units lessens the impact of the overall size. Comments from people living in the service and who visits were: “It is bright and cheerful, majority of staff relate well with clients.” “I am happy and feel safe” “ The staff are friendly and caring.” “All my needs are met with kindness and sensitivity.” “I am pleased with my surroundings are willing to respect to my needs should they arise.” “Although my relative is able to do very little for himself, he has a sense of his own identity and staff ensure that he makes his own choices wherever possible.” “My relative has only been at Bridgeside Lodge for approximately three weeks. In that time I have very impressed with the way staff carry out their duties.” Comments about the food ranged from always enjoying the meals to feeling that the variety is poor. The menu does include other choices. The home has full disabled access, which is important as many of the service users can only get around in wheelchairs, or use walking aids, such as frames. There is a robust recruitment process, comprehensive induction, and a training programme, which is relevant to the roles and responsibilities of the staff. This means that staff are supported to meet the needs of the people referred to the service. The staff team come from a variety of racial and cultural backgrounds although this is not reflected in the resident group. However the manager recognises that communication is an important skill and supports overseas staff with practical steps to improve diction. The assessment and care planning system is being developed to include relevant social history that will inform the care planning process. Complaints are responded to promptly and fully investigated. What has improved since the last inspection? There are been developments in the Dementia Care Unit. Privacy and dignity is being upheld. Although the progress is slow there is a definite commitment for staff to produce care packages that are tailored to individual needs. The introduction of current research tools ensure that staff can make judgements Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 7 about whether the care is suitable for the people living in that specialised unit. Similar progress is being made in the fledgling physical disablement unit. The home has addressed the requirements set at the last inspection. 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. The summary of this inspection report can be made available in other formats on request. Bridgeside Lodge DS0000061535.V333590.R01.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.V333590.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can feel confident that their needs and aspirations will be met by moving into this care service. EVIDENCE: A total of eleven people who live in the care home were involved in the inspection. Five were part of the case tracking process and the remaining six were involved in general discussions. Remarks from people living in the care home and comments on relative’s surveys revealed that people had different experiences during the admission process. Although a few had felt that there had been little information available, the majority of people had received a positive experience during admission: and felt that they had received sufficient information and attention from the home. Comments received were: Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 10 “My daughter visited the home on my behalf and was given all the information I needed to see before I myself visited the home. I was very pleased with my impression and felt that I could be happy in this environment.” “I am expecting to receive my contract after my six week review”. The manager confirmed that it is the intention of the service to produce a stand-alone service user guide for the Dementia Care Unit. The Commission for Social Care Inspection (CSCI) would support such a move as any information about this specialist unit should clearly set the admission process and the level of involvement required by relatives, friends and advocates. The care records of five service users were looked at. Some of whom 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. However staff need to be mindful of signing pre-admission assessments and making sure that they complete the scores. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the care home are assured that their care health needs are understood and met by a trained team of nurses and care staff. EVIDENCE: In total, five care plans were looked at and six further service users contributed their views. Care staff were observed interacting with service users whilst carrying out their duties. The daily records were looked at. 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. An inspection of the care records showed that all service users have a care plan and key workers allocated. Care plans are being reviewed on a monthly basis or as and when care needs change. The care plan follows standard activities of daily living format. Although this is a standardised approach, there is evidence that this is becoming a more person centred approach. This inspection highlighted that there is a more progressive approach especially in Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 12 the Dementia Care Unit (Bradbury). Discussions with the nurse in charge of this unit showed that the care planning process is designed to be ongoing and responsive to the people who live there. It is clear from talking to staff that they have been responsive to the comments made on the last inspection report. The staff are beginning to take a more enabling approach. They are using research tools in order to identify where the service is good and in what areas improvements are required. Although people using the service may have cognitive impairments, the process enables them to make a contribution. It is evident that it will take time for the new approach to become established practice. Social profiles are being developed but information is patchy and should be recorded on an ongoing basis. However the staff are showing a commitment to gathering information for life histories and addressing emotional needs as part of the care plan. It is advocated that more could be recorded about people’s residual skills. Comments from people living in the service and relatives clearly demonstrated that they have access to medical and remedial care. Care records also supported this and it was evident that people living in the service had been seen by a dietician, chiropodist, community psychiatric nurse (CPN), occupational therapist (OT), tissue viability nurse and a physiotherapist. The GP holds regular surgeries in the home and discussions with staff highlighted that medication reviews are organised. Staff are clear about their responsibilities in making sure people in the care have are comfortable and have access to fluids during any period of hot weather. The Camden Primary Care Trust NHS, “Local Heat wave Action Plan” is available on display in the home. Fans are available, water dispensers are located in lounges, jugs of juice are available and staff were observed ensuring people had enough to drink. Fluid charts are evident and were noted to be completed accurately for the vulnerable service users particularly those who were bed fast. The last time a full pharmacy inspection was carried out by a Pharmacist from Commission for Social Care Inspection (CSCI) was on 19th August 2005 and at that time the Pharmacist found that the home was managing medication well. The lead inspector will make another referral to the CSCI Pharmacy for another full inspection. In the meantime a limited audit was done involving eleven people who live in the home. All medication is administered by qualified staff that continue to follow the home’s efficient medication policy and are supported by NMC procedures. The training programme includes further training for nurses on the administration of medication. The audit showed that the receipt, administration and disposal of medication is being managed well and records are accurate. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 13 People spoken to and relative confirmed that staff respect the privacy and dignity of those receiving a care service. Comments received from people living in the home and their relatives were: “All my needs are met with kindness and sensitivity.” “We are happy to know that all our mother’s care needs are met and she is safe.” “My mother recently became a resident at this home. My observation is that the staff are very caring and the residents I feel are treated with respect.” These comments were backed up by the inspectors’ observations during this site visit. The care home has a thorough induction procedure, which includes a value-based model. Discussions with staff clearly showed that they understood the concepts of privacy, dignity, choice and independence. The home has received several “thank you” cards expressing relative’s appreciation for the care of their parents. An inspection of the care records showed that end of life decisions had not been recorded. It is acknowledged that this is an emotive area and needs to be handled with sensitivity. However it is important that people living in the care home are able to discuss their end of life wishes and have these recorded. The GP needs to be involved. This should include whether they want active treatment or not, what support they may require and from whom and if they are any cultural or belief systems that staff may need to take account of. This is Recommendation 1. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are able to follow their preferred lifestyle and are able to make choices from a varied menu plan. EVIDENCE: Feedback from people living in the home and their relatives confirmed that there is always activities going on and that they can join in if they choose to. There is a commitment to finding out about the past hobbies and interests of the service users. It is acknowledged by the nurse-in-charge on the Dementia Care Unit that this kind of background information is important especially to enable key workers to provide more spontaneous individual activities. Comments received were as follows: “Although he is able to do very little for himself, he has a sense of his own identity and staff ensure that he makes his own choices.” “My mother is given choices and is encouraged to interact with other residents.” “I am limited to what I can do physically and therefore I am not an active participant but I am willing to take part within my limitation.” Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 15 The comments from the majority of relatives highlighted that they are made to feel welcome in the home. Comments received were: “Most of the time my daughters speak to the staff on my behalf – things can be confusing for me. The staff always act upon their requests and my daughters are happy with my care.” “I feel the nursing staff and carers are approachable and will act upon our concerns.” “We have easy access to our mother and staff make us feel welcome.” Although not all relatives had such a positive experience. A couple of negative comments were received, such as: “Sometimes relatives who cannot visit find it difficult to communicate over the phone, sometimes waiting a long time to home to answer.” “I feel that the home has no dialogue with me regarding my mother’s care as I now feel that she requires more one-to-one care.” “I have called usually on the weekend and it’s an answer phone, no one got back to my message.” It is evident that the home needs to consider improving communicating with relatives who rely on the telephone to make contact. Generally there was a positive response to the quality and variety of the food served in the home. Residents all said that they enjoyed the food however a relative commented: “The only downside is the variety of food is not very imaginative and does not take account this age group, who ate very simple plain foods” Nutritional and malnutrition assessments are on file. The meals identified on nutritional assessments were being served to residents at meal times. The presentation of soft or pureed diets were noted to be appropriate. Where it is appropriate service users are weighed on a regular basis. Any weight loss or gain is investigated. A sample menu was supplied with the pre-inspection information, and there is also a menu on public display. 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 seen offering service users choices for each meal including items that were not on the main menu. The menu records that it is soup and sandwiches each teatime however alternatives are available. Overall service users said that the food served in the home is very good. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this care home can be confidant that any concerns are taken seriously and that safety and well being are assured. EVIDENCE: Complaints records were examined. There was discussions with the manager about two adult protection cases and staff were asked about their understanding of the inter-agency adult protection procedures. The home has a complaints procedure. This is contained within the service user guide and it is on display throughout the home. Most of the service users and relatives knew how to make a complaint however two relatives recorded on surveys that they did not know. The pre-inspection information recorded that there have been six complaints received and two are still awaiting an outcome. The outcome is dependent on the local authority fulfilling its’ responsibility. The manager of the home has been proactive and chased this up with the relevant person. Feedback from people living in the home and relatives confirmed that the staff within the home are approachable. Comments received were: “ I am happy and feel safe. My family are supportive and the staff are friendly and caring.” “I would let the nurses know.” “I feel the nursing staff and carers are approachable and will act upon our concerns.” Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 17 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. Prior to this site visit a strategy meeting had been organised following concerns, which had been raised. The Local Authority was taking the lead. The home has always co-operated fully and professionally with any investigation through attending a strategy meeting and producing all the written documentation necessary for scrutiny. The policy of the home is to send out clear messages that poor practice will not be tolerated. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care home provides a clean, safe and pleasant environment in which can live and work EVIDENCE: During the site visit a sample of bedrooms was taken with the permission of the people living in the home. The bedrooms were those of the service users who were being case tracked. Communal areas were also looked at. All the accommodation was found to be in good order. There is a rolling programme of maintenance and decoration. All the service users spoken to said that the home is fresh and clean. No malodours could be detected. Comments received were: “The environment is clean and comfortable and the view from my mother’s window is just what she needs – a moving picture.” Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 19 “I am pleased with my surroundings, the staff are willing to respond to my needs should they arise.” 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. Staff understand and practice the prevention of cross infection policies and procedures. Protective clothing such as gloves and aprons are available. COSHH training is attended. 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.V333590.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff group who have been provided with appropriate training meets the needs of the people who live in the care home. EVIDENCE: Staff were observed carrying out their duties, service users and relatives were asked for their views and training records and rotas were looked at. The home continues to be staffed with a consistent and clear management structure with a manager, deputy and a sister-in-charge 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 but this similar to the feedback received at the last key inspection. Comments received were: “More activities co-ordinators.” “Extra housekeepers.” “I am often told that they are short staffed so that they cannot meet my mothers needs”. “Sometimes shortage of staff or equipment does not always help them follow requests of clients.” Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 21 An inspection of the rotas showed that the home is deploying sufficient staff on each floor. The inspector would advocate that the manager look into why staff are telling relatives that they are short of staff especially as staffing levels must be determined by the assessed needs of people living in the home. The provider has always demonstrated a commitment to invest in the training and development of the staff team. The pre-inspection information contained a list of training that staff have attended and training that is proposed. All the sessions identified will give staff the knowledge and skills to look after the needs of the current service users. One relative commented, “My mother has Dementia and I often wonder if all staff are Dementia trained and have accreditation.” The training records showed that staff have attended training on Dementia, Dementia Care Mapping, Activities for Elderly People and Reminiscence and Equality and Diversity. Sixty seven percent of the staff have achieved NVQ Level 2 or above. Staff were observed putting this training into practice. Feedback from people who live in the care home and their relatives generally felt that the staff had the right kind of skills to look after them. One relative commented, “Sometimes personal knowledge of a client is taken as a criticism of the way staff are working even when meant to be helpful.” Although it is clear that staff are updating their knowledge and skills with recent training, it is important that they listen to the views of relatives. A sample of recruitment files were looked at. All relevant checks are in place. The Commission is satisfied that the company continues to operate a thorough and robust recruitment and selection process. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care home is run in the best interests of the people who live there. EVIDENCE: Information held at the commission’s office was reviewed prior to the site visit. This included the monthly reports that the organisation providing the service has to send in. It also included reports that the manager has to send when accidents/incidents occur. Staff and service users were asked about the running of the home. The manager, and other management staff were observed during the visit. Judgements and evidence from the previous sections of this report have also been used to come to the above judgement. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 23 The home has a stable management structure with clear lines of communication and accountability. The manager is competent and knowledgeable about the needs of the people living in the home and continues to update her management training in order to manage more effectively. Job descriptions are clear about roles and responsibilities. Staff reported that they found the home good to work in, and service users stated that they felt it was well managed. The manager recognises that the staff team does not reflect the culture of the predominantly white British residents and this may cause problems in relation overseas staff understanding aspects British culture. One relative commented: “Sometimes people get frustrated that they cannot understand the carers dialect.” The manager has responded by supporting staff with English Language tapes in order to improve their communication skills. Staff have attended equality and diversity training and care plans reflect this. The five care plans looked at, were chosen because they represented a range of needs, including diversity in terms of disability, racial origin, gender, and health needs. In relation to disability, gender and health needs, the assessments and care plans followed through, and included risk assessment. The home has a good record in respect of equalities and diversity by respecting cultural issues however a comment from a relative showed that this area may need further attention. A comment was received that showed a male member of staff had attempted to give personal care to a female resident who had a preference for female staff only. The home has an established quality assurance system and sends out an anonymous satisfaction surveys. The results of the most recent has been positive. The home have organised service users’ and relative meetings and minutes are available to show that views and opinions are clearly expressed. A representative of the company should visit monthly and leave a report in the home about the conduct of the service. These reports are not available. This is Requirement 1. 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 35 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. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 24 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.V333590.R01.S.doc Version 5.2 Page 25 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 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 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 3 X 3 X X 3 Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 26 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 OP31 Regulation 26 Requirement It is a requirement that copies of monthly reports are available in the home for inspection purposes. The provider is required to send copies of the report from April, May and June 2007 to the Commission for Social Care Inspection. Timescale for action 30/09/07 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 Refer to Standard OP11 Good Practice Recommendations It is strongly recommended that “End of Life Decisions” are discussed with people who live in the care home. Relatives and advocates should be involved and all decisions must take account of any cultural or belief systems. The GP should sign off any decisions. Bridgeside Lodge DS0000061535.V333590.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V333590.R01.S.doc Version 5.2 Page 28 - 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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