Inspection on 11/06/08 for Barnett Lodge

This inspection was carried out on 11th June 2008.

CSCI found this care home to be providing an Adequate 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

Barnett Lodge 19/06/07

Barnett Lodge 06/12/06

Barnett Lodge 28/09/05

Barnett Lodge 31/05/05

Barnett Lodge 10/02/05

Barnett Lodge 28/09/04

Barnett Lodge 06/06/03

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Barnett Lodge 73 Queens Road Gosport Hampshire PO12 1LF Lead Inspector Laurie Stride Unannounced Inspection 11th June 2008 09:30 Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 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 Barnett Lodge DS0000011699.V365227.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 Adults 18-65. 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. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnett Lodge Address 73 Queens Road Gosport Hampshire PO12 1LF 023 9258 3621 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) Mrs J Lemmon Mrs J Lemmon Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 35 years of age. Date of last inspection 19th June 2007 Brief Description of the Service: Barnett Lodge is a mid-terraced house with bedrooms on the first floor and a downstairs extension comprising of a self contained kitchen and fourth bedroom. It is within walking distance of local amenities. Barnett Lodge is able to accommodate up to three people in the learning disability category. The registered provider is Mrs Lemmon, who is also the registered manager and lives in an extension of the main building. Barnett Lodge currently does not have any residents and has not done since September 2003. This has been the choice of Mrs Lemmon. The cost of living at the home would be set at the local authority rates. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The purpose of this inspection was to assess what the outcomes are for people who use this service and how well the home is doing in the meeting of all key National Minimum Standards and compliance with regulations. The findings of this report are based on different sources of evidence. These include an announced visit to the home on the 11th June 2008, the home’s annual quality assurance assessment (AQAA) completed by the new acting manager prior to the visit and evidence from the last inspection of the home. This visit was arranged with the acting manager a week before, as currently there is not anyone living at the home. During this visit a tour of the premises was completed that included looking at bedrooms and all communal areas of the home. We also had discussions with the acting manager and looked at some of the home’s records and written documentation. Due to the fact that no one has lived at the home since September 2003 and that the home does not employ any staff it was not possible to assess several of the outcome areas or seek feedback from other professionals. What the service does well: What has improved since the last inspection? Since our last visit the home has been redecorated, including carpets, new furniture, fixtures and fittings, so that the service will provide a more comfortable environment for people to live in. The new acting manager has reviewed many of the home’s policies and procedures and is continuing to work on this. This will provide people who may use the service with the relevant safeguards and make certain that they are fully aware of their rights. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 6 Up-to-date certificates of safety tests are available in relation to most of the equipment and appliances used in the home, to show that the environment is generally safe for people who may use the service. The home has consulted with the Fire Authority to make sure that suitable precautions are in place to protect people from the risk of fire. 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. The summary of this inspection report can be made available in other formats on request. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 & 2 People who use the service experience adequate outcomes in this area. We have made this judgement using available evidence including a visit to this service. Systems are in place to assess the needs of individuals before they move into the home. EVIDENCE: The home’s annual quality assurance assessment (AQAA) stated that the home is now ready to take in adults with a learning disability. The AQAA also told us that there is a Statement of Purpose and Service User Guide / brochure. We saw the Service User Guide, which gave required information, such as the fees payable and how to make a complaint. The home has a new acting manager, who told us he had reviewed the documents, as advised at the last two inspections, and was aware that the contact details of the Commission for Social Care Inspection need amending. The acting manager said this would be done, so that people who are interested in using the service have all the necessary and up-to-date information to help them make a choice. No one has lived at the home since 2003 and so it was not possible to fully assess the homes’ assessment and admission process. The acting manager informed us that the home may be admitting people in the next few weeks and that we would be told when this happened. We saw that there is a written Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 9 admissions and discharge policy and procedure with forms to be used when making an assessment of an individuals’ needs. The previous inspection report identified that the registered manager had been uncertain of how she would comprehensively assess someone who was not funded by health or social care agencies. The new acting manager confirmed that privately funded people would only be admitted following a full assessment in line with the homes’ written policy. Prospective individuals would have the opportunity to come to the home for a couple of short stays before making the decision to live there. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Currently no- one is living at this home. Therefore it was not possible to assess these standards. EVIDENCE: The home’s annual quality assurance assessment (AQAA) states that care and support reviews will take place every twelve months. Meetings may be sooner if requested by people who may use the service or other relevant agency. We saw that the home has a range of pro forma to be used in recording peoples’ needs and how these are to be met. We advised the acting manager that the National Minimum Standards recommend that reviews be carried out every six months, or earlier if required. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Currently no- one is living at this home. Therefore it was not possible to assess these standards. EVIDENCE: The home’s annual quality assurance assessment (AQAA) states that there are new policies and procedures in place including nutrition, freedom, employment opportunities and family contacts. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Currently no- one is living at this home. Therefore it was not possible to assess these standards. EVIDENCE: The home’s annual quality assurance assessment (AQAA) states that there are new policies and procedures in place including medication & self-medication, personal care, rights, dignity and respect, and supporting independence in the home & community. The home has a lockable metal box in the kitchen, which is secured to the wall and this would be used to store people’s medication. We advised the acting manager to check the storage arrangements are in line with current legislation, including the new regulations for the storage of controlled drugs. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 People who use the service experience adequate outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who may use the service would have access to a complaints procedure and be protected by the home’s policies and procedures for responding to abuse. This would be enhanced by ensuring that both policies and procedures are up-to-date, so that people can be confident of having the correct information. EVIDENCE: The home’s annual quality assurance assessment (AQAA) stated that new policies and procedures are in place to enable people who may use the service to make a complaint and informing them what the stages in the process are. The AQAA also told us that a policy and procedure in relation to protecting people from abuse is in place. We saw that the home has a complaints procedure and the acting manager informed us that he was looking at ways of providing information in picture formats also, to further enable people who may use the service to understand how to make a complaint. As mentioned in a previous section of this report, the contact details of the Commission for Social Care Inspection need amending and the acting manager said this would be done. The previous inspection report identified that the home did have an adult protection policy as issued by the local authority. In discussion at that time Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 14 with the registered manager she had been unsure whether she had the most up to date information and agreed that she would check this. During this visit it was not clear whether this had been done and the new acting manager said he would ensure that the policy was updated if necessary. The acting manager demonstrated his awareness of the correct procedure to follow and which agency to report to if abuse was suspected. The home has a whistle blowing policy. We discussed reporting incidents to the commission under regulation 37 and advised that the acting manager visit our website for the most recent guidance on this. The acting manager said he would do this. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 People who use the service experience adequate outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home offers a clean and comfortable environment in which people who may use the service could live. EVIDENCE: The home’s annual quality assurance assessment (AQAA) stated that the home has now been re-decorated, with new lounge furniture, new carpets in all bedrooms and communal areas, new worktops and re-upholstered chair covers in the kitchen. The AQAA also told us that there are plans to apply to extend the building after the service has been running for 18 –24 months, in order to put in en-suites for each bedroom. During this visit we undertook a tour of the premises, including the bedrooms and communal areas, which confirmed the improvements had been done as stated in the AQAA. This meets a previous requirement. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 16 The home has three single bedrooms, a first floor bathroom, a kitchen/diner that is domestic in size housing domestic appliances and a family lounge. The home has a room that is used as an office. Facilities are available for the safe storage of people’s files. The home has policies and procedures relating to infection control and the home was clean throughout on the day of our visit, consistent with the findings of the previous inspections of the home. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The home does not currently employ any staff. Therefore it was not possible to assess these standards. EVIDENCE: The home’s annual quality assurance assessment (AQAA) states that the home will be staffed in accordance with people’s individual needs and the homes’ procedures. The AQAA also says that staff recruitment and induction will be thorough. This will ensure that people who may live in the home are protected and are supported by suitably trained and supervised staff. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 40 & 42 People who use the service experience adequate outcomes in this area. We have made this judgement using available evidence including a visit to this service. Changes in the day-to-day management of the home have made improvements to the environment, making it safer if a person was to move in. EVIDENCE: The previous inspection report identified that the registered manager had not attended any training since 2003. Neither had she undertaken a National Vocational Qualification (NVQ). During this visit we did not meet the registered manager and so were not able to discuss this with her. The home has a new acting manager, who assisted us throughout the visit. The home’s annual quality assurance assessment (AQAA) states that the acting manager has the Registered Manager Award (RMA) and has twenty years experience of supporting and developing people who have a learning disability. The AQAA also says the acting manager will undertake NVQ level4 in health and social Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 19 care as soon as the business is up and running. We spoke with the acting manager who confirmed this to be the case. The acting manager said that he had applied for registration two or three months ago in respect of this service. We advised the acting manager about the registration process. The commission had not received formal notification under regulation 8 about the new management arrangements for the home. We discussed this with the acting manager, who said he would pass the information to the registered manager and take this forward. As reported at the previous inspection, the home has not yet developed any formal systems for seeking the views of people and other stakeholders. There is currently no quality assurance policy for the home. The acting manager said that reviews and meetings for people who use the service would be held once a month to obtain their views and discuss any issues. The acting manager said that a system would be put in place to obtain the views of other stakeholders, such as relatives and health and social care professionals, when the service was up and running. Since the previous inspection, the acting manager has written and/or reviewed many of the home’s policies and procedures and is continuing to do so. Examples of those we saw included the admissions process, risk assessment, confidentiality, privacy and dignity, personal support, health and safety, medication, staff recruitment and supervision. This meets a previous requirement. During the last visit we found that requirements from a previous inspection had not been met, however at that time they were still within the timescale for completion. During this visit we saw evidence that three of the four previous requirements had been met. The one outstanding requirement was for consultation with the Fire Authority to take place to ensure that suitable precautions are in place to protect people from the risk of fire. This requirement had stipulated that the requirement must be done by 19/09/07 or before anyone moves in. The acting manager contacted us a following our visit to inform us that he had contacted the fire officer, who had confirmed that the current arrangements were suitable and that they would be conducting a visit to the home to confirm this. This meets the requirement. We were shown a certificate indicating that, since our last visit, the home’s fire extinguishers had been tested by a suitably qualified professional. The previous report identified that the homes’ fire risk assessment has not been updated Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 20 since at least 2003. The risk assessment was not available for inspection during this visit. The acting manager said he has tested the home’s fire alarms but has not recorded these checks; a manual is available for this. We advised that checks be recorded, as the service plans to start admitting people. We saw evidence that portable electrical appliances have been checked and the acting manager confirmed that he was waiting for the certificate for this. A test certificate was on file in relation to the electrical wiring, which has been updated since our last visit. A gas safety certificate was also on file. Forms to be used when reporting incidents or dangerous occurrences had been updated. There is lockable storage space in the kitchen for cleaning and other hazardous materials. The acting manager told us that the Food Standards Agency visited the home in March 2008 and were satisfied with the arrangements for storing and preparing food and kitchen hygiene. The home now has the Safer Food Better Business Guidance. The acting manager has also prepared his own manual of procedures for promoting safe practices in the kitchen. Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 X 2 2 X 2 X Barnett Lodge DS0000011699.V365227.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 YA20 Good Practice Recommendations The registered person should check the medication storage arrangements are in line with current legislation, including the new regulations for the storage of controlled drugs. The registered person should start recording when tests of the home’s fire alarms take place, as there plans to start admitting people into the home soon. 2. 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