Inspection on 11/01/06 for Batchfoot Country House

This inspection was carried out on 11th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Batchfoot Country House 22/09/09

Batchfoot Country House 01/06/09

Batchfoot Country House 24/05/07

Batchfoot Country House 31/07/06

Batchfoot Country House 08/09/05

Batchfoot Country House 09/03/05

Batchfoot Country House 23/06/04

Batchfoot Country House 18/12/03

Batchfoot Country House 16/07/03

Batchfoot Country House 09/12/02

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Batchfoot Country House 181 Church Street Upwey Weymouth Dorset DT3 5QE Lead Inspector Mike Dixon Unannounced Inspection 11th January 2006 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Batchfoot Country House Address 181 Church Street Upwey Weymouth Dorset DT3 5QE 01305 812143 01305 812143 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs M C Taylor Mrs Jacqueline Johnson Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Batchfoot Country House residential home is established in a large detached Georgian listed building set in its own grounds and mature gardens. It is situated in the village of Upwey, half way between the seaside town of Weymouth and County town of Dorchester. The home is close to the local church, wishing well and other village amenities. The home is registered to accommodate a maximum of 16 service users in the category of old age. The service users accommodation is arranged over three floors, with three bedrooms at ground floor level, six at first floor level and four bedrooms on the second floor. For service users with limited mobility there is a stair lift fitted to the back staircase, which accesses the first and second floors. There is a large communal lounge and separate dining room on the ground floor. At basement level there is a storage area, office, laundry room and a staff toilet/shower room. A driveway leads to the home and a car parking area is available to the side of the house. The home is set in its own grounds with large landscaped front and side gardens which boast mature trees and shrubs and is abundant with wildlife, deer, foxes, badgers, squirrels and birds. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted as part of the Commission’s regulatory duty to inspect all care homes twice a year. The purpose was to review the home’s progress in implementing the requirements and recommendations from the previous inspection report. The purpose was also to assess the home’s compliance with the remaining key national minimum standards for older persons that had not been considered during the previous inspection visit. In order to obtain a fuller picture of the home the reader should refer to the earlier inspection report dated 8th September 2005. During the visit which lasted four and a half hours the inspector spoke with seven service users, Mrs Taylor (one of the registered providers) and three staff members. He had lunch with four service users. He looked round the accommodation and inspected records relating to service users’ care, staffing, medication and health and safety and other documentation relating to the running of the home. What the service does well: Service users are encouraged to pursue their own lifestyle and to follow their own daily routine. Where feasible, they participate in decision-making about events that take place in the home. Service users are able to personalise their bedroom by bringing in items of furniture or other features of interest. There is provision for the meeting of spiritual and religious needs. Service users enjoy the meals at Batchfoot and are provided with a nutritious and varied diet. The home has suitable staff recruitment procedures although there has been no need to employ new staff for the past two years. The management encourage staff to receive training in care-related topics and to obtain qualifications. Service users have a high opinion of the staff and the following comments are representative of views expressed to the inspector: • • they’ve done their best for me the staff are very kind and helpful. Mrs Taylor and Mrs Johnson are both experienced managers and they keep “in touch” with the views of service users, the staff and other people who have a connection with the home. There are suitable arrangements in place to assist service users with looking after their money. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: There are five requirements and three recommendations arising from this inspection, including those that have been brought forward from the previous report. Evidence of consultation with service users regarding the content of the care plan must be held on record, e.g. by asking service users or their representative to sign the document. As planned, the registered persons should develop the activity provision, taking into account the needs and wishes of individual service users. The record of meals should include a note of the soup served at the evening meal. Consideration should be given to changing the place mats used in the dining room so that plates are secured more firmly. The registered persons must establish a quality assurance system based on the views of service users and their representatives and which includes an annual development plan. All staff must receive training in first aid, manual handling and food hygiene. The piece of loose carpet in the corridor near to bedroom 4 must be suitably repaired so that it no longer presents a tripping hazard. Safety precautions must be undertaken in all instances where identified by risk assessment with regard to service users vulnerability to the hot surface temperature of radiators. Risk assessments must reflect the changed circumstances of service users. The manager should carry out a session with the one staff member who has not undergone POVA training, familiarising her with the homes policies/procedures and No Secrets guidance. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were considered during the inspection. EVIDENCE: Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were considered during the inspection. EVIDENCE: Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Whilst the lifestyle at Batchfoot accords with service users’ expectations there is room for the development of activities in order to provide a greater level of stimulation. The home encourages service users to retain control over their own lives and to participate in decision-making. The home provides a nutritious and varied diet which meet the expectations and dietary needs of service users. EVIDENCE: The home has the following arrangements in place with regard to the meeting of the social/leisure and spiritual needs of the service users: a Bingo session once a month, a visiting musician every three months, a lay preacher and a group of volunteers to sing songs and hold a discussion once a month and a Holy Communion service with the same frequency. Periodically there are other entertainment events and a number of these took place over the Christmas period. The home endeavours to include friends and relatives of service users in some of the activities. The home has a DVD player and service users have satellite TV in their bedroom. The manager is looking to develop the provision of activities, whilst recognising that the current group of service users for the most part prefer not to engage a Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 12 lot in social activities. From talking with service users during the inspection some had evidently enjoyed the entertainment provided before Christmas and thought there could be more in the way of activities at the home, whilst others were happy with the arrangements that were in place already. Batchfoot is a home where service users are encouraged to pursue their own lifestyle and daily routine. Consultation with service users about matters which affect their lives or the home take place on an informal basis. As a relatively small group of people who generally remain in their own bedroom more formal resident meetings have not proved successful and therefore do not take place. Bedrooms are “personalised” with features of interest which may include their own furniture and additional items such as pictures and photos. Service users may access their personal records and information on this topic is included in the service user guide. There is a choice of items and dishes at each meal. Account is taken of service users’ likes and dislikes and of any specific dietary needs. At present there are three people with diabetes and there are suitable alternatives provided, where necessary. It is understood that the cook is shortly to attend a nutrition course relating to diabetes. The menu is planned and reviewed by the catering manager once a month; service users are asked informally for their views on the content. Good stock levels of food are maintained and there is a weekly supply of fresh vegetables and fruit. The emphasis is on “home” cooking and most dishes are prepared from “scratch”. Most service users choose to have their meals in their bedroom whilst a few eat in the pleasant and light dining room. A record of meals is maintained, including the individual choices that service users make. At tea-time soup is ordinarily served as an option, sometimes it is a home-made variety; the food record does not currently reflect this provision. The inspector joined service users for lunch which was well cooked and presented. Service users evidently enjoyed the meal and confirmed that the standard of food was always as good. The inspector noted that the glass surfaced place mats presented some difficulty to service users as plates tended to slide when food was cut up. Food and drinks are offered at regular intervals throughout the day and service users said that they always had enough to eat. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were considered during the inspection. EVIDENCE: Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were considered during the inspection. EVIDENCE: Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 The home has the necessary staff recruitment procedures in place to protect service users. Staff training is promoted by the home, but some staff are not up-to-date with all aspects of health and safety training. EVIDENCE: The home has a full complement of staff and has not had to recruit any new members in the past two years. There is a clearly set out recruitment procedure which includes the completion of an application form, the carrying out of an interview, the taking up of two references and the conducting of a police/POVA check through the Criminal Records Bureau. There have been no recent staff appointments so it was not feasible to assess the home’s compliance with induction and foundation programmes for new staff. However, the home has the information in place to carry out such programmes in accordance with National Training Organisation specifications. The individual training needs of staff members are considered when they have an appraisal and these needs are kept under review. When a particular issue is identified, such as a specific condition developed by a service user, the manager arranges for a staff training session to address it. Where applicable, staff hold certificates for courses attended. Examples of courses/sessions noted in the home’s training record include promotion of continence, diabetes care, dementia awareness, adult protection (“No Secrets”) and safe handling of Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 16 medication. In discussion with the inspector staff said that they received the training that they needed. There is also provision for training in topics that relate to health and safety. Some staff are not up-to-date with moving and handling, first aid and food hygiene and this is recognised by the registered persons who are taking action to address the matter. Service users were very complimentary about the kindness and competence of the staff. One service user said “they’ve done their best for me” and another said “the staff are very kind and helpful”. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The registered manager is experienced, undergoes training in management and care related topics and manages the home efficiently. The registered persons keep themselves informed of the views of those who live at and have a connection with the home but the lack of a more formal quality assurance system limits the extent to which the home is able to demonstrate how it achieves its stated aims and objectives. The home has the necessary arrangements in place to safeguard service users’ financial interests. A few shortfalls with the health and safety provision at the home mean that service users’ welfare is not fully safeguarded. EVIDENCE: Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 18 Mrs Taylor, registered provider, has a background in social work and has many years experience of running a care home. Mrs Johnson, registered manager, has several years experience of running a care home and has a diploma in welfare studies. She is nearing completion of the registered manager’s award which equates to NVQ level 4. She undertakes training to keep abreast of topics that relate to the care of older persons. Day-to-day management tasks are mainly the responsibility of Mrs Johnson who is in frequent contact with Mrs Taylor. Batchfoot is a relatively small home with a stable service user and staff group. The manager is in regular contact with service users, staff, relatives and visiting professionals and therefore is conversant with the views of those who have a connection with the home. Staff meetings are minuted and policies and procedures are reviewed each year. Comments received by the inspector from service users and staff indicated that the management were “in tune” with the views of those who live and work there. However, there is little evidence of a formal quality assurance system to back up the more informal arrangements and there is no annual development plan. The home has a policy that relates to the management of service users’ finances. The home does not act in any formal capacity on behalf of service users who look after their own affairs or have a representative to assist them. Small amounts of cash are held in a secure place for some service users. The manager reported that records were kept of all transactions. In the course of looking round the accommodation the inspector noted two matters of potential concern: a small section of loose carpet in a doorway in the first floor corridor and very hot unprotected radiator surfaces at the same level. Through looking at examples of risk assessments in relation to radiators these were found not to be consistently up-to-date or relevant to the changed circumstances of the service users in question. For example, one service user with a propensity to walk about unaccompanied at first floor level may go past two unprotected hot radiators and this aspect is not considered in the risk assessment. Ground floor corridor radiators have covers, these having been identified as the areas presenting most risk. As noted under Standard 30, a few areas of staff training are in need of attention and a requirement to that effect has been made in the report. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement Evidence of consultation with service users regarding the content of the care plan must be held on record, e.g. by asking service users or their representative to sign the document. Where it is not possible to do so a note to that effect should be kept on record. Previous timescale of 30/11/05 not met. The registered persons must establish a quality assurance system based on the views of service users and their representatives and which includes an annual development plan. All staff must receive training in first aid, manual handling and food hygiene. This requirement has been amended from the requirement in the previous report and includes a recommendation from the same report which has not been addressed. Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 21 Timescale for action 28/02/06 2. OP33 24 31/05/06 3. OP38 18(1) 31/05/06 4. OP38 23(2) 5. OP38 13(4) The piece of loose carpet in the corridor near to bedroom 4 must be suitably repaired so that it no longer presents a tripping hazard. Safety precautions must be undertaken in all instances where identified by risk assessment with regard to service users vulnerability to the hot surface temperature of radiators. Risk assessments must reflect the changed circumstances of service users. This requirement has been partially met and has been expanded from the previous report; earlier timescale of 30/11/05 not met. 31/01/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP15 Good Practice Recommendations As planned, the registered persons should develop the activity provision, taking into account the needs and wishes of individual service users. The record of meals should include a note of the soup served at the evening meal. Consideration should be given to changing the place mats used in the dining room so that plates are secured more firmly. The manager should carry out a session with the one staff member who has not undergone POVA training, familiarising her with the homes policies/procedures and No Secrets guidance. 3. OP18 Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Batchfoot Country House DS0000026763.V277615.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!