Inspection on 09/02/07 for Badgers Holt Residential Care Home

This inspection was carried out on 9th February 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... 01/10/07

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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 Jane Gurnell Unannounced Inspection 9th February 2007 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 Residential Care Home DS0000067028.V321139.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.V321139.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.V321139.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. 07/06/06 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 8 service users for the reason of sensory impairment, primarily hearing loss, who may also have a learning disability. The home is situated in a residential area of Stoke close to local facilities and transport links. The home is a large period property and offers a lounge room, dining room and kitchen on the ground floor and a conservatory on the lower ground floor with access to a small garden. All the bedrooms are single and are accommodated on the lower ground floor and the 1st and 2nd floors: all bedrooms are fitted with a sink and 3 have en suite toilet facilities. A bathroom with toilet is situated on the lower ground, 1st and 2nd 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 for residents from the age of 18, those currently living at the home are all of, or nearing, retirement age. Badgers Holt Residential Care Home DS0000067028.V321139.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 9th February 2007. The inspector was accompanied for the first part of the inspection by a sign language interpreter to enable the inspector to consult with the residents over their views of the quality of the service provided. Mrs Derbyshire the Registered Provider was present. The inspector spoke to in private to each of the 6 residents currently living at the home as well as the staff on duty. A tour of the building was made and 3 care plans were examined in detail along with records relating to medication administration, staff recruitment and training, and fire safety procedures. 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 residents. Recommendations were made to ensure each resident’s care plan provides a detailed description of their known care needs and the action undertaken by staff to meet those needs, and that all currently prescribed medication, regardless of the infrequency of its use, should be recorded on the resident’s medication administration sheet with instructions for its use. Two advisory points were also made, firstly to provide the Service User Guide in a simpler format and to consider the use pictures for those prospective residents who may have a learning disability, and secondly, to periodically formally consult with the residents over the quality services provided in the home. Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 6 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.V321139.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.V321139.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, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with sufficient information to make an informed decision about the home. The new pre-admission documentation allows for a detailed assessment of residents’ needs prior to admission. EVIDENCE: The Service User Guide is the document that allows prospective residents and their representatives to make an informed decision about the suitability of the home as it describes the services provided at the home, such as the accommodation, staffing arrangement and daily routines and activities. Due to the small nature of the home, the Registered Provider confirmed that she is able to meet with each prospective resident and fully explain the service to him or her; prospective residents are invited to spend time in the home, including Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 9 an overnight stay. The Registered Provider was advised to provide the Service User Guide in a simpler format and to consider the use pictures for those prospective residents who may have a learning disability. The inspector had the opportunity to speak to the most recently admitted resident and he confirmed that he had been made welcome and that he is well supported. The Registered Provider has addressed the requirement made at the previous inspection in June 06 to assess each person’s needs before they are admitted; this is necessary to ensure the suitability of the home to meet the resident’s needs. New documentation has been developed that if used in full allows a thorough assessment of each person’s needs. There have been no admissions since the previous inspection and the use of this assessment will be reviewed at the next inspection. Many of the staff have received training in British Sign Language to facilitate communication with the residents, although not all residents use this recognised sign language and have developed their own signs. Badgers Holt Residential Care Home DS0000067028.V321139.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 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are being met and residents are treated respectfully. Care planning and medication documentation needs to be more detailed to protect residents. EVIDENCE: Three of the 6 residents’ care plans were examined in detail. These are the documents that are used by the home to record the residents’ care and support needs to ensure these are fully met in a consistent manner and noting any risks to the welfare of the resident. The documentation has been improved since the last inspection and is now in an easy to follow format that firstly assesses the resident’s personal and health care needs; the level of their sensory impairment; their mobility and their social interests and hobbies as well as their religion, and secondly, detailed these needs and the action Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 11 required by staff to meet those needs. From discussion with the Registered Provider is was clear that she and the staff knew a lot more about the residents than was detailed in these care plans and the Registered Provider was advised to include all that is known about each resident and how care and support is provided. For example, one resident with diabetes was assisted to take his blood sugar level each week and also to administer his insulin twice a day. This information was not recorded in the care plan neither was any information about what was a normal blood sugar level or what action to take should the resident have too high or too low a reading. Although the Registered Provider could provide the inspector with this information, it is important that this is recorded to ensure everyone has the same level of knowledge regarding a resident’s needs and allows the home to demonstrate their good practice. The home used a measured dose system for medication administration and medication is stored in a locked cupboard in the dining room. The Registered Provider confirmed that she and 5 care staff have received training in the safe handling of medicines from the local pharmacist. Records were generally well maintained, however one medicine used for the emergency treatment of very low blood sugar was not recorded on the resident’s medication administration sheet for whom it had been prescribed nor was its use recorded in the resident’s care plan. Therefore there was no written record of how and when this medicine was to be administered. The Registered Provider was advised that all currently prescribed medication, regardless of the infrequency of its use, should be recorded on the residents’ medication record with instructions for its use. The inspector observed the Registered Provider and staff interacting with the residents in a very friendly and respectful manner: both staff and residents appeared happy and jovial. The inspector spoke to all the residents with the assistance of a sign language interpreter who was known to the residents. All confirmed that they were 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.V321139.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they will be encouraged to make choices about their lifestyle at Badgers Holt. Meals are nutritious and varied. EVIDENCE: Residents 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 and baking, board games, reading and gardening. Some of the residents attend the local club for people who are deaf. The Registered Provider confirmed the majority of residents are able to go out of the home without the 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. Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 13 Residents said that the food good, and staff confirmed that drinks and snacks were available at all times. Alternatives to the menu are available upon request. In the afternoon of the inspection residents were observed going about various activities, such as walking to the shops to buy a newspaper and baking cakes. Badgers Holt Residential Care Home DS0000067028.V321139.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, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that any issues of concern will be taken seriously and dealt with promptly. Residents are protected from abuse. EVIDENCE: Neither the home nor the Commission for Social Care Inspection has received any complaints regarding the services at Badgers Holt. The residents said that they had no issues of concerns and indicated through signing that they received the assistance they required. The home has a complaints procedure displayed in the hallway making it accessible to all residents and visitors to the home. Two care staff have recently 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 resident is at risk from abuse. 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 residents. Badgers Holt Residential Care Home DS0000067028.V321139.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 and 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 its residents. EVIDENCE: The home was found to be warm, comfortable and clean. Communal areas were well decorated and provided comfortable seating. Residents were able to personalise their rooms with their own furniture and belongings. None of the bedroom doors were fitted with locks and therefore the security of the residents’ 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 resident that they were at the door. The Registered Provider Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 16 confirmed that should any other resident wish to have a lock or the light system installed it would be done. Two residents had been able to bring their small pets with them into the home, a rabbit and a bird, and maintained responsibility for their care. Bathing and toilet facilities were suitable for the current residents. Specialist support was available for community services such as the Occupational Therapist who provided mobility aids for a resident’s use. Badgers Holt Residential Care Home DS0000067028.V321139.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent and caring staff. Recruitment practices protect residents. EVIDENCE: Personnel records of the 3 most recently recruited staff were available for inspection. These contained all the necessary documentation, including 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. Fifty percent of the staff have obtained an National Vocational Qualification in Care, for which they have been assessed as having demonstrating their knowledge and skills in supporting adults in a care environment. Two further staff are in training. Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 18 Staff have also received training in first aid, food hygiene, fire safety and British sign language ensuring they have the knowledge and skills to support the residents and deal with emergencies. The Registered Provider confirmed that she is in the home on most days and as such works closely with the residents, staff and visitors. Daily handover reports between each shift take place and the Registered Provider used these times to communicate any changes to the residents’ 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, 8 staff in total, and all having access to the Registered Provider on a daily basis. Badgers Holt Residential Care Home DS0000067028.V321139.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Badgers Holt is a well managed home. The Registered Provider and her staff team strive to provide a safe and stimulating environment for the residents. 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 residents for a long period of time. Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 20 Due to there only being 6 residents in the home, Mrs Derbyshire confirmed that she consults with each everyday. No records of this were maintained unless a resident were to raise a matter of concern. Advice was given that periodically the residents should be formally consulted over the services provided in the home to allow Mrs Derbyshire to demonstrate the quality of the services. All residents maintain responsibility for their own finances and the home does not hold any money for safekeeping. The records relating to the fire safety equipment testing were examined and demonstrated that the equipment is maintained in good working order, serviced regularly and tested weekly. Badgers Holt Residential Care Home DS0000067028.V321139.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Badgers Holt Residential Care Home DS0000067028.V321139.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 OP9 Good Practice Recommendations Each resident’s care plan should provide a detailed description of their known care needs and the action undertaken by staff to meet those needs. All currently prescribed medication, regardless of the infrequency of its use, should be recorded on the resident’s medication administration sheet with instructions for its use. Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office 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. Extracts may not be used or reproduced without the express permission of CSCI Badgers Holt Residential Care Home DS0000067028.V321139.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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