Inspection on 15/11/05 for Barrowhill Hall

This inspection was carried out on 15th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barrowhill Hall 11/02/08

Barrowhill Hall 23/08/06

Barrowhill Hall 21/04/05

Barrowhill Hall 30/09/04

Barrowhill Hall 27/05/04

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

CARE HOMES FOR OLDER PEOPLE Barrowhill Hall Barrowhill Rocester Near Uttoxeter Staffordshire ST14 5BX Lead Inspector Mrs Sue Mullin Announced Inspection 15th November 2005 10:15 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 Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barrowhill Hall Address Barrowhill Rocester Near Uttoxeter Staffordshire ST14 5BX 01889 591006 01889 591512 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) Staffordshire Property Investment Fund Ltd. Nada Ana Evans Care Home 45 Category(ies) of Dementia (45), Dementia - over 65 years of age registration, with number (45), Mental disorder, excluding learning of places disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10), Physical disability (5), Physical disability over 65 years of age (5) Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 10 MD - minimum age 45 years on admission 41 DE - minimum age 45 years on admission 5 PD - minimum age 45 years on admission Date of last inspection Brief Description of the Service: Barrowhill Hall is registered to care for 45 adults and provides both long term and respite personal care. The home, a detached, spacious property, in its own extensive rural grounds, is situated in an elevated position on the outskirts of Rocester, near Uttoxeter. The accommodation for service users is available in two distinct buildings, one known as the main house, which is two storey and served by lift and wide staircase. In this part of the home there is a spacious main lounge with a separate dining area. There is further accommodation known as The Stables and all 13 bedrooms in this part of the home are single occupancy and provide en-suite facilities. There is a separate lounge and dining room with an attractive courtyard area, which provides pleasant seating in the better weather. There are sufficient parking areas and the establishment is surrounded by attractive open countryside and farmland. Staffordshire Property Investment Fund Ltd, who has a number of care establishments nationwide, manages the home Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by one inspector and took place over a 7-hour period. The registered manager and deputy manager assisted throughout the inspection process. 19 questionnaires were retuned to the inspector from a cross section of people including service users, relatives and external professional support staff. In those responses were many praises for the hard working staff and structured activity/spiritual programme. The registered manager and deputy manager of Barrowhill Hall have continued to promote the good quality of care delivered within the home. Staff at the home generate a friendly, professional and consistent approach, this is both comforting for the service users and welcoming for visitors. The home is able to provide a homely and friendly environment. During the inspection several visitors requested to speak to the inspector and were engaged in conversation at length. A partial tour of the home was undertaken and all areas seen were clean, warm and comfortable. Observation of activities took place. Staff were heard offering choice and enabled the service users to make decisions and as many choices as they were able in their daily lives. The home continues to strive for excellence, this is not only demonstrated in practice but also in written format. Care planning and reviews, risk assessments, supervision records, medication administration records, day-today operations and recruitment procedures are all of a robust nature. New care planning systems are in place and the inspector undertook case tracking of two care plans. These were found to be comprehensive and reflected the current condition of each resident. The inspector observed the senior staff administer medication appropriately. All staff spoken to confirmed that they have received the necessary mandatory training and this was documented. No requirements were made at this inspection. However, two good practice recommendations were made and these are outlined below. Give consideration to the installation of devices that will retain the fire doors in the hallways of the main house, in an open position. These must conform to Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 6 the fire authorities regulations and be able to close automatically when the fire alarm sounds. Due to two lengthy power cuts in the home over the last year consideration should be given to facilitate services of an electrical power source, a mobile generator, that the home could utilise, as an important back up in the event of an emergency crisis of a lengthy power cut. Other factors need to be considered such as alternative methods of heating, torches, hot water bottles, and extra blankets/duvets etc. What the service does well: What has improved since the last inspection? What they could do better: Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 7 It was pleasing to note that the needs of the residents lie at the heart of the homes service provision. There are no outstanding requirements and none arose from this inspection. Two good practice recommendations should be considered. 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. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 8 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 Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 9 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): 1,2,3,4,5 (the home do not offer intermediate care) All of the information about the home is clear and concise and is used by prospective residents and their representatives to help them choose a residential home that is right for them. Relatives of residents said they had a full assessment and a trial period to ensure the home could meet their needs. EVIDENCE: Questionnaires received from relatives and visitors spoken to express their continued satisfaction with the home and the commitment of care staff. One of the many positive responses received from a relative was: ‘ I am so pleased to have found somewhere for my loved one that is like home from home, nothing is too much trouble and the care and consideration by everyone is overwhelming.’ Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 10 The homes Statement of Purpose and Service User Guide meet the national minimum requirements. The contracts of residency are compliant with legislation and all relevant information required by the resident, is in place to ensure that they (or their representatives) are aware of their rights and entitlements. On admission, personal care, mobility and medication needs were documented along with mental state, social interests and carer/family involvement; service users relatives/representatives are also included in this procedure. Each resident and their relatives are fully informed prior to admission that the home has the capacity to meet their needs. Evidence was seen to verify that any specialists’ needs were arranged as required. One relative of a resident who has resided at Barrowhill Hall for the last four weeks, stated that ‘the staff in the home have been very supportive to me during this difficult time.’ The relative went on to say that she had looked at several homes but did not feel that they were able to meet her loved ones needs, until she came across Barrowhill Hall Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 11 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 Individual’s personal care needs are met by knowledgeable and well-trained care staff who make sure the resident are comfortable, happy and safe. Medication is well managed and the systems in place safeguard the residents. EVIDENCE: Care plans, daily records, reviews and risk assessments are of a good standard and individualised to evidence ongoing consultation with residents (where they have capacity), families and other healthcare professionals. The health care sections of the care plans evidenced that needs were closely monitored and medical professional help sought where necessary. Suitable recording of body weight, nutritional needs and skin integrity were in place. Staff observed had a knowledgeable and positive attitude towards residents and feedback from relatives was very encouraging. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 12 The systems in place for the administration of medication were examined by the inspector and were of a good standard. The care manager explained that all senior care staff have a sound knowledge and understanding of medicine administration, disposal and ensuring residents were protected at all times. All had received appropriate training in this field. The local pharmacist in Uttoxeter undertakes a regular audit service for the home and provides a written report every three months. The last report was seen in the treatment room on the top level of the home. The treatment room contained a drug fridge, which was operating at the recommended temperature and stored insulin in line with requirements. Controlled drugs were seen and checked against the drug register and found to be all in order. There was no Oxygen stored in the home. Staff in the home were monitoring the one resident who able to self-medicate. This was constantly under review. Risk assessments are carried out on both a personal and environmental basis to reduce potential accidents. The care manager undertakes an individual risk assessment for each resident so that the risk of potential accidents is either removed or reduced. The risk assessment is reviewed on a regular basis, or if circumstances change, and is added to if any hazards present themselves. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Worthwhile activities and stimulation for residents are in place; this provides daily variation and interest for people living in the home. It was obvious from the comments and observations made that the home has a relaxed welcoming atmosphere where people are encouraged to continue with their individualised lifestyle EVIDENCE: The home has a robust activities programme arranged over the week to meet the needs and capabilities of residents. Unfortunately, most of the residents spoken to were unable to make any comments in this regard but relatives engaged in conversation, confirmed that their loved ones enjoyed a variety of leisure pursuits. A number of residents still access the local community, with the help of the staff and the mini bus and are actively encouraged to maintain an enjoyable lifestyle. One regular visitor confirmed that Barrowhill Hall was always striving to meet the social needs of residents, ‘ the general atmosphere is always lively, and everyone is very well catered for.’ Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 14 Visitors comment cards also verified the open and inclusive atmosphere, ‘ We are very happy with all aspects of the home and know that our dear Cousin is well cared for, it makes such a difference to our lives, no worry. Good luck Barrowhill Hall, long may you reign’. As part of the inspection process the provision of lunch was observed and staff provided appropriate sensitive support where required, they were friendly and unobtrusive throughout the meal. A varied menu is available for residents with alternative meals where requested. Drinks and snacks are readily available. All staff working in the kitchen have the appropriate food hygiene training Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 15 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 Measures are in place to protect residents from abuse, including robust recruitment, staff training and a sound knowledge of the appropriate procedures to follow. EVIDENCE: Policies, procedures and training are in place to protect residents from abuse. Staff spoken to were aware of the procedures to follow. Relatives confirmed they were aware of whom to speak with if they had any worries and those spoken with added that they would have no hesitation in doing so. The home operates a safe system of working and ensures that strict recruitment procedures are adhered to Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 16 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): 19,26 The standard of the environment within this home provides residents with an attractive and homely place to live. Infection control measures were in place EVIDENCE: A partial tour of the environment was undertaken during this inspection. The home was clean and all areas inspected were appropriate for the purpose of registration. Equipment was made available to residents dependent on their needs and mobile hoists and bath hoists were serviced 6 monthly as required. It was evident that the disposal of incontinence waste was being dealt with appropriately, reducing risk from cross infection. The home are using footoperated pedal in line with infection control guidelines. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 All staff were found to be competent and suitably trained to carry out their duties. Residents can be assured that they are being cared for by staff who ensure that they reside in a safe environment at all times EVIDENCE: As Barrowhill Hall is a residential care home only, no nursing care is provided in house. Staffing was discussed and it was determined that there is a senior care assistant on duty on each early and late shift on each side of the home. Additionally there are on duty: • • Early shift there are 4 care assistants Late shift there are 4 care assistants Throughout the night on the complex there is one senior care staff and three care assistants. There are currently 41 residents in the building and the above levels of care staff were deemed sufficient for a residential care home. There were sufficient staff to undertake laundry duties and there was adequate domestic cover seven days a week. The cook(s) and kitchen staff cover the catering duties. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 18 The care manager works supernumerary 9 – 5 Monday to Friday and the home employs a part time administrator. It was noted that the care manager would from time to time undertake duties in the home, on care or catering duties when there were un avoidable shortfalls. Discussions with the care manager and care staff alike confirmed that the establishment undertakes a comprehensive induction, so the staff are fully supported and given the confidence to undertake their duties outlined in their job descriptions. The content and procedures for induction training are in line with the national minimum standards. This will be pursued on subsequent inspections. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,38 The management team have a clear development plan and vision for the home, this is effectively communicated to the residents, staff, relatives and significant others EVIDENCE: Both the registered manager and the deputy manger are committed to ensuring that the best quality of care is offered to each individual. Relatives confirmed that their loved ones daily lives were varied and they were empowered to live the life they chose, as far as practicably possible. The health, safety and welfare of staff and residents are protected. The registered manager ensures that all maintenance work, repairs, annual checks, mandatory training, testing of equipment and regular fire drills are undertaken. Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 20 Fire alarm tests are held weekly and emergency lighting is tested monthly in accordance with the fire authorities requirements. The appropriate insurance certificate is in place alongside the homes registration certificate. During the inspection it was noticed that several residents were trying to access the hallway throughout the main building. However, this was proving difficult for some residents, as the fire doors were kept in the closed position, and posed somewhat of a challenge for the confused resident. A recommendation has therefore been made, that the registered person should give consideration to the installation of a device that will retain the fire doors in the hallways of the main house, in an open position. These must conform to the fire authorities regulations and be able to close automatically when the fire alarm is activated. Following a lengthy discussion with a relative, the inspector was informed that there had been a recent power cut to the home that rendered the establishment powerless; in excess of a period of five hours. The emergency lighting system was only operational fully, for a period of between two to three hours. In view of this incident and an earlier one reported to the Commission in January 2005 when the power was cut off for a period of 24 hours, the registered person is recommended to introduce a fail-safe system to the home; particularly throughout the winter period. This may involve the need to facilitate services of an electrical power source, a mobile generator, that the home could utilise, as an important back up in the event of an emergency crisis of a lengthy power cut. Other factors need to be considered such as alternative methods of heating, torches, hot water bottles, and extra blankets/duvets etc. Updating and informing staff of these possible eventualities and projected contingency plans need to put in to place Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X X X X 3 Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 22 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. 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 Refer to Standard 23 (2)(n) Good Practice Recommendations Give consideration to the installation of devices that will retain the fire doors in the hallways of the main house, in an open position. These must conform to the fire authorities regulations and be able to close automatically when the fire alarm sounds. Due to two lengthy power cuts in the home over the last year consideration should be given to facilitate services of an electrical power source, a mobile generator, that the home could utilise, as an important back up in the event of an emergency crisis of a lengthy power cut. Other factors need to be considered such as alternative methods of heating, torches, hot water bottles, and extra blankets/duvets etc. 2 23(2)(p) Barrowhill Hall DS0000004913.V261132.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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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