Inspection on 20/10/05 for Barn Park Residential Home

This inspection was carried out on 20th October 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 Park Residential Home 09/01/08

Barn Park Residential Home 16/08/07

Barn Park Residential Home 07/03/07

Barn Park Residential Home 24/07/06

Barn Park Residential Home 03/03/06

Barn Park Residential Home 08/03/05

Barn Park Residential Home 14/10/04

Barn Park Residential Home 23/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Barn Park Residential Home Barn Park Halwil Beaworthy EX21 5UQ Lead Inspector Graham Thomas Announced 20 October 2005 th 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 Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Barn Park Residential Home Address Barn Park, Halwill, Beaworthy, Devon, EX21 5UQ 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) 01409 221201 Mr William Dereck ScantleburyMrs Anna Patricia Scantlebury William Derek Scantlebury Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (22), Old age, not falling within any other category (22), Physical disability over 65 years of age (22) Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: PD, MD & DE categories are for people over 65 years of age only Date of last inspection 8th March 2005 Brief Description of the Service: Barn Park is a large Victorian House on the edge of Halwill Village. It is registered to provide personal care to 22 elderly people, who may have physical disabilities, dementia or mental disorders. The home has been extended but still retains many of the features of the original house. The property is set in extensive grounds. On the ground floor the home has a dining room, lounge leading to a large conservatory and private lounge. There is a kitchen area, small office, laundry area, and utility/sluice room. There are 6 single bedrooms on the ground floor, bathroom with toilet and 2 other toilets. There is a stair lift to the first floor where there 12 bedrooms, two of which may be used as double rooms, four of the single rooms have en-suite toilet facilities- one has an en-suite bathroom. There are two bathrooms and a toilet used by staff, one of the bathrooms has a shower. There is also a separate toilet. There are two stair cases to the second floor, one with a stair lift, where there are two bedrooms with en-suite toilets and a staff sleep in room The home has a number of floor based hoists to assist with bathing and two mobile hoists.The home is staffed 24 hours a day, including waking night staff. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a review of a pre-inspection questionnaire submitted by Mr. Scantlebury and 4 comment cards returned by relatives / visitors. A tour of the home was conducted. The inspector spent time with 15 service users in groups and / or individually. Four staff were interviewed and discussions took place with the Registered Provider. Three relatives were spoken with. Care plans, medication records and a variety of other documents were inspected. What the service does well: What has improved since the last inspection? What they could do better: Individual risk assessments need to be reviewed. Drugs not in current use need to be returned promptly and controlled drugs must be recorded in a separate register. An independent professional assessment of the premises is needed to ensure it is properly arranged and equipped to meet service users’ Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 6 needs. The management of the home would benefit from appropriate formal training. Staff need regular supervision to ensure they are meeting service users’ needs. Regular systematic audits of the quality of the service provided are needed. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 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 Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 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, 3 and 6 Service users are provided with adequate information to facilitate their choice of living at the home. Comprehensive pre-admission assessments ensure that service users’ needs can be met by the home. EVIDENCE: The Registered Provider has produced a Statement of Purpose and Service User Guide. Copies of the latter were seen in some service users’ rooms. Mr. Scantlebury stated that all Service users had received a copy. The Commission has received copies of both in accordance with requirements made at the last inspection. Mr. Scantlebury and his Matron stated that, where possible, prospective service users are visited prior to admission at which time assessment information is gathered. The care plans of the most recently admitted service users showed evidence of pre-admission assessment. The assessments covered physical, psychological and social needs and preferences. Mr. Scantlebury stated that intermediate care is not provided by the home. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 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, 9 and 10 Service users receive and adequate standard of health and personal care. EVIDENCE: A sample of care plans was examined. A new system of care planning had recently been introduced. The plans sampled included details of individual needs and preferences including physical, healthcare, psychological and social needs. There was detailed information about how each individual’s needs were to be met. Comprehensive risk assessments were included in the care planning process. Some of the care plans and or their elements were not signed and dated. Some of the risk assessments required review. Service users and their relatives confirmed that prompt access to medical services is supported by the home where required. Care plans provided details of individual physical health needs. Discussion with the Matron and evidence in the care plans showed that the home maintains good links with District Nursing and other health services. The Deputy Matron provides liaison with the local continence advisor. One comment card suggested that a service user’s hearing aid was not kept in good working order. The Registered Provider is advised to check all service users’ hearing aids. The Home’s systems regarding medicines were inspected. All medicines were securely stored with additional security provided for controlled drugs. Separate Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 10 refrigerated storage has been obtained for drugs held at low temperatures. One controlled drug was being retained which was not in current use. This was discussed with the Matron who undertook to return the drug. There was no separate controlled drug register. Discussion with the Matron confirmed that staff training in medication includes the policies and procedures of the home. A monitored dosage system is in use which is supplied by a local pharmacy. In accordance with the requirements of the last inspection, recording of the administration of drugs had improved and those records sampled were found to be accurate and up to date. It is recommended that Patient Information Leaflets should be obtained for all drugs in current use, including those supplied in the monitored dosage system. Information obtained from speaking with service users, relatives and staff, reviewing comment cards and direct observation indicated that the dignity and privacy of service users is respected. A small second lounge is available for private visits and consultations if required. Staff were seen knocking on bedroom doors before entering and addressing service users respectfully. In interview, one relative commented that the staff were excellent, adding “I’ve never seen a cross face!” Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 11 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 to 15 Service users are well supported to maximise their autonomy and pursue the daily and social activities of their choice. EVIDENCE: There was evident choice for service users in their daily routine. Those service users who wished to remain in their rooms were able to do so. Individual interests are recorded in care plans. A variety of social and leisure opportunities is provided. These include musical entertainment, exercise and table top activities. Some service users attend day centres. Support is also provided for church attendance and shopping trips. Relatives and service users confirmed that they are able to see visitors in private if they wish. The home has a separate small lounge which is used for this purpose. Relatives confirmed that they were able to visit at reasonable times and that they were always made welcome and offered refreshments. There are fixed times for lunch and the evening meal. However breakfast and supper are provided flexibly. Service users confirmed that drinks are available at any time in addition those provided at regular intervals throughout the day. The home has a small dining room which cannot accommodate all the service users at once. Mr. Scantlebury stated his intention to increase the size of the dining room as part of a proposed extension to the building. A meal was sampled which was plentiful, wholesome and nutritious and contained fresh ingredients. Individual dietary needs are catered for and daily choices are Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 12 offered. Discussion with the kitchen staff indicated that any liquified meals would be presented in separate portions. Mr. Scantlebury confirmed that he is not involved in service users’ personal finances. These are dealt with by relatives or professionals. The home does not handle any cash on behalf of service users, if money is spent on behalf of service users then relatives are billed. Service users are able to bring in their own furniture and personal possessions into the home. Those service users who are able, hold a front door key and come and go as they please. Information on local advocacy services is made available to service users and their relatives. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 13 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 and 18 There is an adequate system in place to enable service users and their relatives to complain. Service users are properly protected from potential abuse. EVIDENCE: In feedback from relatives via comment cards and interview, none had felt the need to make a complaint to the home. Policies and procedures are in place concerning complaints, the abuse of vulnerable adults and whistle-blowing. Some staff have received training about the abuse of vulnerable adults and more is being sought. This training is also included in the induction of new staff. The Registered Provider stated that neither he nor his staff are directly involved in the private finances of service users. Staff files were examined including those of the most recently recruited. These included checks of criminal records and the national list of staff referred as unsuitable to work with vulnerable adults. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 14 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, 22, 24, 25 and 26 Barn Park provides a comfortable, attractive, clean and hygienic home for its residents. EVIDENCE: Barn Park is located on the outskirts of the village of Halwill. There are extensive, accessible grounds which include a patio area. Access to the upper floors of the home is facilitated by stair lifts. Four of the ground floor bedrooms are suitable for wheelchair users. Signage and layout enable service users to find their way around the home easily. The home is well decorated and furnished in a homely style. A tour of the home provided evidence of ongoing maintenance and upgrading. This included new non-slip flooring in two toilets, New flooring in the conservatory and utility rooms, new stair carpet and reroofing of the conservatory. In accordance with a previous requirement, the use of low energy bulbs in the home has been risk assessed. Fire safety measures are in place and a recent Environmental Health inspection report was seen whose findings had been acted upon. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 15 Aids for service users with physical disabilities were evident. These included bath hoists. An assessment of the premises by a suitably qualified professional has yet to be undertaken Service users own rooms have been fitted with suitable locks to which service users are offered a key. All the rooms visited were attractively decorated and comfortably furnished. Many rooms contained items of furniture brought to the home by service users. Each service user has lockable storage in their room. Radiator covers have been fitted throughout the home. Thermostatic valves have been fitted to all baths in the home. A legionella risk assessment has been carried out and evidence was seen of regular water temperature checking was seen in accordance with a previous requirement. At the time of inspection, Mr. Scantlebury was considering a water supply system which eliminates infection risk. During the inspection all parts of the home were found to be clean and free from offensive odours. A laundry facility is sited away from the kitchen and food storage. This room has an impermeable floor and washable walls. Mr. Scantlebury stated that the washing machine has the required hot cycles and a sluicing facility. Alcohol hand cleaning dispensers are strategically sited throughout the home. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 16 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 to 30 EVIDENCE: Staffing for the home is arranged in a fortnightly rota. The usual pattern provides: In the morning, 1 Manager (Matron or Deputy), 4 Care Assistants, 1 Domestic, and 2 kitchen staff. In the afternoon /evening there are 3 care assistants, and one kitchen staff. Night cover is provided by one waking staff member and one who sleeps in. This is supplemented by an on-call system. Most relatives believed this to be sufficient to meet the needs of service users. Examination of staff files showed that those most recently recruited had been subject to a thorough recruitment procedure. This included checks of criminal records and the national list of staff referred as unsuitable to work with vulnerable adults. Two references had also been requested. Statements of terms and conditions were seen on staff files. A programme of training is working towards the requirement that 50 of direct care staff must be trained to level 2 NVQ by the end of 2005. The Matron holds a level 4 NVQ and her deputy holds a level 3 qualification. Other staff hold level 2 NVQs or are working towards this qualification. Evidence was seen of systematic induction training based on national standards. At the time of inspection a training package had been purchased by Mr. Scantlebury which was awaiting implementation. Evidence was seen on staff files of training in such topics as moving and handling, food hygiene and non-abusive physical interventions. A new system of staff supervision linked to training was about to be implemented. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 17 Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 18 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) 31, 33, 35, 36 and 38 The home is generally well managed. However a better service could be provided by addressing shortfalls in management qualifications, staff supervision and quality assurance systems. EVIDENCE: Mr and Mrs Scantlebury, own Barn Park, with Mr Scantlebury currently managing the home on a day to day basis. In addition there is Matron and Deputy Matron. Mr & Mrs Scantlebury have considerable experience of running a home, though neither of them have the Registered Managers Award or NVQ 4 in care and management. Mr. Scantlebury stated that it was not his intention to undertake this training. A quality assurance system has yet to be fully implemented. The home has sent out questionnaires to visitors. Some responses have been received and some suggestions for improvement have been acted upon. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 19 Mr. Scantlebury stated that the home does not manage any money on behalf of service users. Immediate payments for items such as personal shopping and chiropody are paid for by the home. Receipts are kept and bills presented to relatives. Current staff supervision arrangements do not provide supervision at the required intervals. The Matron stated that a new supervision system was about to be introduced. Since the last inspection, Mr, Scantlebury has commissioned a complete independent health and safety audit of the home. Records of recent gas and electrical safety checks were seen. A contract for the disposal of hazardous waste was available for inspection. Fire safety records showed checks of alarms and emergency lighting. Various documents were seen in respect of equipment checks and maintenance. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x 3 3 3 STAFFING Standard No Score 27 3 28 3 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 2 x 2 x 3 2 x 3 Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 21 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 9 Regulation 13 Requirement The Registered Provider must ensure that medications not in current use are promptly returned. The Registered Provider must obtain a controlled drugs register in which the receipt, administration and disposal of all controlled drugs is recorded The registered person must demonstrate that an assessment of the premises and facilities has been made by a suitably qualified person, including a qualified occupational therapist. (This requirement was made at the inspection on 12/10/04). Mr Scantlebury must provide evidence to CSCI that he has completed an NVQ4 in care or management, or Registered Managers Award. The home complete the development of the Quality Assurance system based on seeking the views of service users. (This requirement was made at the inspection on 8th March 2005) Timescale for action 21.10.05 2. 9 13 27.10.05 3. 22 23 31.1.06 4. 31 7, 8 1.1.06 5. 33 24 31.1.06 6. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 22 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. Refer to Standard 7 7 9 36 Good Practice Recommendations Care planning documents should be signed and dated Individual risk assessments contained in the care plans should be reviewed. Paitent information leaflets for all drugs in use in the home should be obtained. The new staff supervision system should be fully implemented. Staff should be supervised at least 6 times per year. Barn Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Park Residential Home D54-D07 S3646 Barn Park V241929 201005 Stage 4.doc Version 1.20 Page 24 - 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. 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