Inspection on 25/05/06 for Barlavington Manor

This inspection was carried out on 25th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Barlavington Manor 03/10/05

Barlavington Manor 05/05/05

Barlavington Manor 25/11/04

Barlavington Manor 04/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Barlavington Manor Burton Park Road Heath End Petworth West Sussex GU28 0JS Lead Inspector Mrs S Gawley Unannounced Inspection 25th May 2006 09:00 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 Barlavington Manor DS0000014386.V295755.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. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barlavington Manor Address Burton Park Road Heath End Petworth West Sussex GU28 0JS 01798 343309 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) amanda@barlowingtonmanor.co.uk Realmpark Health Care (Petworth) Limited Vacant Care Home 64 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (21), Old age, not falling within any other category (43) Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 21 (Twenty-one) persons in the category MD(E) to be accommodated A maximum of 21 (Twenty-one) persons in the DE(E) category to be accommodated A total of 64 service users may be accommodated at any time. Date of last inspection 3rd October 2005 Brief Description of the Service: Barlavington Manor is a Care Home, standing in extensive, well cared for grounds, in a rural area near Petworth. It is owned by Realmpark Healthcare (Petworth) Limited (Organisation). The main house is for forty-three service users in the category of Older People. In addition to this there is separate extended accommodation for service users with dementia. This unit provides en-suite accommodation for twenty-one service users making a total of sixtyfour service users. Separate entrances, reception offices, car parking and communal areas are provided for each category of registration with a security system for the service users with dementia. The responsible person on behalf of Realmpark Health Care (Petworth) Ltd is Mr Lawrence Harvey and the registered Manager is currently vacant. The Commission is in receipt of an application for the registered managers post. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 25/05/06. Preparation for the inspection included a review of the documentation on file, a review of the service history and complaints. Three comment cards were received in respect of this service and the comments were noted. Information supplied in the pre inspection questionnaire supplied on the day was also read. Mrs S. Gawley and Mrs. V Gay carried out the inspection. The premises were inspected, residents, visitors and staff spoken to and all expressed that a high standard of care was offered. Two district nurses were interviewed and they did not have any concerns on the care offered. The premises remain in good decorative order. The overall standard of care observed was excellent and there was evidence that the needs and opinions of residents are taken into consideration. Residents able to express an opinion spoke very highly of the staff and the care offered, all felt they could complain but stated the need to do so was rare. The fees are £595 in the main home and £795 in the Emi unit What the service does well: What has improved since the last inspection? What they could do better: The home needs to have Criminal Records Bureau clearance for all staff prior to their commencement in post and mandatory training should be in place to ensure staff are competent in the work they perform. The fire service should be consulted on the practice of wedging/propping doors open. Barlavington Manor DS0000014386.V295755.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. Barlavington Manor DS0000014386.V295755.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 Barlavington Manor DS0000014386.V295755.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, Prospective residents have the information they need to make an informed choice about where to live. 2, Each resident has a written contract/ statement of terms and conditions with the home. 3, No resident moves into the home without having had his/her needs assessed and been assured that these will be met. 4, Residents and their representatives know that the home they enter will meet their needs. 5, Prospective resident service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visits to this service. EVIDENCE: There is a statement of purpose in place containing the information required. More detail on staff qualifications is to be added. This was discussed with the person in charge. There is a Service User Guide in place and available in all rooms Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 9 Evidence of pre assessment was seen in care plans. A newly admitted resident confirmed that the admission process was smooth with all necessary information given. Barlavington Manor DS0000014386.V295755.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7. Residents health, personal and social care needs are set out in individual care plans 8. The resident due to the physical and mental frailty requires varying degrees of support from the staff. Health care need are met in full 9. Medication procedures in the home are being well managed. 10.Residents are treated with respect and their rights and privacy are up held. Quality in this area is excellent. This judgement was made available using evidence including a visit to this service. EVIDENCE: Two service users files were examined in the north wing Emi unit including a recently admitted resident. A further four residents files were examined in the main home. This was undertaken as part of the case tracking process. Daily care needs together with risk assessments of the environment were in place. The staff have access to each residents plan and make daily and nightly entries after each shift to ensure a continuity of care is provided. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 11 The plan is reviewed by the deputy manager monthly or as needs dictates. GP visits are recorded and District Nurse support is documented. The social and recreational interest of residents was recorded which residents confirmed were appropriate. Residents who were able to engage in meaningful conversation said the home was comfortable and that staff were kind and helpful. Residents were very positive about the care offered and the respect offered by staff. Staff were observed offering care in an appropriate manner. Medication is safely stored and suitably recorded. A Pharmacist reports on the arrangement for the safe storage, and handling of prescribed medication. The inspector was informed that a previous inspection had been satisfactory. Lockable space is available for any resident wishing to self medicate. . Barlavington Manor DS0000014386.V295755.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, Resident find the lifestyle experienced in the home matches expectations and preferences, and satisfies their social, cultural, 13, religious and recreational interests and needs. 13, Residents maintain contact with family/ friends/ representatives and the local community as they wish. 14, Residents are helped to exercise choice and control over their lives. 15, Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service EVIDENCE: Emotional and social care needs of the residents are met and are recorded in care plans. On discussion residents confirmed this. The routines in the home are flexible and meet with the service users wishes. Three comment cards received by the commission were positive in their comments/The service users have contact with their families and friends Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 13 During the inspection a visitor and two professionals were visiting and from observations made it was obvious that they enjoyed a good relationship with the staff. Two District Nurses said found the standard of the home satisfactory and that they had no complaints to make. A visitor told the inspector that they thought the home was a good place and she had no adverse comments to make. An activity organiser is employed 2pm-4-30pm five days a week to broaden the scope of in-house activities for the residents. The programme included Art and Crafts, Musical Exercises and Quizzes. Staff also takes residents out for walks. Activities are recorded in the residents care plans. The majority of residents spoken to stated that they enjoyed the activities. A hairdresser also visits to attend to the needs of the residents and manicures are offered every three weeks The meals are varied, well balanced and served at times convenient to the residents. The majority of residents said the food was very good. Lunch was observed and was appetising, offering a good choice, and was noted to be generous in quantity and was well presented. Choices to the main menu were available. The dining room is pleasant and well decorated. Barlavington Manor DS0000014386.V295755.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. 18, Recruitment practices are not robust enough to ensure the protection of vulnerable persons Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service EVIDENCE: There have not been any complaints received since the previous inspection. The majority of residents spoken to stated that they could complain if necessary but rarely found it necessary to do so. The majority of the residents have the benefits of families or friends who visit the home. Abuse procedures are in place but there is not mandatory annual training. (See standard 30) Staff files were examined in North Wing and in the main home as part of the case tracking process. Not all contained the necessary documentation in required by Schedule 4, Regulation 17 (3 of The Care Regulations 2000. Criminal record Bureau checks are not being obtained prior to staff working in the home. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 15 Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, Residents live in a safe, well-maintained environment. 20, Residents have access to safe and comfortable indoor and outdoor communal facilities. 21, Residents have sufficient and suitable lavatories and washing facilities. 22, Residents have the specialist equipment they require to maximise their independence 23, Service users’ own rooms suit their needs. 24, Residents live in safe, comfortable bedrooms with their own possessions around them. 25, Residents live in safe, comfortable surroundings. 26, The home is clean, pleasant and hygienic Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 17 EVIDENCE: A tour of North Wing (EMI Unit) revealed attractively presented accommodation that was well proportioned, clean and fresh as was the main home when inspected. There are large gardens leading from the lounges and conservatories area which residents make good use of in the summer months. The area adjacent to the EMI unit is secure The home is suitably equipped with aids and adaptations to promote residents independence and assist with their mobility requirements. Doors are however being wedged open which may pose a risk to residents health and safety in the event of fire. The EMI wing is a new build and therefore facilities meet the National Minimum Standards for a service of this type, which caters for persons suffering from dementia. There is ample space for the residents to wander with no restrictions placed upon them. The atmosphere on arrival at the home was calm and pleasantly busy. Some residents were having their nails manicured, whilst others were having a late start to the day. A video was commencing in the small lounge in the main home. A housekeeper is employed to ensure residents clothing is laundered to a good standard. Bathroom and toilets were clean and contained hand washing facilities and paper towels. Hygiene cleanliness throughout the home was of a very good standard. The home is working towards meeting the requirements of a recent Environmental Health Department inspection. Residents live in a wellmaintained environment. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. The numbers and skill mix of staff meets residents needs. 28, Residents are in safe hands at all times. 29. Residents are not supported and protected by the home’s recruitment policy and practices. 30. Staff are not trained to ensure competency. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service EVIDENCE: The duty rota examined showed adequate staff on duty with adequate domestic support. Three staff files were examined in the North Wing Unit (EMI) and they contained appraisals that had been carried out in March 2006. Four staff files inspected in the main home did not all have Criminal Records Bureau clearance. The need for files to contain the necessary documentation required by standard 29.3 of the National Minimum Standards was discussed with the person in charge. Copies of certificates of attendance at courses are kept in Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 19 staff files but mandatory training is not in place. Staff do not receive three paid days training per annum as recommended in the National Minimum Standards. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31. Residents 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. 33. The home is run in the best interests of residents. 34. Residents are safeguarded by the accounting and financial procedures of the home. 35. Residents’ financial interests are safeguarded. 36. Staff are appropriately supervised. 38. The health, safety and welfare of residents and staff are mostly promoted and protected Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager has resigned to move on to another position and the head of care for the dementia has applied to the commission for registration. Observation of care and interaction between staff and residents indicate that the home is run in the best interests of the residents. There is a monthly newsletter in place and regular surveys. There are residents and staff meetings to share news and events Monies are held securely and separately. Training needs to be more robust to protect the health and safety of residents. The home should consult with the fire department to ensure the safety of residents in the event of fire. Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 22 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 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 4 4 3 3 4 3 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 4 X 3 Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 23 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 2 Standard OP19 OP29 Regulation 23 (4) 19(4) 9b) Requirement Timescale for action 31/07/06 The building to consult and comply with the requirements of the local fire service. The registered person operates a 31/07/06 thorough recruitment procedure based on equal opportunities and ensuring the protection of service users RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. Extracts may not be used or reproduced without the express permission of CSCI Barlavington Manor DS0000014386.V295755.R01.S.doc Version 5.2 Page 25 - 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!