CARE HOMES FOR OLDER PEOPLE
Barn Close Well Lane Stanwix Carlisle Cumbria CA3 9AZ Lead Inspector
Mrs Margaret Drury Unannounced Inspection 04 January 2006 12:30 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 Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 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) Henry Lonsdale Trust Mrs Jean Margaret Feddon Care Home 40 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (39) of places Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 20th June 2005 2. Date of last inspection Brief Description of the Service: Barn Close is owned by The Henry Lonsdale Charitable Trust with Mrs Mary Styth being the responsible individual. The registered manager, Mrs Jean Feddon, runs the home on a day- to-day basis. 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. Accommodation 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 handrails on the corridors to assist with movement around the home. There are large, well kept gardens and car parking is available. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place over one afternoon. It was the second inspection of the year and those standards not assessed on this occasion were inspected and met during the previous inspection that took place in June 2005. Time was spent talking with the manager, care officers, residents and visitors to the home. Records to do with the running of the home were examined and some parts of the home were looked at. What the service does well: What has improved since the last inspection?
The care planning system/documentation has been revised and all care plans have now been transferred to the new format. Each of the plans, which are easy to read and follow, now gives an in-depth picture of the resident’s needs and how best these can be met A new induction/training programme for the catering staff has just been introduced. This covers, food hygiene, food preparation food chilling and serving.
Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 6 The manager has updated all the staff files and improved the filing system. A new initial induction procedure has been prepared for all new staff. This takes place during the first week of the 3-month induction programme. Details of all the training arranged and completed are now recorded on the new training file. One of the lounges has been completely refurbished and the 10-bedroom redecoration programme has been completed. 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 DS0000022534.V269365.R01.S.doc Version 5.1 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 Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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, 4 & 5 The home’s introduction pack is excellent, providing residents and prospective residents with details of the services the home provides. This information enables an informed decision to be made about admission to the home. EVIDENCE: The home has an excellent introduction pack that is given to anyone who makes an enquiry about any vacancies there may be. It includes the statement of purpose, resident guide, complaints procedure and other documentation about services on offer at the home. This gives all the necessary information required for any prospective resident to make an informed choice about moving into the home and having their needs met. All those wishing to move in are invited and encouraged to visit the home to meet the staff and other residents and to enjoy a meal and/or refreshments. This also gives opportunity to view the accommodation provided. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 the following standard(s): 7, 9 & 11 The home has a clear and consistent care planning system, which ensures residents health, and social care needs are met in a way that promotes their privacy and dignity. EVIDENCE: The documentation for the new care planning system has now been completed and the inspector was able to examine a sample of the care plans during the visit. They were all found to be up to date and contain a wealth of information to assist the care staff in the delivery of care. The care officers have delegated responsibility for ensuring all the reviews are completed on time. They work closely with the care staff, which benefits the residents and guarantees that the assessed needs are met. Discussions with a number of residents and family members during the visit confirmed they find the care staff “very kind and helpful” and that they are always treated with respect and courtesy. The policy for handling the death of a resident is clear, with residents’ wishes recorded on the care plans.
Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 the following standard(s): 14 & 15 Residents benefit from regular meetings during which they are able to air their views about the running of the home. Dietary needs of the residents are well catered for with a balanced and varied selection of food that meets the resident’s tastes and choices. EVIDENCE: The home manager organises regular meetings for the residents, which gives them the opportunity to “have their say” about the running of the home. Topics discussed include, changes to the menu, outings and activities. Minutes are taken and are made available for the inspector to read if required. Activities and outings are organised and the inspector was able to watch the residents playing a game of bingo whilst some residents went out to a local tea dance. The home offers a nutritious diet with a choice at each meal. Those residents who spoke with the inspector all expressed their satisfaction with their meals and the variety and quantity offered. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 the following standard(s): 17 & 18 Service users benefit from the availability of an advocacy service should this ever be required. Staff have a knowledge of abuse issues, which protects those living in the home. EVIDENCE: At the present time the use of an advocacy service is not required as all residents have family members or solicitors to assist with their affairs. The manager did, however, understand that there could be a need for this service in the future. Discussions with the manager evidenced that talks with the staff regarding adult protection took place and that this subject is covered in NVQ training. The manager will look at organising in-house training in the protection of vulnerable adults in the future. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 the following standard(s): 19, 21, 22, 23 & 25 Regular investment in the building and grounds creates a comfortable, warm and safe environment for those living there and visiting. EVIDENCE: This home has an extremely high environmental standard with excellent quality furniture and fittings. The manager conducts regular inspections of the home and notes any repairs that may be required. One of the lounges has been completely refurbished, including carpets and curtains and the scheduled ten bedrooms have been redecorated. All except eight bedrooms have en-suite toilet facilities and there are sufficient communal toilets and bathing facilities to meet the needs of those living in the home. The home has specialist equipment for those residents requiring them. These include, handrails on corridors, assisted bathing, raised toilet seats and hoists. All of these facilities ensure the residents live in safe, comfortable and suitable surroundings.
Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 13 The inspector viewed a number of the bedrooms that have recently been redecorated and found them to be warm, comfortable and personalised with small items from the residents’ own homes. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 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, 28 & 30 Staff morale is high resulting in an enthusiastic workforce that works positively with the residents to improve their quality of life. EVIDENCE: The staffing arrangements within the home are very good with 6 members of care staff on duty from 7.30am to 2.00pm. There are 4/5 care staff on duty from 2.00pm until 10.00pm. In addition there are 2 care officers on duty between 8am and 4pm and a further 1 care officer on duty from 1pm to 10.00pm. There is also a team of catering and ancillary staff who, together with the registered manager and care staff, provide a qualified and experienced workforce, well able to meet the needs of those living in the home. The home has an established staff training programme and the inspector was able to examine the records detailing staff development. All of the care staff, with the exception of two new carers, have or almost completed the NVQ levels 2 or 3. All staff undertake NVQ training after the completion of the 6-month probationary period. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 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, 32, 34, 35, 36 & 37 The manager has a clear development plan and vision for the home, which she has effectively communicated to the residents, staff and relatives. EVIDENCE: Discussions with the registered manager confirmed her commitment to giving the highest level of care to the residents. She works closely with the staff team to ensure all the assessed needs are met. She is well qualified, and has considerable experience in the care and support of older people. During the inspection she demonstrated clear lines of responsibility and delegation to the senior care team but also provided a “hands on approach” when necessary. The home has a full set of policies and procedures in place and the manager is always looking at ways to ensure these are kept completely up to date. Record keeping is of a high standard, which safeguards the residents.
Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 16 Residents’ personal finances are safeguarded by a high standard of records, now signed by two members of the senior team. The home is operated as part of a charitable trust with the financial viability in the hands of the trustees. Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 4 X 3 3 3 X 4 x STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 3 3 3 x Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? NO 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. 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. Refer to Standard Good Practice Recommendations Barn Close DS0000022534.V269365.R01.S.doc Version 5.1 Page 19 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
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