Inspection on 03/11/05 for Barnhaven

This inspection was carried out on 3rd November 2005.

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 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

Barnhaven 28/09/06

Barnhaven 07/04/05

Barnhaven 01/09/04

Barnhaven 29/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Barnhaven Barnhaven Barnhay Bampton Devon EX16 9NB Lead Inspector Jo Walsh Unannounced Inspection 3rd November 2005 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 Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barnhaven Address Barnhaven Barnhay Bampton Devon EX16 9NB 01398 331566 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) Devon County Council Ms Christine Barbara Williams Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Barnhaven is a care home providing personal care and long stay accommodation for up to 15 older people. The home is owned and managed by the local authority, Devon County Council. The home is centrally located, in Bampton, a small market town, close to local shops, pubs, post office and other amenities. The home first opened in 1977, and comprises a two-storey purpose built building. All the homes bedrooms are single. There are shared bathrooms and toilets. There is a passenger lift to the first floor, and a call bell system is installed throughout the home. There are three lounges in the home for communal use and a dining area. The home has outdoor seating to the front of the building and there is a grassed area to the rear. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced meaning that the home were not aware an inspection was to take place. The inspection was completed in 5 hours during which time 10 residents were spoken to, as well as the entire staff group on duty . Time was also spent with the manager looking at key records, such as residents care plans, medication records, staff files and financial records held for residents. A tour was made of the building and some but not all of the resident’s bedrooms were viewed. What the service does well: The home was found to be exceptionally clean and homely, despite the fact that the décor could do with some updating. The staff group are to be commended for the level of cleanliness achieved within the home. The home has a core group of staff that has worked at the home for a number of years and has good knowledge and experience of the residents needs. This is key to providing consistent good quality care in a respectful and caring way. Residents spoken to stated one of the things they liked most was the staff that worked at the home. Comments included, ‘they can’t do enough for you’ and its like a four star hotel here, nothing is too much trouble.’ Staff are given opportunities to do regular training and this assists them to do their job effectively. The service is seen to provide excellent quality care and helps maintain residents in their local area, which means they are able to maintain vital links with family, friends and their local community. The home provides residents with a good range and choice of meals that are cooked from fresh ingredients and take into consideration individuals likes, dislikes as well as special dietary needs. The home has robust procedures in place for record keeping following the I.S.S.90002 which ensures all residents needs are well recorded in their individual plans. The plans clearly detail people’s care and health care needs, which enables staff to work with individuals in a consistent way. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 6 The manager is qualified and experienced to run the home and has developed an open and inclusive approach so that staff and residents feel their opinion is listened to and acted upon. What has improved since the last inspection? 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. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 the following standard(s): 3,5 Initial assessment information is backed up by the homes own assessment where necessary ensuring that clear information is available to make a decision about whether the home can provide the right care and support for the individual. EVIDENCE: Individual care plans and files were viewed for residents and discussed with the manager. There is evidence that care plans or joint assessments are obtained and the manager stated that if needed they will visit the individual to gain further information. It would be beneficial for the home to have a recorded format for this. Residents spoken to confirmed either they or their relative had visited the home prior to making a decision to move in. Several residents stated they had known the home from having day care and respite care, which was a good introduction to the home for them and one person stated, ‘I knew the home form coming for days, so it was easy to make the decision to move in when I needed more care’ Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 9 Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Good quality and updated care plans that are developed with the residents ensure that staff can meet individual’s personal and health care needs. The home has robust medication procedures in place and protocols ensure that resident’s rights, respect and dignity are upheld at all times. EVIDENCE: Four care plans were viewed and discussed with the manager. The plans are well written, clear and detail how individual needs are to be met. The home evidence that these plans are reviewed monthly and residents sign to say they agree with the plans. Staff sign each plan to say they have read and understood the plans. Residents spoken to believed their personal and health care needs were met promptly and that staff were very caring and would get medical advice when needed. Comments included ‘they really look after you when you are poorly’ ‘the call bell is answered straight away, so there is no need to worry’ Staff were directly observed to be showing respect for residents privacy and dignity during the inspection visit, knocking on doors before entering, providing discrete care in a respectful manner. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 11 The medication system was observed being administered. The procedure is robust and ensures residents are protected from mistakes. Only senior staff that have undertaken medication training have responsibility for administering medications. The home has a stated policy and procedure on death and resident’s wishes for last rights etc are recorded where known. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15 The routines of daily living and activities made available are flexible and varied to suit individual preferences. Visitors are made welcome and residents can choose when and where to see them. The meals provided are varied, wholesome and take into consideration individual choice and preferences. EVIDENCE: Residents spoken to confirmed that they can make choices about their own daily routines when to get up, where they choose to eat etc. They also confirmed that visitors are made welcome, are offered a drink and are free to visit when they like. Resident’s rooms were seen to be personalised and residents confirmed they are able to bring in their own belongings if they wish. Staff and residents stated that there are a variety of activities on offer including paid entertainers once every 4-6 weeks. Residents said they enjoyed afternoon’s playing cards, dominoes and making crafts; currently some are making Christmas cards. Activities are based on resident’s choices and include meals and trips out occasionally. The menus were discussed with the cook and demonstrate that the home offers a good variety and choice of meals. The mid day meal was well Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 13 presented and residents were served in a relaxed and unhurried manner. The meal was sampled and was tasty. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The home has a simple and effective complaints procedure, which assures residents any concerns are dealt with promptly and effectively. Robust procedures are in place to protect residents from abuse. EVIDENCE: Records show that complaints are investigated and followed through. There have been no new complaints since the last inspection. Residents spoken to stated they would be able to raise any concerns they had about the home. There are regular residents meetings where each resident is asked if they have anything they wish to discuss any areas of concern etc. The home has stated procedures in place for responding to any allegation of abuse and staff spoken to were aware of this and what they should do. They also receive training in the protection of vulnerable adults and more staff are due to complete this training in the near future. Staff files viewed evidenced that staff are CRB and POVA checked as well as references followed up to ensure that residents are protected. Financial records are robust to ensure that where resident’s monies are held on their behalf there is a clear line of accountability. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 the following standard(s): 19,20,23,26 The location and layout of the home is suitable for its stated purpose; it is accessible, safe and well maintained. The resident’s bedrooms are comfortable, provide privacy and meet the space requirements. The home is exceptionally clean and free from offensive odours, but the laundry and sluice being together compromises residents health as there is a risk form cross infection. EVIDENCE: A tour of the building was conducted. All parts of the home were very clean and in the main part homely. It was very warm, and staff had alerted maintenance to check the heating thermostat. The home is to be commended for the cleanliness it maintains. Staff understand infection control and have training in this area, however residents remain at risk due to the sluice being sited where the laundry is and clean linen being stored in this area. The manager stated that they use Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 16 disposable laundry bags for soiled linen that they try to get clean linen out to residents as quickly as they can. It was suggested that they contact the infection control specialist in their area for advice regarding reducing the risk of cross infection and the possibility of using disposable commode pans. The residents are not able to fully access the back garden safely and this has also been previously highlighted in inspection reports. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing numbers and skill mix are appropriate to the needs of the residents, and there are opportunities for staff to receive regular training and support, which enables the staff team to work more effectively. The home has a robust recruitment process to protect residents. EVIDENCE: All staff on duty was spoken to during this inspection. They confirmed that training was offered in all core areas, as well as NVQ training and the home has more than 50 with an NVQ 2 or above. Staff also confirmed that new staff reciveve an induction programme and that regular support and supervision is given, which ensures staff are well supported and trained to do their jobs. Staff files were viewed and evidenced that the home follows a recruitment process that ensures staff have 2 references, CRB and POVA checks completed, to protect the residents. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,38 The registered manager is qualified, competent and experienced to run the home, and ensures the management approach is open and inclusive. The home has a quality monitoring system in place that takes into account the views of the residents. The registered manager ensures as far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: The registered manager has many years experience in the care industry, and is a registered nurse, and has also completed NVQ 4 in care and management and has ensured her core training skills are kept updated. The training records are well documented. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 19 The home uses resident satisfaction surveys, ensuring that residents complete these either after 3 months or after each visit if they are receiving respite care. This means they are getting feedback form residents but currently they do not publish the results of the surveys or formally let people knew what they are doing about any issues. The manager agreed they would start to do this to help inform the home how to improve the quality of care they provide. Staff and residents meetings are held regularly where they are encouraged to put forward their views. Staff and residents spoken to confirmed that the management approach was open and that their opinion was listened to and valued. Records in respect of maintenance of the building, fire checks and risk assessments on safe working practices were all viewed and found to be well maintained and kept up to date. Staff training includes all core areas ensuring they can do their job safely and effectively. Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 20 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X X 3 X X 1 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X X X 3 Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 21 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 OP26 Regulation 23 Requirement The registered person must, having regard to the numbers and needs of the service users, ensure that any necessary sluicing facilities are provided. The sluice should be removed from the laundry and relocated. (Timescale of 30.7.04 and 30.06.05 not met) The home must consult with the infection control specialist regarding safer measures for commode sluicing and use. Timescale for action 30/03/06 2 OP26 23 30/12/05 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 OP3 Good Practice Recommendations To review the assessment procedure to ensure that you have sufficient information in advance of a service users admission, to ensure that the home has the capacity and understanding to meet service users needs. DS0000039198.V262255.R01.S.doc Version 5.0 Page 22 Barnhaven 2 3. OP33 OP20 The home should ensure that all results of resident surveys are published and made available to residents and a copy sent to the CSCI. To provide a level area which is accessible and safe to the back garden Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Barnhaven DS0000039198.V262255.R01.S.doc Version 5.0 Page 24 - 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!