Care Home: Bradbury House

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well This service gives out good information brochures about the company and about Bradbury House. They assess the needs of new people and allow them to make an informed choice about becoming resident in the home. "I have been given wonderful support during one of the hardest things I have ever had to do...but I am staying as I like it so much." They have a person centred approach to individual care and find out all they need to know about peoples` needs and wishes. We read a number of the written plans of care and found them to be detailed and up to date. "...provide carefully constructed care plans to help people live as independently as possible." We saw that people get good health and personal care provided. Health care professionals confirmed that they are more than satisfied with the way the team deliver health care. "The residents are cared for in an excellent way." We checked on the medicines management and found this to be done with care and precision. No one in this service is given drugs that will make them less alert. We observed staff treating people with dignity and respect. We learnt from people that the team allow them space to get on with their own lives. There are `dignity champions` on the staff team who speak up if anyone, at any level, treats people without respect. People told us on the day and in surveys: "A wonderful staff...I have been here for ...years and at no time have I had a wrong word with a carer." "Standard of care is excellent...the staff are always helpful, cheerful and happy." People in this home tell us they lead very full lives if they so wish. There are educational and leisure activities, craft sessions and exercises classes. People go out to village activities and there are activities in the home that people from the village attend. Spiritual, cultural and social needs are met to the satisfaction of residents. There is plenty of opportunity to go out as the home has its own transport. There is a day centre in the building and residents can attend this. "The garden is nice and there is a nice area to sit outside. The day centre is good and I enjoy the trips out." "Although I am not as able as I once was I still read my newspaper and get out and about and I go to everything ...never too old to do something new...". One survey did make a useful suggestion: "Encourage the very shy to join in more...I am aware of the difficulties...and people do get to do their own thing ...". People were very complimentary about the food provided. They told us it was varied and nutritious and very well made. "Very nice...always high quality...not good for my figure but I just can`t help myself...every day I say I won`t have a cake ...but they are homemade and lovely and I do." People in this service are encouraged to speak up if anything is not satisfactory. We met assertive people who were not afraid to voice their opinions. Any problems recorded were minor and dealt with promptly and to the satisfaction of residents. "Yes I had a complaint...but it was solved and sorted and forgotten...it was nothing but was treated with importance." Staff are fully aware of what is abusive practice and they know how it should be reported and managed. They are given regular training and support. People who live in the home understand their right to live a life free from this kind of threat. On the day and in surveys we were told that nothing abusive was happening in this service. "The staff team create a good, cheerful atmosphere all the time even when under pressure." Bradbury House is a purpose built home that is carefully maintained and upgraded. Furniture and fittings are of a high standard. It is in a rural setting but has the benefit of being in the centre of a lively village. "I am very lucky to have found such a comfortable and clean home...I am very settled." People told us they liked their large, en suite rooms and felt comfortable in the shared areas. There is a secluded and well kept garden. All parts of the building were very clean, orderly and warm on the day. Good infection control measures were in place. This home always has two carers on duty by day and night. At busy times there is a third person so people don`t have to wait. The carers are supported by housekeeping, administrative, catering and management staff. We judged that there are good staff ratios in this service. Staff told us that they are properly supported and supervised and are given plenty of training. We confirmed this by talking to people who live in the home and looking at the staff personal development files. There is a low turnover of staff but we checked on a recent recruitment. This was done correctly. No one starts to work with people until their background, identity and references have been thoroughly checked. This home has a well qualified and experienced manager who we discovered is trusted and respected by staff and by the people who live in the home. She had plenty of evidence to show that the service runs smoothly and she uses company systems appropriately. We also observed her working with people in an easy and confident way that merges a `hands on` approach with these good systems. She is ably supported by her deputy. "The two in charge are always there if we have any queries and they are very supportive." The quality monitoring in the service is extremely thorough with both internal and external audits taking place all year round. People are involved in how the home runs and in future planning. People deal with their own finances but there are suitable systems in place if support is necessary. All the repair, maintenance and safety systems in the home were operating smoothly. People told us that they felt very free from worry living in such a good home. What has improved since the last inspection? We had evidence to show that the management team and the staff are dedicated to continuous improvement. There were lots of small changes since we last visited and plans for even more improvements. The upstairs lounge had been redecorated and refurnished and people are being encouraged to use it more. What the care home could do better: There was nothing of concern we wanted the service to do better but we had lots of discussions with management and staff who are keen to do everything better all the time. As one survey said: "Everything is done well" and another : "Keep up the good work!" Key inspection report Care homes for older people Name: Address: Bradbury House Wasdale Road Gosforth Seascale Cumbria CA20 1AU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nancy Saich     Date: 2 3 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Bradbury House Wasdale Road Gosforth Seascale Cumbria CA20 1AU 01946725061 01946725938 n.hallett@abbeyfield.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Abbeyfield Society Name of registered manager (if applicable) Nicola Hallett Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 18 The registered person may provide the following categories of servoce, Care Home only, Code PC to service users of the following gender, either, whose primary care needs on admission to the home are within the following categories, Old Age, not falling within any other category, Code OP. Date of last inspection Brief description of the care home Bradbury House is owned by the Abbeyfield Society. This is a nationwide company that operates care homes and sheltered accomodation for older people. This service is run by Nichola Hallett. The home has been registered for a number of years but all of the services have recently been re registered under a new name and this meant a change to the corporate name. The operating company has had some operational changes but Care Homes for Older People Page 4 of 29 Over 65 18 0 Brief description of the care home is fundamentally the same provider. There has been no other changes to this service. Previous inspection reports under the former registration can be obtained from the company as they are no longer available on our website. Due to this legal change this service, despite having no changes, is classed as a new service. The building is a modern purpose built home on two floors with a passenger lift. People have single rooms with en suite shower, toilet and wash hand basin. All areas of the home are designed and adapted for people who may have mobility issues. There is a passenger lift. The buidling has a large sitting and dining room and a smaller quiet lounge. It is situated in the lakeland village of Gosforth on the edge of the national park. It is in a rural location but benefits from the proximity of all the village amenities. There is a bus service to the village, ample parking at the home and they have their own transport. The house is home to up to eighteen older adults who are in need of personal care only. Further information can be obtained from the manager or the company. The cost is £1825 per month and the cost of respite care can be obtained from the manager. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the second full or key inspection of this service in 2009. The company had changed their corporate arrangements so they had changed the registration of all of their homes. Nothing had changed in this service apart from these changes related to company law. This meant they are treated as a new service. We had visited in January 2009 and found them to be an excellent service. This second visit confirmed what we discovered then. Some weeks before this visit we sent out a second Annual Quality Assurance Assessment (the AQAA). This is a legal document required annually. It asks for information about progress in the service and about plans for the future. This was completed for a second time with plenty of detail and within the given time frame. We also checked on the regular monthly reports sent by the company and any notifications of significant events. This includes accidents, incidents and allegations. Care Homes for Older People Page 6 of 29 There had been nothing worrying or significant in the last year. We had received no complaints and no safeguarding referrals. We then sent out surveys that the residents representative kindly gave out. We sent surveys to staff, relatives and professionals who visit. We had a high number of returns that were, in the main, extremely positive. Our inspection was an unannounced visit that started around 8.30 a.m and lasted until late afternoon. We met all of the residents either individually or in groups. We chatted about general things to do with their lives and asked one or two individuals about very specific things related to their care and the protection and support afforded to all the residents. We also met with the manager and her deputy and had discussions with the staff on duty. We read a wide range of files and documents that backed up what we heard, what we were told and what we saw. Care Homes for Older People Page 7 of 29 What the care home does well: This service gives out good information brochures about the company and about Bradbury House. They assess the needs of new people and allow them to make an informed choice about becoming resident in the home. I have been given wonderful support during one of the hardest things I have ever had to do...but I am staying as I like it so much. They have a person centred approach to individual care and find out all they need to know about peoples needs and wishes. We read a number of the written plans of care and found them to be detailed and up to date. ...provide carefully constructed care plans to help people live as independently as possible. We saw that people get good health and personal care provided. Health care professionals confirmed that they are more than satisfied with the way the team deliver health care. The residents are cared for in an excellent way. We checked on the medicines management and found this to be done with care and precision. No one in this service is given drugs that will make them less alert. We observed staff treating people with dignity and respect. We learnt from people that the team allow them space to get on with their own lives. There are dignity champions on the staff team who speak up if anyone, at any level, treats people without respect. People told us on the day and in surveys: A wonderful staff...I have been here for ...years and at no time have I had a wrong word with a carer. Standard of care is excellent...the staff are always helpful, cheerful and happy. People in this home tell us they lead very full lives if they so wish. There are educational and leisure activities, craft sessions and exercises classes. People go out to village activities and there are activities in the home that people from the village attend. Spiritual, cultural and social needs are met to the satisfaction of residents. There is plenty of opportunity to go out as the home has its own transport. There is a day centre in the building and residents can attend this. The garden is nice and there is a nice area to sit outside. The day centre is good and I enjoy the trips out. Although I am not as able as I once was I still read my newspaper and get out and Care Homes for Older People Page 8 of 29 about and I go to everything ...never too old to do something new.... One survey did make a useful suggestion: Encourage the very shy to join in more...I am aware of the difficulties...and people do get to do their own thing .... People were very complimentary about the food provided. They told us it was varied and nutritious and very well made. Very nice...always high quality...not good for my figure but I just cant help myself...every day I say I wont have a cake ...but they are homemade and lovely and I do. People in this service are encouraged to speak up if anything is not satisfactory. We met assertive people who were not afraid to voice their opinions. Any problems recorded were minor and dealt with promptly and to the satisfaction of residents. Yes I had a complaint...but it was solved and sorted and forgotten...it was nothing but was treated with importance. Staff are fully aware of what is abusive practice and they know how it should be reported and managed. They are given regular training and support. People who live in the home understand their right to live a life free from this kind of threat. On the day and in surveys we were told that nothing abusive was happening in this service. The staff team create a good, cheerful atmosphere all the time even when under pressure. Bradbury House is a purpose built home that is carefully maintained and upgraded. Furniture and fittings are of a high standard. It is in a rural setting but has the benefit of being in the centre of a lively village. I am very lucky to have found such a comfortable and clean home...I am very settled. People told us they liked their large, en suite rooms and felt comfortable in the shared areas. There is a secluded and well kept garden. All parts of the building were very clean, orderly and warm on the day. Good infection control measures were in place. This home always has two carers on duty by day and night. At busy times there is a third person so people dont have to wait. The carers are supported by housekeeping, administrative, catering and management staff. We judged that there are good staff ratios in this service. Staff told us that they are properly supported and supervised and are given plenty of training. We confirmed this by talking to people who live in the home and looking at the staff personal development files. There is a low turnover of staff but we checked on a recent recruitment. This was done correctly. No one starts to work with people until their background, identity and Care Homes for Older People Page 9 of 29 references have been thoroughly checked. This home has a well qualified and experienced manager who we discovered is trusted and respected by staff and by the people who live in the home. She had plenty of evidence to show that the service runs smoothly and she uses company systems appropriately. We also observed her working with people in an easy and confident way that merges a hands on approach with these good systems. She is ably supported by her deputy. The two in charge are always there if we have any queries and they are very supportive. The quality monitoring in the service is extremely thorough with both internal and external audits taking place all year round. People are involved in how the home runs and in future planning. People deal with their own finances but there are suitable systems in place if support is necessary. All the repair, maintenance and safety systems in the home were operating smoothly. People told us that they felt very free from worry living in such a good home. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 10 of 29 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 11 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 12 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home gives people the information and opportunity to make the decision for themselves to live in the house. Evidence: We looked at the information available to prospective new residents. We found this to be up to date and comprehensive. Brochures and guides about Abbeyfield and about the home were useful and realistic. They were easy to read and had photographs of the home and key members of staff. We spoke to people who told us they gave a true picture of the home. Inspection report summaries were also given to new people.They said they had been given plenty of information so they could make the right decision for them. We saw pre-admission assessments completed by management with the person so that people are encouraged to express their needs and wishes right from the start. Care Homes for Older People Page 13 of 29 Evidence: The management team go out to visit new people. When we were in the home we saw the manager and her deputy with a family who were looking for accommodation for a relative. They took time to explain the process and gave them good advice as well as detailed information. We checked on residents files and we saw Social Work and health assessments and the pre admission assessments completed by the manager and deputy. These were all of a very high standard. One person explained to us how she had gone through the process and she said it was easy and stress free and she had already made up her mind to stay in the home. She told us the staff helped her to settle in well and she understood the terms and conditions of her stay and told us she had signed a legal document about this. Care Homes for Older People Page 14 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home receive dignified and specific health and personal care that allows them to be independent and takes into account their individual needs. Evidence: We read a number of the written plans of care that help people tell staff what they want and need. Each file had details written about the individual in the first person so that the plan says I prefer... or I need... and there is also a section on peoples life history, their personal strengths and also a description of the positives other people think of them. These files were a good example of a person centred approach. This is also backed up by a more problem solving approach to planning care so that staff know exactly how to deliver individualised and appropriate care. The plans were very precise about preferences and the notes showed that requests like daily showering were followed through in the way people wanted. People understood their care plans; had copies in their rooms and could ask for changes to be made at any time. There were good risk assessments in place and good strategic management plans in place. Care Homes for Older People Page 15 of 29 Evidence: We received positive surveys about health and personal care delivery in this home and we had evidence from health care providers who judged the home to be good at helping people stay as well as possible. The daily notes and care plans showed that people saw the G.P and the district nurses and, when necessary, were supported in getting more specialised care from people like speech therapists or physiotherapists. One person who had only been in the home for two weeks had already had a complete check up with the local surgery, had been visited by the chiropodist and was going out to the dentist during our visit. People told us they could go to the surgery but the local G.P visits weekly. We met her on the day and she was very satisfied with the way her patients were cared for by the staff. If someone goes into hospital the staff send a condensed version of their care plan - the hospital passport - to help staff in hospital continue with the kind of personal care and choices people want. Several people said it was the good care and good food that kept them well. People looked well and said their health and weight improved when they came to the home. We looked at the care plans that related to nutrition and we discussed with the manager ways she might like to fomalise nutritional planning for one or two people and she outlined her ideas for future developments. We checked on the medication held on behalf of residents. We saw that people were encouraged, where possible, to manage their own medicines. We checked the arrangements in place for ordering, storing and administering medicines and this was done carefully and the system audited regularly. No one had any strong sedatives or other powerful drugs that might make them less alert. Staff are careful to call in experts if anyone needs medicines that help with things like behavioural issues. The people in this service are all very alert and assertive and feel comfortable to speak their minds, follow their own chosen lifestyle. They choose how they live their lives and how they sustain friendships, family links and other relationships. Staff treat people with respect and politeness and allow plenty of space for residents to be as independent as possible. We shared some comments from surveys with the manager who wanted to use this feedback about staff interaction with residents for future inhouse training on the rights and needs of people. Staff have training about respect and dignity and there is a dignity champion on the staff team. We did not check the standard that relates to death and dying fully but we had good feedback from a health care professional who judged that the home was good with people at the end of life. Care Homes for Older People Page 16 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home tell us their lifestyle, social and cultural preferences are respected and supported Evidence: People in the home told us they followed their own preferred lifestyles. Most people spend a lot of time in their own rooms but they also enjoy meeting together for meals or to participate in the activities, outings and entertainments on offer. Most people had some kind of hobby or interest that they enjoyed and were encouraged in. We were told that they got up and went to bed as they chose, could eat in their own rooms and go out as they wished. There were no restrictions on their lifestyles. We had a number of surveys from friends and relatives who said they were always made welcome and kept informed. There is a small visitors room so that visitors can stay overnight. This house is very much part of the local community. There are classes for the community held in the house that residents also take part in. The local church visits and people go across the road to services. The house has its own mini-bus and there are monthly trips out to places of interest and people enjoy this along with a meal out Care Homes for Older People Page 17 of 29 Evidence: in a restaurant. There is also a weekly trip to Seascale where people can go to the G.P or the bank or do their own shopping. People are also taken to the village shops and other local activities. People told us they were encouraged to help out with light chores and were supported to do some gardening. The staff arrange regular activities in the home and there are parties and entertainers. The home has an official Pat-a-Dog visitor and residents enjoy having this access to a pet. People enjoy games and entertainments and there is a group of people who play dominoes every day. People told us they lived very full lives and were given support to join in or maintain their own interests and friendship groups. Some of the varied interests and activities are yoga class, reflexology, talks on various subjects, themed evenings and cheese and wine parties. We had evidence to show that peoples beliefs, cultural, spiritual, social and sexual needs are respected by the way this home is managed. There is a positive application of individual lifestyle choices seen in care plans and in the way people still continue to be interesting and interested people. We had very positive responses about food in our surveys and on the day. We shared a very pleasant meal with residents. The dining room is well decorated and the tables were set with good quality linens and crockery. We were told that they influence the menus and on the day of our visit they were offered three courses with a minimum of two choices and staff also offered salad as a side dish. Vegetarian diet options are always on offer. People told us that they were offered wine or sherry when they had bar open days. We saw the menus and these were balanced and varied using fresh, local produce. People were asked their preferences and their wishes followed. The kitchen was well organised and there was a good range of foods available. The home has a water cooler so people can have cold, filtered water when they want and we were told there was always plenty of hot drinks served. Residents have a small kitchen area where they can help themselves to drinks and snacks. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home are listened to, respected and protected from harm by a committed and trained team of staff. Evidence: This service has never had a major, formal complaint. There is a very good complaints policy and people are guided to talk to management in the first instance if anything is not to their liking. People told us they felt confident in the staff and management but they could also easily talk to someone from Abbeyfield if things did not improve. The manager keeps a log of minor niggles and everyone is aware that even minor problems are important. Everything logged was minor and had been resolved appropriately and quickly. People told us they were encouraged to voice any issues that might make them unhappy and they said they felt they could do that individually or at regular meetings. No one had any complaints and were very satisfied with the care and services provided. This home has never had to make a referral under Adult Safeguarding. Management and staff were knowledgeable about what was abusive and were clear about their role in reporting or managing any concerns or allegations. People who live in the home trusted the staff group to protect them from harm and they said that they had never seen or heard anything untoward. They were fully aware Care Homes for Older People Page 19 of 29 Evidence: of their right to have appropriate care and to live without fear or stress. Surveys also confirmed that nothing abusive was happening in the service. Staff are suitably trained and mentored so that they understand what is abusive and their practice is reflected upon so that people are kept safe and happy. Staff have also completed training that helps them to understand the rights of the individual under the law. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bradbury House is a safe, clean and comfortable home where people feel relaxed and free from worry. Evidence: Bradbury House was purpose built some eleven years ago and has suitable adaptations both inside and out for people with restricted mobility. It is situated in the centre of the village of Gosforth. The home looks out on to the fells. There is a large car park at the front and the village has a bus service. The home has its own transport. Accommodation for residents is on the ground and first floor with access by a passenger lift. Each person has a single bedroom that exceeds the minimum room size and bedrooms have shower, toilet and wash hand basin en suite. People are encouraged and supported to bring in their own furniture and bedrooms are all personalised. People are encouraged to lock their private rooms. On the first floor there is a small lounge that has been redecorated and refurbished and the manager is encouraging people to make use of this pleasant room that looks out towards Wasdale. There is also a small kitchen with fridge, kettle, toaster and microwave where people can make their own snacks and drinks. Care Homes for Older People Page 21 of 29 Evidence: On the ground floor there is a large sitting and dining room that leads out into a secluded and well tended garden. This room has been recently redecorated and refurbished. It is used for entertainments and activities and people used it throughout the day to meet together. A number of people regularly have morning coffee and afternoon tea here so that they can socialise. The home has two specially adapted bathrooms with rise and fall baths and plenty of toilets in communal areas. The home has hoists and other equipment and adaptations for people who find moving around difficult. The home was specifically designed so that corridors and doors are wide enough for wheelchairs and electric points are at a suitable height. There are thoughtful yet discreet adaptations around the home. All areas of the home were clean, warm, well decorated and furnished. There were no unpleasant odours anywhere and staff were careful about housekeeping tasks and the prevention of cross infection. Staff are trained in health and safety and the prevention of infection. Bed linens and personal laundry were clean, well pressed and fresh. We checked on the laundry and this was orderly and clean. Residents can use this themselves if this is their preference. People told us that they were very happy in their rooms and the shared areas. They were more than satisfied with the way their environment was kept clean and orderly. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team in this home is recruited, trained and developed so that they can deliver high standards of care to the residents. Evidence: We were given four weeks of rosters and from this and information in the AQAA we could see that there are always two members of staff on duty. At key times of the day there is a third person so that people do not have to wait for attention. The manager and deputy are normally not part of this care roster so their hours are spent ensuring things run smoothly.They do deliver care when necessary. The care team are supported by an administrator, handyman, catering and housekeeping staff. Staff and residents told us that they judged that the home runs well with these staffing levels. A high proportion of staff have National Vocation Qualifications in care at levels 2 and 3. Senior and management staff are trained to level 4 in care. Twelve out of thirteen care staff have these qualifications. New staff are registered for this award after they have completed their induction. We checked on recent recrutiments in the home. There is a low turnaround of staff in this service but there had been some changes and new staff had been taken on. These had been done correctly with suitable references received and checks done on background. Care Homes for Older People Page 23 of 29 Evidence: Every member of staff then completes an induction and all staff have core training in things like health and safety, adult protection, manual handling, fire safety and food hygiene. The manager keeps a good record of this so that she can see at a glance when people need updates. She also makes sure that she knows about staff training needs. We saw supervision records where individual needs are looked at. Staff told us they were trained in supporting specific needs. For example they have received training on understanding Parkinsons disease and helping people who have had strokes. We looked at the personal development files for the staff on duty and could see that people were given support and training so that they could develop to their full potential. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a well run home where people feel relaxed and happy because they need not worry about the way their home is managed. Evidence: The manager of this home has been in post for a number of years. She is suitably trained and experienced in care of older people and in managing staff. She is supported by her deputy who also has suitable qualifications and skills. Both of them attend training on updates to legislation and are currently finishing different management training courses that will give them further qualifications. The manager has the Registered Manager award at level 4. People in the home and relatives told us in surveys that they trusted and respected the management team. They are in turn supported by two senior staff from Abbeyfield. Every month the manager has supervision from the operations manager and another person completes a quality audit of the home. Care Homes for Older People Page 25 of 29 Evidence: There are good systems in place to ensure that there is regular monitoring of quality. As well as a monthly audit by the quality manager, the operations manager completes a monthly report on the progress of things in the home. This is also sent to us so we are kept fully informed. Residents told us that they are given opportunities to speak to both of these people and also have monthly residents meetings. They are asked their opinions during regular updates to their care plans. The manager also gives each person a yearly questionnaire that can be done anonymously. These surveys are also sent to relatives and professionals who visit the home. We saw evidence to show that systems in the home are monitored and regularly audited. The manager and senior managers from the company then analyse this and suggestions and improvements are then put into a yearly plan for the home that runs alongside the business planning for the whole organisation. The people who live in this home tell us that they manage their own money or are supported by relatives or solicitors. The manager told us they do not keep any money on behalf of residents. No one in the home is under any kind of legal safeguard and no one is deprived of their liberty. We looked at the files kept in relation to health and safety, maintenance and repair. These are also subject to regular quality audits. We found that this home has very smooth routine checks that keep people safe and well. Kitchen safety checks are in place and environmental health rated them as Very Good for food hygiene. The handyman keeps checks on water temperatures and water is tested regularly for legionella. Individual bedrooms are redecorated when they are vacated and carpets cleaned or replaced. Fire safety is good with regular checks on the system, all staff have fire training and there are regular drills and instruction. Staff were confident that they could manage a fire situation. The fire risk assessment and individual resident assessments were up to date. There is a good system in place to identify peoples needs if the staff had to evacuate the home. Over all this is a very well managed home where all aspects of care, staffing and environment operate within the systems of the provider company. Everything is double checked and residents are consulted about all aspects of their lives so that the management and operation of the home is geared to their wellbeing. It is also a very happy place where older people are free to be themselves and are not stereotyped. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!