CARE HOMES FOR OLDER PEOPLE
Badgers Holt Butts Ash Lane Hythe Southampton Hampshire SO45 3QY Lead Inspector
Beverley Rand Unannounced Inspection 19th January 2006 10:00 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 Badgers Holt DS0000011926.V279214.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. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 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) www.badgersholtresidential.co.uk Mrs Teresa Rayner Ms Gina Rayner Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st August 2005 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 DS0000011926.V279214.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the year which looked at eleven key standards. This report should therefore be read in conjunction with the previous report. The inspector spoke with four residents, two staff, the deputy manager and the manager, and looked at records such as menus and rotas. What the service does well: What has improved since the last inspection?
The last report did not suggest any improvements, but the home has improved activities and meals: both these standards are now exceeded. The programme of activities in the home covers Monday to Friday and includes exercise to music and art classes, run by the local college. One resident told the inspector they particularly enjoyed the exercise programme. Residents are offered choices at meal times, and there is a snack bar available in the afternoons. Residents told the inspector how much they enjoyed their meals, and one resident said a birthday cake had recently been made for them. It was evident to the inspector that a lot of thought goes into mealtimes, both in terms of the food provided and individual needs. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 DS0000011926.V279214.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed. EVIDENCE: Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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): These standards were not assessed. EVIDENCE: Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 10 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, 13, 14 & 15 The home ensures that residents enjoy activities and their meals, and these standards are exceeded. The ethos of the home means that visitors are welcome and residents can make choices in their lives. EVIDENCE: Residents can choose when to get up and go to bed and residents can choose not to get up if they wish. Residents said they enjoyed the activities, and one said they particularly enjoyed the weekly exercise session, which is bought into the home. Records show who has undertaken the exercises. A person is employed to facilitate activities such as bingo, quizzes, reminiscence work, arts and crafts, dominoes, making Christmas cards, etc. twice a week. The home organises trips out in good weather. The home has recently employed the services of the local college to provide art classes within the home, for a maximum of eight residents, which has been beneficial, particularly to residents with dementia. The pictures they have painted have been displayed around the home and in residents’ bedrooms. Holy Communion happens on a monthly basis. Throughout the week, there are activities every day. Visitors are able to visit at any time, and are welcome to eat with their relatives or friends. One resident confirmed that they had a visitor twice a week and that they could come when they liked and were offered a drink.
Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 11 Residents are able to bring possessions into the home. Staff respect residents’ choices, for example, two residents like to lay the tables. The inspector observed one resident asking the manager to organise a taxi so they could go shopping. The residents told the inspector they had enjoyed Christmas dinner which was the traditional turkey dinner. One resident who had recently had a birthday said the cook had made a birthday cake. Three residents also agreed that, ‘tea has been nice recently: cooked tomatoes, bacon etc.’. The inspector saw staff providing and prompting extra fluids. The day’s menu is displayed in the dining room and residents are offered two lunch choices, or something different to the menu. The cook also gives a teatime choice, but prepares some sandwiches in advance as residents sometimes change their mind. The menu has recently been changed to include breakfast items such as croissants, cooked breakfast and different fruit juices. Another addition to the menu is a, ‘snack bar’, which consists of a box containing chocolate bars and fruit, which is placed in the kitchen along with glasses and fruit squash. Residents can help themselves if they are able, or staff can take the box round to where residents sit. Special dietary needs such as diabetes are catered for. The manager gave an example regarding the need to change a special diet in phases by working with professionals. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 The home ensures that residents can complain, and that they are protected from abuse. EVIDENCE: The home has a complaints procedure in place and has not received any complaints. Staff confirmed that if a resident wanted to make a complaint, it was their right to do so. Staff explained the correct procedures to follow if there was an allegation or suspicion of abuse, and were aware of the role of Social Services. The manager and deputy manager have attended an Adult Protection course for managers. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 the following standard(s): 26 The manager ensures that residents live in a clean and hygienic home. EVIDENCE: The home employs a housekeeper who maintains the cleaning programme and does the laundry. A rolling rota ensures that tasks are undertaken on a weekly or monthly basis, as necessary, for example, sheets are changed weekly. The housekeeper also has a schedule in place for turning mattresses and checking their condition. Staff gave examples as to how they minimised the risks of cross infection, by wearing protective aprons and gloves which are changed before going to the next resident. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 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, 28 & 30 The manager ensures that residents’ needs are met by trained staff, in sufficient numbers. Whilst there is a commitment to NVQ training, less than 50 have achieved an NVQ award, but the manager continues to seek ways of ensuring this standard is met. EVIDENCE: The home employs care staff, a housekeeper, a cleaner for the weekends and two cooks. The rota has more staff on duty at certain times of the day, for example, between 7 and 9pm to ensure that staff have the time to do the necessary tasks, which includes spending time with residents. The home employs seventeen care staff and five have achieved NVQ2, and three of these have achieved NVQ3. The deputy manager is studying for NVQ4. The manager has encouraged staff to undertake NVQ training, but some remain reluctant for various reasons. The manager is having discussions with regard to seeing if ‘in-house’ training can be organised, so that staff do not need to go to college. New staff undertake a structured induction programme. Training in the past year has included core training, such as Moving and Handling; dementia care; adult protection; safe handling of medicines and awareness of hazardous substances. A course regarding the links between dementia and abuse was tailor made for the home. All staff complete the training, and this amounts to more than the suggested minimum of three paid days.
Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 15 Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 16 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 The home is managed by a person who is fit to be in charge. EVIDENCE: The manager has achieved the Registered Managers Award and has nearly completed NVQ4 in care. In addition to this, she undertakes most of the training offered to staff. Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 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 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 N/A 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 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? NA 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. 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. Refer to Standard Good Practice Recommendations Badgers Holt DS0000011926.V279214.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hampshire Office 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
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