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Inspection on 07/03/07 for Barn Park Residential Home

Also see our care home review for Barn Park Residential Home for more information

This inspection was carried out on 7th March 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The standard of recruitment has improved although there is room for further improvement. A new laundry room was being completed during the inspection. This will provide a cleaner, larger room with more space to separate clean and dirty linen, which improves hygiene. Arrangements have been made to provide locks for bedroom doors, suitable for resident`s own use, and accessible to staff in emergencies. This provides more choice and privacy to residents. There are also plans in place to improve access and safety at the front door. Policies and procedures have been reviewed and are better organised. The risk from very hot water has been reduced.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Barn Park Residential Home Barn Park Halwill Beaworthy Devon EX21 5UQ Lead Inspector Anita Sutcliffe Unannounced Inspection 7th March 2007 08:30 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.V325131.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 Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 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 Derek Scantlebury Mrs Anna Patricia Scantlebury Mr 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.V325131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 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. It is privately owned and managed. District nurses and local GP’s provide any medical care. 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 conservatory, an additional private lounge, six single bedrooms, a bathroom with toilet and two other toilets. There is a stair lift to the first floor where there are twelve bedrooms, two of which may be used as double rooms, four of the single rooms have ensuite toilet facilities - one has an en-suite bathroom. There are two stair cases to the second floor, both with a stair lift, where there are two bedrooms with en-suite toilets and a staff sleep in room. The home has equipment to aid residents’ mobility. Fees charged are: £300 - £425 Additional charges are for: Hairdressing, chiropody, toiletries, transport and tickets for cinema, theatre etc. The latest inspection report is situated in a drawer in the entrance and the summary of the last inspection report is included with the Service User Guide, provided to potential residents. The home and business is currently for sale. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this key inspection was to assess the homes compliance with Key National Minimum Standards. The inspector also reviewed progress on previously set requirements and recommendations communicated following the homes last inspection in July 2006 and a thematic inspection January 2007. The thematic inspection focused specifically on the information given to people about the care home and whether people experience open and fair conditions of care. The findings are included in this report. The manager/owner was unable to provide up to date information about the service at Barn Park for this key inspection. The inspection took place over two weeks and included two unannounced and one announced visit. All service users (residents) were met. Few were able to offer information toward the inspection. However, the care of three was examined in detail. Health, social care professionals and resident’s visitors/family provided information. Staff had the opportunity to complete an anonymous survey. Nine were received. They were also spoken with during the inspection visits and interviewed in small groups. Care, recruitment, training, medicines and complaints records were examined. All areas of the home were visited. Discussion was held with the registered manager, matron and deputy matron. What the service does well: Comments about the home include: “I have found all the staff employed at Barn Park very attentive, always keen to help, and they are very kind to my mother – they help her and encourage her whenever any difficulties arise” and “The care staff genuinely care about what they are doing and the residents in the home. There is usually a good atmosphere and the residents viewed as individual people”. A district nurse said: “Happy place with no stress” There is a core of experienced and competent staff at the home delivering a high standard of care to residents. They are friendly and liked by residents. Health and social care professionals are very satisfied with the standards at the home. The home environment is comfortable; bedrooms very personalised and individual. The home’s surroundings are very attractive. The gardens are pleasant. The manager, matron and all staff care about the residents and all try to provide a good service, treating residents as individuals and understanding and meeting their needs. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Residents continue to be put at risk. Risks identified were: • Unsafe storage of medicines, with the key left in the medicines cupboard • Unnamed medicines left on the office desk • Incomplete records of medication given • Unsupervised access by residents to cleaning materials • Very poor care planning and records of care delivered • An unguarded first floor window from which a resident might fall • Lack of hand washing materials (soap and towels) for staff use to prevent cross infection • A piece of equipment left soiled throughout the day and an overflowing soiled waste container • A disregard for the importance of fire safety checks, which may have been carried out but were not recorded. One fire door propped open • Lack of Induction training for new staff and first aid for all staff Although the standard of recruitment was improved further measures should have been taken to protect residents from people unsuitable to work with vulnerable adults. Relationships between the manager and staff are unsatisfactory. Staff requested their opinion to be surveyed anonymously toward the inspection. Many comments were received. They describe dissatisfaction including: • Poor communication • Lack of information about residents needs; no care plans available • Poor accessibility of manager and matron • Not being listened to • Poor discipline • Issues regarding contracts, salaries and terms of employment Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 7 Staff understanding of dementia needs to be further developed so they better understand the effects of the condition and how to plan personalised care. 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 Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 8 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.V325131.R01.S.doc Version 5.2 Page 9 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, 2, 3 & 4 (Standard 6 does not apply to Barn Park) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides clear, detailed and accurate information to people interested in moving into the home. Care needs are met following assessment, but care is not subsequently planned within a reasonable timescale. The good care of residents with dementia could be improved through further training and a planned approach to meeting their needs. EVIDENCE: Information about the home is provided, questions answered and visits encouraged before a person decides whether to move into Barn Park. A newly admitted resident looked settled and happy. Through survey a relative said: “The home proprietor was extremely helpful, very informative and allowed my Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 10 family to view the home several times before moving my elderly mother there last year. My mother has settled in well and is extremely happy”. Privately funded residents receive a contract. Although those funded through the local authority have not previously received terms and conditions from the home, the manager said this had now been arranged. He also confirmed that residents receive written confirmation, on admission, that their assessed needs can be met. A newly admitted resident had her needs assessed by health professionals prior to admission. Eleven days later the home had not produced a plan of care for daily living, nor examined risks specific to the resident. The manager said there had not been staff available to do this. Care and risk management should be planned within a more reasonable timescale. (Also see Standard 7) Staff feel they provide the emotional and physical support essential for good dementia care. They receive some training and were observed interacting well with confused residents. However, some staff behaviour showed a lack of understanding; a resident was expected to eat a meal she said she didn’t want, and was refusing to eat. Her decision not to eat was not respected and no effort was made to find an alternative meal. There are organised weekly activities at the home, which are both fun and therapeutic. A community psychiatric nurse felt the home could care for ‘the confused elderly’ very well. Where records described a resident with dementia as being “Grumpy, tired and verbally aggressive” for four consecutive days no attempt had been made to find a reasons for the behaviour or plan how staff should respond. The environment is generally suitable for residents with dementia, with a variety of space inside and out. Pictorial signs help residents find their way around. Some furnishings are less suitable, an example being flooring material in a bathroom, which may disorientate, as it continually looks wet. Dangers, especially hazardous to confused residents, had not been identified as dangerous. (Also see Standards 9,19 & 38). Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. Care planning continues to be disorganised and of limited or no value in informing staff how to care for residents in a consistent and planned way. Health and personal care needs are met through staff skill and experience. Medicines are not handled in accordance to legislation or good practice guidelines and this poses an unacceptable risk. Residents are treated with respect. EVIDENCE: The care of three residents was examined in detail. This involved meeting them, reading plans of how their care should be delivered and the records of Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 12 care delivered. A district nurse said: “The home’s continence management is good. They call us quickly if they have any concerns or need advice, and provide all necessary equipment to prevent pressure sores. It’s a happy place, no stress, and their management of health and care is good”. A general practitioner said he was satisfied with the care at Barn Park. Senior staff are able to provide a good level of care through their experience and expertise, not because care is organised or planned. One care plan was very out of date, not having been updated since 2004 and providing no instruction or guidance to staff. One member of staff, in post for three months, didn’t know where care plans were kept. There was nothing to suggest residents have any involvement in their care plans, or staff in using them. Staff comments about care planning include: “I haven’t seen a proper care plan for a long time, only residents day to day notes – not in depth ones” and “I find we don’t have available the information we need. That is care plans”. The records of care provided highlight the disorganised care management. Where a concern such as “Mobility very poor” and “Verbally aggressive” was recorded the reason was not identified, the risk not assessed nor a plan produced of what action staff should take. Neither was there any follow up information to those concerns. The matron was able to show care plans that were of a higher standard, saying she is working toward improving all of them. However, there has been a requirement to improve the standard of care planning since April 2006. Enforcement action will be considered. There were many comments about the friendliness and kindness of staff including: “I have found all the staff employed at Barn Park very attentive, always keen to help, and they are very kind to my mother – they help her and encourage her whenever any difficulties arise”. Residents, their family and staff feel residents are treated with respect. A previous requirement to keep medicines securely has not been met. On arrival at the home the inspector found the key in the medicine cupboard, in an unlocked office, next to an unlocked external door. On the second visit tablets were found on the table in the same room and with no name or label. Once again there were gaps in the record of medicines given. Despite some good medication handling these poor practices add an unacceptable risk, which the home continues to fail to deal with. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Residents are supported to lead a comfortable and fulfilled life and cared for as individuals. Family and friends are made welcome at the home. Food is enjoyed and nutritious. EVIDENCE: The atmosphere at the home is fairly relaxed, a district nurse described the family atmosphere. A new resident has been able to bring a loved pet to live at the home with her. There are weekly, organised activities; details were displayed on the notice board. The inspector observed these on two of the three visits. Resident’s rooms are very homely and comfortable; they contain many personal items of importance. A staff member said: “We respect the resident’s Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 14 wishes, listen to relatives comments and provide a good homely environment”. Most evidence suggests this is true. There are special events organised including a party for every birthday. Photographs were seen of summer and winter events and there are special charity events at the home. Residents said they were very satisfied with the food at the home, and a district nurse said that residents’ dietary needs were met. A resident’s daughter said: “My mother enjoys all the meals provided for her”. The dining room is attractively laid; some choose to eat in the lounge. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and the home’s adult protection and complaints policies protect their interests. EVIDENCE: Staff have an understanding of the vulnerability of the residents in their care and how to protect them from abuse. Most have received training. The whistle blowing policy (which provide staff with information on how to disclose a concern) has been updated. It now contains contact details to ensure outside advice can be sought. The matron said they have received no complaints about the home. Residents said they knew who to speak with if they had a complaint, and one said she didn’t have cause for complaint. The Commission have received no complaints about the home. The home’s complaints procedure is clearly presented and provides all the information residents or their representatives would need to make a formal complaint. However, a member of staff said: “Complaints or concerns are not dealt with just smoothed over”. The home’s ‘grumbles’ book has nothing in it. As it is unrealistic that there is never cause for concern or complaint the home Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 16 should reconsider its approach to receiving information from residents about the service provided. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment is homely, comfortable and meets resident’s expectation, but safety and hygiene are not sufficiently managed. EVIDENCE: The home was generally clean, fresh, warm and pleasant. Residents benefit from a choice of sitting rooms; bedrooms are extremely homely and comfortable. Comments received include: “My mother has settled in well and is extremely happy. She loves her room, likes all the staff and considers the home to be her home from home”. And a resident said: “It s a lovely home in the country”. Safety is poorly considered at the home. (Also see Standards 4 and 38) Twice cleaning chemicals were found left unattended in a corridor, which posed a risk Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 18 to confused residents. The laundry room, also containing chemicals, had its key in the lock and was easily opened. A radiator cover was very loose, coming away from the wall with little effort. A low first floor window was easily opened and posed a risk from falls. Hygiene and the prevention of cross infection are not well managed. In one room a piece of bed equipment was stained with bodily fluids and remained unclean despite several visits to the room by staff. Soiled waste, for specialist disposal, was overflowing the storage bin outside the home. Antibacterial hand gel and protective clothing are available, and yet it is difficult to actually wash and dry your hands, there being no hand towels in either the staff or a residents’ toilet. The kitchen had no hand towel and a district nurse confirmed that she asks for one. Hand towels and solid soap can both transfer bacteria and lead to cross infection; as previously recommended liquid soap and paper hand towels should be available for staff use in all parts of the home including resident’s bedrooms. During the inspection the new laundry facility was nearly completed. This should ensure that laundry is handled hygienically. The changes will also provide new office space, which the manager and matron believe will improve their management and communication and therefore benefit residents. There are also arrangements in place to provide appropriate door locks to resident bedrooms so that they may lock their door should they wish. This is commendable. The home have employed professional fire safety expertise and fully assessed the risk from fire. A member of staff is being trained to oversee fire safety and the manager says he will be informing the fire authority about changes within the home. Staff have recently received fire safety training. However, when the fire safety records were examined there was no record of routine alarm checks between August 2006 and March 2007. Fire safety checks and records have been a previous requirement. Previous concern about the very hot water, increasing the risk from scalds, has now been managed. One bath and one hand basin confirmed that the temperature of water was now been reduced to safe. Immediate requirements were made to improve the prevention of cross infection and remove the risk to confused residents from unsupervised access to cleaning chemicals. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are appropriate to meet the needs of current residents. Residents are protected through improved recruitment practice, but there is room for further improvement. The standard of induction training for new employees is poor and some training needs are unmet. EVIDENCE: Health and social care professionals agreed that staff are competent in their work. There have been several new staff employed who are given time to get to know residents and are instructed by experienced staff. However, for a second time newly employed staff receive insufficient formal induction training. One, employed at the home for three months said: “I’ve not spent much time on the induction” and another shaking her head and saying “None”. Survey comment received from staff include: “Nobody is made aware of whether you work well or if there are training needs” and “There should be proper induction training”. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 20 The numbers and skill mix of staff were appropriate to meet the needs of current residents. Only one negative comment was received about the number of staff: “Often when we have the maximum number of service users we could provide a better service if we had two waking night staff”. Staff receive some training in dementia and the protection of vulnerable adults. Health and safety training is generally satisfactory with the exception of first aid which is not in date. Staff are encouraged to undertake the National Vocational Qualification (NVQ) in care. Although currently less than half have achieved this all staff are considered competent by residents, family and other staff. The standard of recruitment was examined for three newly recruited staff. It has improved but still falls short of being fully robust. For one there was no record of employment history, for another only one written reference. None had provided a statement of their health or had been required to disclose ‘spent’ criminal convictions. None had an acceptable photograph of the staff member. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 21 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, 37 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some very good practice within the home is undermined by significant short falls in health and safety, staff supervision, quality monitoring and staff management relationships, leading to a poorer outcome for residents. EVIDENCE: The registered provider/manager has decided to sell the home, which is currently advertised for sale. The day to day care continues under leadership of a manager designate known at the home as matron. Residents know the manager, matron and deputy well. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 22 Whilst residents appear well card for, family and health care professionals are happy with the service at the home, several of the previous requirements for improvement remain unmet, despite the risk some pose to residents. They include unsupervised access to cleaning chemicals, fire safety checks, propping open fire doors, insecurely kept medicines and some very poor care planning. In addition on this occasion were, an unrestricted first floor window, unsecured radiator cover, poor hand washing facilities for staff and overflowing soiled waste storage. Health care professionals say matron is now spending more time ‘in the office doing paperwork’ and that communication between the home and outside professionals has deteriorated. The manager and matron believe this will soon improve with the office relocation. Staff talk of lack of communication and a lack of information. They want more opportunity to discuss issues of importance to them. Comments include: “I want the matron and deputy to improve communication to avoid misunderstandings within the home and so all staff are informed of the necessary information relevant to resident’s needs” and “There is not enough support because of inconsistent proprietors”. One added: “I think morale in the home is low”. The matron showed records of staff meetings, adding that staff are able to contribute. However, staff said they never have meetings unless they request them. A yearly quality survey of opinion on the home is undertaken. Matron gave examples of changes made following those results. Many letters of thanks and appreciation are received at the home. However, quality monitoring does not include the standards of work; staff are not sufficiently supervised, this leading to some unacceptably poor health and safety practice. Staff say they want formal one to one supervision though more than half said they receive the support they need to do their work. Their opinion is not sought as part of the home’s quality assurance. There are issues that need to be resolved between management and staff. Following the July key inspection the manager engaged professional assistance to update policies and procedures, which are now more organised. The requirement to keep certain records in the home is better, but not fully, met. This requirement is repeated. No residents keep money at the home. Any costs incurred are invoiced. Residents financial affairs are managed either by family or solicitor. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 23 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 3 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 1 2 1 Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 24 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 Regulation 15(1)(2) Timescale for action Unless it is impracticable to carry 31/05/07 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written care plan as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall make the service user’s plan available to the service user and keep the service user’s plan under review and where appropriate and , unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service users plan and notify the service user of any such revision Amended requirement carried forward from 1st. April 2006. The registered person shall make 15/03/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. This refers to: DS0000003646.V325131.R01.S.doc Version 5.2 Page 25 Requirement 2 OP9 13(2) Barn Park Residential Home 3 OP26 13(3) 4 OP29 19(4)(b) 5 OP30 18(1) 6 OP36 18(2) 7 OP37 17 - Unsafe storage of medicines - Gaps in the medicine records Amended requirement carried forward from 31st. August 2006 The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. This refers to: - inadequate hand washing facilities for staff - soiling left on bedside equipment - overflow of soiled waste container Amended requirement carried forward from 31st. August 2006 The provider must ensure the fitness of workers through obtaining the information specified in paragraphs 1 - 9 of Schedule 2. Carried forward from 31/08/07 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the person employed by the registered person receives training appropriate to the work they are to perform, in this case: - Induction training within 6 weeks of employment - First aid The registered person shall ensure that persons working at the care home are appropriately supervised. This refers to: - lack of supervision of work practice - lack of one to one supervision The information listed in Schedules 4 must be kept within the care home, kept up to date DS0000003646.V325131.R01.S.doc 30/04/07 30/04/07 31/05/07 31/05/07 31/03/07 Barn Park Residential Home Version 5.2 Page 26 8 OP38 13 9 OP38 13 10 OP38 13 and available for inspection. Carried forward from 14/08/06 Fire safety checks must be 15/03/07 routinely made with records kept. Carried forward from 14/08/06 Fire doors must not be propped 15/03/07 open. Carried forward from 14/08/06 15/03/07 The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety and unnecessary risks to the health or safety of service uses are identified and so far as possible eliminated. This refers to: -fire safety -hygiene/prevention of cross infection -unguarded first floor window -unsupervised access to cleaning chemicals Carried forward in part from 14th August 2006 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 Refer to Standard OP4 Good Practice Recommendations All specialist services offered, in this case those for service users with dementia, should be demonstrably based on current god practice, and reflect specialist and clinical guidance. Staff should receive induction training to NTO (National Training Organisation) specification within 6 weeks of DS0000003646.V325131.R01.S.doc Version 5.2 Page 27 2 OP30 Barn Park Residential Home 3 OP33 appointment in their posts. The quality assurance process should be expanded to ensure comments are gained from all stakeholders in the service, including staff, relating to the services provided, and an annual development plan drawn up to ensure standards are maintained and improved upon. Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Barn Park Residential Home DS0000003646.V325131.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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