Inspection on 30/06/05 for Barn and Coach House

This inspection was carried out on 30th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barn and Coach House 03/01/08

Barn and Coach House 06/03/07

Barn and Coach House 12/05/06

Barn and Coach House 10/11/05

Barn and Coach House 21/01/05

Barn and Coach House 26/07/04

Barn and Coach House 27/01/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Barn and Coach House High Road, North Stifford, Essex. RM16 5UE Lead Inspector Jacqueline Graves Unannounced 30.06.05 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 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. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barn and Coach House Address High Road North Stifford Essex RM16 5UE 01375 383543 01375 387715 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) Mrs. Susan Carol Merchant Mrs. Sharon Maureen Venton CRH PC 15 Category(ies) of OP DE(E) Dementia registration, with number of places Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st January, 2005 Brief Description of the Service: The Barn and Coach House Residential Home provides care and accommodation for fifteen older people. It has eleven single bedrooms and two shared rooms. Each bedroom has a call bell facility and T.V. point. The home has a stair lift which provides access to the first floor for people who are not able to climb the stairs. The home has a large garden to the front of the property and some car parking space. The home is privately owned. It is situated at the end of the village of North Stifford and is close to Lakeside Shopping Centre and Grays Town. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place over four hours. The manager was on annual leave and the cook was on sick leave. Due to annual leave, extra staff was not available to call in. The three carers on duty had to cover the meal preparation and clearing up, as well as their normal duties, and were extremely busy. The inspector spoke to some residents and to staff briefly. She spoke to a placing social worker by telephone. The inspector toured the premises and examined some records and care plans. Due to the manager’s absence and staff being so busy, the inspector was not able to ascertain the progress the home has made in meeting all requirements made at the last inspection. Therefore, some have been carried forward to the next inspection. What the service does well: What has improved since the last inspection? What they could do better: This report shows that the home needs to do a number of things better. The registered provider must monitor the service provided and give a report of their visit to the manager and CSCI. Such monitoring should identify any improvements that are needed. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 6 Care plans must be written for all residents. The home must ensure there is always sufficient staff to meet residents’ care needs. Treatment from health professionals must be provided when this is necessary. The provider has been told of the need to ensure supervision and regular visits to the home before and must show the Commission that an effort has been made to do this. 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. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 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 standard(s) 1,2,3 and 6 The home provides clear terms and conditions to new residents. Assessments are carried out to make sure people’s needs can be met in the home. EVIDENCE: Assessments were on people’s files and staff said they continue to assess people during the four-week trial period to ensure the home is the right place for them to live. Contracts were seen which contained all the required information to help people understand what they can expect from the home and which room they will occupy. Service user guides were available which gave people information about how the home is run. The home does not accept people for intermediate care. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,and 9 Medication practice was generally sound. Residents’ needs would be better met if care plans were in place for all residents and health needs followed-up. EVIDENCE: Two care plans were seen which detailed the care people needed and had been reviewed with residents where possible. Risk assessments had been carried out to try to keep people safe. One recently admitted resident had been assessed but the assessment had not been used to write a care plan or carry out risk assessments. Health needs were identified and recorded but there was one example of chiropody not being provided when this had been identified as a health need for a resident. A social worker felt that the home was not working sufficiently with health professionals, such as occupational therapists and district nurses, to meet residents’ health needs. Staff were vigilant when giving out and recording medication. Staff said that they attend training in medication and training certificates were available on staff records. The medication records did not have photos of the residents, which would help with identification. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 10 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 standard(s) 12 and 14 Residents are mostly satisfied with the food and activities, but opportunities for community involvement and trips out could provide more interest and stimulation. EVIDENCE: Most residents slept during the morning, with others reading newspapers or chatting. A five-day programme of activities such as exercises, singsongs and memory exercises was written on a notice board for residents to read. One resident said there was enough to do, such as watching T.V., looking at the newspaper and listening to music, but they would like to go out to the shops occasionally. Records showed that religious representatives visit the home. Some residents like to go out into the garden in warm weather. As this is not secure, people who are likely to wander have to be accompanied by staff. Some residents said their relatives occasionally visit and are made welcome by staff. Volunteers are not used in the home and there is limited contact with the local community, or opportunities to go out, unless residents have relatives to take them. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 11 Those residents spoken to said the food was fine and they get enough to eat. Menus of main meals are displayed but the menu was not followed on the day of the inspection, as the cook was ill and care staff, who had to cover, prepared food they were confident about cooking. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 12 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 standard(s) 16 The home has an accessible complaints procedure and a policy to protect vulnerable adults from abuse. EVIDENCE: The complaints policy is available to people in the home and makes clear that people can complain to CSCI if they wish. No complaints have been made to CSCI since the last inspection. The home’s adult protection policy was available but the inspector was not able to discuss this with staff on the day. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,21,24 and 26 The premises are mostly reasonable and homely but some further improvements and small repairs would increase the comfort and safety of residents and staff. EVIDENCE: The garden is an attractive area for residents with a lawn area, garden furniture, pots and hanging baskets of flowers. The garden is not secure so residents who are likely to wander have to be accompanied when out there. Staff were vigilant about securing the front door after people came in or went out, to keep residents safe. Decoration varied around the home and was mostly reasonable. The communal areas were homely but stuffy; the inspection took place on a hot day and although windows were open, staff and some residents wanted the two ceiling fans on, but one did not work. The smaller lounge/dining room was also hot and people sitting there would benefit from further ventilation in hot weather. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 14 A worn stair carpet had been replaced to improve the safety of staff and residents. Residents’ rooms had been made personal with their own belongings and furnishings. Those residents spoken to said they liked their rooms and were comfortable in them. Some bed bases were quite stained, one room did not have bedside lighting and some light bulbs were not working. Some chairs and a table covering in a lounge were in need of cleaning. The home was free from unpleasant odours except in one lavatory: this room was in need of redecoration and refurbishment to create a more pleasant space for residents, with toiletries stored in residents own rooms, rather than communally. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The staff are well regarded by residents. The procedures for the recruitment of staff are not sufficiently robust to ensure the protection of people in the home. Sufficient staff are not available to cover in emergencies when other staff are on leave. EVIDENCE: Those residents spoken to said staff treated them well and gave them all the care they need. The three care staff were stretched to complete their duties on the day of the inspection, as the cook was on sick leave and, due to annual leave, there were no other care staff to call on. The staff were very focussed on the care of the residents. Staff said there are no vacancies for staff at the moment. The inspector felt that further staff should be available to cover in emergencies. Staff training records were very well organised and showed that staff had covered a variety of subjects that would help them in their work. However, records showed that some staff had not attended training for over a year. There were notices displayed in the home of in-house staff training planned for the near future. The recruitment files of four staff were seen. One file contained a Criminal Records Bureau check. Records of applications for CRB checks made some time ago were on the other three files. One file did not contain references or a detailed working history. The recruitment process was not sufficiently thorough to make sure people are safe to work with the elderly. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 38 Staff are not sufficiently supported to do their jobs by regular supervision. The owner does not report regular visits to the home to monitor the quality of the service. Some safety checks have been carried out with some further checks needed. EVIDENCE: The home has taken steps to ensure the health and safety of staff and residents, but further checks were needed. For example, records for gas and electricity safety were seen but a certificate for gas maintenance was not available. The home has produced a fire risk assessment and records of tests of fire alarms were seen, but no fire drills had been recorded this year. Staff meetings are held to inform staff and help them work as a team. Some records showed that supervision of the manager and staff has not been recorded for a year. To monitor and improve the service, the provider should visit the home and give reports of the visits to CSCI and the manager. Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x x 2 2 1 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 2 1 x x 1 x 2 Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 18 Yes 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 OP7 Regulation 15(1) Sch. (1)(b) 13(1)(b) 12(1)(a)( b) Requirement Ensure that all residents have care plans so staff now how to care for them. Make arrangements for residents to receive identified health treatments such as chiropody and to have acces to health professionals. Facilitate local/community activities, for example shopping, should this be required by residents. Ensure the premises are kept in a good state of repair. This relates to the lavatory in need of refurbishment, bed bases that need replacing, ceiling fan and lights that need repair. Timescale for action 15/7/05 2. OP8 15/7/05 3. OP12 16(2)(m) 1/9/05 4. OP19 OP21 23(2)(b)( d) 1/8/05 5. OP25 13(3) Carry out actions in line with the 12/7/05 homes Legionella prevention policy. Ensure rooms have sufficient ventilation and lighting. Keep the home free from offensive odours. Provide a means of hand washing and drying in the laundry. Residents 1/8/05 6. OP26 16(2)13(3 ) Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 19 toiletries must not be stored communally. Ensure furniture and furnishings are clean: this refers to armchairs and a table covering. 7. OP27 18(1) 12(1)(b) 19(1)(a)( b) Sch.2 12(5)(a) Provide sufficient staff in emergencies when there are staff shortages. Carry out all required recruitment checks. The registered provider should maintain good personal and professional relationships with staff. Not inspected. 15/7/05 8. 9. OP29 OP32 15/7/05 Timesacle 4/3/05 carried forward to next inspection 15/7/05 10. OP33 23(4)(e) The registered provider, or their representative, must visit the home in line with this regulationand must supply a copy of the of the report of the visit to CSCI and the home (previous timescales of 4/3/05 and 26/7/04 not met). The registered person must ensure that formal supervision, including the manager, takes place on a regular basis (previous timescale 4/3/05 not met). Provide a certificate of gas maintenance (copy to CSCI) and evidence regular fire drills. 11. OP36 18 15/7/05 12. OP38 23(1)(a) (4)(e) 1/8/05 Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP24 OP26 OP28 OP18 OP30 Good Practice Recommendations That phots of residents are on medication records to assist identification. Provide clean bed bases and bedside lighting in the absence of residents own provision. The home should have a sluice facility which is separate from the laundry. A minimum of 50 staff obtain NVQ Level 2 by 2005.Not inspected. All staff should attend food hygiene training and it is recommended that staff receive training on protecting vulnerable adults from abuse. Not inspected. Staff should receive a minimum of three paid days training per year (including in house training). That formal staff supervision takes place at least six times a year. 6. OP36 Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea, Essex, SS2 6BG 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 Barn and Coach House I56-I06 S18117 Barn and Coach house V230211 300605 stage 4.doc Version 1.30 Page 22 - 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!