Inspection on 06/05/05 for Barclay House

This inspection was carried out on 6th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Barclay House 06/08/08

Barclay House 06/09/06

Barclay House 18/10/05

Barclay House 18/10/04

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

CARE HOME ADULTS 18-65 Barclay House Barclay House St Peters Road Seaford BN25 2HS Lead Inspector Nigel Thompson Unannounced 6 May 2005 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Barclay House Address St Peters Road Seaford BN25 2HS 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) 01323 755000 Seeability Mr David Briant Care Home 7 Category(ies) of Sensory impairment (SI) 7 registration, with number Learning disability (LD) 7 of places Mental disorder, excluding learning disability or dementia (MD) 7 Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with a learning disability, mental disorder and/or physical disability only to be accommodated. 2. The maximum number of service users to be accommodated is seven (7). 3. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Date of last inspection 17 January 2005 Brief Description of the Service: Barclay House is a purpose built home, registered to provide residential care and support for up to seven adults who are blind or partially sighted and who may have additional special needs. The service is situated on a campus, which also includes two sheltered housing units and a day centre. All accommodation for service users is provided on the ground floor and consisits of single rooms with ensuite facilities. Communal areas include a spacious, open plan kithchen and dining room and a large and comfortable lounge. The building is designed specifically for people who have visual impairment problems. It is safe , accessible and fitted throughout with all necessary adaptations and specialist equipment, including assisted baths and hoists. To the rear of the premises, there is a pleasant sensory garden laid to lawn with raised flowerbeds and a patio area. Seaford town centre with its shops and access to bus and rail routes is approximately half a mile away. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours in May 2005. It found that all of the twenty National Minimum Standards that were assessed had been met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. A tour of the premises took place and documentation, including service user and staff files were inspected. A residents’ meeting was also observed, with service users actively involved and clearly encouraged to contribute and share their views and opinions. All the staff on duty and five of the seven residents were spoken to. What the service does well: The Home focuses on a ‘person centred’ approach to care. Independence is promoted and service user consultation and involvement in day-to-day decision making is encouraged. Regular residents’ meetings provide opportunity to discuss many aspects of daily life including menu planning, activities and furniture and colour schemes for communal areas within the Home. Processes including pre-admission assessments are thorough and are carried out to a high standard, that ensures that the specific care needs of an individual are clearly identified and are able to be met within the Home. The Home is to be commended for the high quality care plans that have been developed for each service user. The ‘Support Plan’ is clearly and directly linked to the individual’s assessed needs and is drawn up with the involvement of the service user, together with relatives and, where appropriate, other relevant agencies or specialists. The associated ‘Support Programme’ sets out in detail the actions to be taken by staff, therefore ensuring a continuity of care and a consistency of approach. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 6 Effective quality monitoring systems are in place, based on seeking the views of service users, relatives and other interested parties, to measure success in meeting the aims, objectives and stated purpose of the Home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The admission procedure is comprehensive and thorough, ensuring that service users are admitted only on the basis of a full needs assessment undertaken by people competent to do so. EVIDENCE: Following a referral to the Home, the manager or deputy manager will visit the prospective service user and carries out a full pre-admission assessment, ‘Initial Profile’. Relevant documentation relating to the most recent admission to the Home was inspected and found to be comprehensive, up to date and well maintained. The Initial Profile contained assessed details including; ‘Functional vision assessment’; ‘other sensory abilities’; ‘communication’; daily living and personal care skills’; ‘mobility and orientation’; and ‘education, leisure and daytime activities’. The profile also included reasons for the referral. A care management assessment, care plan (including objectives) and a carer’s assessment were also contained in the file. The manager confirmed that within five weeks of admission an ‘Initial Review’ is held, involving the service user, relatives and the care manager. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The person centred approach to care focuses on identifying individual needs, wishes and preferences and implementing strategies to address and meet the assessed needs. EVIDENCE: High quality care plans have been developed for each service user, with a ‘Support Plan’ clearly and directly linked to the individual’s assessed needs. A ‘Support Programme’ sets out in detail the actions to be taken by staff to ensure that care is delivered in a structured and consistent manner. Positive comments from service users included: ‘The staff are all very kind and know what help I need’. Individual risk assessments are recorded in service users’ files and include: self-medication; control of finances; preparing cooked meals and ‘summoning support/assistance in the event of illness or emergency’. Fortnightly resident and staff combined meetings are held with an open agenda, providing opportunity for each service user to raise issues or concerns and discuss with staff and other residents. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 10 During one meeting, service users were observed readily contributing to discussions and being encouraged and supported by staff, as necessary, to voice their opinions and views on a wide range of topics relating to daily living. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 & 17 Links with the community are good and enrich service users’ social and educational opportunities. The meals in the home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 12 Service users are supported by staff or volunteers and have the opportunity to participate in the community, including visiting the local leisure centre, banks, pubs and restaurants. Service users also attend the local college. Two service users are able to go out independently, within a risk management framework. Four service users currently attend local churches, again supported by staff or volunteers. Service users are supported and encouraged to maintain and develop links with family and friends, as they choose. Visiting is unrestricted and although service users often go on holiday or visit friends and family, there is an expectation that if they attend college, they will not take holidays during term time. Service users are directly involved in menu planning, shopping and meal preparation. It was noted that the home provides a varied, wholesome and nutritious menu. Service users are able to make drinks and snacks as required. The kitchen is designed with adaptations, specialist equipment and appliances, to meet the specific needs of the service users. Service users’ nutritional needs are regularly reviewed and recorded, including any risk factors associated with obesity, diabetes, and alcohol consumption with certain prescribed medication. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Personal support is provided in such a way as to promote and protect service users’ privacy, dignity and independence. The medication at the Home is well managed, with clear and comprehensive procedures being in place, ensuring service users’ medication needs are met. EVIDENCE: All service users are registered with local GPs and have access to other health care professionals, including psychiatric nurses, consultants, physiotherapists and dentists, as required. As service users have particular sight related problems access to specialist ophthalmic services is provided as necessary. Details of individual healthcare needs are recorded in service users’ care plans. Detailed policies and procedures on the handling, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. Following risk assessments, no service users currently self-administer medication. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 14 The manager confirmed that levels of personal care provision are variable. Three service users’ rooms have en-suite shower facilities and all personal care is carried out with regard to the individual’s privacy and dignity. Times for getting up and going to bed are flexible and reflect individual choice. Service users are supported and prompted, as required, in their choice of clothes. Specialist equipment and adaptations, including hoists, talking microwave ovens, automatic doors and grab rails are provided to maximise independence. All service users have a key worker to ensure, as far as possible, continuity of care. A wheelchair accessible vehicle is also provided. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The Home has a satisfactory complaints system in place with service users being confident that their views are listened to and acted upon. Staff have sound knowledge and understanding of Adult Protection issues, which safeguard service users from abuse. EVIDENCE: All service users are provided with a copy of the home’s complaints procedure. This document is available in Braille or on audiotape. All complaints are recorded and include actions taken and outcomes achieved. Service users’ meetings provide an opportunity for concerns to be raised and discussed before they become complaints. At a residents’ meeting taking place during the inspection, staff were observed encouraging and supporting service users to voice their views and opinions on various aspects of daily living, including menus, activities and replacement furniture in communal areas. Service users and members of staff spoken to confirmed that they would have no hesitation speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. The home has produced detailed policies and procedures relating to adult protection, including a whistle blowing policy. The manager has recently completed the East Sussex Social Services Protection of Vulnerable Adults Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 16 (POVA) ‘training for trainers’ and is to ‘cascade’ information throughout the staff team. Detailed policies are also in place regarding the management of physical and verbal aggression and the handling and control of service users’ monies. All permanent staff have undertaken specific adult protection training, in accordance with the multi agency guidelines for the protection of vulnerable adults. There has been one Adult Protection alert at the Home since the last inspection ad it was noted that the matter was dealt with appropriately by the manager and staff and resulted in a satisfactory outcome for the service users concerned. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Barclay House is accessible, safe and clean and is clearly suitable for it’s stated purpose. The home is comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: Independence and individuality is promoted within the home and this is evident from the personalising of service users’ individual rooms, which clearly reflects individual tastes and interests. A Housekeeper is employed in the Home and infection control policies and procedures are in place. Levels of cleanliness were found to be high throughout. The laundry room is sited so that laundry does not have to be carried through areas where food is eaten, prepared or stored. Washing machines have Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 18 adapted controls, enabling service users to do their own laundry, with support. Accommodation for service users is provided on the ground floor and is safe, accessible and well maintained. Appropriate adaptations and specialist equipment is provided, as necessary, to meet the individual and collective needs of the service users. There is a pleasant rear garden laid to lawn with a patio area. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 35 The staff recruitment procedures are sufficiently thorough and robust and provide the safeguards to help ensure the protection of service users. EVIDENCE: Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 20 Staff files that were inspected were found to contain the necessary references and checks. The manager confirmed that he is aware of the need for both Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks to be completed before a newly appointed member of staff can commence working in the Home. The robust staff recruitment procedure includes the direct involvement of service uses in part of the second interview process. In-house induction training is provided. A comprehensive range of care skills training opportunities is available for all staff and is accessible through various providers. Courses include fire safety, safe handling of medicines, first aid, abuse training and food hygiene. All training is recorded. Two members of staff who had recently started work at Barclay House commented on the ‘thorough induction and foundation training’ and ‘the help and support from the manager, colleagues and residents’. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 The Home regularly reviews aspects of its performance through a comprehensive programme of quality assurance monitoring and consultation, which includes seeking the views of service users, staff and relatives. EVIDENCE: The home has completed a service users’ satisfaction survey and has also sent out questionnaires to relatives and stakeholders. Collated responses from these surveys indicate a high level of satisfaction with the care and services provided. ‘Yes, very good in every respect’. Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 22 The manager confirmed that the health, safety and welfare of service users and staff remains a priority within the Home. Policies and procedures regarding health and safety are in place, including Control of Substances Hazardous to Health (COSHH), Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) guidelines. An accident book is in place and all accidents are appropriately recorded. As previously documented, relevant staff training is provided in Moving and Handling, First Aid, Fire Safety and Food Hygiene. Regular fire drills are undertaken and recorded. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Barclay House Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 Standard No Score Version 1.20 Page 23 H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score 24 25 26 27 28 29 30 STAFFING 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 24 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 Good Practice Recommendations Barclay House H59-H10 S32162 Barclay House V218034 060505 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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