Care Home: Bridge House

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Annual service review Name of Service: Bridge House The quality rating for this care home is: The rating was made on: two star good service 2 4 1 1 2 0 0 8 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Marian Whittam Date of this annual service review: 1 7 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: Manorside, Market Street Flookburgh Grange over Sands Cumbria LA11 7JS 01539558622 Telephone number: Fax number: Email address: Provider web address:   Tony.lyons@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Name of registered provider(s): Name of registered manager (if applicable) Conditions of registration: Category(ies) : dementia old age, not falling within any other category Conditions of registration: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE. The maximum number of service users who can be accommodated is: 39. Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Registered manager resigned since last inspection; Manager post Vacant 2 4 1 1 2 0 0 8 Number of places (if applicable): Under 65 Over 65 39 0 0 39 Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Annual Service Review Page 2 of 8 Bridge House is a purpose built residential care home owned by Cumbria County Council and operated by Cumbria Care, an independent business unit of the County Council. Bridge House is registered to provide residential care for up to thirty nine older people. The home is divided into three distinct units, Sandgate, which specialises in Dementia Care for up to 10 people, and Applebury and Humphrey Head. Each unit contains a dining room with kitchenette, two communal lounges, accessible toilets and bathrooms and the residents bedrooms. There is a passenger lift making all three floors fully accessible. There are well kept gardens to the front and rear of the home. The home is situated in the centre of the village of Flookburgh, within walking distance of the local amenities and close to the town of Grange-over-Sands. There are additional charges made for personal newspapers, magazines and hairdressing. The home makes information about its services available through its Service User Guide and Statement of Purpose that are available on the foyer of the home. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? An Annual Service Review for Bridge House Residential Care Home included the following: 1. We sent an Annual Quality Assurance Assessment (AQAA) form to the home and this was completed by the acting manager, Joanne McDermott, and returned by the date requested. The AQAA is a self assessment and a dataset that is completed annually by all providers of registered services. It is one of the ways we gather information from the providers of services about their service and how they believe they are meeting outcomes for the people living there and using their service. The AQAA also gives us statistical information about the individual service and trends and patterns in social care. 2.We sent out surveys to people living at Bridge House and to the staff who work there. We also sent out surveys to medical professionals who come into contact with the people living and working at Bridge House. 3. We looked at all the information we had about any changes that had been made in the running of the home and how any complaints or safeguarding issues had been handled. 4.We looked at what the Providers of the service have told us about things that happened in the service, these are called notifications and are a legal requirement. We also looked at how the providers kept us informed about any changes in the organisation. 5.We looked at the previous key inspection and any calls or visits we have made to the home since their last inspection. What has this told us about the service? The home does not have a registered manager in post at present but the acting manager Joanne McDermott completed and sent us the Annual Quality Assurance Assessment (AQAA) when we asked for it. It contained the relevant information we asked for. The AQAA information provided examples of what the acting manager was doing to make sure that the views of people living at Bridge House were listened to and promoted in the way the home was run. This is by using questionnaires and through holding meetings where people can help decide the agenda, raise issues and give their views. The manager says they encourage an open door policy and encourage people to be open about any complaints or concerns. The acting manager gave examples in the AQAA of what they had done as a result of this consultation and getting peoples views. One outcome for people is that the afternoon teas provided had been altered to incorporate a greater number of snacks for people as they had requested. The acting manager also told us that a weekly activity programme has been developed to offer two different activities each day for all three units. Following a suggestion at the residents meeting a Nintendo Wii has also been bought for people to use for Annual Service Review Page 4 of 8 recreation. Examples of changes made to improve the service for people in other important areas were given in the AQAA. This included staff training on medication handling with more staff having completed medication training courses and improvements made in the stock control of medication and medication reviews. The manager told us about changes they have made to the environment to keep it homely and safe for people including the changes made to the entrance hall to make it more welcoming and provide useful information leaflets and information for people coming to the home. They told us that new curtains have been fitted in most bedrooms and the dining and lounge areas and that old items of furniture have been replaced. We received surveys back from seven people living in the home and their responses were generally positive about their experiences of living at Bridge House. Their replies indicated that they receive the personal and medical care and support they needed and wanted and that staff listened and acted upon what they said. Peoples responses also indicated that overall there were staff available when they needed them. Responses also indicated that people liked the meals provided for them, that the home was always fresh and clean and that overall there were usually activities arranged for them to take part in if they wanted to. Several people commented in their surveys on how much they enjoyed the food. Half the people who responded did not know how to make a formal complaint but all said in the surveys that they had someone they could speak to informally if they were not happy. The acting manager should look at finding out why so many people were unsure about how to make a formal complaint. Comments made in the surveys from people living there under what the home does well included: Meals. They look after me well. They keep me safe and the food is good. I enjoy the meals very much. One person commented If I could run a home as well as this one I would be very happy with myself. No one returning their surveys had any comments to make on what the home could do better. Surveys returned by relatives were also positive and indicated satisfaction with the service their family members received and that they were kept up to date with important issues affecting their relative. We were also provided with copies of letters sent to the home, by families and relatives of people who had used the service, praising the care received. The comments and surveys we received from medical professionals raised no concerns about the way peoples personal and health care needs are monitored, reviewed and met by the service. The response indicated that advice is usually sought and acted upon to meet peoples social and health care needs and help people make choices in these areas. The comment was made that: The home enables people to live in a Annual Service Review Page 5 of 8 friendly homely environment whilst retaining close links with the local community. Eight members of staff replied to our surveys and the responses indicated that staff had all necessary security checks carried out before they started work in the home, that they had been given induction training and training they found relevant to their roles. This supports the other information provided in the AQAA. Staff responses also indicated they felt they were supported by their manager and were able to meet with her and discuss how they were working. Comments from the care staff on management included; The manager gets stuck in and is approachable. It has been a nicer place to work over the last 12 months. Their replies and comments did indicate there were some areas the manager needs to look at further, if she is not already aware. One of these issues was around staffing as none of the staff who responded felt there was always enough staff to meet peoples needs. The majority said there was only sometimes enough staff available. The manager needs to discuss this with care staff and look at rotas to make sure no unit is ever left unattended. We (CQC) have received one complaint about this service since the last inspection, which we passed to the acting manager to investigate and respond to using the services own procedures, which they did. The AQAA states the service has received ten complaints in the last year and these have been investigated and responded to within 28 days. We looked at the information we had on changes that had been made in the management of the home since the last inspection. We found that the current acting manager had not applied for registration as manager as their post had been viewed by the provider as temporary to cover the registered managers absence. Ms McDermott is registered with CQC as a manager of another home. The registered manager at Bridge House has had a protracted period of absence and the registered manager has now resigned from their post. It is required by legislation that the care home should be managed by a person registered with CQC after being assessed as suitable through the registration process. We have discussed with the representative of the provider of the service (Operations Manager) and the acting manager the reasons why an application for registration of the acting manager had not taken place after so lengthy a period of time with the temporary manager running the home. As a result of our discussions, and the registered managers recent resignation, the process has begun to recruit a new permanent manager for Bridge House. Whilst there is no evidence to suggest that the acting manger, Joanne McDermott, had not been very effective in the acting manager role there has not been a permanent manager registered with CQC for Bridge House since before its last inspection. We will therefore be monitoring the application process closely to make sure the service provider addresses the management situation more promptly to make sure it does not breach regulations. This is in order to make sure that the welfare and safety of people living there is being promoted and to ensure full compliance with the legislation. We will take action if it is not fully addressed. Annual Service Review Page 6 of 8 We looked at all of this information that we had gathered about Bridge House to form a judgement about outcomes for people living there. The information in the AQAA was clear and detailed, was supported by survey information and indicated how service developments and improvements in care and support were being managed and how complaints were being taken seriously. The responses from people living there and coming into contact with the service were positive. The acting manager had notified us of accidents and events in the home. On this basis the service still continues to provide good outcomes for people living at Bridge House. However we will be monitoring the progress of the recruitment of a new manager and the application for the managers registration with the CQC Registration Team to ensure this is being done as we have been told it will be. What are we going to do as a result of this annual service review? The Care Quality Commission will continue to monitor information about this service and will carry out an inspection when required. 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