Inspection on 14/11/07 for Barnfield Manor Care Home

This inspection was carried out on 14th November 2007.

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 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

Barnfield Manor Care Home 28/07/09

Barnfield Manor Care Home 07/05/09

Barnfield Manor Care Home 03/06/08

Barnfield Manor Care Home 09/01/07

Barnfield Manor Care Home 06/09/06

Barnfield Manor Care Home 09/05/06

Barnfield Manor Care Home 22/02/06

Barnfield Manor Care Home 05/10/05

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

CARE HOMES FOR OLDER PEOPLE Barnfield Manor Care Home Barnfield Close Holmewood Chesterfield Derbyshire S42 5RH Lead Inspector Sue Richards Unannounced Inspection 14th November 2007 09:30 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 Manor Care Home DS0000064197.V354308.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 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 Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnfield Manor Care Home Address Barnfield Close Holmewood Chesterfield Derbyshire S42 5RH 01246 855899 01246 852953 jeanette.kimberley@hallmarkhealthcare.co.uk www.hallmarkhealthcare.co.uk Hallmark Healthcare (Holmewood) Ltd 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) Vacant Care Home 39 Category(ies) of Dementia (39) registration, with number of places Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only:Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Dementia - Code DE The maximum number of service users who can be accommodated is 39. 9th January 2007 2. Date of last inspection Brief Description of the Service: Barnfield Manor Care Home is located in the village of Holmewood, close to shops, a post office and local amenities. It is on a direct bus route to Chesterfield and within a short distance of Junction 29 of the M1 motorway. The home provides personal care and support for up to 40 older persons with dementia delivered from a team of care and hotel services staff and with a newly appointed acting manager. Accommodation is over two floors, providing level access throughout, together with environmental adaptations and equipment to assist those who may have mobility problems, including a shaft lift and emergency call system. There is a choice of lounge and dining space and communal bathing and toilet facilities. A majority of single room accommodation is provided, with many having en suite toilet and wash hand basin. There is an enclosed patio garden area, which people can access via the rear lounge, which provides seating and planting and safe provision for people who may wander. There is also gated access to a central enclosed garden, although supervised access is required for people here given the layout of the garden, which has a large raised bordered lawn area. Car parking is also provided to the front of the home. Kitchen and laundry services are centralised with a separate single storey building located within the grounds, which provides laundry and staff facilities. The range of fees charged per week are as follows: £325.05 - £343.20 per week excluding hairdressing, private chiropody, toiletries and newspapers, for which there are additional charges as per vendor. Information about fees is correct at the time of this inspection, as provided by the home’s administrator. A copy of the most recent inspection report is available at the home. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 5 Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. For the purposes of this inspection we have taken into account all the information we hold about this service. This includes our previous key inspection report of 10 January 2007. At this inspection there were 17 people accommodated at the home. We used case tracking as part of our methodology. This involved the random sampling of three people, whose care and service provision was more closely examined. Given the mental capacities of people accommodated, we are unable to hold meaningful in depth discussions with them about their care. However, we spoke with representatives. We looked at their written care plans and associated health/care records and inspected their private and communal accommodation. We spoke with staff and management about the arrangements for their recruitment, induction, training, deployment and supervision. Examined related records and observed some of staffs’ interactions and approaches with people. We spoke with the newly appointed acting manager about her role and responsibilities and about the management and monitoring arrangements for the home. What the service does well: What has improved since the last inspection? Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 7 Items outstanding in respect of our improvement plan agreed with the home in November 2006 are not complied with. There are adequate medicines storage facilities. The central garden area is now secure, (although access there for people who live at the home can only be provided under staff supervision given the high walled/raised lawn area). Maintenance/analysis report for hot and cold water storage systems at the home is provided, including legionellas testing. What they could do better: Ensure copies of the home’s service guide/brochure are always available at the home. Develop peoples’ written care plans, to more consistently detail care interventions, which accord with recognised care practises associated with short term memory loss, confusion and wandering behaviours. Provide that people’s dignity is always best promoted in terms of always wearing their own clothing and (properly fitting) dentures. Make sure that the list of staff signatures kept of those staff responsible for the administration of people’s medicines is always kept up to date and that those staff are provided with up to date information about the medicines they administer to people. Better account for people’s individual’s mental capacity to exercise choice and control over their lives, by way of individual record keeping, with consideration to the Mental Capacity Act. Ensure that staff, is always effectively and adequate deployed in people’s best interests. Ensure that the home is safe and well maintained in order to adequately promote peoples’ health, safety and welfare and that it is run in their best interests. Provide prompt written notification to the Commission where any person is appointed by the provider to manage the home. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 8 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 Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 9 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 Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1 & 3 (NMS 6 – the home does not provide for intermediate care). Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are reasonably well accounted for. EVIDENCE: At our last key inspection of this service we judged that peoples’ needs are suitably assessed and reasonably well accounted for. At this inspection looked at how information is provided for people about the home and its service provision and also how their needs are assessed. This included examination of the records of those people case tracked and discussions with staff and peoples’ relatives/representatives. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 11 There was no service guide/brochure available for us to look at, although people spoken with said they were given some information about the home. There is a standardised format in place for the recording of people needs, based, which provides a fairly comprehensive basis for recording. Those seen were reasonably well recorded, although there were some omissions. Staff spoken with is clearly conversant with peoples’ needs. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ health care needs are met, although their personal dignity is not always best promoted. EVIDENCE: At our last key inspection of this service we judged that we judged that peoples’ health care needs are effectively accounted for and met. We made one requirement in our report of that inspection regarding medicines storage. This is complied with at this inspection. At this inspection we spoke with staff about the arrangements for peoples care delivery, observed the organisation of care and also staffs’ interactions and approaches with people. We also looked at the written care plans of those people case tracked, along with their associated health care records and we Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 13 examined the arrangements for the management and administration of peoples’ medicines via case tracking. Staff did interact with people in a thoughtful, calm and sensitive manner and are considered in their approaches with them. They took time to address people directly and used validation and diversionary techniques as appropriate their communications with them. People’s written care plans provided good detail in terms of health and personal care interventions and were overall reflective of recognised practise, including risk management. They also had recorded reviews at monthly intervals. However, there are some inconsistencies in the quality of recording within peoples’ care plans, particularly for the care interventions people require in respect of their confusion. Daily records kept in respect of the care people receive are also not person centred. Individuals’ access to outside health care professionals is reasonably well accounted for. We are also advised that people do not always wear their own clothes, albeit clean and well laundered. A written notice from management to staff displayed in the office. Also indicated this to be so. During our visit to the home we observed a significant number of female residents who did not appear to be wearing a bra, although peoples’ care records did not detail their known individual preferences/reasons for this, including individuals’ preferences. In addition we observed some people either not to be wearing dentures, or to be wearing ill-fitting ones. The arrangements for the management and administration of peoples’ medicines are overall satisfactory. Although the list of staff signatures kept for those who are responsible for administering peoples’ medicines is out of date as is the copy of the British National Formulary, which provides information for staff about medicines. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for people to engage in activities and to maintain their family contacts are reasonably well promoted, although their individual capacity to exercise choice and control over their lives is not best accounted for. Food provided for people is nutritious and wholesome. EVIDENCE: At our previous inspection of this service we judged that the organisation and provision of social care, occupation and leisure activities for people was considerably improved in accordance with their, known lifestyle preferences and capacities and they are provided with a wholesome balanced diet. At this inspection we looked at peoples’ daily living arrangements, including organisation and opportunity for people to engage in suitable activities for their recreation and leisure and also the arrangements for and provision of peoples’ meals. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 15 All people accommodated are of British white nationality and of Christian based religion. We did this by observing, speaking with people and examining records. During the morning of our visit people engaged in gently exercise facilitated by an outside agency, ‘Progressive Mobility.’ During the afternoon one staff member engaged in a game of dominoes with two people. An activities organiser employed on a part time basis had recently left her employment at the home. Information about activities regular organised by her is displayed on the notice board in the entrance hall in a simple picture format. Care staff said that they always try to make time to engage people in activities, which they aim to match with peoples’ known preferences. Examples of activities regularly organised, include music, books/magazines, reminiscence, baking, dominoes, cards, magnetic darts, crafts and painting/drawing. However, all people spoken with said that staffing arrangements are a constraint in staffs’ ability to provide activities on a regular basis, including regular access to the local community. (See Staffing section of this report). Although during the summer there had been a few trips out, which a small number of residents engaged in, including a trip to Matlock Bath. Photographs of people engaged in activities are displayed around the home. Some peoples’ care records had life stories completed, together with personal profiles detailing some of their lifestyle preferences and likes and dislikes. Although one person case tracked had a detailed care plan in place in respect of their preferred night time routine, there are no daily living plans routinely provided for people, which detailed their preferred daily living routines and likes and dislikes, or including any religious requirements they may have. In addition, individuals records do not account for their given mental capacities in relation to their rights and abilities in making choices about their lives, or their care and treatment. However, staff spoken with is familiar with many aspects of peoples known daily living preferences and their personal likes and dislikes. All people spoken with said that the quality, variety and choice of food are very good. We observed the organisation and serving of lunches to people. Dining tables were attractively set with suitable equipment aids to assist those people who require them. Lunches were served in a calm and unhurried manner. Staff provided assistance to people in a sensitive manner and took great care to address people and offer choice from a varied menu. Drinks are always readily available for people and are served at regular intervals. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 16 Peoples’ nutritional status is monitored and regularly reviewed, including their body weights. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ rights to complain and to be protected from abuse are suitably promoted. EVIDENCE: At our last key inspection of this service we judged that people know how to complain and there are suitable systems and arrangements in place to promote the protection of service users from abuse. We made one requirement about the provision of complaints information, which is complied with. At this inspection we spoke with people about the arrangements for providing information about how to complain and also with staff about the handling of complaints and we discussed the home’s complaints record with the acting manager. A copy of the home’s complaints procedure is displayed in the main entrance area to the home, in standard print format. We are also advised that Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 18 information about how to complain is provided within the home’s service guide/brochure, although copies of these were not available at this inspection. Information provided for people about how to contact us (CSCI) however, is incorrect. Staff spoken with is conversant with their role and responsibilities in respect of handling complaints. The home say they have received no complaints since our previous inspection of this service. The Commission has received anonymous concerns, which are raised recently about staffing arrangements at the home. (See also our Staffing section of this report). We also spoke with staff about training and instruction they receive with regard to recognising abuse and reporting and responding to witnessing or suspicion of the abuse of any service user. Staff confirmed they received instruction and training in respect of the above and the majority understood procedures to follow/action to take in this respect. There has been one allegation of physical abuse and of theft from a named resident by a care staff. The acting manager at that time appropriately referred this to Social Services in accordance with recognised joint agency procedures concerned with safeguarding adults. The home also notified us in writing of this and the action they had taken. The police authority undertook an initial investigation via those procedures, although found no evidence to substantiate this allegation. An internal investigation was then undertaken, which also did not substantiate allegations made. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19, 24, 25 & 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment is clean and comfortable, but not safe and well maintained, which places people at unnecessary risk. EVIDENCE: At our last key inspection of this service we judged that overall, people live in a safe, comfortable environment. Although the central garden area may pose potential risks to people, and the environment is not best adapted to assist in promoting peoples’ wellbeing with regard to their dementia/sensory care needs. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 20 We made one requirement about ensuring peoples’ safety within the central garden area and two recommendations about adapting the environment to better assist people with their dementia/sensory care needs. At this inspection we looked at the private and communal areas accessed by those people case tracked and also some additional areas. Areas seen were reasonably clean and comfortable. Peoples’ bedrooms are well furnished, equipped and decorated. However, there are three areas of serious concern where safety within the environment is not best promoted. (See also the Management section of this report). We have written separately to the registered provider about these, which are as follows: The building does not comply with the requirements of the local fire authority as detailed in the report of their visit to the home in February 2006. Records kept at the home identify that here are two bathrooms, where hot water emissions from those bathing outlets are not within the recognised range for safe water temperatures. And that this has been the case for some months. There are many windows, which require repair, many having broken window restrictors. Since our last inspection, measures have been taken to promote peoples’ safety within the central garden area. However, no action has been taken with regard to adapting the environment to better assist people with regard to their dementia and sensory care needs. We are informed at this inspection that this is planned. Bathrooms are stark and uninviting. The mechanical sluicing disinfector does not work, being in a state of disrepair. There is one hand sluice provided, although given size and layout of the home, this is not within reasonable access from many areas. Suitable hand washing facilities are provided throughout the home, with the exception of the staff toilet. There are not paper hand towels provided here, having a domestic type communal towel, which does not promote good infection control. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are met by staff, which are properly recruited, inducted and trained, although not always effectively deployed in their best interests. EVIDENCE: At our last key inspection of this service we judged that the clear and measurable improvements regarding arrangements for staff recruitment, deployment, induction and training better promotes peoples safety and the meeting of their needs. And, that if sustained, may ensure that people’s individual needs, is effectively met by staff. We made a requirement that the staff training programme be effectively completed and sustained and include staff training arrangements for infection control. This is complied with at this inspection. At this inspection we spoke with staff about the arrangements for their recruitment, induction, training and deployment. We also examined related records, including personal records for four of the most recent staff starters and observed staff deployment arrangements. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 22 Staff spoken with confirmed satisfactory arrangements in respect of their recruitment, induction and training and records examined reflected the same. Although were not able to access up to date information at this visit about the number of staff that has achieved at least NVQ level 2. However, care staff raised concerns about the lack of kitchen staff cover for teas. Staff rotas planned for three care staff during the afternoon and evening to provide care for the seventeen people accommodated, including tea cover and putting away clean laundry to people’s bedrooms. However, due to recent staff turnover and recruitment of new staff, there are reports of occasions where only two care staff is on duty at these times. There are some people who require two staff to assist them. We are advised recently via an anonymous concern raised with the Commission that there have been recent occasions where only two staff have been on duty during the day. Accurate and recorded information was not available regarding people’s dependency needs and also previous duty rotas. On the day of our inspection visit, the three care staff on duty in the morning consisted of a skill mix of one senior, one long standing carer and one new carer undertaking their induction, together with the acting manager, who commenced her role the previous week and with domestic, laundry and kitchen staff. However, during the afternoon and evening, the three care staff on duty consisted of one senior and two new staff starters, one who commenced four weeks previously and one on their first day. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31, 33, 35 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Peoples’ health, safety and welfare are not adequately promoted and the home is not consistently managed and run in their best interests. EVIDENCE: At our last key inspection of this service we judged that he improvements in the arrangements for the management and administration of the home now better promote and protect service users’ best interests and their health and welfare. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 24 At that time (January 2007) an acting manager had been in post since October 2006 and had not submitted an application for registration with the Commission. We therefore made a requirement at our last key inspection that a person must not manage (or carry on) a care home without being registered and that the acting manager must submit their registration application to the Commission. Since that inspection that person no longer works at the home. We also made a further requirement then that evidence/certificate of testing and maintenance of the hot and cold water systems, including legionellas testing must be provided. This is complied with. At this inspection we looked at the management arrangements for the home, including management and quality monitoring systems and arrangements for consultation with people and the management and handling of peoples’ monies via case tracking. We did this by speaking with the acting manager and staff and examined associated records. Arrangements for the management and handling of people’s monies are satisfactory. We also looked at management arrangements for ensuring safe working practises in the home, which included discussions with the acting manager and staff, examination of associated records and our observations of the environment. There has been no registered manager for the home for some 18 months, with a series of four acting managers, who have each left their employment there. At this inspection, a new (fifth) acting manager is recently appointed, who had been in post for one week. With the exception of one, we have not been provided with written notification as to any of those management changes, including the most recent. Some records relating to quality assurance and management monitoring systems are provided at the home, including monthly systems audits up to November 2007. Copies of recent monthly visits undertaken by a representative of the registered provider were also provided. Records of monthly validation audits of the environment undertaken by the providers’ external management arrangements were seen from February onwards. Which recorded serious concerns about health and safety in the home in respect of hot water emissions from some bathing outlets presenting a risk of scalding. Records of hot and cold-water temperature testing from all bathing outlets were provided, which are recorded at monthly intervals. These continue to detail unsafe temperatures, including a risk of scalding from some bathing outlets recorded from February 2007 to date. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 25 We have written separately to the registered provider raising our serious concerns about these. A copy of the Fire Officer’s report of their last visit in February 2007 was also provided, which we have discussed with the Fire Officer since our visit. (See also the Environment section of this report regarding our serious concerns raised with the registered provider). During our tour of the environment, we observed a number of windows, with broken ineffective restrictors in situ. Again, we have written separately to the registered provider raising our serious concerns about these. Discussions with staff and examination of training records confirmed that staff is provided with ongoing training in respect of safe working practises. There is also a recognised system in place at the home for the reporting and recording of accidents and incidents at the home. Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 26 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 1 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 X X X X 2 1 2 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 1 Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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 OP1 Regulation 5 Requirement The home’s service guide/brochure must be available for people to access and provide information in accordance with Regulation 5 (amended 2006). Peoples’ care plans must detail as to how their needs in respect of their health and welfare are to be met. In this instance, consistency ensured in terms approaches to peoples’ care in respect of their confusion. A list of signatures must be kept in respect of each staff responsible for the administration of peoples’ medicines. Up to date information must be provided for staff about peoples’ medicines. The home must be conducted in a manner, which respects peoples’ dignity. In this instance, care taken to ensure people wear their own clothes at all times and also their dentures, which should fit correctly. The complaints procedure must DS0000064197.V354308.R01.S.doc Timescale for action 31/01/08 2. OP7 15 28/02/08 3. OP9 13(2) 31/01/08 4. 5. OP9 OP10 13(2) 12(4)(a) 31/01/08 31/01/08 6. OP16 22(7) 01/01/08 Page 28 Barnfield Manor Care Home Version 5.2 7. OP19 23(4)(a) & (c) 8. OP27 18(1)(a) 9. OP31 8(2)(a) & (b) 10 OP38 13(4)(a) & (c) 11. OP38 13(4)(a) & (c) be amended to provide the correct contact details of the Commission. Adequate precautions must be taken against the risk of fire and for the review and maintenance of fire precautions and equipment. In this instance and with reference to matters raised in Fire Officers report for the home dated 280207. Action must be taken to ensure peoples’ safety. At all times, there must be suitably qualified, competent and experienced persons working at the home in such numbers as are appropriate for the health and welfare of people accommodated there and to ensure safe and effective staff supervision. (In this instance, sufficient cover provided for teas, together with adequate staff skill mix). Where the registered provider appoints a person to manage the care home. He must provide written notification of the name of the person appointed and the date on which the appointment is to take effect. The home must be free from unnecessary risks to peoples’ safety and risks identified must be eliminated as far as possible to ensure peoples’ safety. In this instance ensuring safe water temperatures from all bathing outlets. The home must be free from unnecessary risks to peoples’ safety and risks identified must be eliminated as far as possible ensure peoples’ safety. In this instance the provision and maintenance of window restrictors, based on assessment DS0000064197.V354308.R01.S.doc 30/11/07 14/12/07 31/12/07 14/12/07 14/12/07 Barnfield Manor Care Home Version 5.2 Page 29 of peoples’ vulnerability and individual risk. 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. 2. 3. 4. Refer to Standard OP3 OP10 OP12 OP14 Good Practice Recommendations Peoples’ assessed needs should be fully recorded with no omissions. Care should always be taken to ensure that people wear their own clothes at all times. People should have a daily living plan, which details their known preferred daily living routines and likes and dislikes. Consideration should be given to the implications of the Mental Capacity Act for the homes care planning and record keeping practises in respect of peoples’ capacity to exercise personal autonomy and choice. The environment should provide for suitable aids and adaptations to better assist people with their dementia care/sensory needs in accordance with good dementia care practise. The ratios of care staff to residents should be determined according to peoples’ assessed needs and a system operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health. 5. OP19 6. OP27 Barnfield Manor Care Home DS0000064197.V354308.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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