Inspection on 28/04/05 for Barrington House

This inspection was carried out on 28th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barrington House 23/09/08

Barrington House 31/07/07

Barrington House 18/07/06

Barrington House 08/11/05

Barrington House 21/10/04

Barrington House 26/05/04

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

CARE HOME ADULTS 18-65 Barrington House Rye Road Ore Hastings, East Sussex TN35 5DG Lead Inspector James Houston Unannounced 28 April 2005 09:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Barrington House Address Rye Road Ore Hastings East Sussex TN35 5DG 01424 422228 None None Barrington House Limited 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) Mrs Delize Pardii Care Home 26 Category(ies) of Learning Disability (LD), 26. registration, with number of places Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is twenty-six (26) Date of last inspection 21 October 2004 Brief Description of the Service: Barrington House is a large Georgian house situated on a prominent junction in the village of Ore on the outskirts of Hastings. It is convenient for main bus routes and is within walking distance of all local amenities. There is no lift in the home and wheelchair access is only available on the ground floor. The home is registered for 26 adults and older people with a learning disability. Only people with a mild to moderate learning disability can be accomodated. The home has two people carriers for trips and transport to clubs. There is a designated area in the home for smoking. There is a lawned area to the front and side of the building of the house and a wheelchair ramp at the rear of the house allows wheelchair access. Limited parking is available on site. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a day on 28th April 2005. Pre inspection preparation consisted of file reading and preparation for those sections of the National Minimum Standards to be inspected on this occasion. The inspection took 6.8 hours. During the course of the inspection the inspector met with the registered manager and spoke with three members of staff and ten residents. A tour of parts of the building was made and a wide range of documents policies and files was read. What the service does well: What has improved since the last inspection? What they could do better: The home should complete the revising of care plans so that they include explicit advice on the actions required by staff to meet the goals identified. The home’s health and safety risk assessment of the building must include reference to each residents’ bedroom. These requirements are outstanding from the last two inspections. The home must record administration of all Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 6 medicines to residents for the well being of residents and the protection of staff. It is recommended that daily notes held in respect of residents should refer to progress with the goals set out in residents’ care plans. It is recommended that there should be no unexplained gaps in the list of jobs that they have held prospective staff put on their application forms. The home should have 50 of staff with NVQ level 2 in care by 2005. Some areas of exterior woodwork need attention. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 and 4. People using the home receive clear information to enable them to make a choice about whether they might wish to live in the home, to this end prospective residents also visit the home prior to moving there. The home obtains Care management assessment papers from placing authorities and conducts its own assessment before deciding whether they can meet the needs of prospective residents. EVIDENCE: The home has a combined statement of purpose/service users guide. Since the last inspection this document has been amended to include the full address of the Commission for Social Care Inspection. Records inspected in respect of two residents admitted to the home showed that the home has obtained detailed information from Social Services and has carried out its own assessments on the needs and abilities of prospective residents. The manager said that prospective service users usually visit the home on at least three occasions before admission, staying longer on successive visits. The home does not intend in the normal course of events to make emergency admissions as the manager sees this as unlikely to be in the best interests of the prospective resident or of existing residents. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 and 10. The home needs to complete the review of care plans so that staff have explicit advice on the action required of them to meet the goals identified for all residents. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: The manager is working to amend the care plans of all residents so that they include explicit advice on the actions required by staff to meet the goals identified. Staff said that they write daily notes and their remarks showed that they are aware of how to record. Daily notes should refer more systematically to progress made with individual goals. Regular reviews were seen to have been held. The manager and a staff member confirmed that since the previous inspection staff on duty at evenings and weekends are left with a small sum of money for emergencies and unforeseen shortages. Detailed risk assessments were seen. Since the last inspection a resident no longer uses a hot water bottle. Staff are aware of the risk assessments and see it as their responsibility to assist and train residents about their personal safety. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 10 The home has a code of conduct policy, which includes information regarding confidentiality. The manager has amended this to include when information shared in confidence with staff by residents cannot be kept confidential due to the nature of the information. Discussion with staff showed that they have a clear understanding of issues and conflicts involved in this crucial area of their work with residents. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 and 17. Social activities are well managed, and provide interest for residents. Visitors are made welcome. Food served is of a good standard. EVIDENCE: The home has reassessed each residents’ wishes as to how they wish to spend their days and copies of weekly plans were inspected. No residents go out to paid work. Two residents take part in fund raising activities at a local church. Staff said that they are well aware of local resources. A resident said that they would like to go out shopping. The manager said that with it’s own transport resources-the home has two people carriers- and some times in partnership with a voluntary organisation- service users are taken out. Visits are for example for shopping or to a favourite local pub. Several residents go out alone to Ore village nearby. A number of residents attend day centres, and the home organises in house activities in the afternoons. Residents are registered to vote and some may do so. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 12 Staff confirmed that they see it as part of their role to make residents visitors welcome. A resident said that a friend visits regularly. Residents said that they like the meals served. Staff said that they are aware of residents’ likes and dislikes. The meal served during the inspection was seen to be in ample quantities and to be attractively presented. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 and 21. The home makes proper arrangements to meet the healthcare needs of residents. Medications are securely held, but the record of administration was incomplete and this does not safguard residents. The recording of residents wishes regarding arrangements to be made after their death assists staff to ensure that residents wishes are respected and carried out. EVIDENCE: Records inspected showed that proper arrangements are made to meet the healthcare needs of residents. During the inspection a resident was taken to a clinic by a staff member for an appointment. Staff said that they usually go in with the resident to meet the health care professional, but would respect a residents’ wishes, should the resident not wish the staff member to come in. Medication is securely stored, but the record of medication administered is incomplete in that there are isolated gaps in the record. A requirement has been made regarding this. No controlled drugs are currently held for service users but the facility to do so exists. The home has a list of staff who can give out medication and staff who said that they do so said that they had received appropriate training. Records inspected confirmed this. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 14 The manager has established the wishes of recently admitted residents regarding arrangements to be made after their death, and recorded these in their plans. A plan inspected confirmed this. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home has a suitable complaints procedure. The home has an adult protection procedure to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The manager said that there have been no complaints since the last inspection. No complaints have been received by the Commission for Social Care Inspection. Residents said that they were aware that they can raise concerns. The manager amended the home’s adult protection procedure during the inspection to include reference to the fact that Social Services is the lead agency on adult protection matters and that the home’s staff will need to contact Social Services about how to proceed should an allegation of abuse be made. Staff said that they are aware of the procedure and have had relevant training. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,and 30. The home is generally well maintained, furnished and equipped to provide a congenial home for residents. EVIDENCE: The home is in keeping with the local community. The premises are safe, bright, comfortable, airy and free from odours. The first floor of the premises is not accessible to residents in wheelchairs or with limited mobility. Furniture, fittings and equipment are of good quality and as domestic as possible. Attention is required to some exterior woodwork. The home has a plan for regular maintenance. This was not seen on this occasion. Since the last inspection the programme of guarding radiators has been completed. The environmental health officer visited in February 2005. He gave advice, and no matters are outstanding. A fire risk assessment has been completed, and fire drills have been held including one at night, and evaluations of drills now includes staff performance. Fire alarm points are tested regularly. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 17 Several bedrooms were inspected. They are well decorated and furnished. Several have been fitted with new carpets. Residents said that they like their rooms and have been able to bring in items of their own. They said that they do not want to have a key to their rooms. The laundry is sited away from food preparation areas, and is well equipped, and has been repainted since the last inspection. The home has purchased a new washing machine, and hopes to replace the tumble drier over the summer. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,and 34. The home has enthusiastic and involved staff and turnover is low, assisting in the provision of continuity of care to residents. The home has increased its staffing in the evening for the benefit of residents. Recruitment procedures are thorough. EVIDENCE: Staff spoken to were knowledgeable and experienced. Residents said that they find staff helpful and friendly. The home has two staff with NVQ level 2 in care, and two staff are doing NVQ level 3 in care. The 50 level for care staff to have NVQ level 2, recommended to be reached by 2005, has not yet been attained. On the day of the inspection staff were present in sufficient numbers to meet the needs of residents. The manager and staff confirmed that the staffing level in the evenings has been increased to three on duty. A rota inspected now contains the role of staff on duty. There is always a manager on call available to staff. The manager confirmed that staff left in charge are always aged at least 21. Staff confirmed that staff meetings are held very regularly and that minutes are made available to all staff. One service user uses Makaton on occasion and a staff member confirmed that resources –a Makaton manual- is available to assist communication. Staff turnover is low, and no new staff have been recruited since the last inspection. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 19 Recruitment procedures are thorough. It is recommended that there are no gaps in the employment history of prospective carers, and that references are taken up only from employers and not from former colleagues. Staff confirmed that they are given copies of the General Social Care Council Code of Conduct, and have been issued with job descriptions and contracts. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,40,42 and 43. The manager is qualified and experienced. Procedures inspected are well presented. The registered manager has systems in place to ensure the health and welfare of staff and residents and further developments would enhance this. EVIDENCE: The manager has considerable relevant experience, and has qualifications in management and care. She holds the NVQ assessors award, and evidence inspected showed that she has undertaken periodic training to update her skills. The homes’s procedures were reviewed and dated by the registered manager in April 2004, and those amended since that date were clearly marked. Staff confirmed that they have access to the home’s procedures. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 21 The home’s accident record was reviewed and is sufficiently detailed. The home’s health and safety risk assessment should include reference to every service users’ room. At the last inspection it was recommended that the manager should keep a record of the dates of manual handling training, who provided it and the content as well as just the names of those trained. The manager is going on a course on a moving and handling training course in May 2005 which will then qualify her to train her own staff. She plans over time to do similar courses in First Aid and Health and Safety. The home has suitable insurance, and the certificate is displayed in the home. The home has a business plan and systems to cover financial planning. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 Barrington House Score 2 3 Standard No 24 25 26 27 28 29 Score 2 x 3 x x x Version 1.20 Page 22 H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc 8 9 10 LIFESTYLES x 3 3 Score 30 STAFFING 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 2 3 Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15(1) Requirement Timescale for action 31 May 2005 2. 3. 20 42 17(1) & Sch 3 3(1) 13(4)(c) Care plans must include explicit advice the action required by staff to meet the goals identified. (Previous timescale of 30 January not met) Keep a record of all medecines 28 April given to residents. 2005 The homes health and safety risk assessment of the building must include reference to each residents room. (Previous timescale of 30th January 2005 not met). 31 May 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 6 24 32 34 Good Practice Recommendations Daily notes held in respect of service users should refer to progress made with individual goals. Attention could be given to some exterior woodwork. 50 of care staff achieve an NVQ 2 in care by 2005. There should be no unexplained gaps in prospective staffs employment history. References should be from employers rather than work colleagues. H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 24 Barrington House 5. 40 In addition to recording the names of staff who have received manual handling, the manager should keep a record of the date training was provided, who provided the training and what the training entailed. Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Barrington House H59-H10 S21040 Barrington House V222908 280405 Stage 4.doc Version 1.20 Page 26 - 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!