CARE HOME ADULTS 18-65
The Bridgings Limited (Redcar) 7 Blenhiem Terrace Redcar TS10 1QP Lead Inspector
Neil McKenzie Unannounced Inspection 18th January 2006 09:30 The Bridgings Limited (Redcar) DS0000000111.V267481.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 (Redcar) DS0000000111.V267481.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 (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Bridgings Limited (Redcar) Address 7 Blenhiem Terrace Redcar TS10 1QP 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 483837 The Bridgings Limited Miss Michelle Jones Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th August 2005 Brief Description of the Service: Redcar Bridgings is registered for the care of 10 younger adults with a learning difficulty. Situated in Blenheim Terrace, a residential area of Redcar, the house is a three storey Victorian terrace house, which is in keeping with other properties in the road. Accommodation is provided for ten residents in eight single rooms and one double room. Communal space consists of an upstairs lounge, with a dining room downstairs. There is a garden at the front of the house and at the rear an enclosed yard. Residents are able to personalise their rooms according to preference and taste. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection and was completed within one inspection day, four inspection hours in total. The previous inspector was spoken to before the inspection. The inspector also spent time talking to two residents and one staff member and seeking their views. There was also detailed discussion with the manager. A tour of the home was undertaken, the homes medication procedure and practice was inspected. Documents looked at included resident files, staff file, and health and safety records. The complaints, financial and abuse policies and procedures. Indirect observation took place throughout the day with interactions between residents and staff noted. The inspector was made very welcome into the home and was grateful for the permit to park his car. What the service does well: What has improved since the last inspection?
Since the last inspection there had been a number of improvements made to the environment that included decoration and a new heating system. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 6 There had also been recent meetings with residents to ask them what they wanted to do other than access the usual formal community facilities. This included more bar meals, going to the pictures and the ‘Banana Leaf’ club. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Bridgings Limited (Redcar) DS0000000111.V267481.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 (Redcar) DS0000000111.V267481.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): None of these standards were looked at during this inspection. EVIDENCE: The Bridgings Limited (Redcar) DS0000000111.V267481.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): None of these standards were looked at during this inspection. EVIDENCE: The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 10 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): 16 Residents’ benefit from having their rights respected although there were no lockable facilities provided for residents in their own rooms. EVIDENCE: Residents have access to individual contracts and a service users guide that describes to them their rights and responsibilities. This guide is presented in a friendly manner with pictures and words that are simple and easy to understand. Residents also spoke about having keys to their own rooms and one resident confirmed, ‘staff ask me if they can come into my room’. When the front door bell rang it was a resident who answered. Residents said they have access to money to spend on what they want but this was usually kept upstairs. One resident the inspector spoke to had returned shopping and had brought herself goodies from the Pound shop.
The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 11 There were no lockable facilities in resident rooms to keep their own medication and money although the manager assured me that in the past this has been provided on request. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 12 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): 20 The home demonstrated robust procedures for the safe handling of medication with 3 staff currently engaged in medication training. EVIDENCE: The MDS system is used by the home although the manager commented that in the past they have been frustrated by delivery that was a day short. The home has since resolved this issue. Protocols were in place for controlled drugs and this included personal protocol plans held in resident files. In addition to this records confirmed that 3 staff were receiving training in the ‘safe handling of medication’ at Middlesbrough college. It was noted that at the time of the inspection none of the residents handled their own medication. The manager commented that this has always not been the case and referred to a previous resident who had self-medicated. This was confirmed by documentation held on a previous resident who had handled his own medication in his room and that this had been monitored by personal risk assessment.
The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 13 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 are aware that if they had any concerns or complaints, these will be dealt with quickly and robust procedures are in place to protect residents from abuse. EVIDENCE: Staff aware of the complaints procedure and knew about the protection of vulnerable adults. As one staff member confirmed, ‘we have a complaints procedure to follow and depending on the severity of the incident I would contact CSCI and the police and see the outcome’. They confirmed they had received up to date training on the topic of abuse and were in the process of starting a no secrets module linked to NVQ Level 2. Resident stated, ‘If I had concerns, I would know what to do and I would to staff. I also go out on my own to see my dad and brother who are Residents also talked about open, supportive relationships with the staff ‘I like all the staff, they are friendly, you can also have a laugh and mess speak there’ team, on’. A random sample of 3 residents’ personal allowances and records were examined and there was one small discrepancy with the balance stated on the transaction sheet and the actual amount contained in the individual money pouch. The home must ensure that transactions are counter signed by two staff signatures. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 14 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 Since the last inspection there had been a number of improvements made to the environment that includes decoration of bedrooms and a new heating system. However, decoration and maintenance remains a real concern. EVIDENCE: Decoration and maintenance remains a concern for staff. The main hall appears ‘tired’ in deco and recent work on a new heating system remained incomplete with exposed wires and pipes in the kitchen and exposed pipes in the downstairs passage way. There was also a gap in the flooring in the laundry room where part of the flooring had been removed and then screwed back down. These are hazards that require immediate action. As the manager commented,’ what we find really hard in here is the decoration and the maintenance’. One resident still has a window that is clouded with condensation and this was highlighted in the last inspection as a requirement to be made good. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 15 The downstairs bathroom has no window and is, therefore, prone to condensation and smells. The bathroom has a small extractor for ventilation but the home should invest in a larger one to improve comfort and hygiene. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 17 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): 39 42 Residents’ benefit from an approach by staff that ensures resident interests and views are sought. The health and safety procedures appeared up to date although a recent gas inspection required certification. A recent fire inspection recommends the fire brushes replaced and all bedroom fire doors to have selfclosures fitted. EVIDENCE: During discussions with staff and residents the home was described as active in seeking the views of residents. This included resident meetings, individual resident action plans that are reviewed every 3 months and residents’ attending a course at college designed to help them say what they want. As one resident commented, ‘sometimes they have meetings down the road, near that big house, and talk about having your own doctor and the cinema’. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 18 Details of Health and Safety were made available and these were found to be to date and a key individual is responsible for taking care of the health and safety. Staff aware of the need for regular fire drills, not to leave things lying about and to check that doors are not wedge open. The home requires the Corgi certificate from a recent gas inspection to confirm their new heating system and gas appliances are safe. Action was taken to ensure a copy of this is forwarded to CSCI. A fire inspection has recommended the home replace fire brushes and all bedrooms have self-closures fitted to their fire doors. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 19 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 X 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 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 3 X X 3 X The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation 23(2b) Requirement The window in one of the bedrooms is clouded with condensation and must be replaced. This is outstanding from the last inspection 04/08/05. A certificate confirming that all gas appliances’, the new central heating system has been serviced by a Corgi engineer must be provided. This is outstanding from the last inspection 04/08/05 Gap in laundry room floor remaining from recent work on the heating system must be made good. Exposed wiring and pipes left from a recent installation of heating system must covered and made safe Recommendations from a recent fire inspection report to replace fire brushes and install selfclosure to bedroom fire doors must be completed. The home must ensure that two staff signatures recorded when handling residents’ money. Timescale for action 18/01/06 2. YA24 23(2b) 18/01/06 3. YA24 23(2b) 01/02/06 4 YA24 23(2b) 25/01/06 5 YA24 23(4C) 31/03/06 6 YA23 16(2I) 18/01/06 The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 21 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 YA24 YA24 Good Practice Recommendations The downstairs bathroom should install a larger ventilator to prevent condensation. The home should extend their decorating programme to include the main hallway. The Bridgings Limited (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 Page 22 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 (Redcar) DS0000000111.V267481.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
