Inspection on 16/05/05 for Barrington Lodge Nursing Home

This inspection was carried out on 16th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Barrington Lodge Nursing Home 01/05/07

Barrington Lodge Nursing Home 09/01/06

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 9-15 Morland Road Croydon Surrey CR0 6HA Lead Inspector Michael Williams Unannounced 16th May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barrington Lodge Address 9-15 Morland Road, Croydon, Surrey, CR0 6HA 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) 020 8654 9136 020 8662 0060 jag@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 G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 19/1/05 Brief Description of the Service: Barrington Lodge is a Nursing Home providing nursing care to a total of 44 older 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 service users admitted under the physical disability category need to be compatible with the main client group. The home can also accommodates up to 3 service users (within the two categories OP and PD) who are terminally ill and require palliative care. The home is not registered to provide care for people with Dementia nor any other form of mental health problems or learning disabilities. 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 service users. 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. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This nursing homes has been achieving consistently high standards in all areas including the social and nursing care of service users, catering; staffing support and training; administration and the maintenance of the fabric of the building. The service users were very complimentary about the home and the staff team. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 The Statement of Purpose has been updated and provides important information for prospective service users. Detailed assessments are in place for each service user including details of their nursing needs. EVIDENCE: The home uses a standardised format for the service users’ case files and these contain detailed documentation including separate forms for each type of assessment as required by this standard. The assessments provide general information about each service user, including details of their background, medical and social history, and also evaluates comprehensively the details of specific areas such as nutrition, skin care (tissue viability risk assessments), medication and so forth. Service users, with their representatives, assist in the compilation of these case notes. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. All service users have individual plans of care plans that indicate that service users’ identified needs are being fully and regularly updated. Medication policies and procedures ensure the safety of the service users. Service users confirmed that they are treated with respect and dignity. EVIDENCE: The service users’ case files include the initial assessments from which arise the goals designed to meet the specific needs of each service user. The care plans include details of clinical, health needs and treatment plans. A sample of case were checked and it is clear that health care needs are monitored and appropriate intervention provided either by the on-site nursing staff or by involving professional agencies such as the General Practitioner or hospital specialists such as the Palliative care or Tissue Viability Nurses. During the course if the inspection no service users were identified as self-medicating but nursing staff will support them if they wish to do so. Provision is made to ensure service users’ right to privacy is respected and service users say they are treated with respect and kindness by staff. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 to 15 This is a comfortable and friendly care home were service users are encouraged to maintain contact with their families as well as being given every opportunity to exercise choice and control with their health and daily lives. The meals are nutritious and well presented. Service users praised the quality of the meals provided. EVIDENCE: A full programme of activities is provided by an activities coordinator. The range of opportunities for social and recreational pursuits, such as quizzes, outings, garden fetes and gentle exercise, was appreciated by the service users. Whilst many service users mourned the loss of their independence, and their own homes, they nevertheless said that the care and activities provided in Barrington Lodge were very good. Relatives were on site and also confirmed that they are welcomed into the home and visit when they wish. This is a nursing home so service users are somewhat dependent and vulnerable and so the exercise of choice and control of their daily lives is inevitably restricted but within those constraints the home offers a typical range of choices such as choice of meals, of daily activities, choice about the time they rise and retire to bed, and where and with whom they sit each day. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 There are policies and procedures in place for service users and their relatives to either complaint or compliment the service. These ensure that the home’s manager or the owners deal with complaints promptly and with careful consideration of the issues. Although the homes has policies and procedures and staff training regarding the protection of vulnerable adults, the recruitment procedures do not ensure that the service users are protected. EVIDENCE: A record of complaints is in place and shows that one complaint has been dealt with by the home since the previous inspection. This dealt with a matter of technical Nursing care and the complainants confirmed that the matter has been dealt with appropriately. No complaints arose during the course of the inspection. Staff are aware of their responsibility to protect service from abuse and to report untoward incidents to the correct authorities. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 Service users are cared for in a clean, safe, well-maintained and comfortable environment. EVIDENCE: This is not a purpose built care home, it is a terrace of large domestic premises that have been converted. Inevitably the home will show some signs of wear and tear but the owners ensure there is ongoing refurbishment of the premises. A new lift has been installed; some areas have been redecorated and the fire warning system is being upgraded. On the day of inspection it was clean and comfortably warm. But a visitor noted, and the manager confirmed, that an unusual odour on the ground cannot be traced with any certainty and is still being dealt with. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 12 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 There are sufficient numbers and skill mix of nursing, care and ancillary staff to ensure the care needs of the service users are met. A training programme is place and this provides a comprehensive schedule of induction and ongoing training for all staff. Failings in the recruitment procedure and the inconsistency of staff supervision could compromise service users safety. EVIDENCE: Staffing levels for existing care homes, including those that provide nursing care, must be no less than the guidance issued by the previous regulating body, the Health Authority. There was a qualified Nurses and at least two carers on each of the three floors of the home and in addition there were catering, cleaning, maintenance, activity and administration staff- plus the Registered Manager who is a qualified Nurse. Staff confirmed that they receive induction training but in at least one instance a member of staff had not had under a new police check (but it is to be noted that a recent and satisfactory police check was in place for the previous employer) nor was this member of staff being supervised in accordance with regulations – that is, by a named supervisor until all checks are complete and thereafter six supervision meetings each year. One of the Nurses had English as her second language; the manager must ensure that when recruiting staff they have the linguistic skills to communicate effectively with other staff and service users. Arrangements must be made to ensure new staff complete new police checks and are supervised by a named person pending completion of all recruitment checks and ongoing supervision meeting must be provided at least six times each year. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 13 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 38 This well managed nursing home ensures the health and well being of the service users. No health and safety hazards were identified. EVIDENCE: Inspection reports over a number of years indicate the skill and dedication with which this home is being run. The service users attest to the quality of the services including personal care, catering and comfort of the setting. Money records are in place and an audit of a sample of these records indicate they are well organised protect the service users from financial abuse. However a requirement is made to keep the record of accounts for service up to date in the home itself and not just at the head office. No hazards were identified. Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 14 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 2 x x 3 Barrington Lodge G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 15 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 29 29 Regulation 19(1) 18(2) Requirement Staffing: It required that a new CRB (Police) check is undertaken for each new member of staff. Staffing: All staff new staff must be supervsid by an appointed supervisor in accordance with the amended Regulation 18. Staffing: All nursing and care staff employed in the home must have adequate linguistic skills to communicate with the service users and other staff. Money: If money is held on behalf of service users an up to date account must be held in the home for inspection by CSCI in accordance with Schedule 4:9. Timescale for action 30/8/05 30/7/05 3. 27 18(1)(a) 30/9/05 4. 35 17 30/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 26 Good Practice Recommendations Environment: Is is recommended that the manager uses her best endeavours to eleminate the odour mentioned by visitors. G53-G53 S19022 barrington V226463 160505 stage 0.doc Version 1.30 Page 16 Barrington Lodge Commission for Social Care Inspection CSCI 8th Floor Grosvenor House 125 High Street, Croydon CR0 9XP 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. 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