Care Home: Bridge View Care Home

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What the care home does well The home was generally clean and tidy. There were no mal odours evident. Residents and relatives said that the home was always kept clean. We spoke to two relatives who said that they were happy with the standard of personal care provided. They said that staff kept them informed of changes to the health of residents. They said that residents always looked clean and well cared for. Relatives told us that staff were kind and patient with residents. We checked the arrangements in place to ensure that residents receive good nutrition and sufficient fluids. Staff were able to identify who required help to eat and who needed to have their food and fluid intake recorded. Records of food were properly filled in, though there was some confusion as to which form was used to record food intake. Records of fluid intake were either not fully completed or people were not getting enough to drink.Those people who were identified as at risk of tissue damage due to pressure were nursed on appropriate pressure relieving mattresses and cushions. There were care plans in place for staff to follow to ensure that people`s risk of getting pressure sores was reduced. We case tracked three people. This means that we identified three people and discussed their care needs with staff. We then matched our observations to what was written in the care plan. One of the three care plans contained good information about the current care needs of the person. We examined the arrangements made for the storage, administration and disposal of medication. Medication was properly stored in a secure room. All administration records were fully completed. The auditing of medication was very good. All tablets are counted by the nurses at every drug round and the manager completes a weekly audit. The service has received few complaints. Residents spoken to said they would complain to the manager if they needed but none of them had any current complaints. There is a complaints record to use when needed. Staff have received recent training in the recognition and management of abuse. The manager is clear regarding her responsibilities for reporting this and there was evidence that she has done so in the past. The manager has a system of auditing which ensures that all areas of the home run smoothly. She has developed a reminder matrix to ensure that staff receive regular formal supervision. This enables staff to contribute to the development of the service and address any training needs they might have. We examined the records of incidents and accidents in the home, including those that must be notified to CQC. All accidents, incidents and deaths had been appropriately notified. The manager has an overview of accidents and verifies every accident report in the home. The provider`s representative visits the home monthly. They are required under regulation 26 to produce a report of that visit. We examined the reports for the last six months and found that these visits have been taking place regularly. What the care home could do better: There was not enough information available in the kitchen about individual`s specific dietary needs. The chef had a white board which specified which residents were on special diets, however, large portions of this were not completed. The chef had no knowledge of which residents were gaining or losing weight. Two of the three care plans were not good enough. They were not person centred and, though they have been regularly evaluated, did not reflect the current needs of people. The relatives communication sheets were not filled in. One care plan stated that the resident should be weighed weekly and this had not happened. Some of the residents had not been weighed at all because of their poor health or because they were nursed in bed.The home does have a hoist that has a weighing sling attachment, therefore at least one of the people we case tracked could have been weighed. The recording of food and fluid intake was muddled. There is a pink record form issued by the provider, this is not very good because it does not have space to record portion size or content. There is a white form which has been devised locally, this is a better recording tool. Staff have been instructed to use the white form for those on weekly weights. This does not, however, take account of those who are ill and not weighed at all. Sometimes pink charts were used and other days white charts. One resident that we case tracked was not recieving enough fluid. She had recieved less than 1000mls for the last three days. There was no overview of the fluid records by the nurses who could not demonstrate that they were aware of this. Relatives told us that they were happy that people were recieving good personal care but felt that staff were very rushed at mealtimes. On the nursing floor there were five people on each unit that required help to feed. Staff were very busy during this time. Relatives and staff told us that sometimes staff work with less numbers on duty due to sickness. The duty rostas confirmed that three shifts the previous week were short of a care assistant on the nursing floor. We observed that, during quieter times, staff gathered in communal areas with each other rather than spending time with residents. The supervision and deployment of staff needs to be improved. Some staff training had lapsed. Staff training in relation to fire procedures was not up to date. Records showed that the manager had requested this for the previous two months. Fire training was due to take place in the two days following the inspection. Random inspection report Care homes for older people Name: Address: Bridge View Care Home Ashington Drive Choppington Northumberland NE62 5JF three star excellent service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Janet Thompson Date: 0 7 0 6 2 0 1 0 Information about the care home Name of care home: Address: Bridge View Care Home Ashington Drive Choppington Northumberland NE62 5JF 01670811891 01670522939 Telephone number: Fax number: Email address: Provider web address: www.southerncrosshealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Southern Cross BC OpCo Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 61 Number of places (if applicable): Under 65 Over 65 0 61 0 dementia old age, not falling within any other category physical disability Conditions of registration: 61 0 5 The maximum number of service users who can be accommodated is: 61 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, Code OP - maximum number of places 61 Dementia Code DE, maximum number of places 61 Physical Disability, Code PD, maximum number of places 5 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Bridge View is a home that is purpose built. It is located in Stakeford. Accommodation is over two floors. The kitchen and laundry are on a lower ground floor. All accommodation is based in single bedrooms, all fixtures and fittings are of a good standard. The home can accommodate frail elderly people, including some that require nursing care. Car parking is provided to the front of the home and there are landscaped gardens to all sides. Local shops are within walking distance, as are local transport facilities. There is level access to all parts of the building. A passenger lift is available to take residents from the ground floor. The fees for the home vary, further information on fees is available from the home.. Further information about the home is available in the service user guide, which contains the statement of purpose and previous inspection reports. This is kept in the reception areas of the home on each floor. Care Homes for Older People Page 3 of 10 What we found: The quality rating for this service is three stars. This means the people who use this service experience excellent quality outcomes. We made this quality rating at a key inspection of the home in February 2008. The purpose of this inspection was to check that the home was still performing at a good enough level. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they care for people. This inspection was unannounced and took place on 7 June 2010. During the visit we talked with people who use the service, some staff, some relatives and a visiting manager. We looked at information about people who use the service and other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for and we looked around the building to make sure it was clean, safe and comfortable. The manager for the service was not present. A manager from another home attended for the inspection and feedback was given to her at the end of the visit. What the care home does well: The home was generally clean and tidy. There were no mal odours evident. Residents and relatives said that the home was always kept clean. We spoke to two relatives who said that they were happy with the standard of personal care provided. They said that staff kept them informed of changes to the health of residents. They said that residents always looked clean and well cared for. Relatives told us that staff were kind and patient with residents. We checked the arrangements in place to ensure that residents receive good nutrition and sufficient fluids. Staff were able to identify who required help to eat and who needed to have their food and fluid intake recorded. Records of food were properly filled in, though there was some confusion as to which form was used to record food intake. Records of fluid intake were either not fully completed or people were not getting enough to drink. Care Homes for Older People Page 4 of 10 Those people who were identified as at risk of tissue damage due to pressure were nursed on appropriate pressure relieving mattresses and cushions. There were care plans in place for staff to follow to ensure that peoples risk of getting pressure sores was reduced. We case tracked three people. This means that we identified three people and discussed their care needs with staff. We then matched our observations to what was written in the care plan. One of the three care plans contained good information about the current care needs of the person. We examined the arrangements made for the storage, administration and disposal of medication. Medication was properly stored in a secure room. All administration records were fully completed. The auditing of medication was very good. All tablets are counted by the nurses at every drug round and the manager completes a weekly audit. The service has received few complaints. Residents spoken to said they would complain to the manager if they needed but none of them had any current complaints. There is a complaints record to use when needed. Staff have received recent training in the recognition and management of abuse. The manager is clear regarding her responsibilities for reporting this and there was evidence that she has done so in the past. The manager has a system of auditing which ensures that all areas of the home run smoothly. She has developed a reminder matrix to ensure that staff receive regular formal supervision. This enables staff to contribute to the development of the service and address any training needs they might have. We examined the records of incidents and accidents in the home, including those that must be notified to CQC. All accidents, incidents and deaths had been appropriately notified. The manager has an overview of accidents and verifies every accident report in the home. The providers representative visits the home monthly. They are required under regulation 26 to produce a report of that visit. We examined the reports for the last six months and found that these visits have been taking place regularly. What they could do better: There was not enough information available in the kitchen about individuals specific dietary needs. The chef had a white board which specified which residents were on special diets, however, large portions of this were not completed. The chef had no knowledge of which residents were gaining or losing weight. Two of the three care plans were not good enough. They were not person centred and, though they have been regularly evaluated, did not reflect the current needs of people. The relatives communication sheets were not filled in. One care plan stated that the resident should be weighed weekly and this had not happened. Some of the residents had not been weighed at all because of their poor health or because they were nursed in bed. Care Homes for Older People Page 5 of 10 The home does have a hoist that has a weighing sling attachment, therefore at least one of the people we case tracked could have been weighed. The recording of food and fluid intake was muddled. There is a pink record form issued by the provider, this is not very good because it does not have space to record portion size or content. There is a white form which has been devised locally, this is a better recording tool. Staff have been instructed to use the white form for those on weekly weights. This does not, however, take account of those who are ill and not weighed at all. Sometimes pink charts were used and other days white charts. One resident that we case tracked was not recieving enough fluid. She had recieved less than 1000mls for the last three days. There was no overview of the fluid records by the nurses who could not demonstrate that they were aware of this. Relatives told us that they were happy that people were recieving good personal care but felt that staff were very rushed at mealtimes. On the nursing floor there were five people on each unit that required help to feed. Staff were very busy during this time. Relatives and staff told us that sometimes staff work with less numbers on duty due to sickness. The duty rostas confirmed that three shifts the previous week were short of a care assistant on the nursing floor. We observed that, during quieter times, staff gathered in communal areas with each other rather than spending time with residents. The supervision and deployment of staff needs to be improved. Some staff training had lapsed. Staff training in relation to fire procedures was not up to date. Records showed that the manager had requested this for the previous two months. Fire training was due to take place in the two days following the inspection. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 1 7 15 Care plans must identify the actual care needs of residents. Actions must be clear, specific and personal. All parts of the care plan must be fully completed. This enables staff to have access to clear instructions for each residents care. 01/09/2010 2 8 12 Staff must ensure that residents are recieving enough fluids. Records of food and fluid intake should be clear and consistantly filled in. Catering staff should be fully aware of the dietary needs of residents. This ensures that people retain good health through adequate nutrition. 10/07/2010 3 27 18 Ensure that there are 01/07/2010 Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 sufficient staff on duty at all times to meet the current needs of residents, based on an assessment of dependancy. Carry out a review of staffing to ensure that there are sufficient numbers of staff on duty at busy periods. This is to ensure that there are sufficient staff to care for residents. 4 30 18 Ensure that essential training 30/07/2010 for staff remains up to date at all times. This ensures that staff on duty have up to date knowledge. 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 2 3 30 31 32 Staff should be trained in person centred care. The manager should seek registration with CQC. Staff should be given clear direction and leadership on a day to day basis. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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