Care Home: Bradwell Court

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What the care home does well There are good recruitment practices in the home to help make sure that the people living at Bradwell Court are supported by staff who are suitable to provide care for them and they are protected from harm and poor practice. There is a lengthy procedure for people wishing to move into the home, including visits to look around, staying for a meal and details about the home in an information pack. This gives the person the chance to see if the home is the right place for them to move into. People living in the home and their relatives were complimentary about the staff, including the manager, saying they were "lovely girls". The relationships between people living at Bradwell Court and the staff were relaxed and friendly so people were comfortable and appeared settled. The activities on offer at the home are varied and people`s interests and abilities are considered to make sure that activities they would like to join in with are included in the programme. This helps to make sure they can continue to be active and have opportunities to join in social occasions. There are good links with health and social care workers, including district nurses, GPs and social workers. A variety of health professionals are asked to visit when they are needed so people living in the home can be confident their health care needs will be met. People`s rooms were kept clean and well maintained. All of the rooms are en-suite shower and toilet which helps people maintain their privacy and dignity. A representative of the people who live at Bradwell Court is included in the interviews for new staff so that people can have a say in who comes to work at the home to provide care and support for them. Relatives we spoke with during our visit commented, "couldn`t wish for a better place", "the home is always clean and tidy" and "mum is well cared for". The home is well run and the manager operates an open door policy to encourage people living in the home, their relatives and the staff to contribute to the running of the home. This helps to make sure that Bradwell Court is run in the best interests of the people who live there. What has improved since the last inspection? An activities coordinator has been employed for 25 hours per week to make sure a range of activities that will suit the interests of the people who live in the home is available for them to take part in. General maintenance has continued and some bedroom carpets have been replaced and a jacuzzi bath installed so that people continue to live in comfortable surroundings. What the care home could do better: We consider that Bradwell Court provides excellent outcomes for the people who livethere so rather than state what they could improve we would expect the home to continue to review how it is running to ensure that the very high standard of care we found at the time of this inspection is continued and improved upon where possible. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bradwell Court Bradwell Grove Congleton Cheshire CW12 3SA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Porter     Date: 0 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Bradwell Court Bradwell Grove Congleton Cheshire CW12 3SA 01260281428 01260291855 lynda.schofield@centurycare.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sanctuary Care Ltd care home 27 Number of places (if applicable): Under 65 Over 65 1 27 dementia old age, not falling within any other category Additional conditions: 0 0 This home is registered for a maximum of 27 service users to include: * Up to 27 service users in the category of OP (old age not falling within any other category * One named service user in the category of DE(E) (Dementia over the age of 65) Date of last inspection Brief description of the care home Sanctuary Care Ltd has recently taken over the ownership of Bradwell Court Care Home. Previously it was owned by Beth Johnson Housing Group. The home is close to the town centre of Congleton and to a wide range of shops, churches and other facilities. There are limited car parking facilities available at the home. Bradwell Court was previously used as sheltered accommodation and has been adapted to provide accommodation for older people who need personal care. It is a three-storey building with bedrooms on the three floors. There is a passenger lift, which serves all floors. There are 27 single bedrooms in the home, all of which have a small kitchenette with a Care Homes for Older People Page 4 of 26 Brief description of the care home fridge and en-suite facilities with showers. Day space consists of a lounge/dining room and a second lounge with a bar on the second floor. The bar is not currently in use. There are four bathrooms and a number of additional toilets available for people who live in the home to use. There are several aids installed throughout the home to help people be as independent as possible; these include bath hoists, grab rails and an emergency call bell system. The scale of charges range from £343.43 - £420 per week. A copy of the latest inspection report can be obtained from the manager on request. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use the service experience excellent outcomes. This visit, part of the key unannounced inspection of the home, took place over 6 hours. It was carried out on 5 June 2009 by one inspector. The report will refer to we and us, as it is written on behalf of the Care Quality Commission. The visit to the home was just one part of the inspection. Before our visit the manager was asked to provide information as part of the inspection. The views of residents and relatives about the home were also sought; their comments are incorporated into this report. Care Homes for Older People Page 6 of 26 During the visit we spoke to the manager, some staff members and most of the people who live in the home. The records for two people who live in the home were looked at to check the care they receive. Policies and procedures, records of medication, care plans and training records were also examined to see how the home is run, how care is provided for the people who live there and what training staff have received. What the care home does well: What has improved since the last inspection? What they could do better: We consider that Bradwell Court provides excellent outcomes for the people who live Care Homes for Older People Page 8 of 26 there so rather than state what they could improve we would expect the home to continue to review how it is running to ensure that the very high standard of care we found at the time of this inspection is continued and improved upon where possible. 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 set out 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 9 of 26 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 10 of 26 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. Potential service users and their families are provided with opportunities to visit the home and information about it. Peoples care needs are checked thoroughly before they move in so that they know that their needs can be met at Bradwell Court. Evidence: We looked at a care plan of one person who had moved into the home not long before our visit. This showed us that the local authority had checked the persons care needs and a representative from the home had also met the person before they moved in, to find out more about their care needs. We could see from the file that full information was available about the persons medical needs and about their life story so staff working in the home could get a sense of what the person was like before they came to live in the home. The checks done by the homes staff before the person moved into Bradwell Court gave information about how much each person could do for themselves. They also showed what help they might need plus other information that Care Homes for Older People Page 11 of 26 Evidence: staff would need in order to provide the right care to the person in the way they would prefer. We spoke with two families whilst they were visiting relatives in the home and they told us they had looked at a number of care homes before choosing Bradwell Court. Both families said they had visited to look around and were provided with lots of information before their relative moved in. This and the checks made about peoples care needs, help to make sure that the persons needs can be met at Bradwell Court. Intermediate care is not offered in the home. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are well written, clear, up to date and accurate care plans that help to make sure that people living at Bradwell Court receive the care they need in the way they prefer whilst being able to remain as independent as possible. Evidence: We looked at two care plans during our visit to check on the care people living at Bradwell Court are receiving. The files were of a very good standard; they were easy to read and accurate with clear guidance for staff on what they must do to meet peoples needs in the way they prefer. The initial care plans are drawn up from the checks that are done before the person moves into the home. Further information is added by staff as they get to know the person and more about how they prefer their support to be provided. The plans we saw covered peoples needs fully, including their mobility, personal support, medication, bathing and nutrition. Checks had also been done about any problems that might happen to each person, such as pressure sores, falls and injury. Plans had been put into place to help staff make sure that the risks identified were reduced. This clear guidance would help to make sure that people living Care Homes for Older People Page 13 of 26 Evidence: at Bradwell Court were receiving good, safe care that met their needs in the way they preferred. The care plans we looked at showed us that the health and welfare of people living at Bradwell Court is monitored at least monthly, and more often if needed, if the persons needs change. We saw in the care plans and other records we looked at that healthcare professionals such as doctors, district nurses, continence advisors, dietitians, chiropodists, opticians, audiologists and dentists were involved in the care of each person living at Bradwell Court. This helps to make sure that peoples healthcare needs are being met and treatment and advice is available to make sure they remain as healthy as possible. During our visit we saw a doctor going to visit their patient in their own room; we were told this is usual practice. This helps to make sure that peoples privacy and dignity is respected. Each person who lives at Bradwell Court has a named key worker. People we spoke with told us that this was their special member of staff, the one that helps them sort things out does shopping and things like that. There are medication administration policies and procedures at the home to give clear guidance to staff about giving out medicines. The senior staff who do this also receive regular training to make sure they can administer medicine safely in line with best practice. We observed lunch time medicines and were satisfied that the staff gave medicines as discreetly and safely as possible. All bedrooms in the home are single and we spoke with families who told us that they enjoyed visiting and were always made to feel very welcome. Each bedroom has its own kitchenette where residents and their visitors can make drinks and en-suite shower room so that the persons privacy and dignity can be maintained. Each bedroom has a telephone line and one family we spoke with said that they valued being able to contact mum directly or for her to be able to ring them. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Bradwell Court are able to exercise choice over the way they live their daily lives, including what they do and what they have to eat, so that they remain as independent as possible. Evidence: There is an activities room on the first floor of the home. People living at Bradwell Court told us they prefer to do things in the main lounge and so that is where most activities take place. During our visit we saw the the activities coordinator organising activities and and interacting with a large group of people to take part in them. We saw that the co-ordinator was skilled at adjusting the activity to suit peoples individual abilities, in order to make sure that each person taking part enjoyed themselves. We saw information was available to the people living in the home about what activities were planned. One person told us that he went out regularly to a farm in Cheshire to buy tomatoes. He said that he enjoyed this as it reminded him of his younger days. Another person had been helped to do some gardening and this had resulted in a remembrance garden being made. We saw relatives visiting the home throughout the day of our visit. Some went to see Care Homes for Older People Page 15 of 26 Evidence: their relatives in their bedrooms and others chose to stay in the lounge. All the relatives and visitors we spoke with said that they visit at various times of the day and are always made to feel welcome. One relative was very complimentary regarding the standard of hygiene and care. They said that they felt included and involved with their parents care. Lunch appeared to be a relaxed and a sociable occasion with only a few people choosing to have lunch in their own room rather than the dining room. The chef told us that the menus are planned at the central office of the organisation that runs the home, so that they can get the best price for some food items. She said that although menus are planned in advance by this central office she is able to adjust them to suit the tastes of the people living at Bradwell Court. The example she gave was that the people living at Bradwell Court do not like sweet and sour pork so she replaces this with a pork casserole that they do like. The people who live at the home who we spoke with told us the food was wonderful. On the day of our visit, we saw that they had fruit juice, steamed or battered fish (or egg) with chips and peas, followed by baked apple and custard. The evening meal was soup and a selection of sandwiches. Care Homes for Older People Page 16 of 26 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. There are thorough procedures and staff receive training so the people who live at Bradwell Court can be confident that their concerns are listened to and that they are protected from harm and abuse. Evidence: We spoke with visitors to Bradwell Court who told us that they had received information of how to make complaints when their relative came to live in the home. Relatives told us that they never felt it was necessary to make a formal complaint. They said that any grumbles they have, they raise with the staff who respond efficiently and effectively. Relatives told us that they never felt it was a problem to raise issues. They told us that the manager encourages them to meet with her regularly and she is always around the home available to speak with them. The concerns and complaints raised are not recorded and we recommended that a record be kept that would show what concerns had been raised and how these had been resolved. This would help to show that staff at the home listen to concerns, take them seriously and take effective action to resolve them. People living in the home told us that they dont have any problems. They were aware of who and how to complain but said there was no need, things were just fine. We spoke with staff who were aware of the action they should take should they Care Homes for Older People Page 17 of 26 Evidence: suspect any form of abuse in the home. Staff had attended training on safeguarding adults in March 2009 so they had up to date information on what they needed to do to protect the people who live at Bradwell Court. The manager showed us that she is keeping up to date with legislation and has identified that staff need to receive training so they have an awareness of the Mental Capacity Act. Information was available on the notice board of the home about local advocacy services. People living in the home are registered to vote. They are encouraged to manage their finances for as long as possible. When this is not possible some people have small amounts of money stored in the homes safe. We inspected the records of one person and saw that the home manages this money well and that accurate records are kept. Care Homes for Older People Page 18 of 26 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. Bradwell Court is well maintained so that the people who live there live in comfortable, safe and clean surroundings that are suitable for their needs. Evidence: All the people living at Bradwell Court who we spoke with during our visit were happy with their rooms and told us they were kept clean and tidy. We saw some rooms when invited and they contained peoples own possessions, which helped them look more homely and welcoming. All the rooms were saw were fresh and bright, nicely decorated and well maintained. At Bradwell Court, each bedroom door is painted in a bright colour, has a knocker, a letterbox and lock in place, giving the appearance of being a front door. Everyone has a key to his or her own room. Some of the bedroom carpets have been replaced since the last inspection. The communal areas including lounges and bathrooms were fresh, clean and tidy. One of the bathrooms has been fitted with a jacuzzi bath since our last visit to the home. The outside of the building is well maintained. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures are thorough to make sure staff are suitable to work with the people who live at Bradwell Court and they receive good training to make sure they know how to do their jobs safely and well. Evidence: People who live at Bradwell Court and their relatives were very complimentary about the staff working in the home. People told us the staff were, nice girls, lovely, very helpful and that they knew their stuff. Staff we observed during our visit to the home appeared calm and unhurried while supporting people. The atmosphere in the home was friendly and respectful whilst residents and visitors felt comfortable enough to share a joke and a laugh with staff. We checked the staff training records to see what training was being provided for them. These showed that staff receive regular training in food hygiene, infection control, safeguarding adults, emergency aid, fire safety and moving and handling. Staff are also encouraged to complete national vocational qualifications (NVQ) relevant to their jobs. These are nationally recognised qualifications and achieving them shows that staff have reached the competence to do their jobs well. We looked at recruitment files to see what checks had been done before new staff Care Homes for Older People Page 20 of 26 Evidence: came to work in the home. The files we saw showed that all the necessary checks had been done including completed application forms, references and criminal bureau checks. These checks help to make sure that the staff are suitable to work with the people living at Bradwell Court and had all been obtained before the member of staff started working there. We were told that representatives from the people living in the home are also involved with the recruitment process as they sit on the interview panel. This gives them the chance to have a say in who works in the home to provide their support and care. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bradwell Court is very well managed, in an open and friendly way, so that people who live there know their opinion matters and that the home is run in their best interests. Evidence: The manager of Bradwell Court has worked there for a number of years; she is qualified and registered with the Care Quality Commission (CQC). People we spoke with during our visit to the home confirmed that she operates an open door policy for people living in the home , their families and the staff. This helps them to be confident that she will listen to their concerns and suggestions. The manager provides a very good role model for staff and has worked with them to make sure that the diverse and individual needs of the people who live at Bradwell Court are met with respect and dignity. Throughout the day of our visit, we observed that the interactions between staff and the people who live at the home were polite and showed a degree of mutual respect Care Homes for Older People Page 22 of 26 Evidence: for each other. The manager encourages people living in the home to be involved in recruiting staff and to be involved in residents meetings so they can have a say in how the home is run and who is employed to provide their care and support. Relatives meetings are held regularly but are not always well attended. One relative we spoke with told us that she found relatives meetings valuable as they enable relatives to also have a say in how the home is run for the benefit of their relatives who live there. The organisation that runs Bradwell Court has thorough quality assurance processes in which they ask people involved in the home for their views about then publish the findings. Not long before our visit, the regional manager from the company had carried out a check of the home against the national minimum standards for care homes for older people. Bradwell Court had scored very highly and the report was available on the notice board for people who live at the home, their relatives and the staff to see. Staff at the home look after a small amount of money for people who live there. Records are kept of all transactions and these were found to be accurate to show that peoples money is accounted for properly. We looked at a sample of records that showed us the fire safety equipment is checked regularly to make sure they were working properly and that staff took part in regular fire drills to make sure they knew what to do if fire broke out at the home. Before our visit, the manager gave us information to confirm that regular servicing contracts are in place for baths, hoists, electrical and gas equipment in the home. This all helps to make sure that Bradwell Court is a safe place for people to live and work in. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 16 A record of concerns and complaints raised about the home, either formally or informally, should be kept to show they have been listened to, taken seriously and resolved. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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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