Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 23/02/09 for Bartlett Close 1

Also see our care home review for Bartlett Close 1 for more information

This inspection was carried out on 23rd February 2009.

CSCI found this care home to be providing an Poor service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bartlett Close 1 Bartlett Close 1 Witney Oxfordshire OX28 6FD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kate Harrison     Date: 2 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Bartlett Close 1 Bartlett Close 1 Witney Oxfordshire OX28 6FD 01993709646 01993709659 donnamfp@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : MacIntyre Care care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. The registered person may provide the following categories of service only: Care home only - (PC) to service users of the following gender: Either Whsoe primary care needs on admission to the home are within the following categories: Learning Disability (LD) Date of last inspection Brief description of the care home 1 Bartlett Close is home to four adults with learning and some physical disabilities close to the centre of Witney, a market town in West Oxfordshire. The home is managed by MacIntyre Care. The building is modern and purpose built to meet the needs of people with physical disabilities. Care is provided by a staff team and the homes manager. Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was an unannounced Key inspection and was conducted by one inspector over one day. It was a thorough look at how well the home is doing, and took into account detailed information provided by the home through the Annual Quality Assurance Assessment (the AQAA) and any other information we received about the service since our last inspection. We asked the views of people living in the home through our survey, and staff members we met during our visit. Due to the nature of the service it is difficult to get accurate reflections from people using the service and we used observation, documents and records about the care provided to help us. We discussed the running of the home with the manager and asked about the barriers to improvement. We saw all communal areas of the home used by the people living there and we saw how the home manages peoples medication. We looked at how the home Care Homes for Adults (18-65 years) Page 5 of 25 is meeting the standards set by the government, and in this report we make judgements about the standards of the service. The date of the last inspection of the home was 31st October 2007. The fees range from GB pounds XXXX to GB pounds XXXXX. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs and aspirations of people looking to move into the home are assessed before they move in. Evidence: No new people have been admitted since our last inspection, when outcomes were judged as good. This was because the needs of the people were properly assessed before they moved into the home. The registered manager confirmed that the homes admission procedures have not changed, and include an assessment of the needs of the individual, several visits by the individual and relatives or supporters to check out the home, and discussions with staff and other people living in the home about the new person moving in. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the increasing care needs of the individuals living in the home have been documented, the home is failing to meet the needs of the individuals to appropriate night time care. Evidence: All the individuals living in the home have difficulty in communicating their needs and preferences, and through experience, the staff team has built up a knowledge of how they like to be treated. The manager has recently started to revise how the care plans are written, to make sure that they properly reflect the individuals preferences. We saw examples showing how some of the individuals preferences are recorded, and noted that they are written in a more person centred way. We noted that the needs of some of the individuals needs were changing, in that care was needed at night, and that these needs were documented by a healthcare professional in June 2008. The healthcare professional believed that if care was provided at night their needs would be met, including the need to preserve their Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: dignity and show respect for the individuals. The home has not provided this care at night, and continues to provide a sleep-in carer only. We noted that the individuals are not able to independently contact the sleeping staff member if they need help at night regarding continence issues or seizures, because of their disabilities, and as a consequence all the individuals are allowed to take unnecessary risks with their health and safety. Their individualised needs due to their particular disabilities are not met at night. We saw completed risk assessments for several health and safety issues, but no risk assessments were completed for the individuals regarding their health and safety risks at night because of their unmet care needs, or for the other individual living in the home. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are limited opportunities for life long learning for the individuals living at the home, and opportunities for some of the individuals to make new relationships are limited. Evidence: Since our last inspection in October 2007 the home has purchased a specially adapted vehicle, and it is used to take the individuals out of the home. Trips out include for shopping, to the library and to have lunch, but most of the activities provided are at the home. One person goes twice a week to a special activity, and another goes at times to a theatre group. The manager is seeking opportunities for the individuals through MacIntyres day centres and hopes to have arrangements in place in the near future. The home supports family and friends involvement and welcomes visitors to the home. Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: We saw a record of recent evening menus and discussed food and mealtimes with the staff members. We noted that the evening meal is cooked by the staff, but the food offered at lunchtime depends regularly on tinned foods. We discussed lunchtimes with staff members and understood that there is no lunch time menu, and staff members said that there was not enough time available to prepare healthy choices more regularly. The AQAA information shows that staff have taken training about healthy lifestyles since our last inspection. This training needs to be used to involve people living in the home to experiment with healthy foods and in developing lunchtime menus, and the knowledge should be applied so that people living in the home are offered a variety of healthy foods to choose from at lunchtime. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have their healthcare needs met but have inadequate support to meet their needs during the night. Evidence: We saw the care plans for two people and noted that the health care needs are recorded in the Health Action Plans. All the individuals are registered with a local general practitioner, and see the dentist and optician as necessary. The homes manager meets regularly with a team of professionals involved with the three individuals, to make sure that their physical and emotional healthcare needs are met. The personal care needs of the individuals are documented and met with care during the time staff are on duty, but are not always met at night as the home does not employ night care staff, apart from one sleep-in staff member. The health and safety risks to the individuals from the absence of care at night are not documented, but may include from evidence seen, risks from falling, from seizures and from reflux. We made a requirement about this issue earlier in the report. No one at the home manages their own medication, and the home has policies in place to help staff manage their medication. We noted that records are kept of all the Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: medication received from and returned to the pharmacy, and of the medication administered to individuals. We saw that one medicine bottle was missing its box with the pharmacists label, and the manager said she would investigate what had happened to it. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can depend on the staff team to understand if they have any concerns, and the home provides training and information for staff to help them keep people from harm. Evidence: None of the people living in the home are able to make complaints, but the care staff team take care to learn the differences in behaviour that can alert them to anxiety in the individuals, and are responsive to any concerns. The home has a complaints procedure in a format more suited to the needs of the individuals, and we noted that it does not mention the necessary timescale for response. The manager said she would address this. We have received no information about complaints made to the home since our last inspection. All the staff team have training in how to protect people from harm, and the home provides staff with information about how to respond to allegations or suspicions of abuse. The home has made two referrals to the safeguarding team since our last inspection to make sure people are properly protected. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes environment is comfortable and homely, but the organisation needs to plan effectively to meet the increasing needs of the people living there . Evidence: The homes environment is comfortable and homely, and is suitable for the needs of the people living there. There is a system in place to address any maintenance issues within the home, but there is no regular arrangement to maintain the garden, and the home needs to address this issue, to make it suitable and safe for the people living in the home. The homes laundry is managed by the domestic washer and dryer, and a recommendation was made at our last inspection about the suitability of the washer for the needs of the home. The laundry arrangements needs to be reviewed as the needs of the people in the home are increasing, and a requirement is made in this report. Care Homes for Adults (18-65 years) Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the organisation takes staff recruitment and training seriously it has not properly met the requirement from our last inspection about reviewing and assessing staffing levels at night, and so is putting the people in the home at risk. Evidence: We checked three staff recruitment files to see if all the necessary information was available. We noted that key information was available, but noted that although identification information was seen at the time of recruitment no record was kept of the documents. The manager said that although the information was on file at the organisations headquarters that she would make sure that it was also available in her staff files. The organisation has a good induction and staff training programme, and two of the homes staff hold the National Vocational Qualification Level 2 in Care. We looked at the staffing needs of the people in the home. At our last inspection in October 2007 we made a requirement that the registered person review and risk assess staffing levels, including at night, and ensure that these were in keeping with peoples needs. The manager said that this requirement had been met, as it related to a time when another individual was living in the home and this issue had been addressed. Although the individuals may be different, we saw evidence about the Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: needs of two individuals from a healthcare professional provided to the organisation in 2008. This showed that people are at risk because of their unmet needs during the night, and these needs have not decreased. We have made a requirement about this earlier in the report. Care Homes for Adults (18-65 years) Page 19 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not always act in the best interests of the people living in the home, and is slow to recognise and provide for the night time needs of the people living there. Evidence: The manager is qualified and experienced and is aware of the need for staff to be available at night to meet the needs of the people living in the home. She has provided this information to the organisation, but the organisaton has not acted to make sure that their needs are met at night. On the day of our visit we asked about the care needs of individuals during the previous night. The manager said she had been on sleep-in duty, and was awake looking after one individual when she heard another individual having a seizure. As she was awake she was able to provide support, but this was accidental. The organisation needs to review how the increasing needs of the people living in the home are impacting on the way the service is provided, and work to make sure the needs of the individuals living in the home are appropriately met. Following our visit the organisation has taken some steps to improve the situation. Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: The manager met with families in early 2008 to carry out a quality assurance exercise, and is planning to carry out another soon with input from healthcare professionals. She has worked closely with Oxfordshire County Council Money Management Scheme, following our last inspection, to make sure that people living in the home or their representatives have up to date information about how much money the scheme is holding on their behalf. Although only one person is now in the scheme, the manager said that sufficient information has not yet been supplied by the scheme to the individual about their account. The organisation has a health and safety department to support the home to meet their responsibilities, and the home has systems in place to keep the home environment safe. A fire risk assessment is in place, and fire training is provided for staff. The organisation carries out monthly monitoring visits about the quality of the service, and we saw from the report for January 2009 that there was no recognition of the health and safety issue arising from the unmet needs of people living in the home. Following our visit the manager confirmed that support was in place temporarily at night to make sure that people living in the home are safe. Care Homes for Adults (18-65 years) Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 33 18.1(a) The registered person is required to ensure that the Home has sufficient staff to meet peoples needs at all times including at night. 26/11/2007 Care Homes for Adults (18-65 years) Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 6 12 That the home make 06/03/2009 arrangements to ensure that all the needs of the people living in the home are met, especially at night, in a manner that respects their privacy and dignity. To keep people safe by making sure that all their personal and healthcare needs are properly and appropriately met at all times. 2 30 13 Review the current laundry arrangements to make sure that the equipment in the home is suitable to manage the homes laundry. So that an effective sluicing facility is provided to deal appropriately with the homes laundry. 30/04/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 23 of 25 No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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!