Inspection on 03/03/06 for Barn Park Residential Home

This inspection was carried out on 3rd March 2006.

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 20/10/05

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 Halwill Beaworthy Devon EX21 5UQ Lead Inspector Graham Thomas Unannounced Inspection 3rd March 2006 09:30 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 Park Residential Home DS0000003646.V269077.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 Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barn Park Residential Home Address Barn Park Halwill Beaworthy Devon EX21 5UQ 01409 221201 01409 221602 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) Mr William Dereck Scantlebury Mrs 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 DS0000003646.V269077.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD, MD & DE categories are for people over 65 years of age only Date of last inspection 20th October 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. A further standing hoist has also been acquired recently. The home is staffed 24 hours a day, including waking night staff. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection was to monitor progress in respect of previous requirements and recommendations and meet service users. During this visit the Inspector spoke with 10 service users individually and spent time with a number of others in groups. Discussions were held with a senior member of the care staff known as the Matron. Mr. Scantlebury, the Registered Provider and Manager spoke with the Inspector by telephone during the inspection. The Inspector also spoke with other member of the staff team and interviewed a visiting District Nurse. Various documents including a sample of care plans were examined. A tour of the premises was conducted and the home’s system for administering medicines was inspected. Issues arising from an additional visit to the home following a complaint were reviewed. What the service does well: What has improved since the last inspection? What they could do better: Care planning records need to more comprehensive and kept up to date. A controlled drugs register and separate cold storage for refrigerated medicines are required. A full record of complaints must be kept and be available for inspection when required. the accessibility of call bells in service users’ rooms Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 6 needs to be checked on as part of a daily routine. An assessment of the premises by a relevant professional is required. The Registered Manager’s qualifications do not meet the National Minimum Standard. The home’s quality assurance system needs to be fully developed and an annual development plan produced. 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 Park Residential Home DS0000003646.V269077.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 Park Residential Home DS0000003646.V269077.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): EVIDENCE: None of the above standards was inspected on this occasion Barn Park Residential Home DS0000003646.V269077.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, 8 and 9 Service users plans do not provide sufficiently comprehensive and up-to-date information. The personal and health care received by service users is generally adequate. EVIDENCE: Ten care plans were sampled. Two systems of documentation are currently in use. One system has been introduced with more recently admitted service users. 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. Not all elements of the care plans had been completed and signatures and dates were missing on some plans and risk assessments. A care plan had yet to be formulated for the most recent admission. Some plans were overdue for review. In some instances, where details were omitted from the care plan files these were to be found in other recording systems. No all care plans included a photograph of the service user. On the day of inspection all service users appeared clean, tidy and well dressed. Those with whom the Inspector spoke said that they received prompt Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 10 medical attention if required. One service user had sustained a minor injury and another was experiencing a deterioration in her health. Both had been referred to the District Nurse who attended during the morning and spoke with the Inspector. She confirmed that all issues requiring her attention were promptly referred. Additionally, advice and regimes of health care which she had instigated were followed by staff who always appeared interested in providing the correct care. She also mentioned good links with the Continence Nurse and other health professionals. Inspection of the Medicines Administration Records showed that all doses administered that morning had been signed for. The records sampled were otherwise up to date, in good order and matched the medicines in the dosage system. Unused medicines had been promptly returned to the supplying pharmacy. No controlled drugs were in use at the time of inspection though appropriate storage is in place for them. A controlled drugs register for recording their use has yet to be obtained. The Matron stated that patient information leaflets had been requested but were still awaited. Separate secure cold storage for refrigerated medicines has yet to be obtained. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: None of the above standards was inspected on this occasion Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is an adequate system in place to enable service users and their relatives to complain. However, there is not a sufficiently coherent system for the recording of complaints. EVIDENCE: The home has a complaints procedure and have responded to the Commission in a timely fashion in response to recent complaints. However, a complaints book produced by the Deputy Matron contained only staff comments concerning issues in the home and no reference to recent complaints received. She was unaware of any other recording system. The Matron stated that the Registered Manager held details of complaints but these were not available for scrutiny on the day off inspection. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22 and 24 Service users live in an adequately maintained home which offers comfortable and homely accommodation. The system for checking the accessibility of call bells is not yet effective. EVIDENCE: On inspection the home was found generally well maintained and evidence of ongoing maintenance and refurbishment was seen. Stair carpets on the upper floor were found to be worn during an additional visit to the home in January 2006. The Matron stated that the risk posed by this wear has been assessed. Mr. Scantlebury has already provided the Commission with a planned date for their replacement. The home has been assessed by an independent health and safety consultant. The Matron stated that security arrangements for access to the premises during the evening had been reviewed following an issue highlighted during a recent additional visit to the home. Communal space in the home includes a comfortably furnished lounge and a recently added conservatory which provides a light and airy space with views over the gardens. There is also a dining room. This cannot presently Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 14 accommodate all the service users at one sitting. Mr. Scantlebury has stated that he has submitted plans for an extension which would resolve this problem. Extensive accessible grounds surround the premises which include gardens and a patio area. Aids for service users with physical disabilities were evident. These included bath hoists, grab rails, lavatory frames and raised toilet seats. A standing hoist has recently been obtained. 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. Most rooms contained many personal possessions including items of furniture brought to the home by service users. Each service user has lockable storage in their room. A portable mains-powered call system is in operation. At a recent additional visit it was found that not all call bells were accessible as some service users had removed them and placed them in drawers or behind furniture. An action plan following this visit stated that a system routine checks on call bells was to be instigated. During a tour of service users’ rooms one call bell could not be found and another was unplugged next to a chest of drawers. In the latter case, this was said to be due to the service user’s habit of “tidying” the call bell away. Cleaning was taking place during the inspection and all areas of the home were adequately clean and odour-free with the exception of one bedroom which was awaiting cleaning. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 Service users are supported by an adequate number of experienced staff. 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. At the time of this inspection there were adequate numbers of staff providing care, domestic support and meal preparation. These comprised mostly experienced staff. A recent additional unannounced visit identified that staff took breaks together in a closed room in the early evening, leaving service users unattended. The Registered Provider has stated that this has never been the policy of the home and that staff have been reminded that this is not good practice. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 33 and 37 Service users live in an adequately well managed home though shortfalls have been identified in record keeping. The qualifications of the Registered Manager are insufficient to meet the national minimum standard. EVIDENCE: Mr. Scantlebury is currently the Registered Manager of the home. Although he has many years experience of running the home, he does not hold an NVQ level 4 / Registered Manager’s Award and has stated that it is not his intention to undertake these courses. He is assisted by senior carers known as a Matron and Deputy Matron. The Matron holds an NVQ level 4 qualification. A quality assurance system for the home which is linked to an annual development plan have yet to be fully developed. The most recently issued Certificate of Registration was not on display in the home. Other shortfalls in record keeping are identified under standards 7 and 16 above. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 17 Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 18 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 3 X 2 X 3 X X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X X Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 OP37 Regulation 15 Requirement Service users’ individual plans must be reviewed by staff in the home at least once per month. The plans must be signed, dated and include a photograph of the service user. The Registered Provider must obtain a controlled drugs register in which the receipt, administration and disposal of all controlled drugs is recorded (Previous timescale of 27/20/05 not met) A record of all complaints must be kept in the home and must be available for inspection 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. (Previous timescale of 12/10/04 not met). A Registered Manager must be in post who has an NVQ level 4 in Care / Registered Manager’s Award or who is working towards these qualifications DS0000003646.V269077.R01.S.doc Timescale for action 01/04/06 2 OP9 13 01/04/06 3 4 OP16OP37 OP22 17 23 17/03/06 01/08/06 5 OP31 7, 8 01/10/06 Barn Park Residential Home Version 5.1 Page 20 6 OP33 24 7 OP37 s.28 C.S Act 2000 (Requirement modified) The home must complete the development of the Quality Assurance system based on seeking the views of service users. (Previous timescale of 08/03/05 not met) The Registered Provider must display in a conspicuous place the most recent Certificate of Registration issued by the Commission 01/05/06 01/04/06 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 OP7 OP9 OP36 OP22 Good Practice Recommendations Care planning records should be comprehensive, complete, and coherently organised Patient 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. The Registered Manager should ensure that there is an effective daily system for checking the accessibility of call bells in individual rooms. Barn Park Residential Home DS0000003646.V269077.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashburton Office 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. 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