CARE HOMES FOR OLDER PEOPLE
Badgers Holt Butts Ash Lane Hythe Southampton SO45 3QY Lead Inspector
Beverley Rand Unnannounced 01.08.05 10:30 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 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. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Badgers Holt Address Butts Ash Lane Hythe Southampton Hampshire SO45 3QY 023 8084 9310 Telephone number Fax number Email 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 Teresa Rayner Ms Gina Rayner Care Home 25 Category(ies) of Dementia, over 65 - DE(E) - 25 registration, with number Old Age - OP - 25 of places Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31.01.05 Brief Description of the Service: Badgers Holt is a home offering personal care and accommodation to 25 older people, some of whom may have dementia. The home is located in an area known as the Waterside, on the outskirts of a village, which in turn is on the outskirts of the New Forest. Both areas offer attractive scenery, being a mixture of beach, sea and forest. The city of Southampton is accessible by car and public transport. The home was opened in 1986 and consists of a two storey building although most of the bedrooms are on the ground floor. There are 21 single bedrooms and two shared rooms. Communal accommodation includes three sitting rooms, and a dining room. There is a large garden which is accessible to service users. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was the first unannounced one of the year and took place over three and a half hours. The inspector spoke with four residents, three carers, the manager, Gina Rayner, and the provider, Theresa Rayner. The inspector also looked at various records, including care plans and recruitment records. What the service does well: What has improved since the last inspection?
The Adult Protection procedure has been amended to include the role of Social Services if there was an allegation or suspicion of abuse. Volunteers will now be treated as paid employees, in terms of recruitment checks such as references and Criminal Records Bureau checks. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 6 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. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 8 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 standard(s) 3 The manager ensures that no one is admitted to the home without their needs being assessed. Standard 6 does not apply to Badgers Holt EVIDENCE: The inspector sampled two pre-admission assessments and found that they contained all the necessary information. The manager visits prospective residents at home, in hospital, etc. as well as obtaining professional assessments where possible. The assessment also has a section entitled, ‘special comforts’ which refers to individual preferences for activities people find comforting, for example, bubble baths. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 The home ensures that residents’ health and social care needs are met, and that their privacy and dignity are maintained. EVIDENCE: The inspector sampled two care plans and found the standard previously set has been maintained: this standard is exceeded. Residents plans contained all the necessary information such as a photograph, personal details etc. Risk assessments and Moving and Handling assessments were in place. Inventories were on file for furniture and other possessions brought into the home. Residents or their relatives are involved in care plans and the monthly reviews. Other information held on file is a ‘record of care’, ‘visiting professionals’, ‘slips, trips and falls’ and ‘operations and treatment log’. Care plans also contained information such as when residents liked to get up, go to bed etc. The manager and deputy manager have a weekly discussion about each care plan, to look at the whole picture and ensure that individual’s physical, emotional and social needs are being met. Seven staff have received training specific to report writing. GPs visit as necessary and District Nurses visit to dress any wounds, etc. The Continence Advisor, a dentist and the chiropodist also visit the home. Staff
Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 10 told the inspector that they monitor and report any changes in health care needs. The manager has developed a system to closely monitor the number of falls, and to try to identify if there are specific individual reasons for falling. Only staff who have have completed the Safe Administration of Medicines course administer medication. One staff member explained the procedure to the inspector which included checking the medication, checking the resident and signing records. One staff member gives the medication and signs and the other checks that the records are signed. Two staff sign for controlled drugs. The inspector checked some of the records against the drugs in the trolley and found that they matched. Three residents felt that the way the medication was given to them was appropriate. The residents who spoke with the inspector said that staff did maintain their privacy and dignity and that they were, ‘good and patient’. Staff said that they always ensure curtains are closed, use the screen in the shared room, that they knock on doors, always ask residents what they would like to wear, whether they would like any make-up, jewellery, perfume etc. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 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 standard(s) These standards were not assessed. EVIDENCE: Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 12 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 standard(s) These standards were not assessed. EVIDENCE: Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 13 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 standard(s) 19 EVIDENCE: Three residents who were asked, said that the environment was, ‘very good’, ‘nice’ and that they were, ‘very happy here’. Re-decoration continues as necessary, and since the last time this standard was assessed improvements have included five new bedroom carpets, a larder fridge, a freezer, a microwave, some new curtains and twenty three new dining room chairs. The provider has had the electricity systems and equipment tested, an Occupational Therapist has visited the home to ensure grab rails etc. are appropriate, and a fire safety inspection has been carried out. The provider has made improvements in line with the findings of the inspections. A physiotherapist is due to visit, to look at the height of chairs and beds, with regard to individual requirements. This standard is exceeded. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 The manager ensures that the relevant checks are undertaken before a new staff member starts work. EVIDENCE: Two recruitment files were sampled and found to contain the necessary information, such as a form of identity, references etc. However, verbal references had been achieved but had not been recorded, pending the paper copy, which had arrived some time later. Additionally, staff had begun work with a Protection of Vulnerable Adults check, (pending the full Criminal Records Bureau check), but the date of confirmation of this check was also not recorded. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 The home’s procedures ensure that resident’s financial interests are safeguarded. The manager and provider ensure that the home is run with regard to the best interests and welfare of the residents. EVIDENCE: The manager has created a residents’ satisfaction survey, which they can complete after they have been in the home for a while. Recently, the manager wrote to some residents and all relatives to seek views as to how the home meets expectations, but as yet, she has not received a lot of responses. The manager, Gina Rayner and the provider, Theresa Rayner are easily approachable within the home. The inspector spoke with two visitors who said that they felt, ‘one part of the team’ which ‘works to improve people’s lives’ and that management and staff were ‘friendly and informative’. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 16 The inspector sampled the money and associated records for two residents and found that they matched. Receipts are kept so it is clear what the money has been spent on. The cook ensures that food is labelled and dated and stored appropriately. An accident book is maintained and falls are always investigated. Various professionals have visited the home to ensure health and safety requirements are met, (please see standard 19). Equipment such as the lift, hoists, etc. are maintained appropriately. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 4 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 x x 3 Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 18 no 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 Regulation Requirement Timescale for action 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. Refer to Standard OP29 Good Practice Recommendations In order to fully evidence this standard, the manager should record verbal references and the result of the POVA check. Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 19 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Badgers Holt H54 S11926 Badgers Holt V241468 030805.doc Version 1.40 Page 20 - 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!
