Inspection on 01/05/07 for Barrington Lodge Nursing Home

This inspection was carried out on 1st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Barrington Lodge Nursing Home 09/01/06

Barrington Lodge Nursing Home 16/05/05

Barrington Lodge Nursing Home 19/01/05

Barrington Lodge Nursing Home 05/04/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Barrington Lodge Nursing Home 9-15 Morland Road Croydon Surrey CR0 6HA Lead Inspector Michael Williams Key Unannounced Inspection 1st May 2007 9:50am 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 Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrington Lodge Nursing Home Address 9-15 Morland Road Croydon Surrey CR0 6HA 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) 020 8654 9136 020 8662 0060 www.lrh-homes.com London Residential Healthcare Limited Ms Veronica Raynor Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (17), Physical disability (14) of places Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of persons for whom accommodation is provided shall not exceed 44 (forty-four) in the following categories 30 Elderly Infirm clients of whom a maximum of 13 will be under the care of the Multidisciplinary Rehabilitation Team 14 Highly dependent, severely physically disabled clients Date of last inspection 9th January 2006 Brief Description of the Service: Barrington Lodge is a Nursing Home providing nursing care for up to a total of 44 persons. 14 beds are on the ground floor; these may also be used for younger adults who have severe physical disabilities. Whilst this home provides care for people with physical disabilities it is primarily a nursing home for those of advanced years and who are very frail; so any residents admitted under the physical disability category need to be compatible with the main client group. The home can also accommodates up to 3 service who are terminally ill and require palliative care. There are 33 bedrooms 11 of which are double rooms and 22 are single rooms. The home has two lounges; a large one adjacent to the dining area and a smaller quiet lounge for more private meetings with visitors. The main lounge leads out onto a raised patio with seating which in turn looks out over a large well-maintained garden that is accessible to residents. The dining room is accessed via the lounge through large sliding doors. The bedrooms are located on three floors, which can be accessed either by stairs or a passenger lift. A new passenger lift has been installed. There is limited parking for approximately 8 cars at the front of the building. The home has achieved an Investors in People award. Fees in April 2007 were £525 to £700. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2007/2008. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. Barrington Lodge is one of a number of care homes owned by London Residential Healthcare [LRH] and two are based in Croydon – the outcomes for both will be similar, for example, in documentation and administration, staff recruitment and training and in the general management of the services so this will be reflected in this report. To monitor all aspects of care in Barrington Lodge we ‘tracked’ the care provided to a sample number of residents and cross checked this information by examining the documentation supporting care, observing the meals provided, checking the arrangements for medication, handling money, records of complaints, accidents and nutrition. Staff providing care were interviewed, and where possible the inspector met with relatives as well as interviewing or observing the residents themselves. We received fourteen very positive written responses by the time of our visit on 18th April 2007; the staff in particular were praised and described as “first class”. What the service does well: What has improved since the last inspection? What they could do better: No requirements arise but recommendations are made to widen the range of elements in some residents’ care plans to include specific communication needs and their social care needs and religious beliefs. Some care plans Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 6 particularly for residents with complex needs and with higher associated risk need to be reviewed by their care managers as well as the home. Some residents like to keep their door open so it is recommended magnetic door holders are put in place. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 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 Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 3: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a comprehensive assessment do so prior to their admission, which ensures meet resident needs. Residents, and their identification of their care needs and planning met in the care home of their choice. EVIDENCE: A sample of residents’ case files were used to cross-check or ‘track’ information. Carers, nursing staff and the nurse/manager contributed in the assessment of this and most other standards. Visitors and residents helped to confirm our findings. We find that all prospective residents have a full assessment prior to admission and a trained Nurse undertakes these assessments. Each resident then has an individual and comprehensive care plan - drawn up in collaboration with the resident if this is possible or their relatives if it is not. A proportion of residents will at any time be self-funding and therefore will not require the assistance of the local authority service services; in these cases the home can undertake its own assessments to Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 9 carried out by staff qualified to that staff know and are able to relatives, are involved in the how they would like them to be ensure the home can meet their needs. Residents confirm that the process of deciding where to live and to help decide if Barrington is the right home for them is detailed and methodical, the admission process is personal and well managed. Prospective residents and their families tell us they are treated with dignity, respect and with an understanding for the life changing decisions they need to make. Inevitably many residents would wish to remain in their own homes but recognise the need for the 24-hour care provided in care homes and to that extent very much appreciate the service provided in Barrington Lodge. Family and friends are consistently involved in the admission process and the subsequent care planning of each resident. Areas of strength are information and support provided at the point of admission and as there are no matters requiring improvement this section, about choice, is assessed as good. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7 to 11: Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All social care and health care needs are assessed prior to admission, these needs are then translated into care plans - which are reviewed and revised periodically. This ensures that residents will know that staff in the home are to able to meet their changing needs. EVIDENCE: Residents and a few visitors in the home when we visited explained how the home involves them in all aspects of their care. Each resident has a well thought out care plan using a standardised format and these are reviewed and updated monthly. Arrangements for additional, more formalised reviews, are made when changes take place. We advised the home that some care plans might be broadened a little in their scope to give more specific guidance on communicating with resident who have difficulties with speech or hearing. Care plans might also be extended to include more social elements of social/religious care rather than mainly hygiene and health matters. Staff (including ancillary staff such as the cooks and housekeeper) spend time with individual residents to ensure they understand decisions and actions. Robust Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 11 quality monitoring systems are evident such as the positive use of owners’ visits and questionnaires. In both of LRH care homes in Croydon the care plans are simple in design, making them easy to use by all levels of staff and it is clear they are being used as daily a working tool. Much of the information is codified for quick and easy use so thus makes the case files easy to use in an emergency for example, by people who are not familiar with its content. Each care plan includes comprehensive risk assessments of key areas such as nutrition, skincare, mobility and so forth. The staff keep up to date with training, professional research and literature, in both the social care and clinical fields; this was also noted in the other care home in Croydon owned and managed by the same company and therefore able to offer training to the larger staff group. Nurses including “Adaptation Nurses” maintain their clinical skills and their registration with NMC [Nurse and Midwifery Council] and this was confirmed a staff nurse who has recently acquired NMC [Nurses and Midwifery Council] registration. Staff actively promote the residents’ right of access to the health and remedial services that they need, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure residents are reminded and appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Staff keep a regular check on health aids, making sure they are working effectively and that each resident has the necessary aids to improve their quality of life Residents have choice over their personal care and are encouraged to be independent and responsible for their own personal hygiene where possible. In respect of risk taking in this area – where for example residents make decisions that the manager might think are not in their own best interests - we advise that a review of their care is undertaking involving placement authorities so that they are involved in these difficult decisions. The home operates to well developed and efficient medication policies and procedures. Staff all have access to the written information and understand their role and responsibilities. Medication records and processes were checked and no problems were identified. The need to respect residents’ privacy and dignity when delivering health and personal care is a key principle of the homes aims and objectives and is stated in their Guide. Staff are aware that this also applies to all areas of the resident’s life. Residents are consulted and can help decide with the senior nurses which staff members they want to help them with their personal care where choice is possible, for example male carers. The registered person routinely observes staff attitude and approach to privacy and respect and constantly seeks and values residents’ views and experiences. This is not a very large nursing home and so the Matron can easily get to know all residents and their regular visitors and those who spoke to the inspector described the management team as very helpful. The wishes of individual residents about dying and terminal care, and the arrangements they want after death can be openly and sensitively discussed with both the residents and their Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 12 family during the development of the care plan. But it was clear from the care plans that few residents actually want to discuss their end of life wishes; nevertheless the home has prepared staff for this sensitive work including talks by undertakers and Coroners as well as priests and other support staff that might be involved in end of life care. The home has a detailed policy, procedures and practice guidance to help staff when handling terminal care and death. All staff receive in house training and practical advice in caring for these residents, and have continuous support and opportunities to discuss any areas of anxiety and concern. The ‘Liverpool Pathway’ is designed specifically to provide for the best care towards the end of life; whilst only two residents have needed this detailed and specific ‘programme’ of terminal care the manager advises us the it has proved very helpful in coordinating procedures that usually take place but in a less planned and organised way. Facilities are provided to allow relatives and friends to stay with the resident and to assist with their care if the resident want this. Despite Barrington Lodge being a nursing home where the turnover of residents might be expected to be high there are many residents who remain relatively healthy well into their 90s and this is a tribute to the quality of care provided. Areas of considerable strength are the detailed and comprehensive care planning and consultation processes and the high standard of health and social care provided. No requirements arise but two suggestions are made to have case reviews involving care managers of the placing authorities and to widen the scope of some care plans. As no matters requiring improvement arise this section, about health and personal care, is assessed as excellent. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 to 15: Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a very congenial setting which offers a comfortable, quiet and peaceful lifestyle for service users and enables the staff to assist and encourage service users to lead as fulfilled lives as they wish or their frailty allows. Service users are encouraged and given every opportunity to maintain contact with family and friends and the community. EVIDENCE: In Barrington residents are able to enjoy a full and stimulating life style with a variety of options to choose from – but only in so far as their age and abilities allow, this means many choose a quiet reflective life in their own rooms whilst some still enjoy going out in the community on short coach trips and out wit friends. The home has sought the views of residents and considered their varied interests and abilities when planning the routines of daily living and arranging activities. Routines are reasonably flexible for the size of the home and residents can make choices about major areas of their life, including diet, medication, money, and how they spend leisure time. A new activity coordinator has been appointed whose role includes daily contact with the residents to offer them choices about how their day will be spent. Both the Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 14 television and daily newspapers were being used positively and constructively to keep residents it touch with news and world affairs. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors were on site and told us how they are welcome at any time and facilities are available for them to have a drink or a meal with the resident. Residents can choose to entertain visitors in their own rooms or perhaps a quiet lounge or the well maintained garden areas. This home does not have small kitchenettes nor domestic scale laundry facilities but in so far as it is possible residents are encouraged to be independent, for example to be responsible for their own money and medication. Staff give help when it is needed and have contacted advocacy groups and encouraged their involvement with individuals in the home. The home’s policies, procedure, guidance and quality assurance systems ensure that service users are protected from financial abuse. The service is very clear about the rights of residents to be able to read their records and staff spend time with them making sure that they are fully aware of their care plans which are held by the home. Food is considered to be highly important and meal times considered a social occasion. The senior cook in Barrington is qualified and experienced in catering for older people, and is seen as important member of the staff team and the documentation shows they are well acquainted with the need to keep records of dietary and cultural needs of each resident. The cook was commended for her excellent cooking and it is clear she is committed to involving service users in menu planning and making sure that they are able to enjoy the homely food they prefer and like. The menu is varied, balanced and nutritious. It has a number of choices including a healthy option, and includes a variety of dishes that encourage service users to try new and sometimes unfamiliar food. On the day of inspection there were two main choices including Chicken and Mushroom pie or Gammon with fresh vegetables plus diets for those that need them. Food is served to meet the need of all service users including those who have swallowing or chewing difficulty. Staff giving assistance to those residents who need help to eat, were discrete and sensitive. Mealtimes are relaxed affairs, staff were patient and helpful, and gave service users the time they needed to finish their meal comfortably, encouraging them to serve themselves. We spoke to residents as group in the dining room and the residents appreciate the good quality food they are served and being able to have a drink when they wish and the availability of snacks. They also enjoy being able to eat in their own room when they wish. Amongst the choices that service users can make known, or their family can assist them in making known, are the residents’ cultural and diversity needs. The home seeks to ensure residents can follow their religious and cultural beliefs whether that is in the form of worship, leisure pursuits or special diets. There are male and female carers so this gives a residents a choice as to the gender of the carer. Staff come from a variety of racial/cultural backgrounds although most residents are in fact English. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 15 Areas of strength are the range of activities and entertainment offered and the sociable atmosphere prevailing in the home; other areas of strength are indicated in the positive feedback from residents and visitors about the quality of life in the home and the flexibility of staff to accommodate individual choice and as no matters requiring improvement arise this section, about daily life, is assessed as excellent. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 18: Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The owners, manager and staff have a positive approach and attitude to service users concerns, complaints and suggestions, which enables service users to feel free to make observations, both positive and critical ones. Procedures and staff training for the protection of vulnerable adults have been introduced to ensure service users are protected from abuse. EVIDENCE: Barrington has a complaints procedure that is up to date, clearly written, and is easy to understand. It can be made available in a number of formats (including other languages, large print, audio-tape upon request) to enable anyone associated with the service to complain or make suggestions for improvement. The complaints procedure is widely distributed, in both the Statement of Purpose and residents’ Guide. Residents and visitors have a good understanding of how to make a complaint and they are very clear of what can be expected to happen if a complaint is made; several visitors explained that when they have had minor concerns they have been dealt with in a timely and helpful way. The policies and procedures regarding the protection of residents are in place and regularly reviewed and updated. Those interviewed were clear about how and when incidents need to be referred to the local Social Service Department and/or the police as well as other involved parties. The Manager confirms that there have been no such incidents requiring referral under these procedures in the last year. Training of staff in the area of protection is regularly arranged by the home. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 17 Residents and others associated with the Barrington say that they are very satisfied with the service provision, they feel very safe and well supported by an organisation that has their protection and safety as a priority. Several residents pointed out that it was a family decision that they enter the home to ensure their own safety and in making that decision they expect to be kept safe from accident, injury or abuse. The promotion of the individual’s rights is central to the aims and objectives of the service and as a central plank of the home’s Statement of Purpose, the home’s documentation reflects the rights of the individual. Advocacy can be arranged if needed to support a resident. Staff ensure that residents can access places of worship or community facilities of their choice. Areas of strength are clear information provided about making concerns known which are in formats residents and their relatives can understand. As well as a positive attitude of the home and owners to deal with those concerns. No matters requiring improvement arise this section, about complaints and protection. This outcome group has been assessed as excellent. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19 and 26: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a very safe, well-maintained and comfortable environment. It is subject to ongoing refurbishment and renewal. It was clean and tidy at the time of inspection. The garden has been designed and well maintained to ensures there is a pleasant environment where residents may sit and spend leisure time should they wish. EVIDENCE: The home is well maintained and provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe place to live in, with a wide variety of bedroom styles. Where rooms are shared it is only by agreement, and screens provided for privacy. Residents are always given the choice to move into a single room when one becomes vacant. Residents showed us that they have the choice to bring small personal items of furniture into the home. All the homes fixtures and fittings meet the needs of the residents and can be changed if their needs change. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 19 privacy or in their own rooms. Some residents say they would like to keep their bedroom doors open so they will need to have suitable safety device fitted if they are to do so. A recommendation is made to fit such devices where needed. It is noted that many doors already have portable magnetic holders. There is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. Residents say that there is plenty of hot water at all times of the day and the temperature of bedrooms can be changed, on request. The place is well ventilated, the home is well lit, clean and tidy and smells fresh. The management has a good infection control policy. They seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the homes’ policy to reduce the risk of infection. Areas of strength are well maintained premises, the homely atmosphere and the range of aids and adaptations in use; the grounds are also an asset. No matters requiring improvement arise but a recommendation is made to install magnetic door holders if residents want to keep their bedroom doors open; so this section, about environment, is assessed as good. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27 to 30: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels, staff training and support are in place and there is sufficient staff with the necessary skills to meet the service users assessed health and care needs. EVIDENCE: Residents tell us that they have confidence in the staff that care for them, they have been described as “first class”. Rotas are clear and simple and show how nursing and care staff are to be deployed and that adequate numbers of ancillary staff are also working in the home – indeed the ancillary staff, cooks, cleaners, maintenance and laundress were complimented for the important part they play in the running of the home. LRH as owners make sure that the home provides clearly defined roles and responsibilities for all staff through their job descriptions and specifications. Residents report that staff working with them are very good, very kind and caring and it seems that staff are consistently able to meet their needs. There is little use of any agency or temporary staff. The Owners ensures that all staff within its organisation including Barrington Lodge receive relevant training, including nursing and care qualifications. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 21 of good quality services and for the protection of residents. A sample of staff records were examined and staff interviewed to confirm good practice in recruitment processes. Police checks [CRB] are now in place for all staff. Areas of strength are stability and loyalty of the staff team that is well trained and skilled in their various roles and as no matters requiring improvement arise this section, about staffing, is assessed as good. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31 32 33 35 36 37 38: Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is a well managed care home; the home has a competent nurse-manager and the owners are clearly dedicated to providing a high standard of service for residents, with regards to both environment and personal care. Residents’ needs are a key consideration to the running of the home and their care and well being is seen as paramount. EVIDENCE: The manager has the required qualifications as a nurse and manager and has considerable experience as a home manager so she is clearly very competent in running Barrington Lodge as a nursing home. She works to continuously improve services and provide an increased quality of life for residents, a point repeatedly confirmed by the residents. There is a strong ethos of being open and transparent in all areas of running of the home. The manager is residentfocused and leads and supports a strong staff team who have been recruited Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 23 and trained to a high standard. The home has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. The manager is regarded highly by other professionals. Staff are positive in their approach to translate policy into practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. Management processes ensure that they receive feedback on their work. The home works to a clear health and safety policy, all staff are given a copies of important policies in particular those relating to staff and resident safety. There are regular random checks to ensure staff are working to these policies. The home has a good record of meeting relevant health and safety requirements and legislation, fire safety, hygiene and maintenance checks are all confirmed by regular certification by the relevant authority. Records are of a good standard and are routinely completed and samples were checked during the inspection to confirm this including, case files, staff files, safety records, food records complaints and accident records. Where issues have been identified, for example, in care plans, these have been acted upon successfully to ensure residents care is not compromised. Residents are aware of safety arrangements and have confidence in the safe working practices of staff. The registered person has the skills and ability to deliver good business planning, effective financial controls and provides a quality assurance and monitoring processes. We are advised that home’s financial and business plan shows continuing growth supported by strong financial arrangements. The home has access to professional business and financial advice and has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. Residents are helped to take responsibility for managing their own money. They are provided with facilities to keep their valuables and money safe. Where the home is responsible for resident’s money it works to a very rigorous system, it maintains very clear records that are routinely kept up to date and can be used to track individual residents finances. Areas of strength include the overall management and daily running of the home backed by owners committed to quality services and as no matters requiring improvement arise this section, about management and administration, is assessed as excellent. Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 24 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 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 4 4 4 X 3 3 4 3 Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 OP7 Good Practice Recommendations Care Plans: it is recommended that the range of care plans for residents is extended so as to include social care, emotional, recreational and communication needs. Care Plan Reviews: it is recommended that for residents who challenge the service, for example by choosing to take high risk decision about their lifestyle, a formal case review is held involving the placing authorities. Bedroom doors: It is recommended that magnetic door holders are installed if residents wish to keep their bedrooms open in the day. 3 OP19 Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Barrington Lodge Nursing Home DS0000019022.V338448.R01.S.doc Version 5.2 Page 27 - 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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