Inspection on 01/10/07 for Badgers Holt Residential Care Home

This inspection was carried out on 1st October 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

Badgers Holt Residential Care... 09/02/07

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The Vicarage

St George`s

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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 Badgers Holt Residential Care Home 63 Haddington Road Stoke Plymouth Devon PL2 1RW Lead Inspector Brendan Hannon Unannounced Inspection 10:00 1 October 2007 st 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 Residential Care Home DS0000067028.V345982.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. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Badgers Holt Residential Care Home Address 63 Haddington Road Stoke Plymouth Devon PL2 1RW 01752 569229 01752 500530 info@badgersholt.co.uk 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) Badgers Holt Residential Care Home Ltd Mrs Diana Derbyshire Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Sensory impairment (8), of places Sensory Impairment over 65 years of age (8) Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Age 18 plus. The home provides a service for people primarily with a hearing disability some of whom may also have a learning disability. A maximum of eight persons may be accommodated in the home at any one time. 9th February 2007 Date of last inspection Brief Description of the Service: Badgers Holt is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for a maximum of eight people. People use this care service because both their care needs and significant sensory impairment needs, primarily hearing loss, can be met. People that use the service may also have a learning disability. The home is situated in the Stoke residential area of Plymouth close to local facilities and transport links. The home is a large Georgian property and offers a communal lounge room, dining room and kitchen on the ground floor. There is also a communal conservatory on the lower ground floor with access to a small garden. All the bedrooms are single. There is one bedroom on the lower ground floor, one on the ground floor, and the rest are on the first and second floors. All the bedrooms are fitted with a sink and three have en suite toilet facilities. Bathrooms with a toilet are situated on the lower ground, first and second floors. The current weekly fees for the home are £350. Information regarding the services provided at Badgers Holt can be obtained directly from the home. Although the home is registered to provide a service for people from the age of 18, those currently living at the home are all of, or are nearing, retirement age. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 1st October 2007 at 10.00am. I was accompanied for the first part of the inspection by a sign language interpreter to enable me to consult with all the people that live at Badgers Holt about their views of the quality of the service provided. Mrs Derbyshire, the Registered Provider, was present at the inspection after returning an hour after I began the inspection, having supported two of the people that live at the home to go to the bank. We spoke in private to each of the five people that currently live at the home as well as the staff on duty. A tour of the building was made and three assessments/care plans and the accompanying personal records were examined in detail along with records relating to medication administration, staff recruitment and training, and health and safety. What the service does well: What has improved since the last inspection? What they could do better: Mrs Derbyshire and her staff team provide a homely and caring environment for the people that use the service. Good practice recommendations were made on the following issues. Each person’s care plan should provide a complete detailed description of their care needs and the action taken by staff to meet these needs. There should be documentary evidence that the sign language training given by the Registered Provider to the staff is adequate to meet the communication needs of the people that use the service. The service should periodically formally consult with the people that use the home, and other stakeholders in the service, about the quality of the service provided. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 6 The certificate for the mains wiring in the building, and the risk assessments regarding unadapted individual hot water outlets and each uncovered hot surface, should be kept available for inspection. 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. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 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 Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering using the service can, with the support of their representatives, make an informed decision about whether to use it from the information provided. A thorough assessment of a persons needs would be made before they are admitted to the home. EVIDENCE: The Service User Guide/Statement of Purpose document enables people that are thinking about using the service to be well informed about what they will receive. The home has also recently developed a leaflet in support of the Service User Guide that contains both basic information and photographs of the facilities. The documents contain information on the services provided at the home, including accommodation, staffing arrangements and daily routines and activities. Due to the small nature of the home, the Registered Provider confirmed that she meets with every person considering using the service and Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 9 fully explains the service available. People are also invited to spend time in the home, including overnight stays. No one has been admitted to the home recently. The pre-admission documentation enables the service to carry out a detailed assessment of a person’s needs before they are admitted to the home. This process is necessary to ensure that the service can meet each persons needs. Some of the staff have received formal training in British Sign Language to enable communication with the people that use the service. The Registered Provider stated that she gives informal training to all the other staff. All the staff can communicate adequately with the people that live at the home, although not everyone uses only recognised sign language. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person’s health, personal and social care needs are being met. People are treated respectfully. Peoples’ medication administration is well managed by the service. EVIDENCE: Three peoples care plans were examined. These documents are used by the home to record peoples’ care and support needs and to plan how staff will consistently meet these needs, noting any risks to the person’s welfare. This documentation is in an easy to follow format and has continued to improve since the last inspection. Additional information has been added to the care plans since the last inspection. The care plan document firstly assesses each person’s personal and health care needs, including the level of their sensory impairment, their mobility needs, and their social interests and hobbies. Secondly this document states the actions to be taken by staff to meet these needs. From discussion with the Registered Provider is was clear that there is more information about peoples needs and how these are met which is still to be Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 11 recorded. The Registered Provider was advised to include all that is known about each person’s needs and how these are to be met to enable the staff to act consistently in meeting peoples needs. For example, there could be more detail in the areas of communication, food preferences, behavioural management, and catheter care. It is important that this information is fully recorded to ensure that everyone in the staff team has the same level of knowledge about each persons needs, and also to enable the home to demonstrate their good practice. The home uses a monitored dosage system for medication administration and medication is stored in a locked cupboard in the dining room. There was a medication profile on each care planning file. The Registered Provider confirmed that she and five care staff have received training in the safe handling of medicines from the local pharmacist. Records were well maintained. The inspector observed the Registered Provider and staff interacting with the people that use the service in a friendly and respectful manner. There was a happy atmosphere in the home. The inspector spoke to everyone that lives in the home with the assistance of a sign language interpreter. Everyone confirmed that they are well cared for and had the freedom to come and go as they pleased from the home. Many had lived at the home for a considerable period of time and appreciated living in a small, family run home. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service are supported to make choices about their lifestyle. Meals are nutritious and varied. EVIDENCE: People that use the service said that the routines of the home were flexible and they were free to come and go as they pleased. The social and leisure activities in the home include cooking / baking, board games, tactile puzzles, Braille books/reading and gardening. Some people attended the local club for people who are deaf. The Registered Provider confirmed the majority of people are able to go out of the home without support from staff however she was available to assist with trips into town or walks to the local shops. Friends and relatives are welcome to visit at all reasonable times. Throughout the inspection people were observed going about various activities, such as walking to the shops to buy a newspaper, going to the bank, and taking the dog for a walk. The people that live at the home said that the food was good, and staff confirmed that drinks and snacks were available at all times. The dining room Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 13 is a pleasant place to eat meals. Some people enjoy helping lay out the dining room table for their meals. The menu for the home is changed seasonally. The Registered Provider said that peoples’ food preferences were taken into account in designing the menu. There was a well maintained record of the food that had been served and the food described was varied and nutritious. There is complete choice of foods at teatime. The main meal of the day is at lunchtime. Although the Registered Provider described the alternatives requested by people at lunchtime, the service was advised to record some of these choices to have something different, in order to demonstrate the level of choice available. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service can be confident that any issues of concern will be taken seriously and dealt with promptly. The people that live at the home are protected from abuse. EVIDENCE: Neither the home nor the Commission for Social Care Inspection has received any complaints regarding the services delivered by Badgers Holt. All the people that live at the home were spoken with, with the support of a sign language interpreter, and no one raised any issues of concern. Everyone indicated during the inspection that they received the support they needed. The homes complaints procedure is displayed in the hallway and is accessible to all the people that live at Badgers Holt and to visitors to the home. The home has a copy of the new Adult Protection ‘Alerters’ guidance on how to use the adult protection system in Plymouth, if there was an adult protection issue. Two care staff have received training in the protection of vulnerable adults through their National Vocational Qualification training, ensuring they are aware of their responsibilities should they suspect a person is at risk from abuse. The Registered Provider stated that she intended to send the other staff on the Plymouth City Council adult protection training. The Registered Provider confirmed that as she lives in close proximity to the home she has instructed her staff to notify her of any concerns regarding the welfare of the people that live at Badgers Holt. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Badgers Holt provides a safe and comfortable home for the people that use the service. EVIDENCE: The home is warm, comfortable and clean. Communal areas are well decorated and comfortable seating is provided. People that use the service were able to personalise their rooms with their own furniture and belongings. None of the bedroom doors are fitted with locks and therefore the security of peoples’ personal belongings could not be guaranteed. Three bedrooms were fitted with switches outside the room to allow staff to turn a light on and off to indicate to the person that uses that room that someone is at their door. The Registered Provider confirmed that should any other person wish to have either a lock or the light system installed it would be fitted. Two people had been able to bring their small pets with them into the home and they retain responsibility for their care. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 16 Bathing and toilet facilities are suitable for the people that currently use the service. Specialist support is available from community services such as the Occupational Therapist who has provided mobility aids for one person’s use. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent and caring staff supports the people that use the service. The homes recruitment practices help to protect the people that live there. EVIDENCE: There is a total staff team of seven including the Registered Provider. There have been no staff changes in the past 12 months. The staffing level is adequate to meet the needs of the people that presently live at the home. Personnel records of two staff were inspected. These contained all the necessary documentation, which includes an application form, two written references and a Criminal Record Bureau disclosure, ensuring as far as possible, only suitable staff are employed. The home uses the “Skills for Care” induction training programme which is nationally recognised training for staff new to the care profession. 83 percent of the staff have obtained a National Vocational Qualification in Care at level 2 or above. This qualification assesses knowledge and skills in supporting adults in a care environment. The one remaining unqualified staff member is following this training. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 18 Staff have also received training in first aid, food hygiene, fire safety and British sign language (BSL) ensuring they have the knowledge and skills to support the residents and deal with emergencies. Badgers Holt states that it is a specialist service providing support for people with a severe hearing impairment. Therefore communication skills are of great importance to provide good support for the people that use the service. The Registered Provider said that she taught the staff basic BSL and other signs used by the people that use the service. One member of staff is formally trained in BSL. The Registered Provider is advised to demonstrate, in a documentary form, that the sign language training that she has given to the staff enables them to adequately communicate with the people that use the service. The Registered Provider confirmed that she is in the home on most days and as such works closely with the people that use the service, staff and visitors. Daily handover reports between each shift take place and the Registered Provider used these times to communicate any changes in peoples’ care needs or any issues relating to the running of the home or staffing issues. Formal supervision is not recorded as the home’s staff team is small and all have access to the Registered Provider on a daily basis. Badgers Holt Residential Care Home DS0000067028.V345982.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): 31,32,33,34,35,36,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Provider and her staff team strive to provide a safe and stimulating environment for the people that live at Badgers Holt. EVIDENCE: Mrs Derbyshire, the Registered Provider, had been a co-owner of Badgers Holt for approximately 20 years and registered with the Commission last year as the sole provider. She has a National Vocational Qualification in Care at level 4 and many years experience in managing the home, having known the majority of the people that use the service for a long period of time. Due to there only being five people in the home, Mrs Derbyshire confirmed that she consults with each person everyday. No records of this were maintained unless a person raised a matter of concern. Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 20 There is no formal quality assurance system in use for the service. Advice was given that periodically the people that use the service, their relatives and other stakeholders in the service, e.g. health and social care professionals, should be formally consulted about the service provided. This system is necessary so that the Registered Provider can demonstrate the quality of the service provided. All the people that live at Badgers Holt maintain responsibility for their own finances and the home does not hold any money for safekeeping. There is a lockable facility in each person room for them to use to keep their valuables safe. The home received the ‘Choose Health’ award from Plymouth City Council Environmental Health on 04/09/07 demonstrating the safety of their food provision system. The following health and safety records were reviewed. Accident records, domestic electrical wiring, mains electrical wiring, fire prevention, environmental health, gas safety and the homes environmental risk assessments. All these records were good except for the following two areas. The Registered Provider could not locate the mains wiring certificate for the building. It was advised that this certificate be kept with the other health and safety documentation to ensure that it is available for inspection. Also the Registered Provider could not locate the risk assessments for either the unadapted hot water taps or uncovered hot surfaces that are accessible to the people that use the service. The wiring certification and the noted risk assessments help to ensure that the safety of the people that use the service is maintained. Badgers Holt Residential Care Home DS0000067028.V345982.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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 3 3 3 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 3 2 3 3 3 3 2 Badgers Holt Residential Care Home DS0000067028.V345982.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. 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. 2 Refer to Standard OP7 OP30 Good Practice Recommendations Each person’s assessment and care plan should provide a detailed description of all their care needs and the action to be taken by staff to meet these needs. The Registered Provider should demonstrate in a documentary form that the sign language training she has given to the staff is adequate to meet the communication needs of the people that use the service. A quality assurance system for the service should be developed and implemented. The certificate for the mains wiring in the building should be kept available. Risk assessments regarding individual hot water outlets that have not been adapted and each uncovered hot surface should be kept available for inspection. 3 4 OP33 OP38 Badgers Holt Residential Care Home DS0000067028.V345982.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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