Inspection on 23/08/06 for Barrowhill Hall

This inspection was carried out on 23rd August 2006.

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

Barrowhill Hall 11/02/08

Barrowhill Hall 15/11/05

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 Key Unannounced Inspection 23 August 2006 10:00 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.V306109.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. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrowhill Hall Address Barrowhill Rocester Near Uttoxeter Staffordshire ST14 5BX 01889 591006 01889 591951 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.V306109.R01.S.doc Version 5.2 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 15th November 2005 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. The current charges were £280 - £360 per week. CSCI reports are available on request within the home. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector and took place over 5 hours. The inspection was carried out under the Care Homes for Older People Standards, the Care Homes Regulations and the National Care Standards Commission (Registration) Regulations 2001. It was a key inspection and, consequently all of the core standards were assessed. The Commission had received the current year’s pre-inspection questionnaire and factual information necessary for this report was obtained from this document. Due to the limited capacity of most residents due to advanced dementia, relatives had completed 9 CSCI questionnaires. The CSCI received a further 13 Comment Cards from relatives, one Comment Cards from a local GP practice and four Comment Cards from Placements Officers and other visiting professionals. Views expressed in the questionnaires were all very positive and some are outlined in this report. Discussions took place with several residents (albeit fairly limited), the care manager, care staff and two domestic staff. The regional manager was also present during some of the inspection. Case tracking of two residents was undertaken which included discussions and checking of their records. Observations were made of staff and resident interaction. The files of two care staff were inspected. A random selection of health and safety records was also examined. A sample tour of the environment was undertaken. What the service does well: The home was well established and had a stable management and staff team who were knowledgeable regarding resident’s needs. Due to the cognitive limitations of residents in the home the inspector took into account those relatives responding to questionnaires supplied by the CSCI. All stated that their loved ones felt secure and safe in the home. They confirmed that the care manager and care staff listened and acted on any issues raised and were committed to ensure all residents received the care and support they needed. The home offered a flexible approach to daily routines. Residents were seen enjoying the food served and they were offered an alternative choice should they not like the food offered on the menu. Relatives also confirmed that they considered their loved ones health needs were addressed and that the care manager and her staff accessed medical assistance promptly when required. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 6 The staff in the home actively seeks out further training, to enhance their skills and continue to strive forward and improve standards throughout the home. The care home was clean and free from unpleasant odour. 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. Barrowhill Hall DS0000004913.V306109.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 Barrowhill Hall DS0000004913.V306109.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 The inspection visit, documentation provided by the manager on the day and discussions with relatives and residents identified that quality in this outcome area was “good”. EVIDENCE: In discussion with Mrs Evans, the care manager, it was established that a full assessment of their physical, mental and social needs, prior to their admission was undertaken for all prospective residents. Reference to the care plan of the most recently admitted resident demonstrated that as well as implementation of long and short term problems, organised reviews had taken place with the social worker, the resident, and relatives, in order to establish how best identified needs could be met, and whether Barrowhill Hall was a home suitable to provide care for those needs. Trial visits were encouraged where residents can meet other residents, staff and become more acquainted with the surroundings and facilities. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 9 The staff confirmed that they were able to meet resident’s needs, and this was supported when talking with residents/relatives about life in the home. The care manager and her staff had a good sound knowledge about the needs of their residents, their lifestyle, and the things each individual liked and disliked. One resident wrote on her comment card ‘ This home is fantastic, my Dad is well looked after, we cannot fault it at all. It is a unique place, unlike any other home, we cannot thank them enough’. Barrowhill Hall DS0000004913.V306109.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area was “good”. The health needs of residents are well met, with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: From information provided at the inspection by care staff and following the inspection of two residents care plans; it was found that the identified needs in respect of health and welfare were well met. The individual plans of care were comprehensive and informative, outlining procedures undertaken and observations made by key workers, who had been allocated to individual residents. Care plans were reviewed monthly. Care practices observed, and the comments of residents/relatives and staff, further evidence that health and personal care needs are being met. All residents receive full NHS entitlements. The care manager confirmed that the home had good working relationships with other visiting professionals. Regular appointments were maintained with chiropodists, dentists, opticians to promote residents health care needs. Two comment cards completed by other professionals stated, ‘The home provides Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 11 excellent specialist care for people with mental health problems. The care manager maintains excellent relations with other professionals and is always available for discussion surrounding residents care’. ‘Barrowhill Hall is an excellent resource for people with mental illnesses especially dementia. I always receive excellent services and liaison and communication is good. The care manager Mrs Nada Evans is the homes main resource’. The care manager and care staff were knowledgeable about each individual’s care needs. An examination was made of the storage facilities for medication on the upper floor. The room was spotless a credit to the care staff. Senior care staff administers medication throughout the residential home. Medication is handled with both competency and safe practice. Senior care staff from the residential unit have received training in medication administration. Stocks and supplies were stored appropriately. Controlled drugs were checked and tallied with the register. The drugs fridge was examined and running at a safe temperature. Records of daily temperatures were maintained. Documents used for recording administration of medication were seen and all found to be in order. The care manager was able to assure the inspector that they received a good service from their local dispensing pharmacy. At all times during the inspection staff were seen to be treating residents with respect and dignity, and this was confirmed by feedback from relatives, who confirmed that staff were sensitive and respectful at all times. Several very positive comments were sent to the CSCI from relatives and a few are outlined below‘We are very lucky to have found Barrowhill Hall, everyone is caring and calm, and this is the best home we have come across’. ‘Barrowhill is a lovely caring home; staff are always pleasant and welcoming. My Mum is happy there’. ‘The home is a very well run home from home, it is lovely and clean and very friendly’. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 12 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): 12,13,1,41,5 Quality in this outcome area was “good”. Relatives expressed satisfaction with their relative’s lifestyles and confirmed that staff treated them with respect. Visitors were made welcome. There was a varied Activities Programme in place. EVIDENCE: The home employed an activity organiser who initiated the daily activities programme. External entertainers visited the home and day trips were organised. From conversations with residents/relatives and details taken from their care plans, there was evidence that they were able to carry out activities in their life that they had become used to. Comment cards returned prior to the inspection all praised the level of care given in the home and satisfaction with the freedom that residents have to live their lives according to their wishes. A hairdresser visited the home regularly. Spiritual needs were met wherever possible and ministers from all faiths were accessed as required. A comment card completed by visitors from St Michaels church, Rocester stated ‘ we are very impressed with the home, we are made very welcome by staff and residents’. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 13 It was apparent that the home endeavoured to meet resident’s daily routine requirements. Residents were observed in the lounges and in places of their choosing. Those who preferred to spend time in their own rooms were accommodated and monitored. Residents were able to receive their visitors in the communal areas of the home or in private. Advocacy services were accessed as and when required. There was a varied rotational menu that took account of individual food preferences. Relatives on resident’s behalf, expressed satisfaction with the quality and quantity of food served. Samples of menus were seen that provided a wholesome and nutritious diet with alternative food choices available. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 14 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): 16,17,18 Quality in this outcome area was “good”. The manager/staff and relatives spoken with, were aware of Complaint and Adult Protection Procedures. EVIDENCE: The home had a comprehensive complaints procedure that was displayed in the main hallway and was, therefore, readily accessible to residents and significant others. Relatives engaged in conversation confirmed that if they had concerns they would feel confident raising these with the manager. The CSCI had received no formal complaints about the home in the last twelve months. The home had a Vulnerable Adults Procedure and staff were advised of this following employment. Staff had received training at induction regarding the Protection of Vulnerable Adults from Abuse and this had been updated. Sensitive and kindly interaction was observed between residents and staff. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26 Quality in this outcome area was “good”. Accommodation was sufficient and maintained to meet individual needs. EVIDENCE: The home was decorated in a traditional manner to reflect its Victorian character. It was clean, comfortable and homely. Part of the inspection included a sample tour of the premise and visiting resident’s bedroom accommodation and communal space. These were all found to be very clean, tidy and very much in keeping with the resident’s preferences and direction. All furnishings provided by the home were of a good standard with good carpeting and comfortable seating in the communal areas. A visual examination was conducted on the grounds and exterior condition of the building. All areas seen were in line with Health and Safety Executive’s regulations. The communal areas of Barrowhill are maintained to a good standard, and overlook spacious rural country views. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 16 The home had sufficient numbers of toilets, bathrooms throughout to meet the needs of the residents. All radiators and pipe works guarded against the incident of accidental burning. Hot water outlets randomly tested in resident’s rooms being regulated to provide a temperature in line with the Health and Safety Executive’s regulations. The home was fitted with aids to daily living to maximise service users independence. The home was clean, fresh, neat and tidy throughout. It was clear that service users lived in a safe, well-maintained environment. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome area is “good”. Robust recruitment procedures were in place. Staff were experienced and received regular training. Staff morale was high resulting in an enthusiastic workforce. EVIDENCE: The registered manager was experienced and qualified having attained the Registered Managers Award. She had managed the home for 3 years. The pre-inspection questionnaire completed by the care manager confirmed that a robust staff team supported her. The level of care staff was considered adequate for the numbers and needs of the present residents, over a twenty-four hour period. Staffing rotas are displayed that evidence these levels. There is a housekeeper employed who oversees the domestic and laundry arrangements throughout he home. Catering staff were sufficient to meet the needs of the residents and staff on a daily basis. The care manager confirmed that mandatory training was up to date. The following training had taken place in the last 12 months: Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 18 Fire Training including drills Moving and Handling Managing & Safe Handling of Medicines Health and Safety Food Hygiene First Aid NVQ levels 2 & 3 in care Policy and Procedure updates The inspector spoke to several disciplines of staff, which lead the inspector to conclude that they had a sufficient level of knowledge and skills, to carry out their duties under the supervision of the care manager and her deputy. There was evidence to confirm that regular staff meetings were taking place at all levels. Recruitment procedures were checked and all found to be in order. Staff have been supplied with a job description and a statement of their terms and conditions of employment. Care staff received two monthly one-to-one supervision and other staff had received annual appraisals. 33 of care staff hold NVQ Level 2 and 3 and 18 members of staff hold a first aid certificate. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 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): 31,32,33,34,35,36,37,38 Quality in this outcome area was “good”. Good working relationships were observed. There was evidence that relatives (where possible) and relative’s views were sought regarding the running of the home. EVIDENCE: An experienced and qualified manager had been in post for several years. There were clear lines of accountability in the home and good leadership, promoted professional relationships throughout. It was apparent that residents/relatives and staff benefited from the open, positive management approach. Regular staff and residents meetings were held. Evidence was seen to confirm that regular supervision was taking place. The following random sample of records was inspected and found to be satisfactory: Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 20 Weekly fire alarm testing Fire equipment testing Fire extinguisher maintenance Emergency Lighting Hot water temperatures Personal and confidential records were securely stored in lockable room and accessible only to those staff with authorisation to see them. Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 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 3 3 3 3 3 3 Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 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. Extracts may not be used or reproduced without the express permission of CSCI Barrowhill Hall DS0000004913.V306109.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!