CARE HOMES FOR OLDER PEOPLE
Barnham Manor 150 Barnham Road Barnham Bognor Regis, West Sussex PO22 0EH Lead Inspector
Mrs S Rodgers Unannounced 17 October 2005 @ 1040 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. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Barnham Manor Address 150 Barnham Road, Barnham, Bognor Regis, West Sussex, PO22 0EH 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) 01243 551190 01243 551190 barnhammanorltd@aol.com Barnham Manor Ltd Mrs Sivagamee Curpen CRH(N)- Care home with nursing 23 Category(ies) of OP-Old age, 23 places registration, with number of places Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7 June 2005 Brief Description of the Service: Barnham Manor is a Care Home registered to accommodate up to twenty-three service users in the category OP (Old age not falling into any other category) with N (Nursing). Barnham Manor is located on the outskirts of the village of Barnham. Local shops and transport services are near by. Accommodation is provided on two floors: the first floor can be accessed by a passenger lift.The responsible Individual on behalf of the organisation is Mr Gary Curpen. Mrs Sivagamee Curpen is the registered manager in charge of the day to day running of the establishment. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.75 hours and was carried out as part of the routine programme of inspections. Preparation for this inspection focused on a review of previous inspection reports and general correspondence. During the course of the inspection the inspector toured the home, spoke with residents either privately in their own bedrooms or within the communal areas of the home in order to gain a sense of how the home is being run and how they experienced living at the home. One staff member was spoken with in order to gain a sense of the support and training they receive in order to carry out their jobs and to gain insight into their knowledge of the aims and objectives of the homes philosophy of care. Of the eighteen key standards that are required to be assessed over the inspection programme those not assessed at this inspection were met in full at the previous visit. What the service does well: What has improved since the last inspection?
The homes recruitment procedure ensures that all new staff undergo a Criminal Records Bureau checks. New dining room furniture has been purchased and Mrs Curpen advised the inspector that there are plans to replace the lounge furniture in the near future. A new boiler has also been fitted.
Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 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. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 7 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 Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 8 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) 6 Intermediate care is not offered at Barnham Manor. EVIDENCE: From touring the building and speaking with staff and residents the inspector was able to determine that all residents residing at the home were living there on a permanent basis. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 9 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) 9 Appropriate systems are in place for the receipt, recording, storage, handling, administration and disposal of medication. EVIDENCE: The home has an agreement with a local pharmacy who supplies the home with prescription medication. The pharmacist visits the home twice a year to inspect the homes systems. The home uses the Monitored Dosage System. All regular medication is received monthly. A system is in place to check medication coming into the home, a senior nurse signs in confirmation that they have been checked and records the number of tablets/quantity of medicine received. Records also record medication returned to the pharmacy. Records of medication administered to residents were in good order. The M.A.R sheets clearly indicate any known allergies, a photograph of each resident is attached to their medication charts which assists new staff with identification of residents. Trained nurses administer all medication; records of their signatures and initials are kept in the medication file. All medication is kept in lockable facilities. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 10 At this inspection there were no residents self administering medication however, should a resident want to self administer a risk assessment would be undertaken. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 Residents are able to maintain contact with their family and friends and are able to make choices with regards their own lives. EVIDENCE: Residents spoken with confirmed that when their friends and family visit they are made to feel welcome. One visitor arrived during the inspection, the inspector noted that during her visit staff were respectful and offered refreshments. The visitor confirmed that they are invited to the homes garden fetes and other organised events. Residents who were asked confirmed that they feel able to make choices with regards their daily lives, they also told the inspector that “you can choose to take part in organised activities or not” and “if you do not want to get up straight away staff will go and attend to something/someone else and return to you a little later”. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 12 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, 18 A complaints process is in place enabling residents and relatives to raise their concerns with the management. Policies and procedures are in place to ensure the safety and well being of residents. EVIDENCE: There is a clear complaints procedure is displayed on the residents notice board in the hallway of the home, the procedure is also included in the Statement of Purpose and Service User Guide. A complaints file was available and indicated that the last formal complaint made to the management of the home was in 2004. Staff confirmed and training record indicated that nursing and care staff have received training in Adult Protection procedures. The member of the ancillary staff told the inspector that although she was offered the opportunity undertake the Adult Protection training but declined, as it was a distance learning certificated course. The inspector recommended that Mrs Curpen provide ancillary staff with basic training with regards definitions of abuse and action they should take should they suspect that abuse of a resident is taking place. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 13 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) 23, 24, 26 Resident’s private accommodation is appropriate to suit their needs. Private accommodation reflects the individuality of each resident. The standard of cleanliness through out the home was of a high standard. EVIDENCE: From touring the building the inspector noted that all private accommodation met the needs of the current service users. Individual aids and adaptations are provided as required, i.e. mobile hoists, wheelchairs etc. Rooms are individually decorated, residents can personalise their rooms with their own personal possessions, arm chairs, chest of drawers etc. All areas of the home were clean and free from offensive odours. Laundry facilities are appropriate to the size and current needs of residents. Policies and procedures are in place for control of infection. The home has a contract with a waste disposal company for the collection and disposal of clinical waste. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 14 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) 28, 29,30 A training and development programme needs to be developed to ensure that all staff are able to meet the care needs of residents. A recruitment procedure is in place. EVIDENCE: Mrs Curpen confirmed that all new staff undergo induction training. At the present time only 2 staff hold an NVQ qualification. Mrs Curpen advised the inspector that she is in the process of organising NVQ training and that the majority of staff are keen to undertake the award. She also confirmed that she is aware of the need for 50 of all care staff gaining an NVQ level 2 qualification or equivalent. Since the last inspection the one outstanding Criminal Records Bureau check has been completed. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 15 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) 31, 33, 38 The home benefits from being run by a manager who has a management qualification. The lack of a quality assurance and monitoring system makes it difficult to determine that the resident’s best interests are being maintained. The lack of fire safety training may put residents at risk of harm. EVIDENCE: Mrs Curpen is the registered manager, she is a Registered Nurse on part 1 of the register, she advised the inspector that she has recently gained the Registered managers award. A quality assurance and monitoring system must be put in place to enable the providers determine that the needs and rights of residents are being maintained. A development plan should also be produced to evidence how and timescales by which any issues identified whilst undertaking the quality assurance system will addressed.
Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 16 Maintenance records indicate that regular servicing of boilers and equipment such as vertical lifts; boilers and electrical appliances are carried out. Systems are in place to ensure safe working practices such as manual handling, food hygiene and infection control however, records of fire safety training indicate that not all staff have received fire safety instruction at the recommended intervals of 6 monthly day staff and 3 monthly night staff. Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 17 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x
COMPLAINTS AND PROTECTION x x x x 3 3 x 3 STAFFING Standard No Score 27 x 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 1 x x x x 2 Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 18 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 18 Regulation 13 (6) Requirement All staff must reciece instruction in Adult Protection procedures commesurate with comesurate with their duties. Staff must recieve training appropriate to the work they undertake An annual quality assurance and monitoring system must be implemented. All staff must recieve fire safety instruction at the recommended intervals of 6 monthly day staff 3 monthly night staff. Timescale for action 04.11.05 2. 3. 4. 28 33 38 18 (c 1) 24 23 04.11.05 04.11.05 04.11.08 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 Good Practice Recommendations Barnham Manor H60 H11 S39654 Barnham Manor V246819 061005 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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