CARE HOME ADULTS 18-65
The Bridgings Limited (Eston) 64 Jubilee Road Eston Middlesbrough TS6 9HB Lead Inspector
Jane Bassett Key Unannounced Inspection 15th May 2006 09:30 The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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 The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Bridgings Limited (Eston) Address 64 Jubilee Road Eston Middlesbrough TS6 9HB 01642 468157 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) The Bridgings Limited Mrs Sheila Dumphy Care Home 12 Category(ies) of Learning disability (12) registration, with number of places The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named individual who is above the age category is allowed to reside in the home. 30th January 2006 Date of last inspection Brief Description of the Service: The Bridgings, Eston, is a care home for twelve younger adults with a learning disability. Situated on the outskirts of Middlesbrough, it is conveniently placed on a main bus route into town. In addition, there are a small number of local shops at Eston and these are within walking distance of the home. Accommodation is provided in 12 single rooms, all of which can be personalised according to the preference and taste of service users. Communal space consists of a sitting room, dining room with lounge area overlooking the garden, a domestic style kitchen and an enclosed rear garden which is used, when weather permits, for outdoor meals. There is a no smoking policy within the home. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection report includes information obtained from a pre inspection questionnaire, six relative / visitor and ten service user comment cards received. An unannounced visit to the home was carried out. During the visit, which lasted five and a half hours the inspector carried out a tour of the environment, an audit of documentation including staff records and residents files, and spoke to five residents, one staff member, the deputy manager and the manager. What the service does well: What has improved since the last inspection? What they could do better:
Whilst the home has a policy and procedure on handling complaints, that is accessible to all, this would benefit from the inclusion of details of the complaints procedures of the local authorities funding the care provided. Documentation must be improved to ensure continuous assessment of the quality of the service provided. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 6 Records of Criminal Record Bureau checks should be developed to include reference number and level of check. 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 Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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 The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The assessment procedure ensured that resident’s needs could be met. EVIDENCE: The Deputy Manager told the inspector that the home has not had any admissions since the last inspection when this standard was assessed and met. Three plans of care examined contained evidence of care management assessment plans and reviews. The manager told the inspector the actions the home would take to gather information and assess needs prior to admitting a resident to the home. This would include a number of visits to the home. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9. Staff support residents to make decisions about their lives. Residents are consulted on all aspects of the life in the home. Risks are assessed and well managed, promoting independence. EVIDENCE: Discussion with both residents and staff during the inspection visit confirmed that residents are able to make decisions about their lives, with support if needed. Residents are supported in all aspects of daily living including visiting friends and relatives, day centres, training courses, social activities and holidays. Informal consultation with residents takes place on a daily basis, residents have input into the daily living of the home including menu planning. Formal residents meetings are held to address issues of importance within the home. Staff were able to demonstrate through their actions and responses to questions a good knowledge of the likes and dislikes of individual residents.
The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 10 Three care plans were examined. These were found to be well organised and contained a detailed picture of residents needs and how a resident would wish these to be met. Risk assessments are reviewed on a regular basis and updated. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Residents are enabled to participate in varied activities, and are supported by the staff to integrate within the local community. Staff encourage contact between family and friends. Residents rights and choices are respected. Responsibility and independence is encouraged and promoted by the staff. Residents are offered a varied diet. EVIDENCE: Discussion with residents, manager and staff confirmed residents have opportunities for personal development, for example attending college courses and work placements within the community. Residents are enabled to participate in activities of their choice such as outings, sport, keep fit and shopping. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 12 A number of residents have been on holidays supported by the staff. For example one resident told the inspector how much she had enjoyed a recent trip to London to see Mary Poppins. Others spoke of planned holidays to Blackpool and Ireland. Contact between residents and their family and friends is supported and encouraged by the staff. Residents told the inspector they are involved in the day to day running of the home, for example assisting in the kitchen and other domestic chores. Residents and staff told the inspector that the menus were varied and the home provides a balanced diet. Resident’s likes and dislikes are discussed and recorded. Fresh fruit and vegetables are used within the meals. In addition, residents enjoy the occasional takeaway or meal out. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Care staff provide personal care and emotional support in the way preferred by the resident, and work alongside other professional to ensure care needs are met, promoting wellbeing. Medication is administered as required promoting the safety and wellbeing of the residents. EVIDENCE: During the inspection three plans of care were examined. Plans were seen to detail all aspects of daily living, resident’s preferences and how needs are to be met. Evidence was seen that care is reviewed and discussed with the resident. Changes in need are recorded and agreed. Residents who spoke to the inspector confirmed staff support them both physically and emotionally, spending time discussing any issues or concerns. Staff who spoke to the inspector had a good knowledge of individual residents history, current needs and how these were to be met. Staff work alongside other professionals in order to ensure that needs are met.
The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 14 One resident who spoke to the inspector said ‘ the staff are great, they always listen’, another said ‘ they look after me well’. An audit of medication found no concerns with the ordering, storage and administration of medication. The manager told the inspector that all staff who administer medication have received the appropriate training. Information received in the pre inspection questionnaire indicated that the home has a policy and procedure in relation to medication. Two residents have some control over their own medication and have locked drawers in their rooms for storage. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has policies and procedures in relation to complaints and protection to promote the safety and wellbeing of the residents. Residents feel safe at The Bridgings and are satisfied their views are listened to and acted upon. EVIDENCE: Residents who spoke to the inspector told her they had ‘ no worries’ and were happy at the home. Staff who spoke to the inspector were able to demonstrate through response to questions the course of action they would take if they had any concerns. All said that they have received training in protection from abuse and ‘no secrets’, as required at the previous inspection. Information received from the manager and in the pre inspection questionnaire indicated the home has not received any complaints in the previous year. The home has a policy and procedure in relation to complaints and concerns. This was seen to be accessible to all. Responses received from families indicated that the majority were aware of the homes complaints procedures, however they had not needed to use it. The information contained within the procedure should be developed to include details of authorities funding the care of residents.
The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 16 The home maintains records of personal monies held on behalf of individual residents. Records seen included details of transactions and signatures, one of which was the resident themselves. A random sample of personal allowances found there were no discrepancies with the balance stated on the record sheet and the actual amount in the individual money envelope. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home was found to be clean and comfortable. EVIDENCE: The inspector toured the home and found it to be clean and tidy. Resident’s bedrooms were seen to be individual to taste and lifestyle. Staff told the inspector that residents are supported to choose colour schemes and furniture. Residents who spoke to the inspector told her the home was ‘homely’ ‘comfortable’ and suited their needs. All spoke of choosing the décor for their own rooms. Staff told the inspector that there are sufficient supplies and appropriate equipment to meet the needs of the residents. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Staff at the home work as an effective and committed team and are well supported by the manager. Training is accessed to ensure staff have the appropriate knowledge to meet the residents needs. EVIDENCE: Three staff files were examined these were found to contain the appropriate documentation in relation to recruitment. The recording of Criminal Record Bureau checks should be made more robust and include the reference number and level of check obtained. Records and pre inspection questionnaire included evidence of staff training for example Administration of medication, Food hygiene, First aid and ‘no secrets’. Further training in fire safety and dementia care are planned. It is also hoped that the deputy manager will be able to undertake the Registered Managers Award. A total of five care staff (80 ) have achieved NVQ at level 2 or above. Staff supervision is undertaken by the manager and is viewed as a useful and positive tool. Staff who spoke to the inspector said they felt supported and there was an open door policy where they are listened to.
The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 19 Staff were able to demonstrate strong commitment and loyalty to their residents. One resident told the inspector the ‘staff were all nice’, another said they ‘ staff are very good, they listen to me’. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. The Bridgings is well run, with an ethos of person centred care. Residents are at the heart of the service provided. EVIDENCE: The manager and staff were all able to demonstrate a commitment to the residents who are valued as individuals. Discussion with staff, residents and comment cards received confirmed the home is well run and place the residents at the centre of all the care provided. The home carries out an annual quality audit, however this would benefit from development to include the date it was carried out, an analysis of the responses and action plan to address any issues raised. The home has produced an annual business plan detailing the developments planned. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 21 The Registered provider should develop a report generated from Regulation 26 visits and make this available to the Commission for Social Care Inspection. The pre-inspection questionnaire indicated that routine maintenance and required checks, including hot water temperatures, fire alarm tests and fire drills are carried out as required. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 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 2 X X 3 x The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 23 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 YA39 Regulation 24 Requirement A service user satisfaction questionnaire survey must be carried out at least yearly and the results published and made available to interested parties including CSCI. (previous timescale 31/03/06 not met) The home must record the outcomes from Regulation 26 visits. Timescale for action 01/09/06 2 YA39 24 01/09/06 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 YA22 YA34 Good Practice Recommendations The Complaints policy and procedure should be developed to include details of all funding authorities. Records of Criminal Record Bureau checks should be
DS0000000114.V294371.R01.S.doc Version 5.1 Page 24 The Bridgings Limited (Eston) developed to include reference number and level of check. The Bridgings Limited (Eston) DS0000000114.V294371.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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