Care Home: The Bridgings Limited (Middlesbrough)

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What the care home does well The home carries out clear assessments, prior to people being admitted to ensure that they can meet people`s needs. Following an assessment a care plan is written which sets out the way in which people,s care needs will be met. There are good social and leisure opportunities for people and those living at the home are encouraged in choosing what they would like to do, what is on the menu and where they would like to go. People are treated with dignity and respect and there is a nice relaxed atmosphere in the home. All of the people spoken too, either on the day or via surveys said that they were well cared for and happy living at the home. There are clear systems in place to safely recruit, train and support staff and policies and procedures in place to support them in their roles. The environment is well decorated and furnished and kept clean. The home is well managed with good systems to monitor the health, safety and well being of people living and working there. What has improved since the last inspection? Pictorial care plans are being introduced to make them more accessible to people living at the home.Work continues to be carried out to the premises, and people living at the home are encouraged to be involved in decisions about how this is done. What the care home could do better: Surveys to gain feedback from other health professionals should be developed alongside the existing quality assurance systems. One person living at the home has a motability vehicle, a policy should be developed to reflect the terms and conditions of use of this car.A copy of an up to date electrical wiring certificate should be forwarded to CQC following the inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: The Bridgings Limited (Middlesbrough) 116 - 118 Woodlands Road Middlesbrough TS1 3BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tanya Newton     Date: 1 9 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 21 Information about the care home Name of care home: Address: The Bridgings Limited (Middlesbrough) 116 - 118 Woodlands Road Middlesbrough TS1 3BP 01642242886 F/P01642242886 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Bridgings Limited care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 10 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 category: Learning disability Code LD, maxdimum number of places: 10 Date of last inspection Brief description of the care home The Bridgings, Woodland Road, Middlesbrough, was opened in 1989 to provide a home for 10 younger adults with a learning difficulty. The home aims to provide care tailored to individual need and the emphasis is on meeting, holistically, the daily living needs of all residents. With the exception of one double room, all rooms are single, and rooms can be personalised by residents according to their preference and taste. The home is situated in central Middlesbrough close to the University of Teesside, and within easy walking distance to shops, cafes and restaurants. The fees charged by the home are £391.00 per week. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 21 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was unannounced and carried out over three and a half hours. During the inspection, time was spent talking to people living and working at the home, looking around the environment and looking at a selection of records. Prior to the inspection the manager was asked to complete an annual quality assurance assessment (AQAA) which provides CQC with information about the home and the services being provided. We also received seventeen surveys which had been completed by residents, staff and other health professionals. Some of this information has been included within the main body of the report. Care Homes for Adults (18-65 years) Page 5 of 21 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 21 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 21 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 have their needs properly assessed prior to them being admitted to the home. Evidence: There had been no admissions to the home during the last twelve months. The home has an admission policy in place and the manager confirmed that people would be able to have a number of visits to the home including an overnight stay as part of the admission process. This is to enable people to make a choice about whether or not they want to live at The Bridgings. Assessments are also provided by the placing authority, this information allows the home to determine if the persons care needs can be met by the home. One of the people living there said, I came and had a look around the home before I moved in. Care Homes for Adults (18-65 years) Page 8 of 21 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 way in which peoples health and personal care needs are to be met are recorded within their individual plan of care. Evidence: Two care plans were viewed. The plans include detailed information regarding the persons care needs and the way in which care should be delivered. There was also information about the persons preferred lifestyle, choices, likes and dislikes. Care plans include risk assessments which detail how any risks to individuals can be minimised. The home is also in the process of introducing pictorial care plans to make them more accessible to people living at the home. People are encouraged to be involved within the care planning process and sign their agreement to any reviews or changes taking place. Care plans were person centered and reflected how people are encouraged and supported to make choices and decisions about all aspects of their lives. One staff member commented, We support people to be involved in all aspects of the Care Homes for Adults (18-65 years) Page 9 of 21 Evidence: home, for example planning menus, holidays and decoration. We hold regular meetings for people living at the home. People living there said, I have a care plan I talk to my key worker about any changes and my key worker helps me keep my care plan up to date. Care Homes for Adults (18-65 years) Page 10 of 21 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 good social, leisure and occupational opportunities for people living at the home. Contact with friends and relatives is encouraged and people are supported to make choices and decisions in all aspects of daily living. Menus are varied. Evidence: People living at The Bridgings had a variety of social, occupational and leisure opportunities. They are also supported and encouraged to be independent and carry out every day practical life skills. This included helping out with cleaning tasks both in their own rooms and in communal areas. One person living at the home was in paid employment, a lot of people attend day services and another person delivers local newspapers. Comments from people include, I go out to work and spend time with my family and friends. I go out independently. Staff take me out shopping for clothes and we have trips to places like Redcar and Whitby. I am going to Tunisia next year and Skegness in October, there is plenty to do and I go out to work and I enjoy Care Homes for Adults (18-65 years) Page 11 of 21 Evidence: going into town shopping. We go out for dinner with staff and we get lots of visitors. Observations made throughout the inspection, showed that there were good relationships between people living and working at the home. People living at the home hold keys to their own rooms and rooms were kept locked when people left the home. Staff did not enter any bedrooms unless they were given permission. The home has a set menu in place, although alternatives are always offered if someone wishes to have something different. Lots of positive comments were received about the food. Comments include, the food is alright, we have plenty of BBQs, I really like the food, we get fish and chips from the fish shop some nights and I help cook meals, we have a set menu but we change it regularly and we can always ask for something else. Care Homes for Adults (18-65 years) Page 12 of 21 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. There are good systems in place to manage and support peoples health and personal care needs. Evidence: The majority of people living at the home were able to carry out their own personal care needs independently, staff offer support and encouragement where this is required. Accurate records of health care needs are recorded in each individuals care plan. This includes any input from other health care professionals. Records examined showed that regular health checks were carried out with appropriate advice and support being sought where this was required. People living at the home said that they were well cared for. Care Homes for Adults (18-65 years) Page 13 of 21 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are clear systems in place for managing any complaints or allegations. Evidence: The home has a clear complaints procedure which is also available in a pictorial format to make it easily accessible. There have been no complaints to the home in the last twelve months. All of the people spoken to said that they knew what to do and who to contact if they wanted to make a complaint. Four compliments have been received by the home. Comments from people include, there is a pictorial complaints policy on the noticeboard, I know how to make a complaint, any problems, I would go to my key worker or the manager or senior. We have residents meetings here too and its a good place to live and I could talk to any of the staff if I had any problem. The home has clear safeguarding procedures in place, staff were aware of these procedures and had received training in the protection of vulnerable adults (POVA). Care Homes for Adults (18-65 years) Page 14 of 21 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 Bridgings is well maintained, clean, homely and free from offensive odours. Evidence: A tour of the home was taken and it was found to be clean, tidy and free from offensive odours. Since the last inspection of the home the yard has been further developed to make it a pleasant part of the home for people to sit outside and relax. Decoration had taken place in the dining room and landings. Two bedrooms had also been redecorated. Comments from people include, I have a nice room, I helped to choose how it would be decorated, I keep it clean and Its a nice home, everyone helps with the cleaning and its just been decorated. There are appropriate infection control policies in place and all staff have received training in this area. Care Homes for Adults (18-65 years) Page 15 of 21 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 living at the home were protected by the homes recruitment procedures. Staff receive training and supervision to support them in carrying out their roles effectively. Evidence: Three recruitment files were looked at, all contained an application form, two references and a CRB (police check). This helps to protect people. Training records were also viewed, mandatory training included an induction, first aid, food hygiene, moving and handling, fire and infection control. All of the six staff employed had achieved an NVQ at level 2, one has NVQ level 3 and three staff are now enrolled on NVQ level 3. Comments from staff include, we work well as a team and I feel that the home supports and respects each individual person, whatever their needs. We have a great staff team, everything is going well. Care Homes for Adults (18-65 years) Page 16 of 21 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run and the people living there are included in any changes or developments which take place. There are good systems to ensure peoples safety and well being. Evidence: People said that the home was well managed and run. Comments from staff include, we get great support from our manager and the care home is a well run, caring environment which caters to the individuals needs. Quality assurance surveys are carried out, with questionnaires being sent to relatives and people living at the home. It would be good if these questionnaires could also be sent out to other health professionals who have input with the service. The results of the surveys are summarized in both written and graphical formats. This information is then shared with those living at the home. It is also used to inform the development plan for the home. A number of internal audits take place to ensure that the home and the systems in place are running smoothly. The provider also visits the home on a monthly basis and provides a report of their findings. Health and safety records were viewed, in the main these records were up to date. Care Homes for Adults (18-65 years) Page 17 of 21 Evidence: The electrical wiring certificate was due in May 2009, a copy of this certificate must be forwarded to CQC once this has been completed. A policy on the use of the motobility vehicle which is leased by one of the people living at the home should be developed. Care Homes for Adults (18-65 years) Page 18 of 21 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 Adults (18-65 years) Page 19 of 21 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 2 39 42 The home should try to gain feedback from other health professionals as part of their quality assurance. A policy on the use of the motobility vehicle which is leased by one of the people living at the home should be developed. A copy of an up to date electrical wiring certificate should be forwarded to CQC. 3 42 Care Homes for Adults (18-65 years) Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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