Inspection on 08/11/06 for Barnfield House

This inspection was carried out on 8th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Barnfield House 11/06/09

Barnfield House 20/06/07

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Barnfield House Barnfield House 9-10 Barnfield Terrace Station Road Liskeard Cornwall PL14 4DT Lead Inspector Alan Pitts Key Unannounced Inspection 8th November 2006 09:30 Barnfield House DS0000066649.V318507.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 Barnfield House DS0000066649.V318507.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. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnfield House Address 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) Barnfield House 9-10 Barnfield Terrace Station Road Liskeard Cornwall PL14 4DT 01579 347617 Rebecca Joy Miller Michael Stephen McGillicuddy Christine Martin Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Room 12a may only be used by the service user who currently occupies the room. Service users to include one named person outside the category of the home. 05/01/06 Date of last inspection Brief Description of the Service: Barnfield House is registered to provide accommodation and personal care for up to 14 service users with a mental health condition. The home charges £350 per week. It is situated close to the local train station, bus services, shops and facilities of Liskeard. The accommodation comprises what was originally two houses, adapted to become one. Accommodation is offered in predominantly single rooms with 2 shared rooms provided. Stairs provide access to the upper floors. Barnfield House is an established service, which came under new ownership in March 2006. The new owners are Mrs R. Miller and Mr S McGillycuddy. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection on 8th November 2006, which took place over approximately 6 hours. The inspector arrived at 09.20am and met with Mr McGillycuddy, residents and staff. The inspection included a tour of the home’s bedrooms and communal spaces, and examination of the home’s records. The home and residents have coped well with what is potentially an unsettling time (change of ownership). Residents commented that they were content, and were seen to be relaxed and interacting with staff on a friendly, equal terms basis. There have been some foreseen and unforeseen changes at management level, though the registered provider intends to submit an application to the Commission for Social Care Inspection for a new registered manager in the next few days. What the service does well: What has improved since the last inspection? Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 6 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. Barnfield House DS0000066649.V318507.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 Barnfield House DS0000066649.V318507.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): Quality in this outcome area is adequate. National Minimum Standards 1, 2, 4, and 5 were inspected. This judgement has been made using available evidence including a visit to this service. The residents have a Statement of Purpose and Service User Guide. Prospective residents are assessed as to their care needs and the home’s ability to meet those needs prior to admission. Where possible, a respite placement is offered prior to making a decision about a permanent placement. EVIDENCE: There is a combined Statement of Purpose and Service User Guide, provided by the previous owners. The current registered providers are in the process of reviewing and replacing these documents with their own. This will be followedup at the next inspection. The records show that the most recent admission to the home was assessed prior to admission, and was offered a 5-day respite placement prior to the resident making the decision to move in permanently. A discussion took place with the registered provider about the home’s categories of registration. All prospective residents are assessed prior to admission, including respite placements. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 9 Each resident has their own copy of the home’s contract/Statement of Terms and Conditions. Barnfield House DS0000066649.V318507.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): Quality in this outcome area is good. National Minimum Standards 6, 7, and 9 were inspected. This judgement has been made using available evidence including a visit to this service. Staff and residents confirmed that there is daily interaction in which the latter are able to express their opinion/participate in the life of the home. Each resident has a plan of care. The registered provider and staff are well aware of the need for confidentiality. EVIDENCE: There is a care plan for each resident, and the records show that residents are actively involved in their development and review (at least 6-monthly). The care plans are generally of a good standard and informative, though there were some exceptions were a care need identified in the resident’s assessment was not mentioned in the care plan, or where an intervention was prescribed, but the daily records did not evidence this being carried through. The registered manager should ensure that the care plans accurately, and comprehensively, describe the care need(s) and a suitable intervention (avoid the use of vague terms, such as ‘regularly’). Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 11 Comments from the residents, staff, and entries in the care records show that the home is very much resident focused. Comments from the residents support the fact that the staff do provide residents with the information and support they need without being intrusive or unnecessarily prescriptive. Residents largely manage their own finances, though the home will keep safe small amounts for them. There are records of all incoming/outgoing payments, which are monitored weekly, monthly and annually. Risk-assessments are recorded for each resident, though there is a tendency for these to repeat the care plan to some extent, rather than identifying the potential risks posed by the lifestyle of the resident in combination with their care needs (e.g. Risk; X suffers from epilepsy, and is unsupported in trips to the local supermarket: Level of risk; X has not suffered a seizure since 1997, and the condition is well controlled with medication. There are members of the public and supermarket staff present at the supermarket - low risk: Action; X is aware of the potential risk and does not wish to stop this activity. Discussed with X, Community Psychiatric Nurse, family, and keyworker. No intervention needed). The registered manager should review and amend the risk-assessments in place for each resident. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. National Minimum Standards 12, 13, 14, 15, 16, and 17 were inspected. This judgement has been made using available evidence including a visit to this service. The home provides individualised support to enable residents to participate in activities of their choice, and to enable personal development. Residents’ rights are respected. Residents make use of the local community facilities. Residents are offered a healthy diet. EVIDENCE: All the residents enjoy some kind of social interaction in the local community. Residents confirmed their own activities in conversation with the inspector. Some residents attend external events, such as art class, football matches, and religious groups. Residents confirmed that they are free to determine their own lifestyle, opting in or out of social opportunities as they wish. Residents have access to professional support. Residents were observed to interact well with each other. Residents also confirmed that the staff and management are respectful of their wishes. Transport is available to assist residents accessing Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 13 events. A minority of the residents have regular contact with family members, but all have an identified Social Worker or Community Psychiatric Nurse. The care documentation could provide more information in respect of residents’ daily lives. There is a tendency for broad-brush comments such as “usual day” or “fine today”, rather than a descriptive entry about how and where the resident spent their day. The registered providers should ensure that staff make meaningful entries in the care documentation on a daily basis. Staff were seen to knock before entering residents’ rooms. Some residents do take advantage of the option of a bedroom door key. The registered providers hold regular ‘house meetings’ at which residents have the opportunity to express any concerns or issues affecting life at the home. Mail is delivered unopened to the relevant resident. All the residents are provided with a copy of the home’s Statement of Terms and Conditions. There is a 4-week rolling menu in operation, which demonstrates that choice is available at all meals. Fresh fruit is freely available. Residents said that the food was good. The menu is discussed at ‘house meetings’. Cakes were being made on the day of the inspection. Food is always available to the service users in the small kitchen, the main kitchen being closed at night. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. National Minimum Standards 18, 19, and 20 were inspected. This judgement has been made using available evidence including a visit to this service. Residents receive personal, physical and emotional support in an appropriate and timely manner. Medicines are administered safely. EVIDENCE: The care documentation shows access to health care professionals as appropriate. Staff offer prompting and guidance in various issues regarding personal care and hygiene. During the inspection it was observed that service users made choices about when to get out of bed, access community facilities or use the facilities at the home. The registered provider confirmed that the home maintains good relationships with various professionals that support service users. The home operates an appropriate medications policy. Medicine Administration Records were inspected and seen to be in order, though the registered provider should ensure that were instructions are transcribed onto Medicine Administration Records two initials are provided to check the accuracy of the entry. A signature is recorded for the receipt of medication into the home. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 15 Photographs of service users are kept with service user Medicine Administration Records. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. National Minimum Standards 22, and 23 were inspected. This judgement has been made using available evidence including a visit to this service. This is a home with a largely established staff group and resident group, which is evident in the comfortable, relaxed atmosphere in the home. Residents confirmed that they would feel able to express any concerns. Residents are protected. EVIDENCE: Service users spoken with confirmed that the staff are very supportive without being intrusive, and they said that they would not hesitate to raise any concerns or complaints being confident in the staff’s integrity and understanding. One member of staff was attending training on adult protection on the day of the inspection. The home has a complaints policy and an adult protection policy that is displayed in the home. The registered provider should implement an adult protection procedure, providing clear instruction as to the steps to take in the event of an allegation of abuse (including relevant contact details). Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. National Minimum Standards 24, and 30 were inspected. This judgement has been made using available evidence including a visit to this service. The registered person is maintaining the home to provide service users with facilities in a comfortable and safe environment. EVIDENCE: Rooms are provided with suitable furniture and fittings to meet individual needs, and were seen to be clean and comfortable with varying degrees of personalisation. Residents said they valued their personal space. Residents are able to bring or choose their own furniture and personalise their rooms. Bedrooms are lockable and staff enter rooms only with the permission of the resident. The present residents do not require any aids or environmental adaptations. A ramp provides wheel chair access to the ground floor. There are a sufficient number of toilets and bathrooms to meet the residents’ requirements. En-suite facilities are not provided, but all rooms have a wash hand basin. These were all clean and odour free at the time of inspection. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 18 Toilets and bathrooms are lockable. The laundry is very small, though the registered providers have plans to relocate this in the near future. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. National Minimum Standards 32, 34, 35, and 36 were inspected. This judgement has been made using available evidence including a visit to this service. Care staff have a good understanding of service users support needs and sufficient staffing is provided to meet these needs. EVIDENCE: There is a current and accurate duty rota in operation (surnames should be entered). There are sufficient staff to meet the residents’ care needs. There are: • 3 carers between 07:30 – 15:00 • 2 carers between 15:00 – 21:00 • 2 carers between 21:00 – 07:30 Staff were observed to interact with residents in an approachable, professional manner, and residents confirmed that they feel comfortable with the staff. The staff demonstrated a good understanding of the residents’ care needs Two sample personnel files were inspected, and these showed a robust employment procedure in operation at the home. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 20 Records show a commitment to staff training since the new owners took over, and this is ongoing. Recent training attended includes: food hygiene, medication, and 1st Aid. Four out of nine care staff have undertaken manual handling training, and five out of nine have achieved NVQ Level 2 or above. The registered providers should implement a National Training Organisation compliant induction programme for new staff (www.skillsforcare.org). The registered providers must ensure that staff receive recorded supervision at least 6 times a year. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. National Minimum Standards 37, 39, and 42 were inspected. This judgement has been made using available evidence including a visit to this service. The registered providers are providing clear and effective leadership and management to maintain a safe and comfortable home for service users. The home operates a proactive approach to the welfare of service users, which is supported by the policies and procedures in operation. EVIDENCE: The home has new owners, and they and the staff are to be complimented on the manner in which they have minimised the potential disruption caused by such a change. Residents said that the changeover had been smooth. The home’s registered manager is stepping down and the home is in the process of making application to the Commission for Social Care Inspection for a new registered manager. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 22 The management approach was observed to be positive and supportive with service users and staff. Residents spoken with confirmed that they felt they had a say in the way the home was run and felt able to express themselves to the staff and the registered providers. The home has comprehensive policies and procedures in place, which are currently under review. Photographs of the residents are kept, and records, and policies and procedures, are kept up-todate and secure. Residents have access to their records. The home is well managed and there is a clear hierarchy of responsibility. Fire training was seen to be up to date. Quality Assurance questionnaires were not inspected at this time, though the registered providers ensure that residents have the opportunity to give feedback, either individually or collectively at ‘house meetings’. The registered providers have daily involvement in the home. Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 23 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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X X 3 Barnfield House DS0000066649.V318507.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA36 Regulation 18(2) Requirement The registered providers must ensure that staff receive recorded supervision at least 6 times a year. Timescale for action 01/01/07 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 YA6 Good Practice Recommendations The registered manager should ensure that the care plans accurately, and comprehensively, describe the care need(s) and a suitable intervention (avoid the use of vague terms, such as ‘regularly’). The registered manager should review and amend the riskassessments in place for each resident. The registered providers should ensure that staff make meaningful entries in the care documentation on a daily basis. The registered providers should ensure that were instructions are transcribed onto Medicine Administration Records two initials are provided to check the accuracy of the entry. The registered provider should implement an adult protection procedure, providing clear instruction as to the DS0000066649.V318507.R01.S.doc Version 5.2 Page 25 2. 3. 4. YA9 YA12 YA20 5. YA23 Barnfield House 6. YA35 steps to take in the event of an allegation of abuse (including relevant contact details). The registered provider should implement a National Training Organisation compliant induction programme for new staff (www.skillsforcare.org). 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