Inspection on 27/02/06 for Barna House

This inspection was carried out on 27th February 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 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 26/09/05

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 27th February 2006 10:20 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.V284662.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. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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.V284662.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 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 at Barna House. Service users have assess to community health services such as GPs and district nurses. 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 in the home. 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.V284662.R01.S.doc Version 5.1 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 10.20am and 3.30pm on Monday 27 February 2006. During this inspection the Manager was on duty along with the deputy manager, a care assistant and the cook. Twelve people were living at Barna House, five of whom 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 staff on duty and the manager. Some of the documentation was looked at in the lounge, this enabled the inspector to see residents in their usual surroundings and see the interaction between staff and residents. What the service does well: Residents were happy to talk to the inspector about their life at Barna House. All said that the food is good, and that the staff are kind and friendly. Some of the comments made are as follows: “I can do as I like, that is why I like living here” “the staff do things for you and help you when you need it” “the food is good” “everyone is nice” “I like the staff and the other residents, we have a laugh”. Staff were seen to have a good relationship with residents and were patient and caring. Residents were at ease in their surroundings chatting freely amongst each other sharing a joke. The atmosphere at the Home is relaxed and friendly. The manager and her deputy have a good knowledge of the needs of residents. The manager also has a clear vision of the way in which the Home should be run and understands the actions to be taken to address issues raised. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 6 Documentation seen was up to date, in good order and contained relevant information. The needs of residents are met with detailed information and guidance being recorded in care plans for use by staff. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barna House DS0000004209.V284662.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 Barna House DS0000004209.V284662.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): Standards not assessed at this inspection. EVIDENCE: None of these standards were inspected on this occasion. Barna House DS0000004209.V284662.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): 8, 9 and 10 Residents have good access to health care and relevant health professionals and their health needs are fully met. Procedures for the management of medications ensure the safety of residents. Residents are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Three care files were reviewed and found to contain sufficient information to demonstrate that the health care needs of residents has been identified and relevant services/professionals contacted to meet these needs as necessary. Residents were happy with the care given and confirmed that their health care needs were being met. All said that their GP is called if needed and they have regular visits from dentist, chiropodist and district nurses as necessary. Care files contained various risk assessments such as nutrition and pressure sores, which have been reviewed and updated as necessary. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 10 Records are kept to demonstrate that the personal hygiene needs of residents are being met. A social activity record is kept in each file that records activities undertaken by residents. Medication administration records had been completed in a satisfactory manner. Six staff have undertaken a safe handling of medication course. Controlled medications in use where being stored appropriately and records were kept according to legislation. The medication cupboard was clean and orderly and there was no evidence of excessive stock. Medication administration records did not have a photograph of each resident. Photographs should be available to reduce the risk of administering medication to the wrong resident. The manager confirmed that action would be taken to address this good practice issue immediately. Throughout the inspection staff were seen to have a good relationship with residents. Staff treated residents with respect and were kind and patient. Two residents said that staff treat them well and are caring and friendly. Staff were seen to knock on bedroom doors and wait to be invited in before entering. Barna House DS0000004209.V284662.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): 15 Meals are well presented, wholesome and provide residents with a nutritious and balanced diet. EVIDENCE: The inspector ate a meal with residents. The meal served was appetising and wholesome. Residents ate their meal and those spoken to said that the food is always good. Residents are told in the morning what is available for the main lunchtime meal. A menu book is used to record the meal served and any changes that individual residents may have requested. The cook confirmed that residents are able to have an alternative if they wish. The cook said that on a resident’s birthday a cake and trifle is made. Residents confirmed this and said that it makes their birthdays seem special. Records seen relating to fridge and freezer temperatures and cleaning rotas were up to date. There were no records to demonstrate when the freezer is defrosted. It was noted that a new freezer is being purchased shortly. The cook confirmed that these records will commence when the new freezer is in place. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 12 The kitchen is domestic in scale and was clean and hygienic on the day of inspection. Barna House have won a “Safe Food Award” issued by Warwick District Council. Residents were offered drinks and biscuits/cakes throughout the day. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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): 18 Policies and procedures in place for the protection of vulnerable adults provide a safe environment for the people living in this home. Some work is required to bring the Home’s whistle blowing policy up to date. EVIDENCE: There have been no allegations of abuse at this Home. Policies are available regarding the protection of vulnerable adults and whistle blowing. The whistle blowing policy requires contact details including to enable staff to make contact should they have any concerns regarding the management of the Home. Staff have not undertaken any protection of vulnerable adults training. This is planned for the next few months. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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, 21 and 25 The standard of décor is good. Barna House provides as a homely and comfortable environment for residents Not all health and safety issues have been addressed to ensure that residents live in a safe environment. EVIDENCE: Barna House is located in a residential area close to the centre of Leamington Spa. Resident areas are provided over three floors. The ground floor housing the lounge/dining room, bathroom, kitchen and bedrooms. The first floor which can be accessed via a chair lift has bedrooms and a toilet. The second floor which could only be accessed by mobile residents who are able to walk up stairs also has a toilet and bedrooms. The Home was in good decorative order, clean and hygienic. Barna House is domestic in nature and furnishings and fittings give a homely, welcoming feel. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 15 Residents appeared at ease in their surroundings and wandered freely around the Home. Residents said that they enjoy spending their days in the lounge area chatting to friends and watching the television. None of the residents said that they preferred to spend time alone in their bedrooms. Records demonstrated that a Fire Officer visited Barna House in June 2005 and was happy with the fire equipment available. A ramp provides access to the rear garden, which had been planted with brightly coloured flowers. Residents said that they enjoy going in the garden in the summer. Bedrooms had been personalised with pictures and ornaments. Opening windows provide ventilation and radiators provide warmth. It was a requirement of the last inspection visit that radiator temperatures are monitored to ensure that temperatures are not above 430C. The manager was aware of the need to complete this task and discussed the process that will be used to monitor both radiator and hot water temperatures. Following the last inspection the manager contacted an infection control nurse in order to review the methods used to clean commodes. The manager is awaiting the report of this visit but confirmed that the infection control nurse stated that the Home are following acceptable procedures. A bath on the first floor is still being used to disinfect commodes. The manager confirmed that residents are unable to use this bath because it does not have disabled facilities. There was no facility to ensure that residents do not go into this bathroom. Residents should be prevented from entering this room due to the risk of cross infection. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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): 30 There is a complement of staff that have worked at the home for many years and staffing levels offer a good consistency of care within the home. In order to ensure that the workforce has the skills to meet the needs of service users mandatory and service user focussed training must take place. EVIDENCE: Barna House has a stable staff group who have worked at the Home for a number of years. The manager said that she was the most recent employee and she has been working at the Home for four years. A very brief induction sheet is available should any new staff be employed. This would not meet the national training organisation’s specifications (TOPSS). The manager confirmed that the owners of the Home have access to the TOPSS induction standards and these would be used for any new staff employed. Ten care staff are employed, five of whom have already attained NVQ level 2 qualifications. The Deputy is in the process of undertaking NVQ level 3 and the manager NVQ level 4. The manager said that a care assistant has expressed an interest in doing NVQ level 2 training. Minutes of staff meetings demonstrated that discussions are held regarding policies and practices at the Home and staff have the opportunity to request training and undertake inhouse training as necessary. The manager must ensure that all staff receive a minimum of three paid days training each year. Discussions were held regarding training planned for 2006, this includes moving and handling, fire and adult protection. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 17 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 38 The Home has an experienced manager who has an in depth knowledge of the needs of those under her care and has a clear vision for the home. The quality management systems in place ensure that the home is run in the best interests of the residents. Updates in mandatory training are required to safeguard the health, safety and well being of residents and staff. EVIDENCE: The registered manager has worked at Barna House for over four years. Records demonstrated that the manager undertakes update training regarding the needs of the client group cared for on a regular basis. The manager is in the process of undertaking NVQ level 4. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 18 Comprehensive quality assurance systems are in the process of being implemented. A quality assurance events planner details tasks to be completed with dates that they are to be undertaken. Standardised documentation is kept in a file. The processes to be followed are also recorded on flow charts and on procedure documents. Records seen demonstrated that a survey of residents was undertaken in May 2005, a medication audit in April and a stakeholder survey in July 2005. The manager is aware that the process needs to be fully implemented and discussed ways of undertaking the resident survey in future. Various records were seen to evidence that the health and safety of residents and staff is maintained. Portable appliance tests, chair lift servicing, fire alarm and emergency light test records were some of the records seen. The date of the last fire training undertaken by staff was recorded as June 2004. Limited evidence was available to demonstrate that mandatory training is up to date. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 x 18 2 3 X 2 X X X 2 x STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Yes Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Barna House DS0000004209.V284662.R01.S.doc 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 OP18 Regulation 13(6) Requirement The manager and staff must undertake vulnerable adults training. The whistleblowing procedure must be amended to include contact details for the Commission for Social Care Inspection and management as detailed in the procedure. 2 OP21 16(2)(j) (k)23(2)k 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. (Note, the manager has contacted an infection control nurse who has completed an assessment, a report is awaited). (Outstanding since 26 September 2005) 28/03/06 Timescale for action 28/03/06 Barna House DS0000004209.V284662.R01.S.doc Version 5.1 Page 21 3 OP25 13(4) The registered provider and 28/03/06 manager must provide evidence that radiator temperatures are monitored and that temperatures do not exceed 430C. Where temperatures are in excess of this, 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. (Outstanding since 26 September 2005) 4 OP30OP38 18(a)(a) (c) The registered manager must be able to demonstrate that staff receive 3 paid training days per year. Updates in training in mandatory areas such as fire, moving and handling and first aid must be undertaken on a regular basis. 28/03/06 Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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 Refer to Standard OP9 Good Practice Recommendations Photographs of Service Users should be available with the Medication Administration Records to aid staff with Medication Administration. Barna House DS0000004209.V284662.R01.S.doc Version 5.1 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. 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