Inspection on 19/12/05 for Barrington Lodge Care Home

This inspection was carried out on 19th December 2005.

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 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 Lodge Care Home 15/08/07

Barrington Lodge Care Home 26/07/06

Barrington Lodge Care Home 06/10/04

Barrington Lodge Care Home 15/06/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Barrington Lodge Care Home St Andrews Road Bishop Auckland Durham DL14 6XX Lead Inspector Mrs Sue Lowther Unannounced Inspection 19th December 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 Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barrington Lodge Care Home Address St Andrews Road Bishop Auckland Durham DL14 6XX 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) 01388 662322 01388 605405 www.fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Joanna Longstaff Care Home 70 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (40), Physical disability (6), Terminally ill (5) Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to a maximum of 30 persons of varying age may be accommodated within the categories of DE and DE (E) Up to 6 persons in the category PD 55 years and over. Date of last inspection 4th May 2005 Brief Description of the Service: Barrington Lodge is a purpose built 70 bedded home located on the outskirts of Bishop Auckland. Accommodation is provided on 2 floors. All rooms are single en-suite and the home caters for elderly service users who require nursing or residential care. There is a 40 bedded unit for service users with general needs and a 30 bedded unit for service users with mental health needs. The home is located in a quiet cul –de- sac and has pleasant gardens, whilst being close to the town centre and other local facilities. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 5 hours on the 19th December 2005. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had implemented the requirements and recommendations made at the previous inspection; to talk with the residents about living in the home; to meet with care staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection? All service users have now been supplied with a statement of terms and conditions. The manager is now registered with the Commission for Social Care Inspection. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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): 2&3 Service users cannot be assured their assessed needs will be met. EVIDENCE: Service users have now been issued with a terms and conditions document. Service users care plans were examined. Appropriate assessment procedures are in place but these needs to include more information about peoples mental health, psychological and physical needs to ensure that the home can meet the needs of service users. Gaps were seen in the recording of the pre admission assessments. These should be completed in full prior to admission to ensure a true picture is gained of the prospective service user. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 &10 Residents cannot be assured that all of there care needs can be met. In some instances service users rights to privacy and dignity were compromised. EVIDENCE: All of the residents who live at Barrington Lodge Care Home had a care plan. Six of the care plans were inspected. They were not written in enough detail to ensure that staff could fully understand service users’ needs. It was sometimes difficult to decipher what care service users were receiving. In some instances the needs of the clients had altered and had been referred to in the daily progress sheets however the actual plan of care detailing instructions to staff had not been updated when the service users needs had changed. One service user was incontinent of urine but there was no recorded strategy on how to manage this. The care plans in place, which gave details about pressure sore treatment and intervention, were lacking in information. Upon reading the plans it was unclear as to what type of dressings were currently being used and how frequently the dressings were being renewed. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 10 The system for ordering, administrating and recording service users medication on the general nursing care unit was satisfactory, however in the dementia care unit the medication systems were in total disarray. Medication that was signed to say had been administered was remaining in the blister pack. Some medication had not been signed for on the administration of medication records, but was absent from the blister pack. Some medication was found in both bottles and in the blister pack, increasing the risk of duplicating the administration of the same medication. The privacy and dignity of service users in the general nursing unit was generally maintained. Visitors to the home confirmed this and from speaking with and observing staff in the unit this was also the inspectors view. However in the dementia unit privacy and dignity of service users was compromised. One service user was observed without footwear, another service user was walking in the unit with only one sock on. There was nothing in the service users plan of care to demonstrate that this was based on assessed need. Some service users clothes were stained with food. There were communal toiletries in all of the bathrooms in the dementia unit. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14, &15 Residents living at the home are supported to have choice and control over how they choose to live. EVIDENCE: There was evidence that activities were taking place in the home. There is an enthusiastic activities organiser in post. During the afternoon of the inspection an entertainer was visiting the home, service users were enjoying this. Residents confirmed that they could have as many visitors as they like and at any time they chose. The visitors are made to feel welcome during their visits and there were several visitors coming and going during the inspection. One visitor said that staff were approachable and that she was going to spend Christmas day in the home. The lunchtime meal was being served during the inspection. It looked nice and service users said they enjoyed it. Staff were able to assist service users who needed help. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 the following standard(s): 16&18 Service users can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: The area manager confirmed that all complaints are taken very seriously and that the company has a robust policy and procedure for dealing with complaints about the service. All complaints investigated by the home are documented with the outcome and actions taken recorded. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 the following standard(s): 19,24 &26 Generally the maintenance of the building was satisfactory. Infection control and cleanliness in some areas of the home was poor. EVIDENCE: The general nursing unit was appropriately furnished. The communal areas and service users bedrooms were clean and tidy. Some service users in this unit had brought small items of furniture into the home to personalise their rooms and make them look homely. In the dementia unit some service users bedrooms had an unpleasant smell. Some bedroom carpets were heavily stained, and some bedding worn and shabby. Some bedroom furniture needs replacing as handles were missing off draws and wardrobes. Bed rails were not fitted correctly and in some cases were not compatible to the bed they were being used on. This is not acceptable. One service users chair had dried food encrusted to the side of it. As yet suitable door locks have not been fitted to all bedrooms. There was no evidence to suggest that service users had been assessed regarding this. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 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 Service users are protected by the recruitment procedure and policy at the home. Staff are suitably trained to meet the needs of the people whom they are caring for. EVIDENCE: The duty rota evidenced that sufficient staff are on duty and deployed appropriately in order to meet residents needs. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Four Seasons Health Care have a training department who are now coordinating staff training in NVQ. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 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 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): 31,33,35 & 38 Whilst there are policies and procedures in place regarding health and safety of service users, the lack of appropriate checks with regard to bedrails places some service users at risk of harm. EVIDENCE: The manager of the home has now registered with the commission for social care and inspection. Four Seasons Health Care have policies and procedures in place to monitor service users satisfaction and financial affairs. There is a maintenance person employed at the home. On a tour of the building it was noted that some bed rails were not fitted correctly. The risk assessment for the bedrails was in the residents care plan. However, there was no evidence available to ensure that the bed rails were checked on a regular basis to ensure they were mechanically sound or that they were still fitted correctly. Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 16 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 X 3 2 2 2 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 2 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 X 3 X 3 X X 2 Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 15 (1)&(2) Requirement More comprehensive information is required in the home’s assessment and care planning documentation. (Previous requirement-timescale of 31/07/05 not met) The manager must review all care plans to ensure that the plan is up to date with the care that service users are receiving. In addition risk assessments and strategies need to be documented clearly when an area of risk has been identified that may effect the safety and well being of a service user. Where service users have special requests as to how they wish to dress, this must be recorded in the care plan. An accurate record of all pressure sores and treatment must be maintained and kept under review. An accurate and full record of medication administration and storage must be maintained at DS0000000690.V257907.R01.S.doc Timescale for action 28/02/06 2 OP7OP8 15 (2)(b) 28/02/06 3 OP7 15(2)(b) 17(1)(a) Schedule 3 13 & 17 28/02/06 4 OP9 31/12/05 Barrington Lodge Care Home Version 5.1 Page 18 5 OP10 12(4) (a) 6 OP19OP26 13,16 & 23 7 OP24 16 8 OP26 13,16 & 23 13,16 & 23 13 9 10 OP26 OP38 all times. (Previous requirement timescale of 31/05/05 not met) Privacy and dignity of service users must be maintained at all times. Communal toiletries must not be used. Service users must be attended to immediately when clothing requires changing. An audit of all bedrooms is required and furniture, bedding and carpets must be replaced in the areas where furniture is broken or where carpets cannot be cleaned. All service users must be provided with locks on bedroom doors. Information must be available within care plans to confirm where a service user has requested not to have one. Where a discussion has taken place and a service user is considered to be unable to use one, this information must also be contained in the plan. (Previous requirement- timescale of 31/07/05 not met) The cleaning schedule must be reviewed and a system put in place to ensure that spillages of food are cleaned immediately. The cause of the malodour in the dementia unit must be addressed. A system for checking bedrails on a regular basis must be implemented to ensure they are correctly fitted and maintained at all times 19/12/05 28/02/06 28/02/06 28/02/06 31/12/05 19/12/05 Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Barrington Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Lodge Care Home DS0000000690.V257907.R01.S.doc Version 5.1 Page 21 - 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. 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