Inspection on 26/09/05 for Barna House

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Barna House 03/01/07

Barna House 27/02/06

Barna House 22/02/05

Barna House 21/06/04

Barna House 16/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Barna House 60 Clarendon Avenue Leamington Spa Warwickshire CV32 4SA Lead Inspector Deborah Shelton Unannounced Inspection 26th September 2005 10:15 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 Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barna House Address 60 Clarendon Avenue Leamington Spa Warwickshire CV32 4SA 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) 01926 421186 01926 316488 Mr B Thorpe-Smith Mrs Eibhlin Agnes Thorpe-Smith Ms Tracy Mauchlen Care Home 12 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (11) of places Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2005 Brief Description of the Service: Barna House is a large converted town house providing domestic, homely accommodation for up to 12 older people. Nursing care is not provided. Residents have assess to community health services such as GPs, district nurses etc. There are 10 single rooms, 3 of which have en-suite toilets and 1 double room. There is a large lounge/dining room and 2 bathrooms. There is a patio area at the rear of the home with raised flowerbeds, planted pots and hanging baskets. The home is located close to the town centre of Leamington Spa and is therefore within easy reach of shops, churches, parks and doctors’ surgeries. Street parking for up to two hours is available in addition to pay car parks within a short distance. Bus stops are near by and the railway station is about a mile and a half away. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The following are the findings of an unannounced inspection visit that took place between the hours of 10.15am and 4.20pm on Monday 26 September 2005. The manager was not available at this inspection as she was on annual leave. The Deputy Manager was on duty along with two care staff, a domestic and a cook. Twelve people were living at Barna House. Six of these people were spoken to about their experiences of life at the Home. The inspection process also involved looking at paperwork, a tour of the building and grounds, discussions with the Deputy Manager and Owners of the Home. What the service does well: What has improved since the last inspection? What they could do better: Some changes need to be made to the process currently used for cleaning commodes. Advice should be sought by the Home regarding the best method available to them to reduce any risk of cross infection. Using this bathroom as a sluice area reduces the number of baths available for resident’s use and is therefore a change to the original information provided to the Commission for Social Care Commission upon registration of the Home. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 6 Some work is required in the laundry as paint is now flaking off walls, the tumble dryer was not working and some staff are using a toilet which is located in the laundry. Use of this toilet may present a risk of cross infection. 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. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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): 3 There is a clear, consistent needs assessment and care planning system in place that provides staff with information to meet residents individual needs. EVIDENCE: Assessment and care management care plans are available. These documents and the pre-admission information obtained by the Home are used to form initial care plans within 24 hours of admission. The care file of one resident newly admitted to the Home was seen. This resident was admitted to Barna House from another Home owned by the Barna Care Group. Documentation such as assessments and care plan information was available in the file. Each person living at Barna House has a plan of care, which contains detailed information to enable staff to meet identified needs. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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, Care plans provide staff with the information they need to meet residents’ health care needs. Health needs of residents are well met with evidence that there is good access to a wide range of health professionals to meet individual needs. EVIDENCE: Three care files were reviewed, each was easy to read and understand and in good order. Detailed care plans and accompanying risk assessments record the information needed by staff to meet the health and welfare needs of residents. Risk assessments such as fall risk, nutrition and pressure sore risk were available. Activities of daily living and social activities are also risk assessed as needed. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 10 Not all of the care plans reviewed had been signed by the resident or their representative. The owner showed a quality assurance questionnaire that is based on information contained in care plans. This demonstrated that residents are involved in the care planning process. The Deputy was aware of the need to review care plans on a monthly basis. One pressure sore risk assessment which identified the resident was at a high risk of developing a sore had not been updated since July. Confirmation was received following the inspection visit that this has been updated as required. A sheet is used to record any specialist equipment needed to meet the health care needs of residents, for example, seat cushions to reduce the risk of developing pressure areas. Documentary evidence is available in care plans to demonstrate input by other health and social care professionals such as GP, district nurse, and optician. Some residents still prefer to visit a local dentist accompanied by relatives. The dentist is called in to visit individuals if they request or if the manager identifies a need. Details of likes and dislikes, leisure and social needs and one to one activities that take place are recorded in care files. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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): 12, 13, 14 Those living at Barna House are supported to maintain and develop family links and friendships in such as way as to promote privacy and independence. Residents still have some control over their lives and choices that they make which gives them an increased sense of wellbeing. EVIDENCE: All residents spoken to said that they are able to exercise some choice over what they do on a daily basis and still have some independence. None were aware that there was a choice available for the main lunchtime meal. However they said that they enjoyed the food and would ask for an alternative if they did not like what was on offer. During the inspection a member of staff was seen giving residents a choice for the evening meal. Although there is no documented activity programme in place care plans demonstrated that activities do take place on a fairly regular basis. Exercise to music is provided by Age Concern each Monday morning, a social evening with wine and nibbles and prize bingo takes place every Thursday evening. Relatives are also invited to attend this. Pat a dog visits the Home once a fortnight. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 12 Three residents spoken to said that they would like to do a bit more in the day, some mentioned that they wish staff could take them for an occasional walk down the street to local shops or just to get some fresh air. One resident said that when there is no planned activity taking place you make your own entertainment by reading, chatting, knitting or watching the television. All said that they were happy and content. A questionnaire was recently sent to residents on behalf of Commission for Social Care Inspection, nine people responded. One of the questions related to activities. Seven people responded saying that the Home provides suitable activities, two people did not answer this question. One comment recorded on the bottom of a form stated, “I would like more day trips”. Residents said that visitors are made to feel welcome, they are always offered refreshments and staff are friendly towards them. One lady said that she was pleased that she still had regular visitors and had the opportunity to go out of the Home with them. Families are encouraged to be involved at Barna House. A party is organised for resident’s birthdays and relatives are encouraged to be involved in the organisation of the party and are invited to attend. Residents have been asked about their interests for social and leisure activities and their responses are recorded in their care files. Needs regarding religion are also recorded and are met. Religious services are held at the Home. None of the people living at Barna House handle their own financial affairs. Each resident is assisted by family or a representative such as a solicitor. Care files demonstrated that residents are able to bring personal possessions in to the Home. An inventory of personal belongings is kept. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 the following standard(s): 16 Complaints are handled objectively and residents are confident that their concerns will be listened to and acted upon. EVIDENCE: Complaint records were seen. Records regarding a concern received earlier this year demonstrated that the manager investigated the matter and addressed the issue to the satisfaction of the complainant. The Commission for Social Care Inspection has not received any complaints since the last inspection. The Home’s complaints procedure gives appropriate timescales for issues to be addressed and states that complainants may contact the Commission for Social Care Inspection direct regarding any concern. However the address and telephone number of the Commission for Social Care Inspection local office is not recorded on this procedure. The document states that the phone number can be obtained from the manager. Three residents spoken to about complaints said that they were sure if they had any problems staff would sort them out for them. They also said that they were happy to speak to the manager or staff regarding any issue that may be troubling them. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 23, 25, 26 The appearance of this Home created a comfortable and homely environment for the people living there. Some improvement is necessary to the environment to ensure that infection control can be managed more effectively. EVIDENCE: Barna House is registered as a care home providing personal care for 12 older people. The Home is a conversion of a domestic setting and is located a short walk away from the shops in the centre of Leamington Spa. Those with poor mobility would not be able to live at Barna House due to the stairs that need to be climbed to gain access to some bedrooms and living areas. On the day of inspection residents appeared at ease in their surroundings and were enjoying exercise to music in the lounge. The décor, furniture and furnishings are homely and suited to residents needs. Dining chairs are starting to look worn and shabby. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 15 A ramp is in place to gain access to the rear garden. Paving slabs have recently been laid and borders of brightly coloured flowers make the garden bright and cheerful. One lady spoken to said that she enjoys going outside because the hanging baskets and flower borders are so beautiful. Throughout the Home bedroom doors were being wedged open. This is apparently at the wish of the resident. This was identified as an issue at the inspection of the fire officer in 2003 who reported, “the practice of wedging open bedroom doors must cease”. Following the inspection the manager telephoned to confirm that doors are only wedged open whilst the domestic is vacuuming rooms. The manager was advised to ensure that the domestic only wedges one door at a time whilst completing this task. Two bathrooms are available, one on the ground floor and a small bath on the first floor that is currently being used to clean commodes. The deputy manager told the inspector that residents do not use this bath. Using this bathroom as a sluice reduces the number of baths available for residents. The manager must ensure that the cleaning of commodes does not pose a risk of cross infection to staff or residents. Evidence that this method of cleaning commodes is acceptable to the Environmental Health Department must be obtained. The laundry is small and houses a toilet, which is apparently still used by staff. The manager must ensure that this toilet is not used as this presents a risk of cross infection. The toilet must be flushed on a regular basis to reduce the risk of legionella. The tumble dryer in the laundry was not working as it is faulty and there was no plug fitted. The part to fix the tumble dryer is on order. The washing machine was in good working order. There was no backlog of items to be laundered. Paint on the walls in the laundry was flaking off. Hot water and radiator temperatures are not monitored and recorded on a regular basis. The owner reported that thermostatic mixing valves have been fitted to all baths and the temperature of the water is checked and recorded before anyone gets in to the bath. Hot water and radiator temperatures above 430C present a risk of burns and scalds to elderly residents. There are no risk assessments in place to demonstrate that residents are not at risk of burns from radiators at Barna House. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 Residents benefit from an enthusiastic, well trained workforce that works positively to improve residents quality of life. The number of staff is sufficient to meet the care needs of those living at the Home. EVIDENCE: Duty rotas show that sufficient numbers of staff are on duty on a daily basis to be able to meet the needs of residents. Domestic and catering staff are also employed for 5 days per week. Care staff complete laundry duties. Care staff also complete domestic and catering duties when ancillary staff are not on duty. A majority of those living at Barna House have a relatively low level of care needs. Staff encourage and prompt residents to enable them to maintain their independence. The staff and management team at Barna House are very enthusiastic and dedicated and appear happy in their work. Staff on duty on the day of inspection had a good rapport with those under their care. Residents spoken to said that staff are kind and friendly and have a laugh with you. They also said that staff are always willing and happy to help. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 17 The responses received from the questionnaire sent out on behalf of Commission for Social Care Inspection records that all who responded feel “safe” and “well cared for” “staff treat them well” “their privacy is respected” The Home has a very low staff turnover and no new staff have been employed in the last six years. Recruitment records were reviewed and staff files seen contained satisfactory information. A photograph is required in one file. Five care staff have done NVQ level 2 training, the deputy is working towards gaining NVQ level 3 and the manager level 4. Other staff will undertake this qualification in the near future. The manager must ensure that systems are in place to enable TOPSS induction and foundation training to be provided should any new staff be employed. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 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): 35 Appropriate systems are in place to safeguard residents financial interests. EVIDENCE: Written records are kept of any financial transactions that take place. Records were kept in a satisfactory manner, receipts are kept for any expenditure. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 2 3 3 X 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP21 Regulation 16(2)j k 23(2)k Requirement The manager must be able to demonstrate that the method used for disinfecting commodes is acceptable to the Environmental Health Department. Sluices provided must be separate from Service Users toileting and bathing facilities. Timescale for action 09/12/05 2 OP25 13(4) The home must be able to demonstrate that the number of baths available is suitable to meet the needs of those that live at the Home. The registered provider and 14/11/05 manager must provide evidence that a risk assessment has been undertaken to identify the risk of burns from radiators. Where a high risk is identified, a plan is to be forwarded detailing the action to be taken to remove the risk of burns to residents from hot radiators and exposed pipe work. Details of hot water temperature monitoring must also be forwarded with the action plan of this report. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 21 3 OP26 13(3) 16(2) The laundry requires redecoration as paintwork was flaking off walls. The manager must ensure that equipment in the laundry is in good working order. The manager must provide evidence that use of the toilet in the laundry area does not present a risk of cross infection. 09/12/05 Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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 Refer to Standard OP16 OP29 Good Practice Recommendations The contact details for the Commission for Social Care Inspection should be included on the complaints procedure The manager should ensure that each staff files contains a photograph of the staff member. Barna House DS0000004209.V252440.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Barna House DS0000004209.V252440.R01.S.doc Version 5.0 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. 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