CARE HOMES FOR OLDER PEOPLE
Barn Close Well Lane Stanwix Carlisle Cumbria CA3 9AZ Lead Inspector
Margaret Drury Unannounced 20 June 2005 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 Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Barn Close Address Well Lane Stanwix Carlisle Cumbria CA3 9AZ 01228 521085 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) Henry Lonsdale Trust Mrs Jean Margaret Feddon Care Home 40 Category(ies) of OP - Old Age registration, with number LD - Learning Disability of places Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: up to 39 service users in the category of OP (Old age, not falling within any other category) one adult under 65 years of age with a learning disability LD (Learning disabilities) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 31 August 2004 Brief Description of the Service: Barn Close is owned by The Henry Lonsdale Charitable Trust with Mrs Mary Styth being the responsible individual. The home is run on a day- to-day basis by the registered manager Mrs Jean Feddon. The home is situated in a residential area close to the centre of Carlisle and all its amenities. Barn Close is an older property that has been adapted,extended and renovated for its present use as a care home. Accomodation for the residents is on two floors, the upper storey being served by a passenger lift and stair lift. There are thirty-four single rooms and three that are registered as double rooms. All rooms are currently used for single occupancy, with the majority having en-suite toilet facilities. There are four communal areas providing lounge and dining facilities and a smoking area for those residents wishing to use it. The toilets and bathrooms are equipped for people with a disability and there are hand rails on the corridors to assist with movement around the home. There are large,well kept gardens and car parking is available. Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and took place over one day. During the visit, time was spent talking with the care officers, and care staff on duty, looking at records to do with the day-to-day running of the home and the care of residents. Time was spent with of the residents individually and speaking with family members and visiting health care professionals. During the inspection all parts of the home were looked at. What the service does well: What has improved since the last inspection?
Since the last inspection many of the bedrooms have been completely refurbished including carpets and curtains, with the general maintenance of the building and grounds ongoing. One of the care officers now has responsibility for activities and an improved programme has been introduced.
Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 6 What they could do better: 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 Close F58 F10 s22534 barn close v232513 200605 ui 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 Close F58 F10 s22534 barn close v232513 200605 ui 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) 2, 3 & 5 The home’s brochure provides any prospective resident with the information about the facilities on offer and the assessment process gives staff the opportunity to provide the correct level of care required. EVIDENCE: The Home’s brochure and Statement of Purpose provides all the information required for residents to make an informed choice about moving into the home. All new residents are given a contract and terms and conditions and copy of the complaints procedure upon admission. There is a clear admission process, which includes a full assessment of needs and capabilities. This ensures the home can adequately meet the individual needs. Barn Close F58 F10 s22534 barn close v232513 200605 ui 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 & 10 The home’s care planning system, ensures residents’ health and social needs are met in a way that promotes their privacy, dignity and independence. A recommendation was made for the care plan format to be revised. EVIDENCE: The care plans contain information about residents’ care needs and also include details of moving and handling needs. The plans are updated monthly although it was not clear from the layout when the reviews take place. Details of healthcare needs and professional visits are recorded in the daily record book and residents said that they only have to request a G.P. visit and the appointment is made promptly. The care officers said that they receive excellent support from the local doctors and district nurses, several of whom visited the home during the inspection. The care staff speak to the residents in a courteous and polite manner and always knock before entering bedrooms. Residents said that the staff always give personal care in a way that preserves their privacy and dignity whilst encouraging independence. Barn Close F58 F10 s22534 barn close v232513 200605 ui 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, 13 & 15 Residents benefit from an improved activity programme and visiting entertainers. Links with the local community are good and meals offer both choice and variety and cater for special needs. EVIDENCE: Visitors are welcome at the home at any time and they were always offered refreshments during their visit, although it is requested that visitors do not come to the home during mealtimes. One of the care officers has delegated responsibility for organising activities and an improved programme is now provided for those who wish to join in. This includes dominoes, bingo and a weekly gardening club. Residents said that they are always given the choice of taking part or not. The home has transport that is used throughout the year and entertainers visit the home from time to time. Links with the local community are maintained via the Church and schools. A coffee morning has been arranged to which the local community have been invited. Residents said they decide themselves how they wished to spend their day. The menus are displayed on each dining table and show the choice offered at each meal. Special diets are catered for. Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 11 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 &18 Residents benefit from a comprehensive complaints procedure. All feel able to approach the care officers or any of the staff if they have anything to discuss. Staff showed an understanding of protection of vulnerable adults issues. EVIDENCE: The complaints procedure is on display in the hall and all residents are given a copy when they move into the home. Although no resident has made a complaint they said they knew what the procedure was if ever they had to use it. They preferred to speak directly to one of the care officers. The home has a protection of vulnerable adults policy, which includes whistle blowing. The care staff showed an understanding of adult protection issues and said they would report anything suspicious to the manager or senior staff. Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 12 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, 23, 24 &26 The standard of the environment is excellent, providing the residents with an attractive, homely and secure place to live. The residents’ bedrooms are comfortable and meet their needs. EVIDENCE: Since the last inspection the home has continued with the maintenance programme and several bedrooms have undergone complete refurbishment. Ongoing maintenance of the building and grounds ensure the residents have a safe and secure place in which to live. The bedrooms are all very well decorated and suitable to meet resident’ needs. All of them contain personal items brought from the residents’ own homes. There are rails on the corridors, a passenger lift and stair lifts to enable people to move freely around the home. The gardens are well maintained by external garden contractors and provide beautiful surroundings for the residents to enjoy. It would be beneficial to the residents if they could be provided with
Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 13 easier access to the lower lawns and it is understood that The Trust are looking at providing this. Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 14 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 &30 Residents are cared for by an experienced and trained staff group appointed following a detailed and thorough recruitment procedure. This ensures that there is maximum protection for people living in the home. EVIDENCE: There were five carers and two care officers on duty during the inspection, to care for thirty-seven residents. There were also domestics, a cook and a kitchen assistant on duty. These staff are able to attend to the residents’ needs in a prompt manner, keep the home clean and provide meals and snacks during the day. Before new staff are appointed, an application form is completed, the person is invited for interview and two written references are sought. No new staff take up their duties until a satisfactory Criminal Records Bureau check has been completed. These measures contribute to the protection of residents. All staff training is up to date, which means that staff is competent to do their job. Residents said that the staff are kind and helpful and look after them very well. Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 15 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) 32, 33, 35 &38 Management practices ensure the home is run in the best interests of residents. Financial procedures safeguard residents’ finances although it was recommended that two members of staff sign the records of residents’ finances. The health and safety policies promote residents safety. EVIDENCE: Although the manager was on annual leave on the day of the inspection, it was evident that she was highly motivated and gave clear leadership to the staff who spoke of her help and support. Records concerning residents’ personal finances ensured these are safeguarded with annual audits of the records conducted by a member of The Trust. It was recommended that two members of staff signed residents personal allowance documentation. Health and Safety and risk assessment procedures promote both residents and staff welfare and safety.
Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 16 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 x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 x 3 x x 3 Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 17 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 35 Good Practice Recommendations It is reccommended that the format of the care plans be reviewed in order to make them easier to understand. It is recommended that two members of staff sign the residents personal allowance documentation Barn Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Close F58 F10 s22534 barn close v232513 200605 ui stage 4.doc Version 1.30 Page 19 - 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!
