Inspection on 24/05/07 for Batchfoot Country House

This inspection was carried out on 24th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Batchfoot Country House 22/09/09

Batchfoot Country House 01/06/09

Batchfoot Country House 31/07/06

Batchfoot Country House 11/01/06

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 Trevor Julian Unannounced Inspection 24th May 2007 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.V340948.R01.S.doc Version 5.2 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.V340948.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Batchfoot Country House Address 181 Church Street Upwey Weymouth Dorset DT3 5QE 01305 812143 F/P01305 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.V340948.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31/07/2006 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. The fees for the home, as confirmed to the Commission for Social Care Inspection (CSCI) at the time of inspection, range from £443 - £450 per week. Additional charges include hairdressing, chiropody and newspapers. The Office of Fair Trading has published a report highlighting important issues for many older people when choosing a care home, e.g., contracts and information about fees and services. The CSCI has responded to this report and further information can be obtained from the following website: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choosing a care home .aspx A copy of the home’s inspection report will be made available to anyone wishing to read it upon request to the manager. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 24th May 2006 and was concluded on the 21st June 2007. Mrs Taylor, owner, and Mrs Johnson, manager were on the premises throughout the visit. Before the inspection, the home had returned a copy of the Annual Quality Assurance Assessment giving information about the management of the home and basic care needs of the residents. Visitors and residents were able to give their views of the home through surveys; 20 were received and all gave a positive view of the home. During the visit, information was gained from a tour of the premises, case tracking, discussion with residents, three visitors, staff and management. At the time of the visit, there were 11 residents at the home. The home had just been advised that a grant application for improvements to the grounds had been agreed. This would provide improved access and a revamped seating area. What the service does well: The comment cards showed continued high levels of satisfaction about life in the home. The home has had no recent admissions but there was a pre – admission assessment process for future vacancies. Records seen during the visit showed that care plans were in place for each person and they were regularly reviewed. There was also evidence that the home had good support from local GP’s and community nursing teams. Residents said that the staff were always helpful and would call for GP support if they had any concerns. There was nutritional information about each resident to ensure that if changes occurred the staff would take appropriate and timely action. Residents reported that medication was well managed. Stocks were at an appropriate level and safely stored. There was a separate fridge for storing temperature sensitive medication, the thermometer indicated that the unit was not operating in the correct temperature range and Mrs Taylor arranged for a replacement. The records seen were up to date and there was a clear audit trail for items held. The comment cards showed that people appreciated the care and support given by the staff at the home. During the visit the staff were observed with the residents, they were supportive and friendly and did not attempt to hurry the residents. They were also seen knocking on bedroom doors before entering. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 6 The home produces a monthly activity list giving residents and visitors information about forthcoming events. Due to recent illness in the home the programme for May and early June had been suspended and it was just being re instated. Several people commented how much they had enjoyed their themed “seaside” coffee morning. The home holds church services in the home once a month, spiritual needs are considered during the admission process to ensure that those needs can be met either within the home or with support from the local community. The residents were able to vote in local elections using postal ballots. The meal served during the visit was nicely presented and looked appetising. Food records showed a variety of traditional home cooked foods offered. The home used local suppliers for all food stocks including fresh meat, fruit and vegetables. The premises were clean and odour free, staff seen were taking care to follow infection control guidance. The premises are accessed along a long narrow track; some potholes in the track could present a hazard to residents and visitors. One resident described the premises as comfortable and homely. Each room seen had been personalised by the occupant using pictures and other mementoes. The home benefits from a stable and loyal workforce, they do not use agency staff to cover absence therefore there is very good continuity of care. The staff training programme ensures that the staff have the skills and qualifications to carry out their work. The home continues to be managed by an experienced team, and the manager is restarting her NVQ level 4 Registered Managers Award to meet the qualification standards. What has improved since the last inspection? What they could do better: A small number of people deposit cash with the manager to cover charges made for hairdressing, newspapers, chiropody etc. The records were well kept and the balances held matched the transaction records. However there was no evidence of internal audit or receipts for expenditure. During the visit an Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 7 internal audit system was set up along with a procedure to retain receipts for expenditure. Fire extinguishers were checked by a contractor on a yearly basis but staff did not complete monthly visual checks. The risk assessment and procedures did not provide staff guidance on the evacuation procedure. This would have serious implications on the event of a fire. Two members of staff had not attended fire safety training in the past year. 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. The summary of this inspection report can be made available in other formats on request. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 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.V340948.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process helps to ensure that the home has the facilities and skills to meet the assessed health and social care needs. EVIDENCE: There had been no vacancies at the home for a considerable time. The home had a process for obtaining information about the needs of the prospective resident. The format for the assessment included identification of those consulted and the resident’s involvement. None of the people spoken with could recall any concerns about the admission process. One person did recall visiting the home before deciding to move in, one of the visitors said she had visited and said that the manager had also carried out an assessment to ensure they could accommodate her relative’s needs. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 10 Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care is well managed within the home with support from the community healthcare teams giving the residents confidence that any needs will be addressed. EVIDENCE: Care plans were developed from the pre-admission assessment and care reviews. Copies of Local Authority care plans were on file for funded residents. As a small home with a stable workforce the care staff were very clear of the tasks needed to meet the assessed needs. None of the residents had pressure ulceration but the staff seen were alert to the early signs. There was evidence of basic nutritional assessments being followed. When staff had concerns these were referred to the manager who would then seek advice from the relevant community healthcare teams. Weight checks were carried out monthly. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 12 Three residents received medication for diabetes, some of the senior staff had attended training courses to inform them about the condition. The files showed involvement from the local GPs and community nursing teams. The medication system was checked; the items were correctly stored and the record sheets were up to date. Where there had been handwritten amendments these had been checked by a second person to reduce the risk of transcription errors. Temperature sensitive medication was kept in a locked fridge, the temperature checks had identified that it was not operating at the correct level and Mrs Taylor was arranging delivery of a replacement. Staff had access to medication reference books. One person said the staff helped her with her medication and she added that the staff were very careful to ensure that the medication was correct and that it had been taken. During the visit staff were seen with the residents and a friendly and supportive rapport was noted. The staff were seen knocking on residents’ doors before entering. The residents said they were very well treated and the staff made them feel part of an extended family. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home allows the residents choice and options in their daily lives dependent on the individual’s own circumstances. EVIDENCE: The manager posts a monthly activity programme in the entrance lobby. The activities feature regular themed coffee morning, church visitor, organist bingo etc. Due to illness the programme was curtailed last month. The home also produces a newsletter, provided to the families of the residents to keep them informed. There were many picture on display showing the activities being enjoyed. Several of the residents said that they preferred not to attend group events and this was accepted by the staff and there was no compulsion to join in. The files seen contained evidence that the residents had been given the opportunity to vote in recent elections using a postal vote. Visitors said they were able to visit at any reasonable time and a good rapport was noted between the staff and visitors. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 14 The food records showed a good variety of food offered. The budget was considered and it showed a very good level of expenditure on food supplies on average over £30 per week per resident. Some kitchen appliances had been replaced since the last inspection. Food stocks were regularly replenished and the home had a local supplier for fresh fruit and another for fresh meat. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to allow residents and visitors to raise concerns. The adult protection procedures inform the staff about how to respond to any adult protection matters. EVIDENCE: The home’s complaint procedure is on display in the main hallway and resident information pack. There had been no recent complaints recorded. Residents said they would approach any of the staff if they had a concern and they were confident that the matter would be addressed. This was also the view of the visitors seen. The manager was looking to see if there were other ways residents could express their concerns. All staff were trained how to handle signs or allegations of abuse. The staff on duty were clear about their responsibilities if an allegation arose. The home has a policy for dealing with allegations of abuse. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises are maintained to a reasonable level and provide the residents with a comfortable and homely environment. EVIDENCE: Since the last inspection, one bedroom had been redecorated and the carpet on the main staircase, lounge and dining room had been replaced. At the time of the visit all rooms were for single occupancy. The home has bedrooms on three floors and there are two staircases, one with a stairlift. The assisted bathrooms were on the first floor. Bedrooms were redecorated as they were vacated. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 17 The home employed a maintenance person who carries out routine repairs and maintenance. There is also a gardening contractor who tends the large grounds. A patio area at the front of the home provides a pleasant seating area for the residents. A grant had been secured to carry out improvements to the patio area. Communal lounge and dining rooms were located on the ground floor and were used by a few of the residents. The bedrooms seen were well laid out and had been personalized by the occupants using photographs and small items of furniture. Some of the radiators were covered in padded cloth protectors to guard against knocks and burns, the remaining radiators had been risk assessed, the assessments were not seen during this inspection. The home was clean and there were no unpleasant odours. There had been a recent infection in the home and the home had been in contact with the relevant bodies. Staff were seen using disposable aprons and gloves to aid infection control. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately staffed by competent carers to promote the wellbeing of the people living at the home. EVIDENCE: The home was staffed appropriately for the number of residents and their current needs. The staff have worked in the home for a number of years and the files seen had the required clearances and checks. The loyalty of the staff was recognised by the residents and the visitors, this also helped with continuity of care. The home had completed an Audit of training for Skills for Care, the national training organisation. One carer was just starting her NVQ level 2 in care maintaining over 50 of care staff trained at NVQ level2. At Batchfoot House 50 of care staff have achieved NVQ at level 3. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well managed and run in the best interest of the residents. However, breaches of fire procedures could impact on the safety of the residents. EVIDENCE: The home’s owner and the manager both have a wealth of experience running the care home. The manager was well advanced in obtaining her NVQ level 4 however due to circumstances beyond her control she had been unable to complete the full programme and was now restarting with another training provider. As a small home the residents and staff described the management as approachable and accessible. Staff felt they could make suggestions about Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 20 any ideas they had. Files seen showed that staff receive regular supervision and appraisal meetings. There were residents’ forums and surveys to help identify any areas for improvement. The quality assurance system was being developed and some advice was offered. The home did not manage the finances for any of the residents, however a number of people did deposit personal allowances with the management to cover personal expenditure e.g. newspapers, chiropody and hairdressing etc. A sample of two accounts showed the balances matched the transaction records however there were no receipts for expenditure and the system was not regularly audited internally. During the inspection an internal audit process was introduced and a process for retaining evidence of expenditure. The home had an accident reporting system which was used to monitor for trends and risks. Fire records were examined, the fire risk assessment had been completed in 2005: it was overdue for review and should consider evacuation procedures. Two members of staff had not attended fire training in the past year. Weekly checks of the alarm system were recorded as were the contractor servicing visits. The fire fighting equipment monthly visual checks were not recorded. Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 23(4) Requirement The registered person must ensure that the suitable arrangements:(a) for the evacuation, in the event of fire, of all persons in the care home and safe placement of service users. (b) for the maintenance of all fire equipment. (c) for persons working at the care home to receive suitable training in fire prevention. Timescale for action 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Batchfoot Country House DS0000026763.V340948.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 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 © 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.V340948.R01.S.doc Version 5.2 Page 24 - 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. 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