Care Home: Bradstowe Lodge

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Key inspection report Care homes for older people Name: Address: Bradstowe Lodge Bradstowe Lodge 22 Victoria Parade Broadstairs Kent CT10 1QL     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: Kim Rogers     Date: 2 2 0 6 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 24 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 24 Information about the care home Name of care home: Address: Bradstowe Lodge Bradstowe Lodge 22 Victoria Parade Broadstairs Kent CT10 1QL 01843861962 01843604672 bradstowelodge@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kent Old People`s Housing Society Limited care home 21 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 to be accommodated is 21 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Bradstowe Lodge is a large older style property, which has twenty-one single bedrooms. Every room has a call bell and TV point. There is a small shaft lift in the home. It is located on Broadstairs seafront, within walking distance of the centre of town and therefore close to all amenities. There is a small paved patio area to the rear of the premises, together with a paved area to the front of the premises. Both areas are maintained for the use of residents. Care Homes for Older People Page 4 of 24 Over 65 21 0 Brief description of the care home On the road parking is limited to one hour around the vicinity of the home. Fees for this home range from about 328.00 to 410.00 pounds per week. A copy of the last inspection report is kept by the front door and there is a website at www.bradstowelodge.org.uk which provides information about the home and encourages people to contact them directly for more information. Care Homes for Older People Page 5 of 24 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: This was a key inspection of the service which included an unannounced site visit by one inspector carried out over about four hours. That means that we assessed all of the Key Minimum Standards. The last key inspection of this home was 19/09/07. We carried out an Annual Service Review on 23/08/08. Copies of these reports are available from the Provider or can be viewed on our website. We talked to service users, to staff, the Head of Care and the provider. We made observations, had a look around and sampled records. We sent surveys to people to see what they think about Bradstowe Lodge. We received 5 surveys from service users, 2 from relatives and 5 from staff. Care Homes for Older People Page 6 of 24 Service users said things like, Very good care, The food is very nice, I find the staff very friendly, They look after me well, I like it here, Staff said I enjoy working at Bradstowe Lodge, I enjoy working with my team members, It is very homely Relatives said The rooms are very clean, Staff are gentle and caring, Staff are kind and considerate, The food is well prepared and presented, The exterior of the building needs painting, Concerns have been raised about the home to us since the last inspection. The Provider has looked into these concerns. We looked into aspects of these concerns during this inspection. We found that the home acted as they should have done. Care Homes for Older People Page 7 of 24 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 24 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 24 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. There is information about the home so people know what the home offers. Assessments are carried out before a person moves in to make sure the home is right for the person. Evidence: We found that there is written information about the home that is given to prospective residents. This means that they have information about what the home has to offer. The provider says that trial stays and visits are welcomed so people can get a feel for what it is like to live at Bradstowe Lodge. Assessments of peoples needs are carried out before they move in. Service users and their relatives are involved in this assessment process so the home gets as much information about people as possible. This means that they can then decide if they can meet the persons needs or not. We saw detailed assessments in some service user plans we sampled. Care Homes for Older People Page 10 of 24 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. People know that their needs including personal care and health needs will be recorded and supported. Medication practice is safe protecting service users. Evidence: We found that each person has a care plan that is developed from the initial assessment. People and their relatives are involved in putting the plans together. The care plans show a persons needs and what staff should do to meet that need. This includes peoples health, personal care and social needs. Plans are clearly written and we found them easy to follow and up to date. We found that plans are regularly reviewed so that changes in needs are picked up early and acted on. We found that staff work closely with health care professionals and make referrals for support and advice when needed. A district nurse was at the home on the day of the visit. This means that people get the support they need to remain healthy and well. We found that areas of potential risk are identified and assessed. Action is recorded that staff must take to reduce risks to people. We found risk assessments are clearly Care Homes for Older People Page 11 of 24 Evidence: written and easy to follow and regularly reviewed. This means that any new risk can be identified at an early stage. We observed the head of care administering medication and we sampled medication records. Records of administration are in order showing the receipt and administration of medication in the home. We found that administration of medication to service users and the storage of medication is safe. We found that staff currently control medication as no one chooses to self medicate. The head of care said if people wanted to self medicate staff would support this and ensure that safeguards are in place. Staff have training before they administer medication to service users. We found that staff speak to people with respect. We saw staff knocking on peoples doors before entering. We saw staff offering discreet support to people when it was needed. To ensure peoples privacy and dignity is safeguarded, the Head of Care agreed to use service users initials rather than full names in the bath record book kept in a communal bathroom. Five service users returned a survey to us. Everyone said in the surveys that they have the support they need and the medical, health support they need. There is a call bell system so people can summon assistance when they need it. Care Homes for Older People Page 12 of 24 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 have the opportunity to take part in some activities. People have support to keep in touch with family and friends and to access the community. The food is wholesome and nutritious. Evidence: We found that there are some organised activities on offer. This includes music, exercise and entertainment sessions. Information about the months organised in house events are displayed on a notice board. On the day of the visit there was an entertainer in the home singing. People were joining in and seemed to enjoy it. Staff said they try to offer walks out to the bandstand and sea front daily. We saw people reading newspapers and doing puzzles. Some people said they like to watch television in their rooms. We had five surveys back from service users. Three said there is always enough to do and two said there is sometimes enough to do. We found that visitors are welcome at the home and people have support to keep in touch with their family and friends. Two relatives sent us surveys saying they feel the home meets their relatives needs and that the home keeps them informed. Care Homes for Older People Page 13 of 24 Evidence: We found that people can make choices about meals as an alterative is always offered. The menu is displayed in the dining room so people can see what the choices are. There is a full time cook and kitchen assistant. Fresh fruit is available on tables and people are offered regular drinks. Five service users returned surveys to us and all said that the food is always good. One person said that the food is very nice. Another person said the food is well prepared and presented. We observed the hot lunch being served. We found that the tables are laid with cloths, condiments and flowers so the dining room is a pleasant place to eat. The meal was served to people hot and people were asked if they would like a napkin. We found that people are given the time they need to eat and can choose to eat in their rooms if they want to. We found that people have the opportunity to make choices about things like how to spend their day, what time to get and go to bed, what to wear and what to eat. Care Homes for Older People Page 14 of 24 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. People know their complaints will be listened to and acted on. People are protected from harm and abuse. Evidence: We found that there is a complaints procedure. This is displayed in the home. The Provider said he will make sure that this contains the new details of the Care Quality Commission for reference. The home have had one complaint since the last inspection. A copy of this complaint was sent to us and we made a safeguarding alert to ensure that people are safe. This means that the safeguarding coordinator from social services carries out an investigation. The home cooperated with this investigation which found that the home acted as it should have and that service users remain safe. For more information please contact the Provider. People have the opportunity to raise any issues at residents meetings and at review meetings. In five surveys we received back from service users four said they know how to make a complaint. We found that they have policies and procedures in place showing how to safeguard people from harm and abuse. Staff have training in how to recognise and respond to abuse. Staff could tell us some types of abuse and what they would do if they Care Homes for Older People Page 15 of 24 Evidence: suspected abuse. We found that staff have reported concerns about possible abuse in the past. This protects service users. Care Homes for Older People Page 16 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean. The planned refurbishments will ensure that the environment suits peoples needs. Evidence: We had a look around the home and found it is clean and smells fresh. All of the five surveys returned to us by service users said the home is always clean and always smells fresh. A relative said that the rooms are always clean as are the communal areas. All bedrooms are single and have a wash hand basin. People we spoke to said they are happy with their bedrooms. We found that some improvements are needed to the environment to ensure that the home meets peoples needs. For example the shaft lift is small, there is some awkward stairs and parts of the home need redecorating. One person said they felt the outside of the home looks shabby and needs painting. The Provider fully agrees with this and has plans to refurbish the building to ensure it is suitable for peoples needs. For more information please contact the Provider. Care Homes for Older People Page 17 of 24 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. There are enough trained staff to meet peoples needs. Recruitment checks are robust protecting service users. Evidence: We found that there are two to three care staff on duty with a senior staff or the head of care during the day and two waking staff on duty at night. There is a cook and kitchen assistant, laundry assistant, domestic staff and administrator employed. The head of care is on call for advice and support. We found that there is enough staff to meet peoples needs. We received five surveys back from service users and all of them said there are always enough staff available to meet their needs. Four out of five said staff always listen and one said staff sometimes listen. One service user said I find the staff very friendly. A relative said that the staff are kind and considerate. We received five surveys back from staff. All said that they feel there are enough staff and that they have the training and support they need. Most of the staff are long standing so know service users well. We found that the provider organises training for staff and ensures that all mandatory training including food safety, first aid and fire awareness is up to date. Nearly 90 of staff have a National Vocational Qualification in care. Staff also attend training related Care Homes for Older People Page 18 of 24 Evidence: to peoples needs like supporting diabetes and nutritional needs. We found that the induction for new staff is in line with the Minimum Standard. All five staff who returned a survey to us said they had a thorough induction. We found that recruitment checks including two written references and a Criminal Record Bureau Check, CRB, are carried out before a person starts work at the home. All five staff who returned a survey to us said they had a CRB check. New staff shadow existing staff until they are deemed competent to work unsupervised. Staff said they have the opportunity to attend regular staff meetings. We observed staff offering discreet and respectful support. Staff said, I enjoy working at Bradstowe Lodge, it is very homely, I enjoy working with my team members. Care Homes for Older People Page 19 of 24 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 home is well managed and is run in service users best interests. Peoples health and safety and finances are safeguarded. Evidence: There has been no Registered Manager at the home for some time. We found that a manager has been appointed but has not started work at the home yet. There is a Head of Care supported by two senior staff, care staff and the Provider. The Head of Care spoke with knowledge and understanding of service users needs. The Head of Care has worked at the home for several years and so knows service users and staff well. The Head of Care manages the staff team and runs the home on a day to day basis, when not at the home she is available on call for advice and support. In the absence of a Registered manager we found that the home is currently well managed. We found that service users views are sought about the service. This is done at residents meetings, review meetings, on a one to one basis and by annual surveys. The provider collates the responses to surveys and produces an action plan to improve Care Homes for Older People Page 20 of 24 Evidence: the service. The provider agreed to survey relatives and other stakeholders in the future to get a wider range of views about the service. We found that there are systems in place to safeguard peoples money. Any money held by the home is kept safely and good records are kept of income and expenditure. There are regular spot checks and audits to make sure that service users are protected. We found that checks of the premises and equipment are carried out regularly. We saw the fire log book and found that regular checks of the fire equipment are carried out and drills held. Staff attend training in areas related to health and safety including fire awareness, food safety, safe moving and handling and infection control. This protects service users. Care Homes for Older People Page 21 of 24 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 22 of 24 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 23 of 24 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 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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