Inspection on 23/01/06 for 42 Barry Road

This inspection was carried out on 23rd January 2006.

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

42 Barry Road 10/11/06

42 Barry Road 15/06/05

42 Barry Road 30/03/05

42 Barry Road 08/02/05

42 Barry Road 02/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOMES FOR OLDER PEOPLE 42 Barry Road Oldland Common South Glos BS30 6QY Lead Inspector Paul Clark Unannounced Inspection 09:30 23 January 2006 rd 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 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 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. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 42 Barry Road Address Oldland Common South Glos BS30 6QY 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) 0117 9329705 0117 9329705 Aspects and Milestones Trust Mr Martin Rogers Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 11 persons aged 18 years and over. May include persons aged 65 years and over 15th June 2005 Date of last inspection Brief Description of the Service: 42 Barry Road is registered to accommodate up to eleven active adults with learning difficulties, which may include people over the age of 65. The home is operated by Aspects and Milestones Trust. The home is on the edge of Oldland Common village within walking distance of shops which include a post office, public house, chemist and other stores. The property is a Victorian detached house which has been extended to create a large ground floor purpose-built area. The original building also houses a self-contained first floor flat which has the potential to be independent from the rest of the home for either a single person or a couple. All communal areas are on the ground floor and consist of a modern and spacious lounge with a partial glass roof with ten bedrooms leading off from this area. There is also a more traditional and comfortable front lounge in the older part of the building, a smaller lounge and a dining room and kitchen. The large and well maintained rear garden is fully accessible to service users. There is parking available to the front of the premises. The Home has a ‘People Carrier’ to transport residents for necessary appointments and for leisure activities. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: 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. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 6 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 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 7 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): 1-5 Available information about the home was good with a well-written and attractively presented Service User Guide. The assessment and administrative process is well-established with potential service users being offered the opportunity to visit and have short stays at the home to see if it offers the facilities they require. EVIDENCE: A Statement of Purpose and a Service Users Guide is available and it gives an excellent and very readable overview of the home and what it provides. The user guide contains details of both 42 Barry Road and the self-contained first floor flat at 42a Barry Road. The guides contain colour photographs of not only the interior and exterior of the home, but also photos taken on trips out and at local functions. Full community care assessments of the needs of new services users have been done, including their health, personal and social needs. Input from professionals outside the home has been sought on a regular basis to ensure that service uses receive the best care available. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 8 Admissions are arranged initially via the organisation’s HQ who then contact the Managers’ of individual homes within the organisation. Overnight stays are provided for potential admissions in order to allow them to decide if they would like to live in the home. The home currently has 5 male and 5 female residents aged over 65 years. There is one vacancy in the self-contained, first floor flat. The home does not provide intermediate care. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 9 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): 6-10 Service users care plans are in place. Service users are consulted about life at Barry Road and their independence is encouraged. Information about service users is kept under secure and confidential conditions. EVIDENCE: Care Plans were seen to be in place for all residents and 4 sample Care Plans were scrutinised by the Inspector. These were seen to be reviewed and updated by key workers on a monthly basis using an Essential Lifestyle Plan (EPL) format. Service users’ meetings are held on a monthly basis. Notes for their meetings were seen. During these meetings service users are consulted about the menu plan and contribute to decisions about activity planning. The Home is geared up around the fact that independence is a major priority for service users, particularly as many may have come to Barry Road from long-stay placements such as hospitals where such independence was not encouraged. Risk assessments to cover aspects of daily life were in place and have been reviewed. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 10 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 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): 12-15 The staff at Barry Road continue to work hard at enabling service users to participate in the life of the home and of the local community and to promote service users leisure and social activities. The food provided is nutritous and of a well-balanced variety. EVIDENCE: Communication between service users and staff continues to be helped by programmed one-to-one sessions and where communication skills are limited staff were seen to use a variety of communication methods to ensure residents participation. Service users help to keep their rooms clean – all those seen by the Inspector were very well kept and personalised. Service users were seen by the Inspector to be accessing all areas of the home with confidence and were being treated with respect and care by the staff. Service users attend such places as Kingswood and Blackhorse RAC, Soundwell College, Longwell Green Luncheon Club and “Hop, Skip and Jump”, which is designed for those less able than others. Hop, Skip and Jump is held in the campus of a local school which helps with local community integration. A large chart on the office wall is used to keep track of who is where during the day. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 12 Besides their regular activities, service users continue to go out a great deal on other occasions to such places as garden centres, skittles and so on, as evidenced by the daily records book. The home’s ‘People Carrier’ is well used for attending leisure activities. However, due to the increased mobility needs of this ageing resident group and the fact that the ‘People Carrier’ is not suitable for wheelchair users, it is recommended that the home seek a more appropriate vehicle. As previously stated, service users are encouraged to help with menu planning; menus were examined and the food provided was seen to be of a good variety. It was noted that the kitchen chopping boards were badly scored and it is required that these be changed. Family and friends are able to visit residents at any reasonable time of the day and are able to sit in the communal lounge or in resident’s rooms. One family visitor told the Inspector that they were always warmly received by staff in the home and made to feel welcome. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 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): 16-18 A system for dealing with any complaints by service users is in place and policies and procedures for the protection of vulnerable adults are also well established. EVIDENCE: The Inspector examined the record of complaints which is kept at the home. Records were detailed and outcomes were recorded. Policies and procedures for the protection of vulnerable adults were in place, based on the Department of Health guidance “No secrets”. The Manager has attended a course on Vulnerability on 16th May 2005. Policies in general are gone through regularly with staff and the Manager has devised a check list where staff sign once they have read (and, it was emphasised, understood) a particular policy. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 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): 19-26 Barry Road is clean, generally well maintained and adequately equipped. Bedrooms reflect the Homes promotion of independence. Specialist equipment is in situ for the service users who may require it. Communal spaces are comfortable and well-kept. EVIDENCE: 42 Barry Road is an extended Victorian detached house in keeping with the properties in the area. The first floor of the original building is able to be used as a self-contained first floor flat with its own amenities and entrance. Recently, it has been used as ordinary bedrooms. The Home overall is bright, cheerfully decorated and reasonably well maintained. However, there was some evidence that day to day maintenance is poor. For example, some light bulbs were not working and the Inspector was told that Health and Safety requirements would not allow staff to change them resulting in delays until a workman could be available to change them. Also, a disused office is used as a storeroom housing a collection of combustible materials. This room is also used as a makeshift dining room for a resident whose behaviour is disruptive to other residents during mealtimes (more is 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 15 said about this later in the Report). It was also noted that boxes of incontinence pads were left in the hall of the home. Additionally, several of the fire door closures were not working properly and the fire door in the laundry was seen to be jammed open with a wedge. Several of the kitchen cabinet doors are in a poor state of repair. To address these issues it is required that the home request inspection visits from the fire authority and provide in writing an action plan for the Commission on how the above items will be addressed. It was noted that an Environmental Health Officer inspected the premises in December 2005. Rooms were clean and tidy. Bathrooms were clean and well kept with adaptations fitted. Further adaptations may be needed with the Home’s aging population. The rear garden is beautifully kept, with chairs, greenhouse and patio furniture. There are two garden doors which lead either side of the house from the garden to the front. To ensure that residents do not wander onto the busy main road these doors have bolts. It is required that the home consider the use of a more secure arrangement for the side garden doors to ensure that residents do not wander onto the busy main road. All bedrooms meet the spatial standards requirements and are single occupancy. Rooms were inspected with the permission of service users. All were clean and well kept and reflected the interests of individual occupants with a very homely feel. Residents spoken with said they were comfortable with their rooms. The Home has toilets and bathrooms in close proximity to all bedrooms and communal spaces. Two bedrooms have en-suite facilities. All were hygienically kept and evidence was seen that they are cleaned throughout the day. Communal spaces are on the ground floor and consist of a large, modern lounge which looks out onto the accessible rear garden. It is recommended that curtains be fitted to the patio doors to provide security and privacy. There is a traditional-style comfortable front lounge in the older part of the building (which the Inspector was told gets little use at the moment). It looks out over fields opposite the Home. There is a domestic-style dining room and well-equipped kitchen. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 16 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): 27-30 Staff at Barry Road are clear about lines of responsibility. There are sufficient numbers of staff on duty at all times. Recruitment policies are satisfactory. Staff are properly supervised. EVIDENCE: The Inspector noted from observation, discussions with staff and the Deputy Manager and a review of records that clear lines of accountability exist within the Home. Job descriptions were available and staff recruitment records are complete and now held in the home. The Inspector saw that there was excellent interaction between staff and service users including those whose behaviour may, at times, have caused some disquiet, both to staff and other service users. However, the noisy nocturnal behaviour of one resident is disrupting the sleep of both residents and staff. Additionally, this person also needs to be apart from other residents during mealtimes because of the nature of his disruptive behaviour. It is required that this person’s needs be reassessed to decide whether the placement at Barry Rd continues to be appropriate or whether alternative staffing arrangements are needed to meet this person’s needs. Staffing levels are appropriate to meet the needs of the ten service users accommodated. All staff are first-aid trained. No staff have left since the last inspection. The Inspector examined supervision records and found them detailed and upto-date with targets and deadlines set. Copies of supervision records are given 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 17 to staff. Staff supervision is every 4 weeks. Staff Team Meetings are held every 4 weeks. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 18 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): 31-38 Barry Road is well run and although the Manager, who is well qualified, was on long term sick leave at the time of the Inspection the Inspector spoke with him at length on the phone during which time he demonstrated a good style of leadership. Quality assurance issues highlighted at previous inspections remain. Policies and procedures are in place to protect service users. The Home is generally safe and service users are happy and protected; however, the issues over fire safety needs to be addressed. EVIDENCE: The Manager, Mr Rogers, holds qualifications in general nursing, nursing those with a learning disability and has also achieved the NVQ 4 in Management. He is an NVQ assessor and also an NVQ verifier for Level 2 and 3. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 19 Team meetings are held every 4 weeks, these are held outside the home, giving staff the opportunity to open up in different surroundings. The Inspector saw that the Home operated an open door policy with service users entering the office at will to engage in general interaction. Service users told the Inspector that they were happy and treated well. The Manager told the Inspector that the quality assurance system is currently being reviewed. A service satisfaction questionnaire for service users has been devised towards the quality assurance goal; the Manager appears keen to create proper tools and to seek methods that will pay more than lip service to quality assurance which is a reassuring attitude. The Inspector noted that policies were in place to cover such matters as bullying, equal opportunities and disciplinary procedures. Freezer and fridge records were examined and were in order. Fire safety records were inspected, these were being carried out at the recommended frequencies. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 20 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 3 3 3 3 3 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? 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 24 Regulation 23 Requirement Timescale for action 01/04/06 2 24 23 An action plan should be sent to the Commission detailing how each of the items listed in this report (with regard to the fitness of the premises) will be addressed and an inspection visit should be requested from the fire authority. It is required that the home 01/04/06 consider the use of a more secure arrangement for the side garden doors to ensure that residents do not wander onto the busy main road. It was noted that the kitchen chopping boards were badly scored and it is required that these be changed. 01/04/06 3 30 23 4 32 15 It is required that the needs of 01/04/06 the person disrupting sleep and mealtimes be reassessed to decide whether the placement at Barry Rd continues to be appropriate or whether alternative staffing arrangements are needed to meet this person’s DS0000003392.V261817.R01.S.doc Version 5.0 Page 22 42 Barry Road needs. 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 13 24 Good Practice Recommendations The home should consider the use of a more appropriate vehicle which would meet the increasing mobility needs of this ageing resident group. It is recommended that curtains be fitted to the patio doors to provide security and privacy. 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 42 Barry Road DS0000003392.V261817.R01.S.doc Version 5.0 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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