Inspection on 06/10/08 for Barnetson Court

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barnetson Court Braintree Road Great Dunmow Essex CM6 1HS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: June Humphreys     Date: 0 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Barnetson Court Braintree Road Great Dunmow Essex CM6 1HS 01371875373 01371873816 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Newstraid Benevolent Fund Name of registered manager (if applicable) Mrs Catherine Carpenter Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 16 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Barnetson Court is a purpose built property, situated near to Dunmow town centre, in a residential location. It is registered to provide to sixteen older people, and is able to meet the needs of people requiring assistance with personal care and mobility. It is not registered to admit people with dementia. The home has level access throughout and accommodation is all on the ground floor. There are sixteen single bedrooms, assisted bathing facilities, a spacious lounge and a separate dining room, and well-maintained gardens. Barnetson court has changed the name of registered provider to The Newstrid Care Homes for Older People Page 4 of 28 care home 16 Over 65 16 0 Brief description of the care home Benevolent Society in April 2008. The registered manager has remained the same, Mrs Catherine Carpetner. A copy of the service user guide is available at the home, and current fees are from £456.00 per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This was a routine unannounced inspection, which included a visit to Barnetson court on the 6th October 2008. The site visit lasted for five hours, and was undertaken by one inspector. During the visit all of the key national minimum standards were addressed. Relevant records and documents were examined and observations of care practice formed part of the inspection, as did observation of staff and resident interaction. There was an Opportunity to speak with residents and staff members. Care Homes for Older People Page 6 of 28 The registered manager completed and returned the Annual Quality Assurance Assessment to the Commission, which is a self-assessment of how the service is doing; and information contained within this document will be reflected within the body of the report. Surveys were sent to residents, relatives, health care professionals and care managers. A total of Nineteen surveys were returned on this occasion, and the information received has be included in the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The statement of purpose and service user guide provides adequate information on what the service offers;and only prospective residents that meet the criteria can be admitted to the home, ensuring residents can be confident that their needs will be met all all times. Evidence: The home has a welcoming pleasant foyer area displaying a current Statement of purpose, and a service users guide, which is regularly reviewed and updated to ensure it provides precise information about the service on offer. The assessment format used for assessing peoples needs prior to moving into the home is adequate in detail to ensure peoples needs can be fully met by the home. Three assessments were looked as part of the inspection, all of which were the most Care Homes for Older People Page 11 of 28 Evidence: recent admissions. Two assessments were satisfactory, but one assessment clearly identified needs which the home has struggled to meet due to the the level of staffing at night. The manager was aware of this, and is in the process of reviewing the placement. Prospective residents are able to visit the home prior to any admission taking place. One .All three new admissions praised the level of care, and support they had been provided. One person said I have been welcomed by both residents and staff. A relative said The staff are very friendly, and have been very helpful. The home does not provide intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assurred that their personal and health care needs will be met in an individual and person centred way. Evidence: Three care plans were looked at as part of the inspection. The manager showed evidence of care plans having been updated since the last inspection to ensure that information for residents with more complex health needs are clearly identified and appropriatly montiored. They were personalised, and contained clear detail. The care plans had been regularly reviewed. Care staff spoken to had a good understanding of the needs of people they were caring for i.e. they prefer to sit there, and always have there own sandwiches at tea time They were observed offering personal care to residents in a sensitive and unobtrusive manner, recognising individual need and preference. Residents views opinions and expectations were clearly recorded, as well as those of significant others. Documentation demonstrated that residents fully participated, Care Homes for Older People Page 13 of 28 Evidence: where ever possible in the planning of their own respective care. Risk assessments were current and detailed. Residents and their relatives whose views were sought as part of this inspection all felt that care staff knew what to do when they visited, reporting that staff listened to them and acted on what they said, and respected their privacy and dignity. All of them felt that staff were competent, had the skills and experience necessary to provide their care, and gave them the support they expected. One relative described care staff as wonderful people, and was impressed that they are always pleasant and caring, even when clearing up a mess. Medication policy and practice is good and the records on administration were appropriately completed. The manager advised as part of the AQAA that the service has improved by auditing medication frequently, staff training, and a introduction of a procedure for residents who choose to self -medicate. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Wherever possible residents are encouraged to make decisions about the food they eat, when their relatives visit, and the way they choose to spend their time during the day, and night in the home;which means residents feel postive about living at Barnetson Court. Evidence: All staff support and encourage service users to maintain and develop social skills. Residents were observed undertaking a variety of tasks throughout the inspection. Dedicated activity staff are not employed to work in the home. Several residents spoken to said that there was not as much to do now because some residents did not find it so easy to join in. One relative survey stated A big concern is the lack of stimulation, i feel each day should be distinguished if only in the smallest way. Another person stated Only the most able seem to use the garden,on a warm sunny day the residents should be encouraged, and wheeled by staff into the garden. This was discussed with the Manager who advised that a range of activties are provided, and residents are involved in choosing what they would like to do. A different entertainer comes to the home each Month, and some residents join in activties at the residential home next door. Activties undertaken were seen to be recorded. The Care Homes for Older People Page 15 of 28 Evidence: manager has agreed to review activties offered in the home due to the possible change in the needs of residents. Contact with relatives and friends is encouraged by the home and visitors made welcome. One relative spoken with said they was always made welcome when they visited and was kept up to date with any relevant information. The kitchen area within Barnetson court is of a good standard. There is a four weekly menu which was inspected, and evidenced a varied and balanced diet.Residents spoken with confirmed that they were consulted on the menus, and that they were changed regularly. Five people said they got enough to eat, and that the food was good. One person said they would like a greater selection of biscuits with afternoon tea. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are acted upon swiftly and all issues are taken seriously to ensure residents are protected by the policies and practices within the home. Evidence: The complaints procedure was on display within the home. As part of the inspection the complaints log was examined. This contained evidence of one complaint since the last inspection.This was dealt with promptly and satisfactorily resolved. Five surveys were received from relatives. Four were were very postive about the way staff manage complaints. The staff are excellent, and if a concern is raised they try their best to resolve it. Another person said They always listen, and the manager is very helpful. The fifth survey stated that there has been occassions when I have raised issues in respect of my Mother and have they not always been fully resolved, but my mother appears to be well cared for. The majority of staff had completed safeguarding training, and the manager was in the process of organising training for the small number of new staff.Two staff interviewed were able to demonstrate good awareness of abuse and the procedure to be implemented within the home if this was suspected. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe well-maintained comfortable environment that meets their needs and it is clean, pleasant and hygienic. Evidence: On the day of the inspection the environment was clean, fresh and of a good standard. The grounds are well maintained, and residents spoken to said that they enjoyed the garden particularly in the Summer months, if not too hot. The registered manager advised that each year a plan is devised of what work needs to be undertaken, and this is usually completed within twelve Months unless an emergency occurs which requires priority. Three bedrooms have been redecorated. New flooring has been laid in the dinning area. A new door has been fitted to the rear of the hall to improve ventilation and access to the garden. The patio area at the rear of the hallway has also been raised, to enable easier access to the garden. Relatives spoken to as part of the inspection were very postive about the home enviroment stating its very homely and comfortable, and staff are seen clearing away all the time. The Manager reported that planning permission had been applied for to extend all bedrooms with the intention of providing en-suite facilities in the next two to three years, and also to improve ventilation in laundry. there is sufficent bathing facilities available which were seen to be odour free, and in good condition. Care Homes for Older People Page 19 of 28 Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents of Barnetson can be assurred that they will be protected and supported through the homes recruitment procedures, and provision of competent well trained staff. Evidence: Barnetson staff were observed to be an enthusiastic and motivated staff team. There is low turnover of staff, with limited agency staff being regularly employed, and high staff morale. Feedback received from relatives indicated that staff took pride in their work, felt supported by the manager and had good job satisfaction. one person said staff are helpful,and very friendly. Information received from the manager indicated that the skills and experience of staff on each shift was varied to ensure good skill mix and monitoring of care provision. Staffing levels were appropriate to meet the needs of residents with exception to the night shift when staffing levels are one waking night carer, and one person sleeping in.Until recently this had been satisfactory,but the admission of residents with higher needs,and current residents also developing increased needs means that staffing levels require review to ensure the safety of residents at all times. Training offered to staff is good. The service has an induction programme for new staff, and there was evidence that one new member of staff had completed the Care Homes for Older People Page 21 of 28 Evidence: competencies alongside guidance from the manager. The training records seen confirmed that staff had completed training on safeguarding, fire safety, moving and handling, and first aid. A number of staff had also completed health and safety, food hygiene and medication training refresher courses since the last inspection.The home has as a high proportion of staff who are N.V.Q qualified which means residents benefit from Staff who are qualified, and feel confident to do the job. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager demonstrates clear leadership within the home, and promotes an open, positive and supportive atmosphere which enables resdent to feel safe and secure. Evidence: Evidence gathered during the inspection process confirmed that residents can be assurred that their changing needs will be re- assessed and met, and that the home is meeting its expressed aims and objectives. The information received from relatives surveys suggested that levels of communication was good, and further discussions undertaken with staff members indicated that overall people consider the manager to be an effective leader.Despite the very positive comments throughout the inspection both from residents, relative and staff evidence of formal supervision is limited. The manager advised that she was aware of this, and that sessions that had taken place had not been recorded. A deputy manager has now been appointed and is currently being inducted into the new post. Formal supervision of staff is a task which the post holder will hopefully be able to give priority to and improve on the current frequency. Care Homes for Older People Page 23 of 28 Evidence: The overall standard of record keeping is good and this enables consistency in the service provided. Care plans are of a good standard, staff know what help each person requires, and what they can do independently. A sample record of financial transactions made on behalf of residents found to be in order with a robust system of checks and balances in place.Fire drills and tests of fire systems had been carried out regularly, along with the sample of other health and safety documentation i.e. regular building checks. Concern was raised in relation to several resident using wedges to keep their doors open. This a breach of the fire regulations, but the manager demonstrated that the service had been proactive, and were in the place of fitting magnetic fire closures on all residents bedroom doors. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 service users must not be 31/12/2008 admitted to the home unless their assessed needs can be met at all times To protect the health and welfare of service users. 2 38 13 Magetic catches must be 16/12/2008 fitted to residents bedroom doors where there is currently a risk of doors being wedged, to ensure fire safety arrangements are adequate to keep people safe. For the protection and safety of residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 A review of the current type, and level of day activities should be undertaken, to ensure all residents benefit regularly from a range of different activties to provide Page 26 of 28 Care Homes for Older People appropriate stimulation. 2 36 The manager must ensure that appropriate levels of supervision are undertaken, and recorded to ensure staff continue to provide high quality care to residents. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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