Care Home: Bradeney House Care Home

What the care home does well This home has an admissions procedure that is designed to ensure that an individual`s needs can be met. The staff in the home identify the needs and preferences of all of the people who live there and have developed a systematic process for meeting health needs and checking how successfully they had achieved their aims. The home provides and continues to develop an environment that is pleasant for people to be. The people who live in this home tell us that they find the staff to be friendly and caring and we saw how they are properly screened before being allowed to start work and receive training when they do. One lady said that the staff are " every inch is a diamond". The manager and the rest of the management team provide positive guidance to the staff team on how to meet the needs of the people living in the home. What has improved since the last inspection? No requirements and recommendations had been made as a result of the last inspection but it was clear that improvements had been made to the way care plans are developed. The building itself is also undergoing major renovation works that already have made improvements to the facilities that are available to people who live there. What the care home could do better: No requirements or recommendations were made as a result of this inspection. However, it would be easier for the management of the home as well as others who may be interested in how well the home meets people`s needs if they were to record in more detail what activities had taken place and who had taken part in them. Key inspection report Care homes for older people Name: Address: Bradeney House Care Home Worfield Bridgnorth Shropshire WV15 5NT     The quality rating for this care home is:   two star good 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: Michael Moloney     Date: 0 3 1 2 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 25 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 25 Information about the care home Name of care home: Address: Bradeney House Care Home Worfield Bridgnorth Shropshire WV15 5NT 01746716686 01746716686 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: None Holy Cross Care Homes Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 50. The registered person may provide the following category of service only: Care Home with Nursing (Code N) 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 (OP) 50 Dementia (DE) 10 Date of last inspection Brief description of the care home Located in a rural setting on the outskirts of the village of Worfield, approximately six miles west of Bridgnorth, Bradeney House is a spacious, detached residence, which has been extended through the incorporation of an adjacent bungalow. The home benefits from having generous, attractive grounds, and there is car-parking provision to the front of the property. There are two wings - Residential and Nursing which between them offer a range of accommodation including single bedrooms (some en-suite), and shared (double) Care Homes for Older People Page 4 of 25 2 0 0 5 2 0 0 9 0 0 Over 65 10 50 Brief description of the care home bedrooms. The range of fees, although not available in published information for prospective Residents, is provided by letter when the Home confirms it is able to provide care to meet that persons assessed needs. Care Homes for Older People Page 5 of 25 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: two star good 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: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete and notifications that have been received by the Care Quality Commission from the home about incidents, bereavements and other incidents that affect the welfare of the people who live in the home. We sent surveys to people who live in this home as well as a number of the staff. Some of these were returned to us enabling us to find out more about what people thought of the service provided by this home. The visit was unannounced with the purpose of carrying out a Key Inspection which is where the homes performance is measured against a set of standards identified by the Department of Health. A visit to this home focusing on specific issues took place earlier this year. A separate report is available which contains details of our findings at that Care Homes for Older People Page 6 of 25 time. Judgements made in this report take into account observations made during that visit. This inspection was undertaken by one inspector, Mike Moloney and lasted six hours. On this occasion we did not involve an Expert by Experience which is someone who has experienced the care provided by this type of service and is asked by the Care Quality Commission to assist and give their views during an inspection.. During that time we Case Tracked a number of the people who live in this home. This means that we talked to them and/or their relatives, where this was practical, to find out their views of the care that was being provided to them. This also enabled us to see if the records that identified peoples needs such as the care plans that are provided for the staff to follow were accurate and covered each individuals personal issues. We also talked to members of the staff team and the manager to check that they were aware of the identified needs of the people who live in this home were and whether or not they had the approach and training required to meet them. The standards set out by the Department of Health are in seven different groups. Each group can be judged as being either poor, adequate, good or excellent. The inspectors reach their judgement by following the guidelines laid down in the document known as the Key Lines Of Regulatory Assessment (KLORA) which is available on the Care Quality Commission web-site: www.cqc.org.uk Care Homes for Older People Page 7 of 25 What the care home does well: 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. 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 8 of 25 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 9 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking to live in the home and their representatives have the information needed to choose a home which will meet their needs The home assesses people who are considering living there before they move in there so that they can be sure that they can meet their needs. Evidence: We looked at the records of one of the people who had been admitted into the home in the last few months. We saw that the manager had carried out her own assessment about whether or not the home could meet that persons needs. The assessment that she carried out looked at how well each person could care for their own personal hygiene, use the toilet, dress themselves, move around and talk as well as how aware they were of where they were. We saw further records that showed that shortly after admission this information had Care Homes for Older People Page 10 of 25 Evidence: been developed to give guidance to the staff about how people should be helped if they needed to move around, what care should be taken if they had fragile skin or were unable to move position for themselves, what foods they liked, needed or should be encouraged to eat and whether or not they should use bedrails. Care Homes for Older People Page 11 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of four of the people who live in this home and, where possible, talked to them about the care that they receive. We also spoke to a number of other people and their relatives who were able to give their views about the home. We saw that the records that were kept described the needs of each person when they wanted to move around. Comments on those records had been signed and dated indicating that the need for this level of assistance had been reviewed monthly. We also saw assessments about people and their eating. These included comments about peoples appetites, their ability to chew and swallow as well as their ability to use utensils and cups. We talked to a lady whose assessment said that she had difficulty chewing and swallowing as well as having a reduced appetite. She was being Care Homes for Older People Page 12 of 25 Evidence: helped by a member of staff in a discrete manner. We saw that people with such problems could have their food liquidised to help them and when this was necessary it was noted in their records. We talked to some of the staff preparing and service the meals and they were fully aware of these instructions. We saw written assessments of each persons skin care needs. We saw that these were also reviewed regularly. We saw that the records included information about such things as continence, peoples ability to maintain their own personal hygiene and individuals weights. Other records included information about visits by healthcare professionals, why these visits had taken place and what action was necessary as a result. We saw that the storage of medication was appropriate and secure and records were being kept appropriately so that it could be seen that the right person was being given the right medication at the right time. The proprietor and the manager explained how they would prefer to use a monitored dosage system rather than keep the medication in its original packs as it would be easier to check their stock levels and identify errors quicker but they were currently unable to create one system that could be used for all of the people living in the home as they curently receive the medication from a number of suppliers. Care Homes for Older People Page 13 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: We talked with the Activities Organiser about the activities she organises such as quoits, ball games and crafts. One lady showed us the table decorations that had recently been made and she also told us that she could join in with the activities or not, as she wished. The Acivity Organiser told us that another activity that she did was the Shopping Trolley which is where she would take a trolley round to those who stay in their rooms and they could buy such things as sweets from it. The majority of people we spoke with enjoy taking part in the range of activities on offer. One of the people that we spoke to told us how she enjoyed watching the building work being carried out. One of the people who live in the home told us about a Christmas shopping trip that some people had been on the previous day. They had been taken by bus to Telford. Care Homes for Older People Page 14 of 25 Evidence: We saw few records that told us who had been involved in the various activities and when and these would have given a clearer picture of how well the home was meeting peoples needs in this area. Visitors to the home told us that they are always made very welcome. People told us that they like the meals at Bradeney and are able to choose what they eat. We talked to a number of the people who live in the home about the food that they are offered. They were all complimentary about it. We saw that a number of people were offered assistance of varying levels by the staff and that food had been prepared that made it easier to eat for those with problems either chewing or swallowing. The manager told us that special meals could be prepared for people who need them for either medical or cultural reasons. The mealtime that we saw was relaxed and unhurried. Care Homes for Older People Page 15 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: We looked at the homes complaints policy and this was seen to contain information on how and with whom issues of concern could be raised. We spoke to a number of the people who live in this home and their relatives who all said that they knew how to raise any issue and that they were confident that they would be dealt with. No referrals had been made into the local procedures that deal with allegations of abuse of vulnerable people. We looked at the training records and saw that staff had received training in the identification of abuse and the procedures that they must follow if they see such an instance. We also spoke to a number of the staff who confirmed that those records were accurate. Care Homes for Older People Page 16 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although there is a lot of improvement work being undertaken currently the physical design and layout of the home gives anyone living there a safe, well-maintained and comfortable environment. Evidence: We saw that building work was under way at the time of this visit. Part of this was to create a second conservatory area, similar to the one in the residential area, for the part of the home where people who need nursing care stay. This will mean that both areas will have their own dining room and lounge areas. We saw that the older part of the home had been refurbished with a number of the bedrooms being equipped with en-suite facilities as well as being redecorated. The proprietors explained that further bedrooms were to be added and these would be added in a prefabricated pod form and at the time of the inspection the access for these was being prepared in the grounds. We also saw that, where possible, measures had been taken to stop the building work intruding into the working of the home. We spoke with one lady who made it clear that the disruption was acceptable to her and that she found the activity interesting to Care Homes for Older People Page 17 of 25 Evidence: watch. Generally the home was seen to be clean, tidy and free of any unpleasant odours. We saw the laundry facilities contained the equipment that would keep peoples clothes and bedding clean and hygienic. The proprietor explained that the laundry was to be relocated to a more accessible part of the building as part of the redevelopment of the home. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who live in there. Evidence: We looked at the employment records of three of the staff and saw that background checks had been carried out before those people had access to people living in this home as part of the procedure that ensures that they are fit do so. The records for each stage in the recruitment process were seen to be clear and easily accessed by those people who need to look at them. Looking at the staff rota as well as talking with the people living in the home, their relatives, the manager and staff showed that there were enough staff on duty to make sure that the care needs of the people living there are met. During the inspection a lot of conversations between people who live in the home and staff were seen and heard. The staff were always professional, clear and polite when they spoke. When we spoke to those living in the home as well as their relatives they were very complimentary about the staff saying such things as, These girls have been magnificent and they treat them with respect and dignity. We talked with a number of the staff who confirmed that they have received or were Care Homes for Older People Page 19 of 25 Evidence: about to go on the training that would ensure that they are able to meet the needs of the people living at the home. This included such things as manual handling training to make sure that when they are helping people to move that they do so in a safe manner and basic first aid so that they can provide support to people who are ill or hurt until more skilled assistance arrives. Infection control training was also in place. The kitchen staff and the care staff who serve out the food confirmed that they had undertaken food hygiene training meals so that they would know how to do so safely. The manager and the proprietor explained the system that the home uses to identify what training each member of staff has had or needs. They showed this to be a systematic process that would put the staffs skills in place so that they could meet the needs of the people who live in this home. Talking with staff and looking at the training records showed that the training included National Vocational Training to level 2 in care to help more experienced staff to develop their skills and knowledge and Common Induction Training which gives an immediate and basic training for those who are new to this type of work. Care Homes for Older People Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she confirmed that she was a registered nurse and had also completed the Registered Managers Award which is a qualification that is considered to be appropriate for someone who runs an organisation such as this. She also confirmed that she is in the process of applying to be registered with the Care Quality Commission as manager. At the start of the visit the proprietors visited the home. They told us that they carry out a monthly quality assurance inspection and we saw the record of these and from those records we saw that these visits take place on a regular basis. The manager told of how the home had been involved in the local procedures that are designed to protect the human rights of people who lack the capacity to do so for Care Homes for Older People Page 21 of 25 Evidence: themselves. She told us that, at the time of the visit, nobody living in the home needed to be deprived of any of their liberty under the Mental Capacity Act 2005. We asked for and were shown the records of the regular testing of such things as hot water temperatures, fridge/freezer and fire alarm systems. We saw that these records were clearly and regularly maintained showing that the safety of the people who live in this home is monitored on a regular basis. We looked for records of staff safety training. We saw that records contained comprehensive records of what training staff had received. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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. 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