Inspection on 12/07/06 for The Bridgings Limited (Middlesbrough)

This inspection was carried out on 12th July 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bridgings Limited... 06/07/07

The Bridgings Limited... 30/01/06

The Bridgings Limited... 22/08/05

The Bridgings Limited... 13/10/04

The Bridgings Limited... 13/04/04

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22 Sandown Road

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Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 The Bridgings Limited (Middlesbrough) 116 - 118 Woodlands Road Middlesbrough TS1 3BP Lead Inspector Jane Bassett Key Unannounced Inspection 12th July 2006 09:30 The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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 The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bridgings Limited (Middlesbrough) Address 116 - 118 Woodlands Road Middlesbrough TS1 3BP 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) 01642 242886 F/P 01642 242886 The Bridgings Limited Mrs Trudy Griffiths Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: The Bridgings, Woodland Road, Middlesbrough, was opened in 1989 to provide a home for 10 younger adults with a learning difficulty. The home aims to provide care tailored to individual need and the emphasis is on meeting, holistically, the daily living needs of all residents. With the exception of one double room, all rooms are single, and rooms can be personalised by residents according to their preference and taste. The home is situated in central Middlesbrough close to the University of Teesside, and within easy walking distance to shops, cafes and restaurants. The fees charged by the home are £335 per week. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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, three relative / visitor and four service user comment cards received. An unannounced visit to the home was carried out. During the visit, which lasted four hours the inspector carried out a tour of the environment, an audit of documentation including staff records and residents files, and spoke to three residents, two staff members and the deputy manager. What the service does well: What has improved since the last inspection? What they could do better: The providers must ensure that the maintenance and upkeep of the home continues to promote the comfort and safety of the residents. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 6 Documentation must be improved to ensure continuous assessment of the quality of the service provided. 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 (Middlesbrough) DS0000000113.V300146.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 The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Evidence gathered at the inspection indicated prospective care needs and aspirations are assessed prior to any admission to the home. EVIDENCE: All residents currently living at the home have been there for some considerable time. The home has not had any recent admissions. The deputy manager confirmed that prior to any admission a multi disciplinary assessment would take place. Prospective residents and their families would be encouraged to visit the home to meet the staff and other residents. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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 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. There is a high awareness amongst residents who spoke to the inspector of their plan of care. Plans of care including taking risks are discussed on a regular basis by the key worker with the resident. 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. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 10 Staff were able to demonstrate through their actions and responses to questions a good knowledge of the likes and dislikes of individual residents. 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. Comments received in questionnaires returned to CSCI from residents relatives included ‘ Excellent care and lovely atmosphere’ and ‘ Wonderful care and attention’. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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 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. Resident’s 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 and staff confirmed residents have opportunities for personal development, for example attending college courses, day centres, and employment within the community. Residents are enabled to participate in activities of their choice such as outings and shopping. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 12 A number of residents have been on holidays supported by the staff. For example one resident told the inspector how much he/she had enjoyed a holiday in Greece. 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. One resident told the inspector ‘I love living at The Bridgings’. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.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 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 professionals 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. It was evident from documentation and discussion with residents and staff that the majority of residents at the home manage their personal care with minimum support. A number of the residents require a greater level of support with emotional and social needs. It was evident that staff support the residents and promote their independence whilst respecting the residents privacy and choice. Evidence was seen that care is reviewed and discussed with the resident. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 14 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. One resident who spoke to the inspector said ‘ the staff are great’ another said ‘ staff are good, they care about me’. Comments received in questionnaires from relatives stated ‘ Wonderful care and attention’. An audit of medication found no major concerns with the ordering, storage and administration of medication. The deputy 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. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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. Residents feel they are listened to and their views are acted upon where appropriate. EVIDENCE: Residents who spoke to the inspector told her they had ‘ no worries’ and were happy at the home. One resident told the inspector ‘ I am happy here’. 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’. Information received from the manager in the pre indicated the home has not received any complaints investigation was carried out by the home in relation by CSCI and the Vulnerable adults team, this substantiated. inspection questionnaire in the previous year. An to an allegation received was found not to be 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 an awareness of the homes complaints procedures, however they had not needed to use it. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 16 The home maintains records of personal monies held on behalf of individual residents. It was noted that records have been developed to include details of transactions, receipts and signatures, one of which was the resident themselves wherever possible. 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 (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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 hygienic, however the providers must ensure that the maintenance and upkeep of the home continues to promote the comfort and safety of the residents. EVIDENCE: The inspector toured the home and found it to be clean and tidy, however it was noted that the dining chairs were stained and required cleaning or replacement. It was also noted the cement facia on the rear boundary wall was loose and falling away. 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. One resident told the inspector that he/she had requested their room was decorated and they had picked the wallpaper. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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 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. 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 prevention of falls are planned. 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 (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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 ‘like all the staff’. Comments in questionnaires received by CSCI included ‘ a big thank you to the manager and all the staff’ and the home is ‘excellent’. The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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: At the time of the inspection the manager was not on duty and had been absence for a number of weeks due to ill health. However the deputy manager and staff who spoke to the inspector 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 places 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 Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 21 The inspector was told that residents meetings are called at the request of the residents themselves and staff meetings take place. 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 (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 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 (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 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. The home must record the outcomes from Regulation 26 visits. Timescale for action 01/11/06 2 YA39 26 01/10/06 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 Refer to Standard YA24 Good Practice Recommendations The premises must be of sound construction and kept in a good state of repair externally and internally, and all parts of the home must be kept clean and reasonably decorated The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 24 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 © 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 The Bridgings Limited (Middlesbrough) DS0000000113.V300146.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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