Inspection on 05/04/07 for Barn Close

This inspection was carried out on 5th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Barn Close 07/12/08

Barn Close 04/01/06

Barn Close 20/06/05

Barn Close 31/08/04

Barn Close 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Barn Close Well Lane Stanwix Carlisle Cumbria CA3 9AZ Lead Inspector Mrs Margaret Drury Unannounced Inspection 5th April 2007 9:30 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.V326936.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. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barn Close Address Well Lane Stanwix Carlisle Cumbria CA3 9AZ 01228 521085 01228 540303 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.V326936.R01.S.doc Version 5.2 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. 4th January 2006 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.V326936.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, which forms part of the key inspection, took place over one day in April. During the inspection time was spent talking to residents, the manager, care officers and members of the care and ancillary staff. The inspector was also able to speak with visitors and a member of the district nursing team who was visiting the home on that day. Records pertaining to the care of residents were inspected and discussions about the general running of the home took place. The report refers to “case tracking”, a process by which the inspector is able to focus on a small number of residents and includes a review of their care documentation. It should be noted that this is not detrimental to other people living in the home. A tour of the building took place during which the physical aspects of the environment were inspected. The fees for this service currently range from £363.00 to £385.00 per week, with extra charges for newspapers, private chiropody and hairdressing. This home does not provide intermediate care. What the service does well: Barn Close provides a safe and comfortable environment in a building suited for it’s stated purpose. The residents benefit from a trained, experienced and stable staff team who, together with the manager and other members of the senior team, deliver an extremely high standard of care. There is an in-depth admission process with all prospective residents fully assessed prior to admission. Arrangements are made for anyone wishing to move into the home to visit and enjoy a meal and meet the residents and staff. There is an excellent activities programme that includes working with the local Art College and Tullie House Museum in Carlisle. Activities take place in the community that have resulted in residents making friends with people that do not live in Barn Close. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. The home has completed the “safer food – better business” course and passed with honours, which has improved communication and helped with structure and training in the kitchen. Residents meetings take place, which give a forum for the residents to voice their opinions and make suggestions about the running of the home. All of these suggestions are looked at and discussed with a view to implementation, if possible. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 6 The home has an excellent set of policies and procedures that ensure the safety and wellbeing of the residents and staff. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Barn Close DS0000022534.V326936.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 Barn Close DS0000022534.V326936.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive admission procedure that ensures a full assessment of needs is completed prior to admission. Information provided guarantees all that use the service know the home will meet their needs. EVIDENCE: The manager has recently updated the statement of purpose to include all the recent qualifications obtained by the staff. This, together with the comprehensive service user guide and brochure ensures all prospective residents and their families and/or friends have all the necessary information to make an informed choice about moving into the home. The registered manager assesses all new residents prior to their admission and this is used as a basis for the plan of care. No resident is admitted without the needs assessment that is provided by the social worker as this also assists with the preparation of the initial care plan. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 9 Prospective residents and their families are invited and encouraged to visit the home to view the facilities and meet the staff and those living in Barn Close. This also gives an opportunity to enjoy a meal and the “activity of the day”. Residents who spoke with the inspector said how much they appreciated seeing the home before they moved in. The manager told the inspector that the residents could visit as often as they wished in order to give them time to “make one of the biggest decisions of their life”. Barn Close DS0000022534.V326936.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on individual need and the principles of respect, dignity and privacy are adhered to at all times. EVIDENCE: The statement of purpose sets out clearly in the aims and objectives and philosophy of care how residents’ individual needs will be met. The staff team is trained and knowledgeable in the care of older people and work well as a team to ensure all the assessed needs are met. All residents have a plan of care that sets out personal and healthcare needs and details how these will be met. The inspector “case tracked” 4 residents, during which an in-depth examination of all the documentation was made. Information was relevant and easy to understand. Each care plan showed a risk assessment to ensure any accidents are kept to a minimum. All residents, wherever possible, take part in the monthly care reviews and “sign off” their care plan. If this is not possible family members discuss the Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 11 plan of care and sign their agreement. The registered manager also checks the care plans on a regular basis and is present during some of the monthly reviews. Details of all healthcare visits/appointments are highlighted in the daily record, which ensures no appointments are missed. Residents can retain their own GP if they wish and many have requested this. Chiropody, optical and dental services are organised when required and the manager confirmed that the home has a good working relationship with the district nursing service. This was also confirmed when the inspector spoke with a district nurse who was visiting a resident on the day of the visit. Medication is provided in a monitored dosage system and all the senior staff responsible for giving medication have been appropriately trained. The records were checked and found to be up to date and in order. Regular audits are completed and recorded by the registered manager to ensure there are no medication errors. The home had no controlled drugs prescribed at the time of the visit although there is a procedure for the recording and giving of such medication. All the rooms currently in use are used for single occupation although the room designated for respite care can accommodate a married couple should the need arise. Observations made during the visit evidenced the care and attitude of the staff when interacting with the residents. Dignity, privacy and respect are considered to be of prime importance to those delivering care and the residents who spoke with the inspector all said the staff treated them with the utmost respect and that their privacy was respected in every way. The home has a small quiet room, which is available for private visits and for families to use should this be necessary. Barn Close DS0000022534.V326936.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their life style and to retain their independence for as long as possible. Social and recreational activities meet the residents’ expectations and needs. EVIDENCE: The home promotes the individual resident’s right to live a life that is fulfilling and meaningful. Residents have a choice of activities that are varied and stimulating. The views of residents are discussed at residents’ meetings with regard to the activities they most enjoy. One of the most popular is a monthly tea dance held at the community centre in Brampton. Transport, which is always full, is organised for those wishing to go and all the residents said they had made friends with people from the local community who also attend. Pottery classes have recently been arranged with the local art college and an exhibition of the pottery took place at Tullie House Museum in Carlisle. A painting class has also been organised with staff from the art college after which a display will also be held at the museum. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 13 There are activities arranged for each afternoon although the residents who spoke with the inspector were quick to point out that they did not have to take part unless they wished to. Easter competitions had been organised for “bonnets, cards and decorated eggs” and a visitor was able to judge all three during the afternoon of the visit. It was noticeable during the visit that the atmosphere in the home was warm friendly and open, a point that was made to the inspector by people who were visiting the home. Another popular activity is the “weekly shopping trolley”, which allows residents to purchase personal items such as tights, toiletries, cards and sweets. This is especially helpful for any resident who is unable to go out to the shops and is another way of retaining independence. Regular Communion services are arranged by the near-by Anglican Church and there are some residents who are able to attend their own churches on a regular basis. The inspector was able to speak to the chef who has been appointed since the last inspection visit. He said he was extremely happy and really liked talking to the residents. New summer menus are currently being prepared with suggestions having been made by the residents themselves. Almost all the food is home prepared and all said they enjoyed their meals, as there was always a choice. Special menus are prepared for special days and the residents had already chosen the “English” meals for St Georges Day. Barn Close DS0000022534.V326936.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns through an effective and accessible complaints procedure. Residents are safeguarded by an efficient adult protection policy. EVIDENCE: Residents who spoke with the inspector confirmed that they can express concerns and opinions at any time and that they are always listened to. Staff confirmed that they were aware of the importance of listening to the residents and responding to any issues that may be raised. All residents are given a copy of the complaints procedure and the path to follow should they need to voice a concern. There is a complaints book in the home but there have been none to record since the last inspection. There is a copy of the complaints procedure on display. The home has a warm and open atmosphere that enables residents to feel safe and supported with policies and procedures in place to ensure the residents are protected at all times. The manager has booked a place on an adult protection training course organised by Social Services for later in the year. In-house staff training in this subject will then be passed on to the care staff team. In the meantime this subject is discussed during staff meetings and supervision to ensure staff are aware of all adult protection issues. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24 25 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enable the residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The Lonsdale Trust, which owns Barn Close ensure that the physical environment of the home provides an environment appropriate to meet the needs of the residents. The home is well maintained, warm and comfortable with staff that encourages all residents to see the home as their own. There is an annual repair and maintenance plan and the manager was able to confirm that the yearly schedule for the redecoration of ten bedrooms has been completed. One of the lounges has been completely refurbished, to include Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 16 carpet and curtains, since the last inspection. Some remedial work has been completed on the baths but the manager is hopeful that one of the bathrooms will be completely refurbished in the near future. Two lounges and two lounge/dining rooms provide communal space and there is also a small sitting room that can be used for private visits or for families to use when visiting the home. These amenities give ample space for enjoying organised activities and for sitting quietly reading or chatting with friends. The home has extensive and well-kept gardens, which provide an excellent amenity for the residents during the warmer weather. Barn close has thirty-four single rooms and three registered for two people wishing to share. Currently all rooms are used for single occupancy, except for one double room which is occupied by a married couple. All of the residents’ rooms are well appointed with twenty-five of them having en-suite toilet and washing facilities. They are well furnished with matching bedding and curtains and many have views overlooking the gardens. The residents have personalised their rooms with furniture, pictures and photographs brought from their own homes. Laundry facilities are provided and situated away from the main living and food preparation areas and the home employs staff whose main responsibility is to ensure the laundry is dealt with in a timely manner. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in this home are trained, skilled and in sufficient numbers to provide a high level of care and support those living there. EVIDENCE: Barn Close has a full recruitment and selection policy managed by the human resources officer at head office. The organisation sees the recruitment of good quality staff as essential to the delivery of an excellent service. Application forms are completed, references taken up and interviews arranged. All new staff are appointed after all the required legal checks have been completed and no new member of staff work without a mentor until their induction programme has been completed. The staffing ratio is very excellent, with 5 – 6 carers on duty during the day plus 2 care officers and the registered manager. The home also employs 6 domestics, 2 cooks, 1 kitchen assistant, 1 laundry assistant, 1 gardener and a handyperson. Night duty is covered by 2 waking staff but, should it ever be necessary, the manager can bring in an extra member of night staff if this would benefit the residents. This level of staff ensures those living in the home are safeguarded at all times. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 18 There is an ongoing staff training programme and there is over 80 of the care staff qualified to National Vocational Qualification (NVQ) levels 2 and 3, with 1 care officer working towards level 4 and another having completed this level and now working towards the registered manager award. All mandatory training is up to date, including manual handling, food hygiene, and risk assessment covering environmental issues and substance/ cleaning products. Training planned for the future includes, care of the dying, dementia and protection of vulnerable adults. Details of staff training are held on individual flies, which means that updates are completed within the required timescale. All of this results in a diverse staff team that has the balance of skills and experience to meet the needs of people living in the home. Discussions with the staff evidenced that they all work as a team and support each other, although they are aware of their own roles and responsibilities. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 36 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. There is an effective quality assurance system that ensures residents are fully satisfied with the care and support they receive. EVIDENCE: The registered manager has the required qualifications and experience, and is highly competent to run the home and ensure it meets its stated aims and objectives. She has the best interests of the residents at heart and has a clear vision of the home that is based on the organisation’s values and priorities. She has a high profile within the home and those residents who spoke with the inspector said she “is very approachable and I can speak to her when I want Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 20 to”. There is a very open atmosphere in the home that stems from the manager and the senior team and is much appreciated by those living in Barn Close. The manager has been instrumental in starting various activities and continues to be involved whenever she is available. Quality audit questionnaires are completed by relatives/visitors, professional agencies and residents, after which the manager prepares an audit report and looks closely at any issues raised. Residents’ meetings are held, which give opportunity for those attending to share their views and make any suggestions about the running of the home. The home has efficient systems for effectively safeguarding individual’s personal money. The records pertaining to the cash held on behalf of residents were examined and found to be correct, with money signed in and out by 2 members of staff as an extra security check. All receipts for goods purchased are retained for reference. Staff supervision take place every 2 months with records held on file. The meetings give opportunity for staff to discuss the policies and procedures that are in place and also to talk about any training needs they may have. Annual appraisals are also in place. There are working practices in place to minimise the risk of accidents and the home has a comprehensive range of policies and procedures in place to promote and protect residents and staff. The manager and senior team have a good understanding of health and safety issues and risk assessments covering all aspects of the running of the home. Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 21 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 4 X 4 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 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 3 4 4 X X 4 4 4 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 4 4 X 4 Barn Close DS0000022534.V326936.R01.S.doc Version 5.2 Page 22 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. 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.V326936.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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