Inspection on 16/11/06 for St Bridget`s

This inspection was carried out on 16th November 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Bridget`s 14/10/08

St Bridget`s 08/03/06

St Bridget`s 18/08/05

St Bridget`s 09/12/04

St Bridget`s 27/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 St Bridgets St Bridgets 64 St Nicholas Street Bodmin Cornwall PL31 1AG Lead Inspector Ian Wright Key Unannounced Inspection 16 and 17th November 2006 16:15 th St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Bridgets Address St Bridgets 64 St Nicholas Street Bodmin Cornwall PL31 1AG 01208 78170 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) Mrs Bridget Mary Byrne Mrs Theresa Alice Mary Platt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: St Bridgets provides residential care for five adults with a learning disability. Mrs Byrne and Mrs Platt are the registered providers, and also live on the premises. The home is situated within walking distance of the town of Bodmin. The lounge is on the ground floor, with 5 bedrooms (of which two are en suite) on the first floor. There is a small garden and also parking at the front of the house. Service users need to be normally ambulant as there are stairs (with banisters) between the floors. The family/staff live on the top floors of the house. A copy of the inspection report is available in the service users’ lounge, and it is suggested a copy is requested from management or CSCI if required. The range of fees at the time of the inspection is £300-£330 per week at the time of the inspection. There are additional charges e.g. for hairdressing, chiropody, and newspapers etc. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection took place in ten and three quarter hours over two days. All of the Key Standards were inspected. The methodology used for this inspection was: • To case track all five service users. This included, where possible, meeting and discussing with the service users their experiences, and inspecting their records. • Discussing with staff their experiences working in the home. • Discussion with other service users and their representatives. • Observing care practices. • Discussing care practices with management. • Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: What has improved since the last inspection? What they could do better: There is one requirement, which is required by law within the timescales set. Although staff training is generally adequate some improvement is required to meet regulatory standards. This includes staff receiving some basic moving and handling training, all food handlers having a food-handling certificate (e.g. one was not available for inspection) and staff who may work on their own having a first aid certificate (at appointed persons level). It is advisable all staff have some more training regarding infection control. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 6 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. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable statement of purpose and service user guide. This enables service users and their relatives to have suitable information regarding services provided. Service users have a suitable contract of care or statement of terms of conditions of residency. This enables service users to be aware of their rights and responsibilities. The pre admission assessment procedure is good, and enables the registered persons to ascertain they can meet the needs of service users, before admission is arranged. EVIDENCE: Copies of the statement of purpose, service user guide and contract of care / statement of terms of conditions of residency, were inspected. Copies of local authority contracts are also on file where applicable. Copies of pre admission assessments were also inspected and these were comprehensive. Discussion with service users, staff and the registered persons outlined a suitable process of how service users moved in to the home. This included, where appropriate, the opportunity for service users to visit the home/ stay at the home before formal admission was arranged. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a care plan and these are reviewed. This ensures staff have suitable information to provide care, and care plans are amended when changes in service users’ needs occur. Service users are encouraged to make decisions about their lives with suitable assistance as required. The registered persons approach to handling service users monies is satisfactory, so service users can be assured their financial interests are safeguarded, where the registered persons are involved in this area of their lives. The registered persons have a suitable approach to risk, so service users can be assured they will be supported to take risks as part of an independent lifestyle. EVIDENCE: There is a copy of a care plan in each service user file. Staff said care plans were accessible to them. The care plan format is comprehensive and gives clear guidance to staff regarding service user needs. There is suitable evidence that care plans are reviewed appropriately for example a formal review is held. At least one service user said they were involved in the development of their care plan. It was suggested care plans could be developed by the introduction of goal setting, and the use of the principles of ‘person centred planning.’ St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 10 Service users and staff said service users are encouraged to make decisions regarding their lives. Suitable risk assessments are in place to assess any risks or actions to promote independence. These seemed appropriate, and bare in mind service user skills and abilities. The registered persons look after some service user monies, for which suitable records are maintained. Suitable risk assessments regarding this intervention are kept. Service user benefits are paid into their personal bank accounts or paid to relatives / legal representatives. Suitable records of money received and expenditure are kept. Monies checked matched with records kept. The registered persons have a satisfactory approach regarding issues relating to diversity and equality. There are currently no service users from ethnic minorities, although the registered persons stated they would be more than happy to accommodate service users from other cultures. The local population is predominantly Cornish, and from ‘White-UK’ background. Issues regarding sexuality, gender and disability seem to be suitably addressed. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can participate in a suitable range of activities, and are able to mix with the wider community. Service users are encouraged to maintain relationships with friends and relatives. Service users rights are respected, and service users are enabled to take a suitable amount of responsibility in their daily lives. Suitable arrangements are in place so service users enjoy a healthy and varied diet. EVIDENCE: Service users said they have a range of activities. These include going attending day centres, having sheltered work placements, educational opportunities etc. The registered persons have a multi purpose vehicle to help service users to move around the community. Regular social trips occur, for example, at the weekend. Service users said they visit friends and relatives regularly, and they are encouraged to maintain contact via the telephone or post. Visiting arrangements are flexible, and there is suitable space for service users to receive visitors privately. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 12 Service users said they could get up and go to bed when they wish, although some may need reminding to get up on the days e.g. when they attend day placements. Service users said staff worked with them in a way, which respected their privacy and dignity. For example staff knock on doors, and mail is not opened without service users’ agreement. Locks are not fitted to bedroom doors, but service users the inspector spoke to, say this was not necessary. Service users and staff said service users have some involvement in household tasks for example doing laundry and cleaning their bedrooms. However a cleaner is employed and staff prepare the main meal each day. Service users said they were encouraged to make other choices how they live their lives. Some service users go out and about on their own, and some use public transport. There seems a suitably individualised approach to the taking of risk in line with service users’ abilities and wishes. Service users said food provided is to a high standard. The inspector shared a meal on both days of the inspection. On the first day the meal was fish and chips, and the second day roast pork. A sweet is also provided. Drinks are available whenever these are requested. A kettle is in the front lounge to enable service users to make their own hot drinks. Suitable records are maintained regarding food provided. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is delivered to a good standard, and there are suitable links with medical professionals. Service users medicines are managed appropriately. Service users can therefore be assured there personal and health care needs are suitably met. EVIDENCE: Service users said they received suitable care and support from staff. Any personal care needs are clearly documented in care plans, and staff seem clear regarding what assistance service users need. Care plans document appropriate links with GP’s, dentists, chiropodists and other professionals. Service users said they regularly saw medical professionals when required. The registered persons and other staff reported no problems with links with medical professionals although dental services appear limited. Medication is stored appropriately and suitable records are kept. Service users order and self-administer medication where this is appropriate, and suitable agreements are in place regarding this. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered persons have suitable procedures regarding complaints and adult protection. Subsequently service users can be assured there are appropriate procedures to deal with any concerns or bad practice. EVIDENCE: The registered persons have satisfactory procedures regarding complaints and adult protection. Staff and service users showed suitable awareness of the procedures, and were able to say whom they would approach if they had a complaint or were concerned about abuse. Staff and service users all said they had not witnessed any bad or abusive practices. All staff have Criminal Record Bureau check, and a Protection of Vulnerable Adults check (where applicable). St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. St Bridget’s provides a pleasant, homely, clean and well-maintained environment for service users to live and feel at home in. EVIDENCE: The building was inspected. The building appears to be well maintained, clean, pleasantly decorated and homely. There is a small garden, which service users can use. Service users can use the communal lounge, and this also has a dining area where the main meal is served. Service users said they could use the lounge at any time, but also have a TV in their bedrooms Bedrooms are to a good standard. They are individualised and comfortable. Two bedrooms have en suite facilities. Decorations throughout the home are maintained to a good standard. There are suitable toilet and bathroom facilities for communal use. Suitable kitchen and laundry facilities are provided. The home was clean and hygienic at the time of inspection. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. Staffing levels appear suitable so service users can be assured they will get appropriate levels of staff support. Personnel records are good so service users can be assured there are suitable personnel checks in place. Staff training provision is generally adequate. There are some gaps in training received, which need to be addressed. Suitable staff training ensures staff have appropriate skills and knowledge to carry out their jobs. EVIDENCE: Staffing is provided by an extended family. Most of the family live on the premises, with the remaining family staff members living nearby. There is at least one member of staff available at any one time, and additional staffing is provided, for example, if there are trips out etc. At least one of the staff ‘sleeps in’ and is available each night. One of the registered provider’s has a registered manager’s award (RMA), and one of the staff has a National Vocational Qualification at level 2 in care. These two staff provide the majority of the care. The registered provider’s approach to ensuring staff have training required by regulation needs improvement. By law all staff must have moving and handling, fire and infection control training. The law also states there must St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 17 always be one approved first aider on duty (this was the case on the days of the inspection), and all food handlers must have a food-handling certificate. At least one of the staff needs a first aid refresher course. Basic manual handling training should be provided (no service user requires assistance but staff should receive training regarding lifting inanimate objects). All staff have suitable fire training. Staff are required to read Health Protection Agency guidelines regarding infection control. It is recommended further training in this area should be provided. For example the Health Protection Agency (tel Sally Palmer 01208 251467) provides free training. Staff appear to have food handling certificates, but one certificate was not available for inspection. Personnel records were inspected. These are to a satisfactory standard. It is recognised that all staff currently employed are family members, so there are no recruitment records as such. However all staff have a Criminal Records Bureau check and Protection of Vulnerable Adults check (where applicable.) St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered persons appear to be suitably experienced, skilled and qualified to manage the home so service users can be assured there are competent people in charge of the home. There is a suitable quality assurance system in place so service users can be assured there is a suitable system to measure and maintain a good quality of service. The management of health and safety issues is good so service users can be assured they live in a safe environment. EVIDENCE: The registered persons appear caring, approachable and competent. Service users were positive about the registered persons approach, and said they found them supportive and caring. The registered persons have a suitable approach to quality assurance. A survey has been completed of stakeholder views and these are positive. A summary St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 19 report of the findings was produced. There are ‘house’ meetings to discuss any issues, which may arise. The registered persons have a suitable health and safety policy. Regular health and safety checks are completed. Other records kept of checks required by regulation are satisfactory. For example there are suitable records of the testing of fire equipment, gas appliances, portable electrical appliances and the electrical hardwire circuit. Accident records are suitably maintained. Health and safety risk assessments are satisfactory including a suitable system regarding the prevention of Legionella. St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 21 St Bridgets DS0000009066.V316500.R01.S.doc NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA35 Regulation 18 Requirement The registered persons must ensure staff receive training appropriate to the work they perform. This includes training required by regulation for example first aid, infection control, food handling, and manual handling. Suitable records of training provided need to be kept. Timescale for action 01/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 St Bridgets DS0000009066.V316500.R01.S.doc Version 5.2 Page 23 - 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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