Inspection on 05/05/05 for Barnfield

This inspection was carried out on 5th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barnfield 22/05/07

Barnfield 29/06/06

Barnfield 14/11/05

Barnfield 07/12/04

Barnfield 26/08/04

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

CARE HOMES FOR OLDER PEOPLE Barnfield Upfield Horley Surrey RH6 7LA Lead Inspector Pauline Long Unannounced 05 May 2005 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 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 H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barnfield Address Barnfield Upfield Horley Surrey RH6 7LA 01293 786798 Telephone number Fax number Email 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 1st Floor, 408 Strand, London, WC2R ONE Mrs Susan Rosalie Linfield Care Home (CRH) 63 Category(ies) of Old age, not falling within any other category registration, with number (OP), 63 of places Dementia - over 65 years of age (DE(E)), 21 Sensory Impairment over 65 years of age (SI(E)), 17 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)), 21 Physical disability over 65 years of age (PD(E)), 17 Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE 2 Up to 21 of the older people acccommodated may have a mental disorder and/or dementia. 3 Up to 17 of the older people accommodated may have a sensory impairment and/or physical disability Date of last inspection 17 December 2004 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. This is used for outside associations for four days of the week, and on Wednesday it is used for the weekly church service for the home. 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 H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first Inspection of the CSCI year April 2005- March 2006 and was unannounced. The inspection was carried out by two inspectors and lasted for five and a half hours. On the day of inspection the Home had a very busy atmosphere. As well as the CSCI Inspectors gas engineers were working in the main kitchen. The Resident’s appearance and obvious wellbeing indicated that their personal care needs were being met. All of the resident’s and staff on duty were involved in the inspection process and were keen to talk about life in the home. During the inspection process, evidence was gathered in the following ways: • • • • • • • • • • Discussions with the Manager. Discussions with the Residents. Discussions with the care and domestic staff. Discussions with the Chef Discussions with visitors to the home. Discussion with The Community Nursing Team. Direct observation of interactions between the residents, manager and staff. Examination of Resident’s, staff and service records. A tour of the Home and gardens. Feedback from the Last inspection reports. What the service does well: The Resident’s spoken to were keen to discuss their lives and living at the home. One resident stated “the staff were kind” The home is very pro-active at ensuring that Residents maintain contact with family/friends and the local community. There are various activities offered both in and outside the home. The staff in the home were seen to be interacting in a very familiar yet respectful manner. There was lots of laughing and joking between the staff and residents. The residents care plans were detailed and involve all aspects of the residents care needs and welfare. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 6 The home is actively promotes residents rights, as demonstrated by the arrangements made for voting in the general election. What has improved since the last inspection? What they could do better: Although many of the previously made requirements had been met, the home still has to address some of these which now must be a priority for attention. Failure to comply with these may result in CSCI seeking legal advice, if these continue to remain unmet. 1. The home needs to focus on improving the environment and the health and safety of all concerned. The health and safety of the residents and staff must be paramount. Particular attention must be paid to the safe storage and disposal of hazardous substances (COSHH ). 2. The regulation of hot water/ hot surfaces needs to be a priority. The thermometers must be assessed for accuracy. 3. All safety devices attached to window must be maintained in good working order. 4. Fire safety procedures must be followed, up to date records of fire drills must be kept and available for inspection. 5. Food Hygiene procedures need to be re-enforced. Kitchen practices with regard to record keeping, cleaning schedules, cleaning and risk assessment need to be improved. 6. The kitchen areas in the homes 7 units must be assessed for risk, bearing in mind the various need of the residents. 7. Medication procedures must be re-enforced with all staff. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 7 8. Resident’s confidentiality, privacy and dignity must be improved, with regard to notices on cupboard doors and unit notice boards. A requirement has been made in all areas .Please refer to pages 24,25 and 26 of this report. 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 H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 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 standard(s) 3, Arrangements are in place to ensure a full needs assessment takes place before any new admission. The home does not provide for intermediate care. EVIDENCE: Each Resident had a comprehensive assessment of needs, which is carried out by the manager or deputy at the home. This indicates that the managers and staff are fully aware of individual residents care needs. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 There is clear and consistent individualised care planning in the home. The manager and staff had a good understanding of the resident’s health and personal care needs, these were well met. EVIDENCE: Each resident had a comprehensive plan of care, in this home it is called “ A Lifestyle agreement” and consisted of: • Personal details • Basic information. • Personal care details. • Aids or special techniques. • Medication. • Cultural and spiritual needs. • Dietary needs. • Resident’s pre review questionnaire. • Quality assurance process. • Residents wishes regarding funeral arrangements. It was pleasing to note this holistic person centred care approach. However it was disappointing to note that not all residents’ life style agreements had Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 11 been reviewed. The manager explained that all of the residents are given the choice to keep their Life Style Agreement’s in their bedrooms, some of them exercise this choice and some do not. Of the files examined there was no evidence to indicate that any of Residents were responsible for administering their own medication. There have been two occasions in the past few months where there have been medication errors in the home. The manager stated these errors had been dealt with through the homes Disciplinary procedures, however this could not be evidenced on the day. The commission for social care inspection had been notified of these errors through Regulation 37 notifications. There was some evidence of secondary dispensing of medication on one of the units. Whilst all of the medication cupboards were locked, the keys to these cupboards were found in one of the drawers. One of the Residents spoken to stated, “that the staff are all very kind, they do their best”. Staff were observed interacting with residents in a familiar yet respectful manner. Requirements have been made in this respect. Please refer to pages 24, 25 and 26 of this report. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 13, 15, The meals at times are poor, with little evidence that service users comments are acted on. There are concerns relating to how and if the special dietary needs of a service user’s needs are being met. EVIDENCE: During the inspection process, several residents received visitors, who were able to come and go as they pleased. Some met with their visitors in their bedrooms and some met with them in the sitting rooms. The Community Nurse was in the home on the day of inspection she stated that the home had a” very welcoming atmosphere”. There were no restrictions observed at the home. The inspection was carried out on the same day as the general election and it was pleasing to note that arrangements had been made in order that the residents could exercise their right to vote. Many residents were consulted about the food in the home. Some of them stated “ the food is very nice”, “ you can always ask for more”, “its the best I have had”. Others stated, “ The food has no flavour”, “it all tastes the same”. Each unit has a comment book in which they record their views about the food. The following comments were copied from these books, 13/2/05 The dinner was awful, 19/2/05 very tasty, 7/3/05 everything was nice except the rice Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 13 pudding, it was a hard as a football, 13/4/05 the meat was tough, 24/3/05 All enjoyed dinner. These comment books were attached to the hot trolleys, which go back to the kitchen several times during the day. The manager stated that was to enable the Chef to monitor concerns and comments. This was discussed with the Chef, who was unable to demonstrate that he had met with the residents to discuss their concerns or that he was actually going to do anything to improve the food. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16, The home operates in a manner that supports residents to air their views and talk about concerns or issues that they are not happy about. EVIDENCE: One complaint has been received at The Commission for Social Care Inspection since the last inspection. The complaints procedure was discussed with the manager, she explained that, recently a resident’s relative was unhappy about the food at the home. He indicated that he would complain to CSCI about it. The manager invited him to come into the home and discuss his concerns face to face with the Chef before he formally complained to CSCI. He was happy to do this. The Commission for Social Care Inspection have received no further complaints. There were comment books in some of the areas of the home, which had evidence to suggest that the manager had read the comments and given feedback to the residents. Residents spoken to said, “they would be happy to complain if there was a need to” and “ I have in the past”. The home has recently sent a communication’s letter to all families and friends reminding them about the complaints procedure. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19,20,25,26. The standard of décor in the communal areas of the home is very poor. The first impression of the home does not, therefore, present as a homely comfortable and safe environment for residents. EVIDENCE: The home is situated on a quiet side road and is surrounded by a very large garden. On the day of inspection it was noted that the grass was very long and required cutting. The manager stated that due to the inclement weather the handy man had not had an opportunity to get in to the garden. The majority of open spaces around the home were overgrown and weeds were evident. The bin storage area to the rear of the building was somewhat cluttered. The manager stated that they had already cleared two skip loads of rubbish and had ordered a further skip. The large clinical waste bins were unlocked, this was seen as unsafe and a requirement has been made in this respect. The home is spacious, and on the day of inspection was mostly free Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 16 from malodour. The main reception is used as a resident’s smoking area, there was a smell of smoke, ashtrays were quite full with cigarettes ends. This was discussed with the manager, she stated that the Operations Manager and herself where discussing alternative arrangements for residents who smoke. She indicated that there would be consultation with all residents and staff about the best possible arrangements for all. Resident’s spoken to in this area of the home stated “they enjoyed sitting with each other in the hall as they could watch what was going on in the place”. Some of the decoration, furnishing and fittings in the communal areas were noted to be of unsatisfactory quality. This was discussed with the manager who agreed that the home was “looking tired” some new armchairs had been bought. The manager stated that discussions were taking place with the Operations Manager to get funding to improve the overall environment within the home. The resident’s bedrooms were observed to be personalised and were clean and free from malodour. One resident stated ,“I like to spend time in my room it is very nice”. The sitting room had notice boards with various leaflets displaying activities programmes, church services and menus. However there were also notices relating to staff issues. This was seen as unsatisfactory and was discussed with the manager. It was also noted that various notes of a confidential nature relating to residents were stuck to cupboard doors and written on unit calendars, this was viewed as poor practice. The kitchen area in each of the units was fitted out with various electrical equipment i.e.: kettles, microwaves and toasters. There was no evidence to suggest that these areas and equipment had been assessed for hazards and risks to residents Water temperatures were checked in various rooms through out the home. These varied from room to room, the thermometers did not appear to be working effectively. An immediate requirement has been made in this respect. All of the bathrooms and toilets had clinical waste bins. Some of these rooms had a malodour, which was due to the clinical waste bags not being emptied from the previous day. This was discussed with the manager and in particular the risks around the dementia unit and general cross contamination and cross infection One of the windows on the first floor did not have a working safety device. Requirements have been made in these areas. Please refer to pages 24, 25 and 26 of this report. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. The staffing arrangements in place on the day of inspection were sufficient to meet the needs of the Residents. EVIDENCE: The home has recently reduced staffing levels to reflect the number of residents. There are 8 care staff on the morning shift, 7 care staff on the afternoon/evening shift and 4 care staff on the night shift. The rational for this reduction in staffing levels was discussed with the manager, she stated, “9 care staff could not be justified as there were 8 empty beds in the home”. The Manager is reviewing all staff files to ensure that the home is compliant with The Care Homes Regulations (amended) 2001 with regard to the recruitment and selection of staff. Staff files examined did not demonstrate all of the information required to ensure that the residents are supported and protected by the homes recruitment and selection practices. The manager stated that the Human Resource Department retained much of the personnel paperwork at head office. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 18 It was pleasing to note that staff training at the home has a high priority. There were comprehensive records of staff training. The training programme includes: • Dining with dignity in dementia. • Disciplinary training. • Manual handling. • Dementia training ( A person Centered Care Approach) It was discussed that one member of care staff would benefit from this training, see page 11 of this report. • Infection control. • Food Hygiene. • Risk assessment. A recommendation has been made with regard to identifying at a glance training dates for staff. Please refer to pages 24,25 and 26 of this report in respect of requirements and recommendations for action. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, 38. The manager had a good understanding of the areas in which the home needs to improve. There are concerns around the health, safety and welfare of residents with regard to kitchen practices. EVIDENCE: The home has a supervision policy and procedure. Supervision contacts were kept in a file. The file also contained a sheet for each member of staff in order to record dates of formal one to one supervision meetings. The last recorded date was April 2004. The manager stated that one of the Senior Care Officers carries out the one to one supervision meetings, but that she had taken the records home. The kitchen was of concern. As stated earlier in the report, gas engineers were working in the kitchen. There was no evidence to suggest that a risk Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 20 assessment had been carried out in this respect. The chef was observed stepping over an engineer with a tray of hot food, this was viewed as a very unsafe practice. The general appearance of the kitchen indicated that it had not been properly cleaned for some time. The areas under the cookers and work surfaces were dirty. The larder cupboard had not been cleaned. The fridges and freezers inside and out were dirty. Food in the fridges had not been labelled. Record keeping was inconsistent and unsatisfactory, the fridge and freezer temperatures were not recorded on a daily basis. The cleaning schedule was not being followed. These concerns were discussed with the manager. The manager stated that the kitchen had been deep cleaned in the last 6 weeks. The area-catering manager was due to visit the home on the 6th May 2005. The manager stated that all of these issues would be discussed and recorded in a formal meeting with the Chef. Requirements have been made in these areas. Please refer to pages 24, 25 and 26 of this report. Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 1 COMPLAINTS AND PROTECTION 1 2 x x x x 2 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x x x x 2 x 1 Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 22 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 29 Regulation 19 Schedules 2&4 of The Care Homes Regulation s 2001 Requirement The Registered provider must ensure Staff recruitment files for those working at the home comply with this standard in respect of documentation held.In complaince with Schedule 4 (6) (a,b,c,d,e,f) of The Care Homes Regulations 2001 (as amended) and must be available for inspection. Timescale of 30/11/04 not met. The Registered provider must ensure that CRB disclousure documentation is kept on staff files untill seen by CSCI. Timesale of1/4/2005 not met The requirements of the Fire Safety Officer’s report of November 12th 2004 must be complied with. Additionally, the home must carry out fire drills regularly and at least once every three months. Timescale of 31/1/2005 not met The Registered Provider must ensure the Residents confidentality, privacy and dignity are respected at all times. The Registered Provider must ensure that risk assessments Timescale for action 5/6/2005 2. 27 17(3)(b) 5/6/2005 3. 38 23 (4) 5/6/2005 4. 10 12(1)(4) 5/6/2005 5. Barnfield 38 13(4)(a,b, c) 5/6/2005 Page 23 H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 6. 9 13(4)(c) 7. 38 13(4)(c) 8. 38 13(4)(c) 9. 38 23(2)(d,) 10. 38 23(2) (o) 11. 38 16(2)(j) 12. 38 16(2)(k) 13. 33 26(4)(a,b, c) (5) (a) 13(4)(a) 14. 38 relating to the main kitchen and unit kitchen areas are carried out The Registered Provider must ensure that Medication cabinets and cupboards are securely locked at all times and the keys are stored securely. The Registered Provider must ensure that Sluice room doors are kept locked when unoccupied by staff.The broken lock must be repaired. The Registered Provider must ensure that any vacuum packed foods stored in the fridges are labelled with the date on opening. The Registered Provider must ensure that all parts of the home including the main kitchen are kept clean and reasonably decorated. The Registered Provider must ensure that external grounds which are suitable for, and safe for use by, service users are appropriatly maintained The Registered Provider must make suitable arrangments for maintainging satisfactory standards of hygiene in the home by providing liguid soap dispensers in the staff and day room toilets. The Registered Provider must ensure that all areas of the home are kept free from offensive odours and review the arrangements for the disposal of clinical waste. The Registered Provider must provide a copy of the Regulation 26 visit report to the Commission on a monthly basis The Registered Provider must ensure that all parts of the home to which Residents have access to are so far as reasonably 5/6/2005 5/6/2005 5/6/2005 5/7/2005 5/6/2005 5/6/2005 5/8/2005 5/6/2005 5/6/2005 Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 24 15. 15 16(2)(i) 16. 36 18(2)(a) 17. 7 15(2)(b) 18. 9 13(2) practicable free from hazards to their safety. Window safety devices must be in working order The registered Provider must ensure that the Chef provides adequate quanties of suitable, wholesome and nutritious food. The Registered Provider must ensure that all staff receive regular one to one supervision meetings and that a written record of these meetings kept. The Registered Provider must ensure that the residents Life Style Agreements are formally reviewed on a monthly basis. The Registered Provider must ensure that all staff at the home are conversant with and adhere to medication policys and procedures. 5/6/2005 5/8/2005 5/6/2005 5/6/2005 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 19 Good Practice Recommendations That the bathroom decor is brightened up throughout the home as indicated in the body of the report, to provide a less clinical appearance for service users.Brought forward to this report. That the home provide a means of routinely establishing an individual’s status in respect of power of attorney, on admission to the home. Brought forward from the last inspection. That all staff have an annual appraisal. Brought forward to from the last inspection. Recording of formal staff supervision sessions must provide more detail of any matters discussed, for future reference purposes. Brought forward from the last inspection. The manager should consider placing all training dates on to a yearly planner. The manager should consider a review as to how records H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 25 2. 18 3. 4. 36 36 5. 6. Barnfield 30 37 relating to staff employed at the home are formated Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection 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 © 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 Barnfield H58 S13562 Barnfield V222607 050505 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!