Inspection on 27/04/06 for The Bridgings Limited (Redcar)

This inspection was carried out on 27th April 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bridgings Limited (Redcar) 17/04/07

The Bridgings Limited (Redcar) 18/01/06

The Bridgings Limited (Redcar) 04/08/05

The Bridgings Limited (Redcar) 19/11/04

The Bridgings Limited (Redcar) 21/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 The Bridgings Limited (Redcar) 7 Blenhiem Terrace Redcar TS10 1QP Lead Inspector Neil McKenzie Key Unannounced Inspection 27th April 2006 09:30 The Bridgings Limited (Redcar) DS0000000111.V292280.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.V292280.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.V292280.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.V292280.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 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.V292280.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, took place over three days within the home and comprised a total of 7 inspection hours. The inspector when visiting the home spent time talking to the manager, residents and staff and seeking their views. A tour of the home was undertaken. Documents looked at included resident files, staff files and policies and procedures. Indirect observation took place throughout the day with interactions between residents and staff noted. As well as the unannounced visit additional data was collected via the preinspection questionnaire, resident and relative survey. What the service does well: What has improved since the last inspection? Since the last inspection there has been improvements in the décor and maintenance of the home, for example, exposed wiring and pipes made safe, and the outside of the house painted. The home has now started to do a person centred plan with one resident, and this is being done by and independent person from the Local Authority. The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 6 The home has produced a business development plan to ensure quality of care and maintenance is progressed. 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.V292280.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.V292280.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 Prospective residents aspirations and needs are assessed either prior to or on admission to the home. EVIDENCE: Documentation seen in respect to resident files contained an Action Plan detailing care needs, including health and emotional needs. In addition to this, ’likes and dislikes’ are documented and individual protocols are included on specific areas of behaviour.. Individual care plans and action plans are reviewed on a three monthly basis to ensure that any changes are documented and acted upon. Research suggests that the style and format of these plans, including the Statement of Purpose, would be more beneficial to residents if they were produced in a ’ pictorial format’ The Bridgings Limited (Redcar) DS0000000111.V292280.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 and 9 Residents are aware of their action plans and that the help they need to look after themselves are recorded in them. As well as being able to make decisions about their lives residents are consulted on life within the home. Risk assessments are carried out and support provided to help residents lead more independent lives. EVIDENCE: Discussion with staff and residents indicated that residents are aware of their Care or Action plan and the contents of these plans are discussed between residents and their key-workers. These are reviewed every 3 months by the home. As on resident said, ‘ we do action plan and we get a little writing book to help us here’ Health care elements of care plans have been introduced and residents were able to state what the home does to help them have better health, ‘we have little green books, a GP that is close by, I am going to the dentist and I get help to take my medication. The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 10 Residents are helped to decide how they would like to spend their day and have support to carry out their activities and maintain contact with family and friends where needed. For one resident this is to be explored in more detail by a person centred plan that is to be done by an independent person working for the Local Authority. When asked what the resident wanted from this plan the resident forcibly stated ‘I want a job’ It was observed that the home is small and staff on duty interact with residents for most of the time making it easier for residents to be consulted on issues, and contribute to the life of the home. For example residents help to tidy rooms and wash up and were seen to be encouraged to take part and use their skills in the home. As one resident said, ‘we tidy messy rooms and help to wash up’. The Bridgings Limited (Redcar) DS0000000111.V292280.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 and17 A range of activity is available for residents living at Blenheim Terrace, as well as opportunities for personal development. Contact with family and friends is encouraged and supported. Residents’ benefit from staff aware of the need to try to ensure a varied and healthy diet is provided. EVIDENCE: Opportunities for personal development are available at the home. Most of the residents attend skills centres, college or work placements during the day, returning home in the late afternoon. One resident said that she went to college and her plan was to get a job. The resident is to be supported with this by a person centred plan. Another resident who recently had been hospitalised due to a fall has returned home and is now smiling because he now going back to his skill centre. Conversation with staff and residents revealed a wide range of activity, both in the house, in the local community and further a field. This activity varied from The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 12 resident to resident. For one resident this was about being able to go out shopping when she wanted, for another this was attending a local gym. As one resident stated,’ holidays excite me and we are off to the Centre Parks where I can bike ride and do disco and drink lager, and staff make me feel safe to go out bowling and the sports academy’ Contact with family and friends’ is encouraged within the home. One resident stays regularly overnight with her brother and relatives all stated in their survey returns that they were made to feel welcome by the home and could visit residents in private. Another resident stated that ‘my good friend is out there’. In respect of diet and meals provided, residents are given consideration to their dietary needs and menus are chosen on a weekly consultation basis with residents living at the home. The main meal is taken in the evening, when most people arrive from their daytime activities. As one resident commented, ‘lots of choice of food with cheese toasty, jacket potatoes and curry’ The Bridgings Limited (Redcar) DS0000000111.V292280.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 and 20 Resident physical and emotional health needs are met in a way which maintains dignity and is respectful. The home demonstrated robust procedures for the safe handling of medication and that this was reinforced by certificated training in the safe handling of medication. EVIDENCE: The manager and staff work hard at meeting both physical and emotional needs, working with other professionals where appropriate to try and ensure all care needs are met. This was demonstrated by the tracking of a resident who had recently returned from hospital and required more personal care. Return was supported by a risk assessment, an occupational therapist, and additional care hours being added to the staff team. The resident is now being supported to return to his community centre. When spoken to a worker the centre was able to confirm that the home had worked closely with them to help the resident return to what he enjoys doing; The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 14 ‘ A little slow to organise things but things have picked up quickly and the home has worked closely with us on this. For example, the resident requires a wheel chair and we have been able to provide one with a strap. Enjoys music and seen plenty of smiles from him’. Personal care provided for the resident is by a female staff team, although staff communicated sensitivity in their approach to their work. It was noted that at the time of the inspection none of the residents handled their own medication. The medication was administered by qualified staff and referred to protocols embedded with the Monitored Dosage system. The Bridgings Limited (Redcar) DS0000000111.V292280.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, and 23 Some of the relatives are not aware of the complaints procedure. Residents’ are protected from a staff team who are aware of the abuse procedures, and current training in Protection of Vulnerable Adults. However, the home must ensure that transactions of money belonging to residents are countersigned. EVIDENCE: A number of relatives in their survey returns stated that they were not aware of the homes complaints procedure and this should be reviewed by the home to ensure service users views are listened to and acted on. The residents are protected by staff who were able to confirm they had training in abuse. One staff member stated ‘ I had a case study to do on the no secrets module, and this made me think of other signs of abuse’ and the manager has just completed a course in POVA. The home has had no complaints or allegations of abuse in the past twelve months. The home must ensure that they protect residents’ money by counter signing any transaction. The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 16 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, and 30 The residents benefit from a home that is clean and hygienic and whilst maintenance and deco has improved this still remains a concern. EVIDENCE: The décor and maintenance of the home in the last two inspections was seen to have fallen below acceptable standard. Whilst improvement has been made this has been on the insistence of CSCI and one resident still has a window clouded with condensation. This is an outstanding requirement from an inspection dated August 2005. A number of radiators require panels to protect residents’ from burn and apart from a brief reference in the business plan there is no evidence of the home providing a maintenance schedule that highlights a planned cycle of decoration and maintenance. The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 17 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, and 34 Residents’ are supported by qualified and competent staff with established roles and responsibilities and have been appointed by robust recruitment practices. EVIDENCE: Discussion with manager, staff and review of staff files indicate a high level of training, both mandatory and professional, with all staff having an NVQ. Staff files confirm up to date supervision, appraisal and recruitment data. The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 On a day to day basis the home is well run with an increasing emphasis of person centred support and care. Health and safety documentation is up to date and a brief maintenance schedule has been incorporated in a business plan for the home. Whilst residents are consulted on a weekly basis about daily life in the home the residents and relatives would benefit from a more detailed published summary of their annual survey. EVIDENCE: Discussion with manager, staff and residents confirmed that care is provided on a more individual basis and this was supported by the move to do a person centred plan on behalf of a resident. This move to doing person centred plans could be reinforced as an objective in the home’s current business plan. The home seeks out the view of residents on a weekly basis although the annual survey should provide more detailed summary that is published. The Bridgings Limited (Redcar) DS0000000111.V292280.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 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 X 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 X X 2 X X 3 X The Bridgings Limited (Redcar) DS0000000111.V292280.R01.S.doc Version 5.1 Page 20 Yes 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 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 two inspections 04/08/05 and the 18/01/06 The home must ensure that two staff signatures recorded when handling residents’ money. The home must provide radiator covers to prevent residents from burns in the main living and dining room Timescale for action 27/04/06 2. 3. YA23 YA13 16(2I) 4(a) 27/04/06 31/05/06 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 YA24 Good Practice Recommendations The home should review the complaints procedure to ensure better access for relatives The home should develop a more pro-active approach to maintenance and decoration via a cyclical maintenance schedule document separate to the business plan. DS0000000111.V292280.R01.S.doc Version 5.1 Page 21 The Bridgings Limited (Redcar) 3 YA39 Resident views should be supported by a more comprehensive annual survey that is published. The Bridgings Limited (Redcar) DS0000000111.V292280.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. 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