Inspection on 04/05/05 for Bridgeside Lodge Care Centre

This inspection was carried out on 4th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bridgeside Lodge Care Centre 04/07/07

Bridgeside Lodge Care Centre 24/07/06

Bridgeside Lodge Care Centre 13/09/05

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 61 Wharf Road Islington London N1 7RY Lead Inspector Pippa Treadwell-Smith Announced 4 May 2005 10:00 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bridgeside Lodge Address 61 Wharf Road Islington London N1 7RY 020 7250 0156 020 7490 8027 carmen.warner@foresthc.com Blackberry Hill Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Carmen Arlithia Warner Care Home 52 Category(ies) of DE 18 registration, with number OP 52 of places BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: Bridgeside Lodge is owned and operated by Blackberry Hill Ltd, which is a subsidiary of Forest Health Care.The home was purpose built five years ago. It occupies a site overlooking the canal. The nearest tube station is the Angel and it is within reach of many bus routes. Bridgeside Lodge is a care home with nursing for 52 service users. This large property stands in its’ own grounds and vehicle and pedestrian access is through large gates. Car parking is available at the front of the building. The ground floor houses the main kitchen, laundry, hairdressing room, and a large lounge overlooking the canal. 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.Accommodation for service users is located on the first, second and third floors. 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. All bedrooms have ensuite facilities, which includes a toilet, hand basin and walk-in shower. Each floor has a nurses’ station, two lounges and a separate dining room. A lounge on the third floor has been designated for smoking. 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 full disabled access. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one and lasted 7 hours. There were two inspectors, one of whom was on induction training. A representative of the company and the manager were interviewed and assisted with the inspection. One of the inspectors was given a tour of the home. Both staff and service users, on all the floors, were interviewed as part of the inspection. A variety of records, including care plans, staff files and health and safety documents were looked at. What the service does well: What has improved since the last inspection? The home is moving towards establishing a staff team that is a good match of well-qualified staff who are able to offer consistency of care. Staff are being BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 6 deployed more efficiently throughout the home, and there is a greater sense of team work. There is a clear development plan and vision for the home, which is being communicated to staff and there is a greater sense of team work. The support mechanisms for the manager are established. 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. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 3 only On the whole good procedures were in place to ensure each service user has their needs assessed prior to admission and that up to date care plans are kept and reviewed appropriately. However more work needs to be put in to the individuals personal profile where there should be emphasis on the individuals life history. EVIDENCE: Six care plans were looked at during this inspection. There was Preassessment paper work done by the home, as well as nursing and community care assessments from the placing authorities. There were also comprehensive assessments relating to medical and psychological needs. Each service users plan contained the appropriate risk assessments as well as addressing their rights, choice, dignity, fulfilment, independence and privacy. Social profiles seen on file were either incomplete or blank. At least three of the care plans did not have signatures from the staff member that completed it or from a service user or relative if appropriate. Discussions with the manager highlighted that a more person centred approach was needed. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 9 BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Arrangements are in place to address the healthcare and social care needs of the service users. There is a good working relationship with the GP who provides a weekly surgery at the home. Service users are protected by good policies and procedures regarding medication. Service users are receiving care that respects their privacy and dignity. EVIDENCE: All of the care plans seen were accurate and up to date including daily evaluations, monthly reviews and risk assessments. Individuals likes and dislikes were recorded in the care plan. Service user who were interviewed at the inspection said that their privacy was respected. One comment in regards to personal care was that “staff were highly professional.” The names of the key worker and link nurse are displayed in the service users room. There is an In-House GP surgery every Tuesday Morning and visits upon request carried out at weekends. Records show referrals to outpatients and the relevant health care specialists. There are policies and procedures in place regarding medication. Each service user has their photograph attached to their medication record. Lockable bedroom doors and cabinets in service users’ rooms support the practice of self-medication. There are recorded monthly visits from the local pharmacist who supplies the medication and provides BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 11 advice and guidance to the home. Systems are in place to monitor the dosage of medication and records are kept of the ordering, supply and disposal of unwanted medicines. Each floor has it’s own storage arrangements for medication. A sample of Medication Administration Records (MARS) were looked at and were in line with the prescriptions. Observation of staff demonstrated appropriate interaction and positive relationships. Two service user comment cards said staff respect privacy, this was also confirmed by interviewing staff. Staff spoken to had a clear understanding of respecting service users’ rights, independence and dignity, which are also reflected in the care plan. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14 & 15 The home provides a good and varied range of activities although some of the activities on offer don’t always reflect individual preferences. Service users’ relatives and friends are regular visitors to the home and are made to feel welcome. Service uses likes and dislikes are known to staff. EVIDENCE: A programme of activities was supplied with the pre-inspection material that covered two consecutive weeks. The home employs a part-time activities coordinator and a volunteer will help out. A programme of forth coming events is also displayed on notice boards and posters on each floor. Observation was made of activities taking place. One service user spoken to said she had different preferences to the activities that were on offer. It was clear she was not comfortable taking part in the group activities that were available. The home has a visitor’s policy and all visits are recorded at the reception. Several visitors were seen on the day of the inspection. A kitchenette is provided on each floor where visitors can make drinks for themselves and those they are visiting. Relative’s meetings are also arranged. The care plan records a service users likes and dislikes, which include activities, food and drink and clothing. Detailed plans included preferences to BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 13 what time service users like to get up, to where they like to eat. Talks with staff indicate service users are assisted fully in making life style choices. An example of a two weeks menu showed a varied diet. Those with different dietary needs were well catered for and identified on the care plan. Examples of alternative menus were given by the cook. Nutritional assessments are done on admission. Catering staff meet new service users and their relative to identify dietary needs. Times of meals and snacks were provided in the preinspection questionnaire. Service users interviewed were all happy with the food they received. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16, 17 & 18 Services users are protected from abuse by the home’s polices and procedures. There is a satisfactory complaints procedure and the home operates a thorough recruitment and selection process. EVIDENCE: Copies of the complaints procedure are available through the admission information (Service users guide) and also on display. They are available to both service user relatives and friends. Service users interviewed said that they felt safe and some commented that they felt able to complain and approach staff should there be any problems. On each floor there is a suggestion book on display for comments from service users and relatives. There is a system in place to record and monitor all complaints. This in turn is monitored by the registered provider through the Regulation 26 visits. The home has copies of Islington Council’s Adult Protection policy. “Responding to abuse inadequate care of vulnerable adults”. There is an in- house policy and procedure. Through the interview process staff demonstrated they knew and understood the adult protection policy. Staff have undertaken POVA and whistle blowing training. When interviewed they demonstrated how they would report any incidents and were able to describe what constitutes abuse. The pre inspection questionnaire and inspection of staff files demonstrated a recruitment process that is thorough with CRB and immigration checks completed on all staff and volunteers. The Personal Identification Numbers (PIN) and qualifications of nurses are also checked prior to appointment. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 15 Financial policies and procedures are also in place. There is a record kept of all visitors to the home. The home has a missing person’s procedure. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 16 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 standard(s) 19 & 26 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: Service user comments and feedback stated that they were happy with their accommodation and felt safe. There were integrated call bell systems in the rooms. One service user demonstrated how she used her call bell and where she kept it so it was accessible. Up to date records of all maintenance work and checks were seen during the inspection. Staff confirmed during their interviews that they have a range of specialist equipment including, which is serviced and maintained. The home has an integrated fire alarm system, which is serviced and regular tests are conducted. The Fire Officer inspects the premises. The home has an infection control policy, which is on display in key areas on each floor. There is liquid soap and hand towels available in toilets and staff have access to suitable hand washing facilities. Adequate arrangements are in BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 17 place for the collection of waste, including clinical waste. Protective clothing is available for staff. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Staff have a clear understanding of their roles and are deployed in sufficient numbers to meet the needs of the service users. EVIDENCE: Staff described the staffing levels in the home as good and realistic. These comments are supported by an inspection of the rota and the pre-inspection information. There has been an improvement in the staffing levels. It is planned to have three qualified deployed over a twenty four period. The home offers a placement for overseas nurses for adaptation training. Comments from staff confirmed that they have access to relevant training courses and individual training opportunities. There is clear evidence from a training plan that qualified staff are able to update current skills and learn new ones. All staff are receiving training commensurate to their role in the home. The organisation has a clear development plan for the home. Previous comments in the report identify that the recruitment and selection process is both thorough and robust. All relevant checks are in place. BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 There is a process of self-monitoring to ensure that the service provided is consistent. Arrangements are in place for the management of health and safety on the premises. EVIDENCE: Service users are consulted in formal as well as informal ways. Audits are conducted and surveys are carried out. The manager confirmed that another anonymous service user questionnaire is due for circulation. Relative meetings are organised and minutes recorded. Service user meetings are also arranged and feedback is encouraged on an individual basis. Four of the service users are subject to power of attorney. There are polices on handling service users monies and valuables. Where service user’s monies are retained for safe keeping, 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 BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 20 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 G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x 3 x x 3 BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 22 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 12 Good Practice Recommendations It is recommended that service users and/or their relatives sign to say the care plan has been discussed with them. It is recommended that all social history profiles are completed and this information is used to develop opportunities for service users to follow individual activities, hobbies and interests BRIDGESIDE LODGE G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Centro 4 20-23 Mandela Street Camden Town London NW1 0DW 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 G58 s61535 Bridgeside v210195 040505 Stage 4.doc Version 1.30 Page 24 - 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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