CARE HOMES FOR OLDER PEOPLE
Barnfield Barnfield 24 Upfield Horley Surrey RH6 7LA Lead Inspector
Graham Cheney Announced Inspection 14th November 2005 09:40 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 Barnfield DS0000013562.V266203.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. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Barnfield Address Barnfield 24 Upfield Horley Surrey RH6 7LA 01293 786798 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) Anchor Trust Mrs Susan Rosalie Linfield Care Home 63 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (21), Old age, not falling within any other category (63), Physical disability over 65 years of age (17), Sensory Impairment over 65 years of age (17) Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE Up to 21 of the older people acccommodated may have a mental disorder and/or dementia. Up to 17 of the older people accommodated may have a sensory impairment and/or physical disability 5th May 2005 Date of last inspection Brief Description of the Service: Barnfield Residential Care Home is owned and managed by Anchor Trust. It is a substantial detached property that has been purpose built to provide accommodation for sixty-three service users. The home is located in a quiet residential area of Upfield in Horley. Access to shops, church, public transport and other local services are within easy reach. The accommodation for service users is provided on two floors, in seven separate units. Each unit has a separate name; each has a lounge, dining room and kitchenette. All bedrooms are single and twelve of them have en suite facilities. There is a passenger lift accessing all floors. In addition to this there is a large communal lounge that doubles up as a day centre. The home is located in substantial grounds that incorporates a garden and a sitting area. The home has a parking area at the front for a number of cars and there is additional parking space on the road outside. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection of Barnfield in the CSCI year 2005/2006. It was an announced inspection, which meant that residents and staff knew that it was to take place. The inspection started at 09.40 a.m. Since the last inspection there has been a change of manager with Ayo Adeluola taking post in September 2005. The details above will be changed once Mr Adeluola has been registered by CSCI. The inspector spent time with the manager and senior staff to start with, followed by a meeting with the catering manager and kitchen staff, then did a tour of the home, spending time talking with residents, staff and visitors to the home. The rest of the time was taken having lunch with residents, looking at care plans, staffing arrangements and other documents and records. Comment cards were sent out to relatives, visitors and professionals attending the home. A large number of these were returned providing the inspector with an insight into how those people saw the home. Residents and staff made the inspector very welcome and were happy to talk about life at Barnfield. What the service does well:
Most of the residents who spoke to the inspectors were happy with the service provided. They said that they found the staff kind and helpful. As in some other Anchor homes, having consistent staff assigned to each unit of the home helped this. The inspector spent time in a first floor lounge and joined the residents there for lunch. During this there were clear indications that staff on duty knew the residents well and a close and respectful relationship had been established. Comment cards returned were very positive about the staffing and management of the home, describing the staff as kind, friendly and supportive. A staff training programme has been developed giving all staff training opportunities and undertake NVQs. Staff files indicated that sound recruitment procedures were operated and the manager was well aware of the need to monitor foreign national staff to ensure they have appropriate work permits and that student staff do not work excessive hours. Indications were that CRB guidelines were being followed with staff being supervised appropriately whilst awaiting CRB clearance. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 6 In the main residents felt in control of their lives, but some found it difficult being reliant on others for support and going out. Residents said that they had the option of various activities and including being able to use the day centre. Please see the section detailing the improvements that have been made. All of the residents said they liked their rooms and most had been personalised to their wishes. Some however did not feel it was as good as being in their own home, although many said they enjoyed having the company of others. The home was observed to be well presented, clean and tidy, comment cards confirmed that the home was always clean when relatives visited. All new residents were offered the opportunity of visiting for a day if they wished, to see whether they liked the home and consider whether their needs could be met. This gave the opportunity for senior staff to undertake an assessment of need, which would form the basis of the resident’s care plan. What has improved since the last inspection?
Findings on this inspection indicated that, although early days, the new management team presented a very positive approach. The requirements of the last inspection had been met and a good level of improvement has been made, with a strong emphasis being placed on the needs and wishes of the residents, for example a residents’ committee had been established chaired by one of the residents. The chairperson explained that the residents were now being consulted on all aspects of the home’s operation including the recruitment of staff. Residents and regular staff said that the home was running well and they felt they were being listened to and supported. The new manager has begun to establish a programme of supervision with all staff having received both a group and individual session since he commenced in September. All senior staff were attending supervision training and would be providing support for a group of staff. The home has also established a staff development programme with staff encouraged to take opportunities to act as a senior. The inspector spoke to staff taking on this dual role, who said they enjoyed this opportunity but were also happy to remain as a carer. An activities person has recently started to organise and provide activities in the home and indications were that this was working well. All of the residents had been consulted to find out what they liked to do, their interests and hobbies so that activities could be geared to suit them. The home has reduced the use of agency staffing in recent times and indications were that the use of temporary (superbank) staff overall had been Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 7 decreased. This meant that residents were attended by familiar staff who got to them well and provided a consistent level of care. The catering manager had only been in post for six weeks at the time of the inspection but despite this indications were that catering arrangements had improved, with greater residents consultation. Residents were asked each day what they would like for the following day. Residents said that they generally enjoyed the food and some explained that they were offered a choice of meals and could talk with the catering manager if they had any concerns. The recommendations from the last Environmental Health visit and the relevant requirements of the last CSCI inspection have been met. The meal taken with residents was to a high standard and overall the catering arrangements were commended. A programme of redecoration and re-carpeting had commenced. 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. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 Evidence gathered on this inspection confirmed that each of the assessed standards was being met. This meant that prospective residents and their relatives were appropriately assessed and provided with good level of information to help them decide if the home was suitable for them. EVIDENCE: All new residents were offered the opportunity of visiting for a day if they wished, to see whether they liked the home and consider whether their needs could be met. This gave the opportunity for senior staff to undertake an assessment of need, which would form the basis of the resident’s care plan. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 10 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, 9 Evidence gathered from a review of care plans indicated that NMS 7 was being met. Sampling of medication practice confirmed that NMS 9 was also being met. EVIDENCE: Medication stocks and records were sampled and showed that the majority of service users were receiving their medication as intended by their doctors. Medication was stored securely for the protection of service users. The home has care plans in place which provide details of each resident’s needs and wishes, those sampled had been kept up to date. Barnfield DS0000013562.V266203.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, 15 The evidence gathered indicated that standards 12, 13 and 14 were fully met and therefore the home was supporting residents to maintain control and autonomy over their lives as far as they were able. NMS 15 catering was commended. EVIDENCE: In the main residents felt in control of their lives, but some found it difficult being reliant on others for support and going out. Residents said that they had the option of various activities and including being able to use the day centre. An activities person has recently started to organise and provide activities in the home and indications were that this was working well. All of the residents had been consulted to find out what they liked to do, their interests and hobbies so that activities could be geared to suit them. The catering manager had only been in post for six weeks at the time of the inspection but despite this indications were that catering arrangements had improved, with greater residents consultation. Residents were asked each day what they would like for the following day. Residents said that they generally enjoyed the food and some explained that they were offered a choice of meals and could talk with the catering manager if they had any concerns.
Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 12 The recommendations from the last Environmental Health visit and the relevant requirements of the last CSCI inspection have been met. The meal taken with residents was to a high standard and overall the catering arrangements were commended. Barnfield DS0000013562.V266203.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): Not assessed on this occasion. EVIDENCE: Barnfield DS0000013562.V266203.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, 23, 24, 26 Improvements were in progress and on that basis all of the assessed standards were being met. Although the grounds were in a poor state, the home generally provides a good standard of accommodation for its residents. EVIDENCE: All of the residents said they liked their rooms and most had been personalised to their wishes. Some however did not feel it was as good as being in their own home, although many said they enjoyed having the company of others. The home was observed to be well presented, clean and tidy, comment cards confirmed that the home was always clean when relatives visited. A programme of redecoration and re-carpeting had commenced. Despite the work of the handyman the grounds were in a poor state and did nothing to encourage residents and their visitors to sit outside. The manager stated that this work was out to contract and that he hoped it would be undertaken in the following weeks.
Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 15 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, 29, 30 The evidence gathered indicated that these standards were being met. This meant that residents were being well supported and cared for and that there was a good relationship between residents and staff. EVIDENCE: Most of the residents who spoke to the inspectors were happy with the service provided. They said that they found the staff kind and helpful. As in some other Anchor homes, having consistent staff assigned to each unit of the home helped this. The inspector spent time in a first floor lounge and joined the residents there for lunch. During this there were clear indications that staff on duty knew the residents well and a close and respectful relationship had been established. Comment cards returned were very positive about the staffing and management of the home, describing the staff as kind, friendly and supportive. A staff training programme has been developed giving all staff training opportunities and undertake NVQs. Staff files indicated that sound recruitment procedures were operated and the manager was well aware of the need to monitor foreign national staff to ensure they have appropriate work permits and that student staff do not work excessive hours. Indications were that CRB guidelines were being followed with staff being supervised appropriately whilst awaiting CRB clearance.
Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 16 Residents and regular staff said that the home was running well and they felt they were being listened to and supported. The home has also established a staff development programme with staff encouraged to take opportunities to act as a senior. The inspector spoke to staff taking on this dual role, who said they enjoyed this opportunity but were also happy to remain as a carer. Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 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, 32, 33, 36 The evidence gathered indicated that these standards were being met. Despite only being recently established the home’s management team appeared to be working effectively towards the ongoing improvement of the service. EVIDENCE: Since the last inspection there has been a change of manager with Ayo Adeluola taking post in September 2005. The details above will be changed once Mr Adeluola has been registered by CSCI. Findings on this inspection indicated that, although early days, the new management team presented a very positive approach. The requirements of the last inspection had been met and a good level of improvement has been made, with a strong emphasis being placed on the needs and wishes of the residents, for example a residents’ committee had been established chaired by
Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 18 one of the residents. The chairperson explained that the residents were now being consulted on all aspects of the home’s operation including the recruitment of staff. The new manager has begun to establish a programme of supervision with all staff having received both a group and individual session since he commenced in September. All senior staff were attending supervision training and would be providing support for a group of staff. Barnfield DS0000013562.V266203.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X X Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 20 Yes 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. 1 Standard OP38 Regulation 23(2)(o) Requirement The Registered Provider must ensure that external grounds which are suitable for, and safe for use by, service users are appropriately maintained Timescale for action 14/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Barnfield DS0000013562.V266203.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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