Care Home: Bradbury House, Brislington

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What the care home does well The home has clear procedures when first admitting people to the home. Peoples` needs are assessed helping to decide if these can be met. People with complex needs are supported well by staff and people benefit from individual structured programmes. These provide them with varied opportunities in accessing local community and other meaningful activities. Peoples healthcare and general well being is monitored well; there are good working relationships with other healthcare professionals who help staff with support and advice. People are supported well in keeping in touch with their family. One family member spoken with said they were very happy with the support and care given to their relative. Another comment from a relative said that they wanted to thank staff for looking after their relative `in keeping them well and happy.`People benefit from a staff team that is well trained and competent. Staff spoken with and surveys received showed that staff feel training is relevant to their role and helps them support peoples needs. Policies and procedures in safeguarding vulnerable people and recruitment have been reviewed and improved to ensure people using the service are protected. This shows that the home has learnt from experiences and issues that arise and responds positively in making improvements. What has improved since the last inspection? The Statement of Purpose has been updated providing information about the range of people a service can be provided to. Care plans provide details of how peoples needs are met. Staff are following instruction through care plans in supporting people with specialist equipment. Medication is recorded when given to people to help keep them safe. CARE HOME ADULTS 18-65 Bradbury House 14 Fairway Brislington Bristol BS4 5DF Lead Inspector Sarah Webb Key Unannounced Inspection 30 May & 9th June 2008 11:00 th Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bradbury House Address 14 Fairway Brislington Bristol BS4 5DF 0117 9716716 0117 9853092 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) Mr Neil Bradbury Debra Jane Vowles Care Home 15 Category(ies) of Learning disability (15), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Can accommodate up to 15 persons aged 18 - 65 years with learning disabilities May accommodate up to 3 persons with Learning Disabilities and Mental Health needs. 12th June 2007 Date of last inspection Brief Description of the Service: Bradbury House and West Town Park are registered with the Commission for Social Care Inspection to provide accommodation and personal care for up to fifteen persons with a learning disability, as their primary need. Their ages are from 18 to 65 years. There is currently one person who is over this age. The home offers a service to both people with autistic tendencies who may exhibit challenging behaviour, and those who may have additional mental health needs. Bradbury House is a listed building which is set back from the road in a quiet residential area. Within the grounds is a detached day care facility (the workshop), which is primarily accessed by the service users from Bradbury House. West Town Park is a four-bedded property. It is situated on the same site but is completely detached from Bradbury House. The current fees are charged from £860 -£1260 Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of a Key inspection of this service. Information was gathered during the visit through discussion with the Registered Manager, senior staff, care staff and two people using the service. Interaction between staff and individuals was generally observed during the visit. Care plans and risk assessments were assessed, as was medication, incident records, finances and recruitment procedures. A tour of both Bradbury House and West Town Park was provided by the manager. Surveys were received from six people using the service; these were completed with the support of staff as some people are unable to express their views fully Surveys were also received from three relatives, four health professionals, and four staff. Two relatives who were visiting also gave us their views. Positive comments were made about the level of care and support offered and some comments have been included in this report. What the service does well: The home has clear procedures when first admitting people to the home. Peoples’ needs are assessed helping to decide if these can be met. People with complex needs are supported well by staff and people benefit from individual structured programmes. These provide them with varied opportunities in accessing local community and other meaningful activities. Peoples healthcare and general well being is monitored well; there are good working relationships with other healthcare professionals who help staff with support and advice. People are supported well in keeping in touch with their family. One family member spoken with said they were very happy with the support and care given to their relative. Another comment from a relative said that they wanted to thank staff for looking after their relative ‘in keeping them well and happy.’ Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 6 People benefit from a staff team that is well trained and competent. Staff spoken with and surveys received showed that staff feel training is relevant to their role and helps them support peoples needs. Policies and procedures in safeguarding vulnerable people and recruitment have been reviewed and improved to ensure people using the service are protected. This shows that the home has learnt from experiences and issues that arise and responds positively in making improvements. What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. People wishing to use the service are given suitable information to help make a decision if the home is the right place for them. Peoples’ needs are assessed to help ensure they can be met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose has been updated providing details of services provided. The home has clear admission procedures. There have been no new people admitted to the home since the last inspection. The last person came to live at the home two years ago; assessment information and records of visits before they were admitted were seen at the last inspection. These held comprehensive information. Prospective people who wish to use the service are given a Service User Guide in a symbolised format and have the opportunity to make several visits before deciding if this is the right choice for them. This was confirmed through surveys received from people. They said they had been asked if they wanted to move into the home. They also said they had been given enough Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 9 information about the home before moving in so they could decide if it was the right place for them. Care plans showed that peoples’ care had been reviewed regularly. Three surveys received from relatives all said they ‘usually’ get enough information about the home to help make decisions. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is good. Care plans provide good information in how to support people individually. Some people would benefit from a more accessible, easy read style of care plan. Care plans are reviewed regularly. People are consulted with and helped to make decisions about their lifestyle. Risk assessments support people to take risks as part of their lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three peoples care files were looked at. These included an assessment of their needs, a personal profile, care plan and risk assessments. Care plans showed individuals identified needs and how they wanted to be supported. There was good information helping staff to support them in a consistent way. Staff confirmed that they were given clear information about peoples needs before working with them. Care plans had been reviewed six monthly and aims are set during reviews. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 11 Keyworkers also complete both weekly and monthly reports showing the different activities people have been involved with and how they have progressed. Care plans are in a written format and discussion was had with the manager about involving people in their care planning through using pictures and individual communication strategies. The Manager said there were some people who may benefit from this approach but felt that for others it was difficult to involve them in a meaningful way. People are supported in making decisions about their lifestyle; we saw some people deciding what they wanted to do during the day and records showed how staff involved people in making individual choices. The home has a risk assessment policy and we saw detailed risk assessments showing how people are helped to take risks in a safe way. However a restriction for an individual is currently not in use and the risk assessment and care plan must be revised to reflect this change. The manager has attended risk assessment training and has involved staff in developing their knowlwdge of working with risk assessments. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, & 17 Quality in this outcome area is good. People benefit from an individual lifestyle taking part in individual social, leisure and educational opportunities. People are supported in keeping in contact with their families. Peoples rights are respected. The home offers a varied choice and well-balanced and healthy menu. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A person centred approach is taken in offering people an individual structured and varied programme. A workshop on site offers a choice of planned activities and courses to suit people’s needs. Records showed that people are helped to develop life skills and benefit from other meaningful activities. Some of these included communication skills and making choices, massage and relaxation; staff keep a record of the outcome of these sessions. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 13 The organisation also offers people placements at Bendalls farm in the Mendip Hills. This site helps people to gain experience in areas of horticulture, together with other daily programmes. The home does not employ agency staff and staff said that there were occasions when activities were cancelled due to unplanned cover of shifts or when people are supported on holidays away from the home. However they also said that people are offered opportunities to go out on trips on a regular basis. People are supported to use community-based facilities. Records showed activities included shopping, visits to pubs, meals out and trips to local venues such as garden centres. Holidays are arranged with peoples individual preferences and needs taken into consideration. Holidays have been booked for this year at Centre Parcs and Butlins. This was confirmed by an individual who said they were looking forward to going on holiday with staff. All five surveys received from people using the service said they can do what they want to during the day, in the evening and at the weekend. One person commented that they would like to go out more. A comment made by a relative said ‘ The daily programmes are usually very good with varied things for people to do.’ People are supported to keep in contact with their families and this was confirmed through relatives’ surveys. Some people regularly visit their families and visitors are welcomed to the home. This was confirmed by two family members who were visiting; both said they were very satisfied with the support their relative received. It is evident that peoples’ privacy is respected; whilst touring the home, the manager knocked on individuals’ doors before entering their bedroom. Risk assessments were seen for people as to whether it was in their own interests and safe for them to keep their own bedroom keys. We spoke with the cook, who has worked at Bradbury House for many years. She had a good knowledge of peoples’ individual preferences, and alternatives are provided for people if the two main choices are not wanted. It was evident through observation of the menu, and discussion with the cook that meals are freshly prepared, nutritious, varied, and offer a balanced diet. The home uses organic meat and vegetables produced at Bendall’s Farm; there are also local arrangements for food to be supplied to the home. People are supported with using specialist equipment to help them in being independent when eating. This was seen while sharing a midday meal with people. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20 Quality in this outcome area is good. Peoples’ healthcare, personal preferences and needs are met and monitored well. People would benefit from a review of current manual handling practices. Peoples right to privacy is respected. People are supported safely with robust medication practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Healthcare records showed that individuals’ physical and mental healthcare needs are being met through regular reviews of medication and support from appropriate professionals. Individuals’ personal support needs are recorded in detail in care plans. Manual handling needs are kept under review through risk assessments. However it was evident that some peoples physical support needs had changed. This indicated that staff may now need manual handling training so that they are trained in supporting people safely with their physical needs. This was discussed with the manager who must review current practice used by staff when offering support with any moving and handling needs. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 15 Monthly keyworker reports monitor peoples’ health and well being and showed visits to local GP, dentist, optician and chiropodist. From discussion with staff, and observation of their interaction with people, it was evident that people are treated respectfully and listened to. Staff have good working relationships with the local Community Learning Disability Team (CLDT) and know when to make referrals to specialist services so that people can be supported in meeting their needs. Positive comments were received from healthcare professionals about the support and care offered to people. The home uses the Boots Monitored Dosage System for the medicine administration. Systems in place were well managed with medication checked in when delivered by the pharmacy, and signed for after administering individuals’ medicines. Individual photographs help to ensure the correct medication is given to people. There are processes in place for when people stay away from the home and take their medication with them. New staff are shown how to give out medication and will only administer medication to people when senior staff are confident they are competent. Some staff have attended local pharmacy training in the past. The manager said she intends to follow up this training for staff. Medication is kept securely in a locked cabinet within the main office. A separate lockable unit is in place for controlled drugs if needed. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. People benefit from a clear complaints policy and procedure. People who may present challenging behaviour are protected through clear reactive strategies and risk assessments. The staff team are provided with training and support to help keep people safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed formal complaints policy and procedure in place. The home also has a whistle blowing policy to help staff to raise any concerns they may have. There have been no complaints recorded since the last inspection. People using the service responded through surveys saying they knew who to speak to if they are not happy; that they would speak to their keyworker or their family. Several people are unable to communicate their views verbally. Staff spoken with had a good understanding and knowledge of how individuals expressed themselves and when they may be distressed. Two of the three surveys received from relatives confirmed they knew how to make a complaint; one said they did not know. There are policies and procedures in place relating to the safeguarding of vulnerable adults. Training records showed that staff have both attended and Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 17 are booked to attend training in abuse; this is part of ‘core’ training that is followed up annually by the organisation. Staff spoken with showed they would respond appropriately to an incident of abuse. Since the last inspection the home has followed appropriate procedures in making a safeguarding referral for an individual. Since this referral the homes policies and procedures in safeguarding vulnerable people and recruitment have been reviewed and improved to help ensure people using the service are protected. This shows that the home has learnt from experiences and issues that arise and responds positively in making improvements. The home has clear guidelines in place for supporting people who are distressed or presenting behaviours which may be seen as challenging the service provided. Each care plan showed details of behaviours that may be displayed by people. Individual trigger points and the appropriate defusing techniques give guidance to staff when supporting people. All staff are trained in Non Abusive Psychological and Physical Intervention (NAPPI) before they support people. People are monitored for signs of injury if physical intervention has taken place. A record is kept of each incident of challenging behaviour of which we are sent copies every month. A recommendation made at the last inspection to review the recording of each incident of challenging behaviour/physical intervention has been met. The manager has recently started a database that now records each incident of challenging behaviour that results in physical intervention. She is aware that analysing patterns of behaviour and common factors may be beneficial for people with good outcomes. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 & 30 Quality in this outcome area is good. People live in a homely, clean, and safe environment. People benefit from bedrooms that suit their needs and lifestyle. Shared space is safe and appropriate to peoples needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bradbury House is a two storey, semi detached, listed, 17th century property. It is set back from the main road and is in keeping with the local community. A separate property, in West Town Park, for 3 people with a learning disability, can be accessed from the rear of Bradbury House. There is also a day facility (workshop) and a training suite, which is detached from Bradbury House. Both Bradbury House and West Town Park come under the registration of Bradbury House. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 19 We saw communal areas of Bradbury House and West Town Park; all communal areas of both the homes were clean. The communal areas of Bradbury House have adequate furnishing, but there is minimal additional furnishing such as pictures/ornaments due to peoples needs. However the carpeting on the stairs was worn and is in need of replacing. Since the last inspection the lounge at West Town Park has been decorated and refurbished. Two people living at the home said they were pleased with the new sofas and pictures. At both homes people can access the lounge, and part of the rear garden area independently. People are supported to access the dining area at Bradbury House at meal times, and a garden area on a higher level. People were seen relaxing in this area during the visit. The main office is restricted and again people would need to be supported if accessing this area. Peoples bedrooms seen had been personalised with their interests and individual belongings. Not all people have access to wash hand basins in their bedrooms; two peoples taps have been removed due to the risks of drinking water in excess and flooding. There was written information and risk assessments supporting the decision process. The home employs a domestic, who cleans the communal areas of the home. They are employed on a part time basis and were seen working in the home during this visit. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, & 36 Quality in this outcome area is good. People are supported by an effective staff team; they have a good knowledge of peoples support needs and have a clear understanding of their role and responsibilities. The training programmes ensure that all staff are provided with the guidance and skills to provide support to people. Robust recruitment practice helps to promote peoples safety. Staff are well supported and supervised on a regular basis This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff are given job descriptions that set out their duties and responsibilities. Staff spoken with described their role and responsibilities and gave examples of how they supported people. People are supported by an effective team who are experienced and have knowledge to meet peoples needs. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 21 There are 4 care staff on duty from 9.00am to 9.00pm. Additional management staff are also on duty during the day. There are two staff who cover a ‘waking’ night duty while one staff covers a sleeping in duty Returned staff surveys said there are ‘usually’ and ‘sometimes’ enough staff on duty to meet peoples’ needs. Comments included ‘The only time we would struggle would be due to staff sickness’ and ‘People would benefit from using bank staff.’ Some staff work long shifts and to work a 24 hour shift is voluntary; this will include an afternoon duty, a night duty and then a morning duty. To work a 24 hour shift is voluntary and this will include an afternoon duty, a night duty and then a morning duty. Since the last inspection a risk assessment is now in place for staff covering a 24 hour shift. Staff covering a morning duty after a waking night, do not drive vehicles, administer medication or support people who may present challenging behaviour. Staff confirmed they are given an induction that included everything they needed to know to do the job when they started. This was also seen in staff files. Staff confirmed they are given training that is relevant to their role, and helps them understand and meet the individuals’ needs. Training records showed dates of when staff had attended specific training and when updates were needed. Areas of training included fire, first aid, food hygiene, autism, mental health, and epilepsy. The files of four staff who had been recently recruited were seen. These showed staff had undergone a thorough recruitment process. Since the last inspection the homes policy and procedures for the selection and recruitment of staff has been reviewed and amended providing more clarity when employing staff. All had two written references, application, interview questions and notes. All but one had a Criminal Record Bureau Check (CRB) and these were signed of. However there was an initial Protection of Vulnerable Adult (POVA First) check for this staff member and risk assessment to show that they would be ‘shadowing’ staff and would not be supporting people with their personal care until their CRB was received by the home. Staff confirmed appropriate checks were carried out before they started work. The manager said peoples past convictions are discussed at interview and recorded in the interview notes. A decision is made with the Area Manager whether to employ staff who have previous convictions taking into consideration the nature of the offence and timescale. The homes selection and recruitment policy state that a risk assessment ‘may be required depending on the type of conviction(s).’ Interview notes were not seen at this visit. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 22 Staff confirmed they meet with their supervisor on a regular basis, that they are well supported and the team work well together. Written supervision notes were seen in staffing files and contained sufficient information to support staff. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, & 42 Quality in this outcome area is good. People using the service and staff benefit from a well run home with good outcomes for people. The home has efficient arrangements in place for the monitoring and review of the service. Record keeping helps to ensure peoples rights and best interests are safeguarded. Peoples health, safety and welfare is promoted and protected. This judgement has been made using available evidence including a visit to this service. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager, Ms Vowles, has previous managerial experience within the organisation. She is in the process of completing National Vocational Qualification level 4. Staff said the management team are approachable and always on hand when needing support. The home has arrangements to measure the quality of the service. Questionnaires are sent out annually to people using the service, staff, and families. Staff have good relationships with families and other professionals who have an interest in peoples welfare; that they can be confident that their views are listened to. The home has good recording systems with written guidelines that help promote staff to record information appropriately. Records kept in the office are held securely promoting peoples confidentiality. Records examined were well maintained, up to date and in order. Senior staff are trained in areas of health and safety, and have responsibilities for the monitoring of specific areas. The home has had a recent visit from the Fire service and have been advised in areas of fire safety. A fire risk assessment was not seen; the manager said this is in the processs of being completed. A requirement is made for this to be completed with a copy sent to us. The home keeps a record of accidents and incidents and keeps the Commission informed. Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 25 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 x 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 3 2 x Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13(4)(c) 15(b) Timescale for action Review both risk assessment and 30/07/08 care plan for an individual to reflect a change in restriction in place. Replace carpeting on the stairs of Bradbury House. Complete fire risk assessment and send copy to us. 31/10/08 31/08/09 Requirement 2. 3. YA24 YA42 23(2)(b) 23(4) 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 YA17 YA6 Good Practice Recommendations Review current moving and handling practice when offering support to people. Continue to review communication strategies/accessible formats in order that service users are involved in their care planning in a meaningful way Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Bradbury House DS0000026526.V363422.R01.S.doc Version 5.2 Page 28 - 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. 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