Care Home: New Bridge House

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What the care home does well We saw that the home provides a good service based on what we were told by individuals living at the home, this supported by records examined. The home is good at establishing what individuals needs and preferences are by involving them in the assessment process. This undoubtedly has helped with the meeting of people`s needs as we were told happens, with a confidence expressed in the staff team that we have been told are good at listening to residents. People living at the home have regular and appropriate access to health care services. We have been told that peoples choices are respected and promoted as is their independence in line with the home`s aim to enable the people it offers a service to. People living at the home have access to a homely and comfortable environment and plentiful communal space. The good outcomes we saw underline that the service is good at listening to the views of the people who use the service. What has improved since the last inspection? There have been clear improvements to the building with it having undergone a complete refurbishment, this resulting in a pleasant living environment. As the service has only been based at New Bridge House a matter of months it is not possible to assess its improvements since the last inspection, as at this time the building was empty and awaiting refurbishment. We have however noted that the service is developing its systems for the management of quality, this drawing on the views of the people it provides a service to. What the care home could do better: There are a few areas we noted where improvement is needed, most importantly in respect of the need to ensure that risk assessments in respect of individuals that self medicate are consistently in place, or when in place up to date. Some dating of medication records also needs to be better. We heard that the heating is excessive on occasions in bedrooms, although this is a matter the home is dealing with. There are some issues in respect of other records as well (such as ensuring the training plan for staff is up to date) although again the acting manager was aware of some of these issues and has committed to addressing them. Inspecting for better lives Key inspection report Care homes for older people Name: Address: New Bridge House Bayer Street Coseley West Midlands WV14 9DS     The quality rating for this care home is:   two star good 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: Jonathan Potts     Date: 1 7 1 2 2 0 0 8 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: New Bridge House Bayer Street Coseley West Midlands WV14 9DS 01384813450 01384813451 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dudley Metropolitan Borough Council Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 14 Number of places (if applicable): Under 65 Over 65 14 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 14. 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 (OP) 14 Date of last inspection Brief description of the care home New Bridge House is located near to Roseville village in Coseley. It is set in its own mature grounds with car parking available within these. Local transport links and amenities are located within close vicinity. The home has recently undergone extensive refurbishment and a major variation to its registration, with a change of purpose from use as a home for younger adults with a disability to an intermediate care unit for older people. Individuals are usually admitted to the home from a hospital setting for Care Homes for Older People Page 4 of 27 Brief description of the care home short term rehabilative care with the purpose of enabling their independence and facilitating their return to their home in the community. The service is managed by Dudley Metropolitan Borough Council but there is involvement of health funded services including occupational and physiotherpy as well as allocated GP services. The day to day management of the service is by a (currently acting) manager supported by a team of senior care officers. This management team oversee a team of rehabilitive care and domestic assistants who work alongside the above mentioned health authority staff. The homes statement of purpose does not currently carry a range of fees, although the service (as long as it is for rehabilitive care) is free at the point of delivery. Care Homes for Older People Page 5 of 27 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: We carried out this inspection over one day. We considered the information we had received from the home via their annual quality assurance assessment (AQAA) and comment cards as well as all the other information we have received from other sources since the last key inspection, this prior to visiting the home. We tracked the care provided to three individuals this meaning we looked at all the records in the home related to their care then discussed their views of the service with them. We also looked at various management records and talked to staff within the home as well as the acting manager. Care Homes for Older People Page 6 of 27 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 27 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 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and their representatives have the information needed to decide as to whether the reablement service at New Bridge House will assit them in regaining lost indepedence. Evidence: New Bridge House is a service that is dedicated to intermediate care and reablement and the service is geared to provide therapies and treatment in accordance with this aim, this through close liaison between the social services department and the health authority. The home has access to an allocated G.P, physiotherapy and occupational therapy services on an allocated and planned basis and the local authority care staff have been trained in the aims of the service recently, this through a planned induction at the point the home was reopened. We saw that New Bridge House has a statement of purpose that is specific to the home Care Homes for Older People Page 9 of 27 Evidence: and the individuals they offer a service to. We saw that this document sets out the aims of the service and information as to how this is to be provided in an accessible document, this presented in an easy to read format with clear print and some pictorial images. The statement of purpose/service users guide contains information on the service provided, the accommodation and how to make a complaint. We saw that a copy of this information was available to all residents in their bedrooms, and some of the people we spoke to said that they had been made aware of what the home provided prior to admission, this when visited by a representative from the home. We noted that the statement of purpose does not contain any information relating to the charges for the service, this as explained to us by the manager due to the fact it was classed as an NHS service, and as such free at the point of delivery, this as it is an intermediate care service and not long stay residential. The only instance where this would not be applicable is if an individual stopped after the agreed period of reablement (normally six weeks) which the acting manager told us is unlikely and certainly the exception to the service provided at New Bridge House. We advised the acting manager to ensure that this information was added to the homes statement of purpose or service users guide so that it was clear to people who may use the service. We saw that individuals living at the home have access to a contract of residency, the ones we saw signed and agreed by the people stopping at the home. These contracts contained the necessary information to comply with National Minimum Standards, with the exception of the fee for residency which in this instance is not applicable. From sight of three individuals case files we noted that there was very detailed information in respect of their needs available in the assessments we saw. In all three instances the home had copies of the social workers assessments (this assisted by the fact the home has a link social worker that manages the majority of admissions to the home) as well as pre admission assessments carried out by a senior member of staff from the home. We noted that these assessments contained information as to an individuals preferences and diversity and was sufficient for a decision to be made as to whether the home was able to provide a reablement service to them. We saw letters to individuals confirming that this was the case, this dated before individuals were admitted to the home. Discussion with senior staff showed that they understood the importance of robust assessment in the process of determining the value of the service to a specific individual. Care Homes for Older People Page 10 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their assessed individual needs with the principals of respect, dignity and privacy promoted by staff in the home. There is scope to improve some practices in respect of medication management, such as risk assessments in respect of self administration. Evidence: We spoke to three individuals who use services provided by the home, discussing their personal requirements with them in comparison to the documented records relating to their care. In all instances we found that care plans reflected the care we were told they received. Based on the the needs individuals told us they had, we saw that the staff at the home were meeting these and care plans overall set out clear and achievable goals in respect of physical and healthcare needs. Based on what individuals told us the care plans and assessments carried out by staff had involved them and the fact that they were accurate underlined that the way care was delivered was person centered, although not all care plans had been signed by them. Promotion of independence was clearly identified within the plans with supporting risk Care Homes for Older People Page 11 of 27 Evidence: assessments that explored the risks associated with reablement. We saw that each individual had access to plans completed with the health staff such as the occupational therapist and physiotherapist. Exercises that had been given to individuals were supported by written information that they had an awareness of. We noted that the care plans we saw are called person centered plans. Whilst the plans as stand alone documents are not necessarily person centered the way care is delivered was, as evidenced by the outcomes of this inspection. We saw that individuals using the service have regular access to healthcare services, this through community services such as an allocated GP that visits the home weekly, as well as a physiotherapist and occupational therapist that are part of the allocated reablement team. People we spoke to were clear that they felt their health care needs were meet with clear written evidence backing these statements up, with appropriate follow up and preventative care for those people that had pressure areas. We saw that the aim of the home to promote independence was clearly evidenced from what people told us, this supported by documented evidence and observed practice. We were told that staff received a full induction to the the aims of the home and how to promote reablement prior to the reopening of New Bridge House, although many staff employed at the home are familiar with such a service from working at the intermediate care unit at Wallbrook house, the induction providing an appropriate update. We saw that the home has an efficient medication policy. Medication is administered by the senior care officers who are appropriately trained. The home promotes the self administration of medication through a risk assessment framework although we did note that not all of these were up to date. When we asked to see a risk assessment for one resident that was self administering creams this was not available and the risk assessment for another that was self administering their insulin was not up to date, with reference to a district nurse administering when this was clearly not the case. Staff and people receiving care did however give us updates on how their safety was promoted in respect of self administration, and other risk assessments we saw were up to date, detailed and understood by those they related to. We also noted that there were some prescribed creams in bedrooms that had not been secured; in such as a lockable drawer in for instance. Medication records overall we saw to be well documented with the exception on one persons records that for one period showed no start or end date, meaning it was difficult to be sure of the period it related to. With the above exceptions we found the homes practices in respect of medication management to be acceptable. We saw that staff clearly explore individuals preferences and wishes through the assessment and care planning process, and individuals using the service told us that their privacy and dignity was clearly respected by the care staff. Examples of how this Care Homes for Older People Page 12 of 27 Evidence: was achieved included staff always knocking on doors, using their preferred names, encouraging people to be independent, providing keys to bedrooms and lockable areas and allowing time alone if wished. The layout of the building in allowing access to private space was also commented on. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their lifestyle, and supported to develop their life skills in line with the aims of the service and their personal objectives. Social, cultural and recreational activities meet individuals expectations. Evidence: One of the main objectives of the home is to promote independence and work towards individuals regaining confidence in daily living skills. This emphasis is clearly shown in the care plans we saw, and people we spoke to confirmed that they are involved in improving their mobility, food preparation and management of their personal care and such like. Reablement is part of the daily activities that people are involved with at the home although there are leisure activities made available as well. The three individual residents we spoke to all said that they were involved in activities if they wished, this on a individual or group basis. They told us about a party at the home the night before where outside caterers brought food in and entertainers attended. One commented to the fact that this brightened me up. Another spoke of planning to watch the football that evening, and we heard that the home has bingo sessions. Their is also a Wii video game available and one of the individuals spoke of their enjoyment when playing on this. This reflected comments about the use of the Wii as recorded in the last residents Care Homes for Older People Page 14 of 27 Evidence: meeting. We also note that the home has a karaoke machine. All three individuals also commented on their enjoyment in watching the squirrels and foxes that they watched in the homes grounds. People also told us that the routines in the home are relaxed and they can get up and go to bed when they want and have free access around the building. The homes visiting policy is available in all bedrooms and there are no restrictions on visiting. We saw that the home has a pay phone in a quieter area of the home although we were told that staff allow residents access to the office phone so as to allow them contact with relatives.Comments from individuals showed that staff encourage and assist with their maintaining contact with relatives and friends All the individuals we spoke to knew why they were staying at New Bridge House and what they hoped to achieve during their stay, this underlining their involvement in what was happening in their lives. The people we spoke to clearly had capacity to make informed decisions and this process is assisted by the staff in preparing them for a move to more independent living arrangements. At present the meals provided at the home are brought in by staff in insulated containers from another social services home literally five minutes drive away. This is not planned as a long term arrangement and there will be a permanent catering staff allocation at some point in the future so we have been told. This does not however present any issues in respect of individuals having a choice of foods as all the people we spoke to told us staff give them a choice well in advance of the meal (as we saw was the case) and the food they have does reflect their preferences. Overall we heard very positive comments as to the quality of the food with the exception been that the fish could be better on a Friday and one person felt the food was not always hot enough (others said the food was always hot enough however). We saw that the staff recorded temperatures of the food when received at the home and if needed reheat to safe temperatures. We saw records of the foods provided and these showed a balanced range of foods that met individual preferences. There is a stock of some food at the home so that snacks can be made and people told us that fruit platters are brought round on a regular basis. Comments as to the meals in in the last residents meeting showed a positive response from residents. Care Homes for Older People Page 15 of 27 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 who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: We saw that the home has a complaints procedure that is clearly written and easy to read, been available in larger print, pictorial formats and other languages if needed. We saw copies of the procedure within all those individuals bedrooms we looked in addition to those seen on display in the reception area. The organization has a robust process in place for dealing with complaints with a dedicated complaints officer that will monitor and pick up on complaints should they not be resolved to the complainants satisfaction during the first stage of investigation. The number for the complaint officer was contained within complaints forms although we did note that the contact details for CSCI still made reference to Ladywood House. As we are no longer based there the acting manager was advised to ensure that the CSCI national helpline number is put within the complaints procedure. There have been no complaints since New Bridge house reopened a few months ago. People told us that staff do listen to what they have to say and there are methods in use for gathering peoples views on the service such as residents meetings and exit questionnaires for people to complete when leaving the service. Care Homes for Older People Page 16 of 27 Evidence: We saw that the policies and procedures for safeguarding adults are available in the home and provide specific guidance for staff as to the process to follow if concerns arise. All the staff at the home have been given recent adult protection training as part of their induction to New Bridge House. In addition the home has clear procedures in place for staff should they need to whistleblow on poor practice. We noted from minutes of a staff meeting that the staff team are comfortable in raising potential issues with management and that the management team place a high priority of safeguarding the people using the service. There have been no safeguarding issues since the home reopened. Care Homes for Older People Page 17 of 27 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. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence in keeping with the aims and objectives of the service. Evidence: New Bridge House was originally a home for younger people with disabilities before its refurbishment and reopening recently as an intermediate care unit. The refurbishment of the home has resulted in a pleasant physical environment that is light and airy with ample space in bathrooms and corridors. There is a lounge area that leads to a dining area as well as two separate and smaller rest areas where residents can have privacy or visitors. Overall communal space exceeds the minimum required. A number of bedrooms are of a good size and whilst there is one slightly under minimum requirements this room unlike the others has an en suite facility. Access into and around the home is suitable for wheelchair users, this assisted by the fact that it is all on one level. The only issues that people raised as problematic was getting through fire doors (to bedrooms) when they have walking aids, and the heat within the bedrooms. This latter point was discussed with the acting manager who did state that there was an issue with the heating and this was to be rectified when a part that was on order became available. Due to having to maintain the heat in all areas of the home this had resulted in some of the rooms been very warm. We saw that fans had been Care Homes for Older People Page 18 of 27 Evidence: provided to the residents. People told us that the water available from faucets was warm enough and we saw that radiators were all fitted with protective screening. We saw that there is one assisted bathroom and flat floor shower available so as to provide a choice of bathing facilities. Whilst only one bedroom has an en suite we saw there are ample toilet facilities available, these fitted with raised seats and grab rails. All the corridors are also fitted with handrails. The aids and adaptations that we saw are available are consistent with the needs of those people living at the home and include a call bell system in every room. The home was also seen to have an assessment kitchen for use by Occupational therapists and care staff in assessing a service users safety and ability prior to going home. The location of the laundry is next door to the kitchen with 2 washing machines and a tumble dryer. There are handwash facilities and ample room for the ironing to be done. We saw that this area was also clean and fresh as was the rest of the home including toilets and bathrooms. We did not at any point note any unpleasant odours, only that the home was fresh and clean. The home was seen to have adequate guidance in place in respect of the management of infection control this supported by risk assessments. We saw that there was handwash available around the home for staff and visitors as well as protective equipment for use by staff when providing personal care. There have been no outbreaks of infection at the home although management are aware of the processes to follow should this occur. We sampled the homes servicing certificates and found that these are all up to date and fixtures, fittings and equipment are fit for purpose. we noted that one bedroom has a compromised double glazing panel, this noted at the time the home recieved a visit in respect of their variation of registration. Whilst there was some slight misting seen in the panel and at some point it will need replacing it was not obscuring the view out of the window and there was no noted inlet of cold air. The occupant of the bedroom did not view this as a issue. In discussion with the acting manager we were lead to believe the misting of the window was more apparent at the point we last visited when the home was unoccupied and the heating was off, this a possible factor. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: We discussed staffing arrangements with the acting manager who stated that due to the nature of the service the dependency levels of the people living at the home can fluctuate. On review of the staffing arrangements for the home, this through looking at staffing rotas, comparing these with the staff on duty and talking to individual residents as to their views we judged there to be sufficent staff available to allow the home to provide the service it states it will. There is always a senior care officer on duty during day and evening hours and they manage up to three care assistants as well as some ancillary staff (such as domestics). Staff support the physio and occupational therapist that are attached to the home in the reablement of residents. People who use the service expressed confidence in the staff team with comments made to us including the following: I cant fault the staff, I have standards, if there was fault would find it, get on well with staff, staff are great have no complaints and Ive been looked after very well. Observation of the staff also showed us that they had a good rapport with residents. Care Homes for Older People Page 20 of 27 Evidence: The service has a robust recruitment procedure although there are no staff at the home that have been employed from outside of the organizations employment, many of the staff having transferred from Wallbrook intermediate care unit. We are aware that this did follow a selection process where staff had to apply for the post so as to allow equal opportunity. When we asked to see the homes training plan we were told this is still in development although we saw information as to the homes induction process that was delivered to all the staff at the home on transfer. This included input in the majority of key areas of skill and knowledge including health and safety, fire safety, aims of the home, medication, adult protection, manual handling and nutrition and hydration as well as other matters. There is a need for the acting manager to finalize the homes training plan and when complete forward a copy of this to the CSCI for reference. The acting manager told us that over 75 of staff have a vocational qualification to NVQ level 2. Seniors we were told hold an NVQ level 3. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, and is developing an effective quality assurance system formulated by a qualified and competent management team. Evidence: Whilst the manager is not currently registered in respect of New Bridge House he has extensive experience of managing a number of local authority homes and has achieved registration as a manager for these other services. We are also aware that he has the required qualifications and have no doubt as to his competence to run the service. The support provided by an experienced senior team, some of who have extensive experience of working with intermediate care further underlines the robust management in place at the home. We have been told that the acting manager is not looking at pursuing his registration in respect of New Bridge House however, and it is expected that the responsible individual will inform us in the near future of their intentions in respect of the permanent management arrangements for the home. Care Homes for Older People Page 22 of 27 Evidence: Discussion with the acting manager and seniors reflected that they had a good understanding of the key focus of the service and how to achieve this. Management of the service involved delegation from the acting manager down, for example each senior care officer is allocated a number of staff to supervise and would carry line management responsibility for this task and the staff concerned. From sight of staff supervision files we saw that one to one sessions have commenced with the staff team, these documented and agreed with them. We saw that the home has commenced introduction of quality monitoring systems through use of an auditing tool that is completed over a 12 month period, this based on National Minimum Standards. We also saw that peoples views are obtained through use of exit questionnaires (completed when individuals complete their rehabilitation at the home). We looked at six of these and they showed a high level of satisfaction with the service they received with comments such as all needs met, everyone kind and helpful and got back my independence. We saw that the home has systems in place for protecting peoples valuables with records of any in safekeeping seen to be well documented and accurate and inventories reflecting the property that individuals had in the home. The home has clear health and safety guidance formulated by the organization and the records we saw that related to health and safety compliance are well recorded. We saw that the home has a robust system for monitoring accidents that highlights any potential patterns and trends to assist the home to reduce potential hazards. Monitoring to date has not shown any particular trends. Care Homes for Older People Page 23 of 27 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 27 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 1 9 13 The registered provider 31/01/2009 must ensure that risk assessments are in place for all medications that are self administered, and that when they are they are up to date. This is to ensure that any risks to individuals whilst self administering medication are identified and minimized. 2 30 18 The registered person must 28/02/2009 forward a copy of the homes training plan to CSCI for evaluation. This is so that we can ensure that staff are receiving or have received training appropriate to the work they perform and the needs of the people they care for. Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 25 of 27 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 1 A statement as to the fact the service is provided free at the point of delivery unless the stay is extended beyond the agreed period of reablement should be included in the homes statement of purpose/service users guide and contract. Individuals should be encouraged to sign and agree care plans consistently. The staff should ensure all prescribed creams are secured appropriately. The start and end dates for Medication Administration Records should always be documented on the said records in the appropriate space. The national helpline number for the CSCI (0845 0150120) should be added to the homes complaints procedure in place of the out of date contact information currently shown. To monitor individuals comments as to the bedroom temperatures to ensure these are in keeping with their preferences. The registered provider should ensure that permanent management arangements for the home are confirmed as soon as resonably possible. 2 3 4 7 9 9 5 16 6 25 7 31 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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