Inspection on 13/10/08 for Barking Hall Nursing Home

This inspection was carried out on 13th October 2008.

CSCI found this care home to be providing an Excellent service.

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

Barking Hall Nursing Home 19/10/06

Barking Hall Nursing Home 06/03/06

Barking Hall Nursing Home 19/12/05

Barking Hall Nursing Home 08/02/05

Barking Hall Nursing Home 25/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barking Hall Nursing Home Barking Hall Nursing Home Barking Nr. Needham Market Suffolk IP6 8HJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jan Sheppard     Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Barking Hall Nursing Home Barking Hall Nursing Home Barking Nr. Needham Market Suffolk IP6 8HJ 01449720793 01449722977 admin@barkinghall.healthcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Patricia Ellen Smaldon Type of registration: Number of places registered: Pri-Med Group Ltd. care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Barking Hall is registered to provide care with nursing for 41 Older People. It is owned by the Pri-Med Group Ltd, who were taken over by Healthcare Homes Ltd in March 2006; a private company with a number of care homes in Suffolk. The home is situated a short distance away from Needham Market, a small rural town with amenities such as shops, public house, Doctors general practice and Post Office. The home over looks the countryside and adjacent to the local parish Church. The building is set in its own extensive grounds with car parking at the front. The accommodation is partly in a converted domestic dwelling and in a new extension, which is linked via an enclosed, glass walkway. All the bedrooms are single occupancy, and have their own en-suite facilities including either a shower or bath. Bedrooms sizes vary from 11.10 square meters in the old part of the home, to 15 and 17.5 square meters in the new part. Communal spaces include a large lounge/diner with views of the new courtyard, Care Homes for Older People Page 4 of 29 0 Over 65 41 Brief description of the care home with its raised flowerbeds and seating areas in the new extension, and separate dining room and lounge in the original part of the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during the inspection. The quality rating for this service is 3*. This means the people who use the service experience excellent quality outcomes . The inspection was unannounced and took place over eight hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to older people. The report was written using accumulated evidence gathered prior to the inspection, including information contained in the AQAA, (Annual Quality Assurance Assessment) completed by the Manager, information given in the preinspection questionnaires completed by residents,staff,relatives,health professionals;and also takes account of statutory notifications sent periodically to the Care Homes for Older People Page 6 of 29 CSCI by the home. During this inspection the inspector made a tour of the building, had in depth discussions with the homes Manager met and spoke with a number of residents and spoke with staff and visitors. Spot checks were made on a number of the homes records. The current fees range from six hundred and fifty to seven hundred and fifty pounds per week plus where appropriate the determined registered Nursing Care Contribution.(RNCC) What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have an assessment of need prior to entering the home and to have the opportunity to assess the service offered. The home does not offer intermediate care. Evidence: Good information about the home and the level of services offered is given to all prospective applicants. People wishing to move into the home will have a full assessment of their care and social needs carried out by the deputy Manager who will visit them at their home or in hospital.Relatives or representatives may be involved in this assessment if the applicant wishes them to be. Information from medical and social care services are gathered so that the home can be fully informed about all aspects of the applicants needs. Care Homes for Older People Page 11 of 29 Evidence: The records of three new residents were seen during the inspection and each one had a pre admission assessment fully documented.Areas of care need that were covered included personal hygiene,diet,mobility,communication,medication and night needs.Other information was about behaviour ,likes and dislikes and relatives involvement in the care given prior to admission.Special needs such as walking aids or a particular chair or bed were also noted and where needed areas of risk appropriately assessed.Information about past medical history and present medication was included. The homes Brochure was clear and informative giving a good visual insight into life in the home.The Statement of Purpose was up to date and informative containing all the required elements. All service users have a contract and information concerning terms and conditions of residency.New residents are admitted on a three month trial basis during which time if they choose to leave they may do so immediately without incurring any financial penalty. Residents and relatives spoken with said that they had had the opportunity to visit the home and assess the service before making the decision to move in.One said I chose this home over three others it was so friendly and everybody helped me settle in at a pace that suited me. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their health and personal needs met in a dignified and respectful manner by staff who have a sound knowledge of their care needs and how these should be met. The home maintains a robust medication system but residents cannot be assured that their medication records are always being completed with full accuracy. Evidence: Since the last inspection the home has revised all the care plans into a new more person centred format which gives better details of the assessed care needs and how these should be met.Three care plans were examined and all were found to be very well recorded with information in clearly defined sections each of which was signed by the service user thereby evidencing their involvement with their compiling.Risk assessments were seen to be regularly reviewed.The care plans were seen to generally contain a good level of detail about the action required by staff to support the service user to meet their assessed needs.References that reminded staff to assist service users to do as much for themselves as they possible could even if this took a little Care Homes for Older People Page 13 of 29 Evidence: longer were noted to evidence good practice. Residents who completed pre inspection surveys all felt that they received the care and support that they needed including medical support. Those spoken with during this inspection were all happy with the way staff supported them and were fully aware of their care plans and confirmed that they signed these and were regularly involved with the reviews of them. One said The staff here are wonderful nothing is ever too much trouble and they always allow me to go at my pace I feel well cared for and very secure in this home. Care plan files contained clear records of contact with other health care professionals including doctors physiotherapists and chiropodists. The manager stated that the home is wanting to improve its end of life care practices and is working with their local GPs and a local hospice who have recently delivered training for the staff. Staff were observed knocking on doors before entering bedrooms and bathrooms.One member of staff spoken with was able to give examples of the way she worked to preserve the dignity of residents.Interactions between staff and residents were relaxed friendly and respectful and residents spoken with said that they had no concerns that their dignity would be compromised by poor practice. During the serving of lunch the inspector observed numerous incidents where staff treated service users in a most respectful and considerate manner enabling them to make their wishes and choices known and assisting them with eating in a dignified manner and at a speed which suited them. Part of the medication administration round at lunchtime was observed. Staff were seen to administer medication in a kindly manner working with the service user at their pace and in a manner which did not interrupt their enjoyment of their meal. The home uses a MDS monitored dosage system for medication this being supplied from a local pharmacy. The home has appropriate and secure storage facilities for medication including a controlled drugs cabinet and a medication fridge.The MAR administration records were seen to be well recorded with no omissions and evidence of regular management reviews of the accuracy of these records could be seen.A record of the audit of the medication received into and disposed out of the home was seen.The records of medication administered was generally clear and complete with appropriate identification codes and a written explanation of variations fully recorded on the reverse of the sheet. A check of the controlled medication found that the correct amount of medication measured against the recorded record was remaining however the administration of one dose was found to have been made against only one staff signature.Although this did appear to be a one off omission the home is reminded of the importance of the medication administration practices and records being maintained in a consistent and rigorous manner in order to fully protect the welfare and safety of the residents. Care Homes for Older People Page 14 of 29 Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good lifestyle that offers choice and meets peoples social and recreational needs. Service users are offered a choice of nutritionally balanced home cooked meals. Evidence: All the service users who completed CSCI surveys reported that they were able to have an excellent lifestyle in the home with a wide choice of activities and outings being available to them. Since the last inspection the home has appointed an activity organiser who works three days a week and have arranged for other organisers to visit periodically for specific activities.A physiotherapist was running an exercise class in the home during the day of this inspection.One resident said when I came to a Nursing Home I did not think that I would be participating in an exercise class but I enjoy it and I also like being able to go walking in the homes grounds. The home is able to access a company bus and driver to transport the residents to visits into the locality and a generous monthly allowance is given to facilitate these outings and to purchase various items of craft equipment. A recent visit to the famous Care Homes for Older People Page 16 of 29 Evidence: fish and chip shop in Aldeburgh had clearly been much enjoyed by the residents and plans for events and outings over the coming Christmas period were being worked on. A garden fete held during the summer had been well attended by friends and relatives and by village people and had generated a lot of interest in the locality. The residents were able to decide that the funds this event had raised ,much of it from the sale of craft work they had made and sold,would be used to purchase new television and film facilities for the enjoyment of the whole home. This arrangement is to be recommended as it empowered the residents to make decisions about their life style in the home. Arrangements for a planned Christmas Fair were shown to the inspector including a number of craft work items already completed. The activity coordinator explained that she had previously worked as a carer in the home but that she was very enthusiastic about her new role and was receiving good support for this from the company and from the homes management.She said that this was enabling her to provide activities linked to the residents particular interests or life experiences. Each resident has an assessment of their activity interests and wishes which is recorded on their care plans.Using this information she compiles a monthly activities programme for the home and then distributes information about this programme to each resident every Monday informing them of the activities for the coming week and enabling them to make their choices.Residents who do not wish to join in with a group activity may choose to have a one to one activity such as poetry reading or music appreciation in their room. All the residents who replied through the CSCI surveys also said that the food was very good hot, tasty and with many choices available. All the residents spoken with during this inspection also confirmed this although one did say that there was rather too much soup but then added it is always home made and there are always other choices available.Since the last inspection the homes new kitchen has become operational and the cook clearly felt that she was now able to offer a much improved menu and improved quality of meals for the residents.The serving of lunch was observed and it was seen that the residents had a choice of tables which were all laid with crisp linen clothes small flower decorations and coordinating china.Vegetables were in tureens on each table and staff were seen to enable residents who could serve themselves to do so and to assist others who were not so able.Residents were frequently asked would you like this or that and is this the right temperature in a courteous manner and at an appropriate pace that enabled them to make choices for themselves. A choice of two main meat dishes and three vegetables as well as potatoes were offered for this meal along with a choice of sweets and a selection of fresh fruit.One resident said the food is lovely such good choices and the cook is always asking us for new ideas for fresh dishes I really couldnt ask for better. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices in this home ensure that people who use the service can be confident that the policies and procedures in place will ensure that they are listened to and are protected from abuse. Evidence: The home has a robust and effective complaints procedure and all the residents surveyed knew who to talk to if they were not happy and wanted to complain.Residents spoken with during the inspection said that they would raise any complaints with the manager directly and one commented that she was always very approachable having an open office door and always seemed to welcome chats with residents. The homes Statement of Purpose and Service Users Guide gives information about the homes complaints procedure and the expected time frame for any issues raised to be dealt with.Information about how to access Advocacy Services is also given. The CSCI has not received any complaints about the home since the last inspection.Information given to us on the AQAA (Annual Quality Assurance Assessment) compiled by the manager tells us that the home has had no formal complaints but that a number of comments and suggestions from service users and relatives have been dealt with at source and promptly. The home has a suggestions box in the entrance hallway and welcomes comments from visitors and representatives. The home keeps records of any Compliments received and a number received since the last inspection were shown to the inspector.These were without Care Homes for Older People Page 18 of 29 Evidence: exception all very complimentary about the services received and the manner in which they had been delivered. The home has a copy of the guidelines issued by the vulnerable adults protection committee for Suffolk and a comprehensive whistle blowing policy to protect staff and residents.Staff interviewed confirmed that they were aware of these policies and of the steps that they should take if they suspected that any abuse practice was occurring.The homes training records evidenced that training covering these subjects was up to date and that further up dating courses had been arranged.No incidents concerning the Safeguarding of Adults had arisen in the home since the last inspection. The Manager confirmed that she had recently undertaken the companys training concerning the Mental Capacity Act and its implications for the care of vulnerable service users.Mental capacity is now noted in the care plans of all the residents. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides spacious high quality accommodation and has a homely atmosphere. Residents benefit from a safe well maintained comfortable clean and hygienic environment which is well appointed with all the appropriate facilities to meet their needs. Evidence: A tour of the building identified that it is a very spacious and very well appointed home maintained to a high standard.All the bedrooms had ensuite facilities and many on the ground floor have french doors that opened onto the garden patio area. Individual televisions are provided and every room has a profiling bed.Decorations are individually chosen and residents were seen to have personalised their rooms with items of their own . All the residents spoken with confirmed that they were very happy with their rooms and one spoke very positively about the prompt assistance given to her when she first moved in by the homes maintenance team in assembling her room just as she wanted it it did help so much with enabling me to quickly feel at home she said. The home has a good number of assisted bathrooms and toilets some with overhead tracking to assist with transfers.Bathrooms are spacious well appointed and yet had a Care Homes for Older People Page 20 of 29 Evidence: homely appearance. Building works completed since the last inspection have provided a new kitchen ,staff offices a staff training room and a spacious new lounge conservatory which surrounds a secure and enclosed patio garden area. The home has three separate dining areas and residents can choose where they eat although it was noted that several chose to eat in their own rooms. A number of lounge sitting areas were dispersed throughout the home provide a variety of secluded and cosy areas. One ground floor lounge which is currently under used is about to be redecorated and to have new furnishings and another large lounge dining room with high ceilings on the first floor is also used for activities and is an ideal area in which to show films.Residents confirmed that the have plenty of space with good opportunity to choose a favorite location. A good sized laundry was found to be well appointed and to have direct access to the garden. Washing machines had a sluice cycle and red bags are used for soiled linen. There was seen to be a good awareness of infection control measures the laundry assistant was wearing protective clothing and gloves .A clearly defined infection pathway in and out of the laundry could be evidenced. Residents were all very complimentary about the standard of their linen with no complaints what so ever being made. The manager said that when occasionally things did go wrong and items damaged a reimbursement was always made. All areas of the home visited were found to be very clean and tidy. Staff were observed to be following safe infection control procedures.Information given on the residents surveys confirmed that cleanliness of the home is consistently maintained one said the home is always clean and tidy and my room is attended to everyday. The home has very generous storage space and the manager showed where more cupboard capacity is to be created. Evidence of routine maintenance works could be seen five radiator covers were waiting to be fitted and works to install new temperature control valves in some bedrooms is also being undertaken. Residents were seen to be able to move freely about the home where the corridors and door ways are of sufficient size to accommodate self propelled electric buggys and wheelchairs. residents who were able were also seen to be able to use the lift. The home was seen to have a variety of hoists to meet the residents varying needs and that there was sufficient designated parking areas for this equipment. Residents had access to the internal courtyard which has raised sensory flowerbeds and seating areas designed for wheelchair users. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can be confident that they will be supported by appropriate numbers of skilled and fully trained staff who have been robustly recruited to protect them and can ensure the smooth running of the service. Evidence: Since the last inspection the staffing levels in the home have been increased to meet the needs of the extra occupancy of the home. During this unannounced inspection it was seen that there were sufficient staff on duty to meet the residents needs in an individual manner. Information given by the residents and their relatives on the pre inspection surveys confirmed that there were enough staff to meet their needs.One said whilst it would always be nice to have more staff they are sufficient to meet our requests quite quickly and if there are to be any delays they will always tell us. During the inspection staff were observed to answer the calls bells within reasonable time frames and residents spoken with confirmed that there were sufficient staff to give them the level of care that they needed.One said the staff are always there to help us nothing is ever too much trouble for them. Staff were seen to be working well together as a team and to be providing support for the residents in a kindly and unhurried manner,allowing them to do as much for themselves as it is safely possible for them to do.Staff were seen to be familiar with Care Homes for Older People Page 22 of 29 Evidence: the needs of individual residents and a good rapport was seen to exist between them.The inspector in speaking with a member of the house keeping staff asked how the various staff, nurses carers housekeepers etc.got along together and was there any them and us attitude?. She replied most emphatically that there was not we are all us here she said. The manager explained that since the last inspection more staff are being put on duty in the mornings to assist with the getting up processes and more nursing hours are being employed in the evenings to cover the administration of medicines.She confirmed that the home retains a very stable core group of staff many of whom have worked at the home for several years.Recent appointments have been needed to cover vacancies caused by the taking of maternity leave.The home does not often need to call on agency staff to maintain its staffing levels. The recruitment files of three recently appointed staff evidenced that all the required checks had been made this to ensure the safety of the residents.New staff commence their duties only after the results of a full CRB check have been received.A six day induction training period is then completed before the new staff member commences duties working alongside an experienced staff member initially.Induction training now includes care planning ,bereavement ,practical skills and dementia care in addition to all the common induction standards. Training on the new Mental Capacity Act is also given. The Healthcare Homes Group Ltd. employs its own dedicated training staff and the manager said that she felt that they were particularly well served in this area and with the new training room facilities making training a very positive experience for all staff. The home has more than 50 of its staff holding NVQ at levels 2 or 3 with more staff completing this training so that by the end of the year this will have increased to more than 86 . Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the sound management of the home and the homes person centred ethos ensures it is run in their best interests. Administration practices in the home protect residents and promote a safe environment. Evidence: The home benefits from a stable management team who are all well qualified and experienced professionals whose ethos is very clearly to put the needs of the residents first. Their confident and calm approach to their work positively influences the homely and relaxed atmosphere in the home where meeting the nursing and social care needs of the residents was found to be well integrated. The Registered Manager Mrs. Patricia Smaldon is a Registered General Nurse ( RGN) and also holds a management qualification.She operates an open door policy of encouraging feedback and throughout this inspection evidence from residents visitors Care Homes for Older People Page 24 of 29 Evidence: and staff all confirmed that the home was well managed that they were well supported by their managers and that their opinions were listened to.One member of staff said I am very well supported all grades of staff work well together and managers are always available for consultation. Another said This is a happy place I really enjoy coming to work it is a really rewarding job. The home has appropriate systems in place to enable good communication between the various groups of staff. Records of staff meetings ,nurse meetings, residents and relatives meetings all evidenced that these were planned well ahead and were properly recorded and also evidenced good participation from a range of staff covering all aspects of care delivery and personal development.All the staff were found to be very positive about their work and in promoting the quality of service given at Barking Hall.During this inspection several staff told the inspector that it was their intention that the home should be the best in the area.The company sends residents relatives staff and external stakeholders annual quality assurance questionnaires from which an annual report is compiled this being available for existing and potential service users.Since the last inspection the home has been awarded Investor In People recognition evidencing that they are essentially committed to the continuous improvement of their service. All the residents have locked drawers and a safe in their rooms for the secure keeping of valuables and money.Whilst the home does not generally keep residents monies small amounts of cash held on behalf of residents at their request to ensure its good safety were found to be being kept so that individual amounts both held and spent could be properly accounted for and tracked.Individual receipts are kept for services such as chiropody and hairdressing. Spot checks made on three of these amounts during this inspection found that they tallied with the records held. Arrangements for staff supervision have been strengthened since the last inspection. Staff consulted all reported that they had regular supervision meetings which they found helpful and enabled them to think about their own personal professional development as well as to talk through any day to day work problems. The homes gives good priority to promoting the health safety and welfare of the residents and staff through the regular maintenance of safety checks, training and record keeping.The records relating to fire testing and the monitoring of water temperatures were found to be regularly completed along with servicing and safety checks for the homes equipment.Risk assessments for the environment were also seen to be well maintained.The manager explained that following upgrading of part of the hot water system in one area of the home it had been decided that new temperature control valves were to be fitted to basins in bedrooms in this area this to ensure full safety for the residents.On the day of this inspection it was seen that radiator covers were being fitted to the remaining five unprotected radiators. Staff training records showed that staff receive appropriate health and safety training during their induction period and on going through regular updates to support them in Care Homes for Older People Page 25 of 29 Evidence: having the knowledge and skills to maintain a safe environment for the residents.This includes mandatory annual training in Safe Guarding of Vulnerable Adults, Health and Safety, Infection Control,Fire, Manual Handling, Basic Food Hygiene and Basic First Aid. The home now has nine Appointed Person First Aiders sufficient for there to be one on duty on all shifts. All accidents ,injuries and incidents are recorded and a copy held on the residents care plan confirming what action has been taken to prevent or minimise the risk of further incidents occurring. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!