Inspection on 06/10/05 for Bartlett Close 1

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bartlett Close 1 23/02/09

Bartlett Close 1 31/10/07

Bartlett Close 1 09/01/07

Bartlett Close 1 25/07/06

Bartlett Close 1 21/07/05

Bartlett Close 1 21/02/05

Bartlett Close 1 13/05/04

Bartlett Close 1 09/03/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 1 Bartlett Close Witney Oxfordshire OX28 6FD Lead Inspector Christopher Hastings Unannounced Inspection 6th October 2005 09:00 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 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 1 Bartlett Close DS0000013063.V256255.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 Adults 18-65. 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. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Bartlett Close Address Witney Oxfordshire OX28 6FD 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) 01993 709646 01993 709659 MacIntyre Care Pauline Buckingham Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: 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. The building is modern and purpose built to meet the needs of people with physical disabilities. Care is provided by a staff team, which aims to enable the service users to lead active lives and pursue their own interests in and out of the home. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection. This means that the home had no prior notice of the inspector’s visit. The inspector arrived in the home at 9am and left the home at 12 noon. During this time the inspector met and spoke with all four service users and the two staff on duty, observed staff as they carried out their work, and looked at some written records and documentation. This was the second unannounced inspection at Bartlett Close this year, and the inspector looked at the standards that have been identified by the commission as needing to be inspected during the inspection year and were not inspected at the previous inspection in July 05. Therefore, to gain a full picture of the service this report should be read in conjunction with the previous report dated 21st July 2005. Service users and staff made the inspector welcome and helped in the inspection process and the inspector thanks them for their cooperation and making him feel so welcome. Overall the inspector found the home to be providing a high level of care in a homely and relaxed environment. There were good relationships between the service users and staff on duty, with staff being responsive to service users’ needs in a respectful manner. Some issues were identified that need to be addressed by the home, but the overall impression that the inspector gained was that the service users in their home were being well supported by staff who treated them with respect. What the service does well: Service users’ choices are acted upon by staff. Staff give service users time to communicate. Service users are respected by staff. The home has a very homely atmosphere. There are generally good systems in place for the management of medication. Health needs of service users are generally met. Staff have good relationships with service users. Staff are generally well trained so they have the skills to do the job. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 6 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. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. There is an ongoing system for the updating of assessments of service users. EVIDENCE: All four service users have lived at Bartlett Close for a number of years and no new individuals have been admitted. The inspector could therefore not look at any new assessments. However, a staff member told the inspector that if a new service user were to be admitted that he/she would have a full assessment. Each service user has an annual review to which families and care managers are invited, and any new needs that are identified can be discussed and any action agreed. Care plans were seen to be updated on a monthly basis when these were inspected in July 2005. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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. Standards 6, 8 and 9 were inspected in July 05. Staff assist service users in making decisions and act upon the choices that are made. EVIDENCE: The individual personal plans for service users were inspected in July 2005, and were found to reflect the way that each person wanted or needed to lead his or her own life. During this inspection, staff were observed to seek the views of the service users and respect the choices that they made. This was seen in relation to drinks and what service users wanted to do. One service user was asked if he would like to help with a housekeeping task and said that he would. He then wanted to do something else first and this was respected by the staff member concerned. Staff were able to communicate with each service user in an individual manner based upon their knowledge and relationship with each service user. During the inspection one service user went to an activity that was taking place outside of the home. Another service user had recently returned from a holiday, and another service user was going on holiday the day following the inspection. Staff, guided by appropriate procedures, assist service users with their money. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All of the core standards were assessed during the inspection in July 2005. The comments made in this section relate to observations made and not to a full assessment. Records in relation to meals given to service users need to be recorded. EVIDENCE: During this inspection, the inspector noted that the choices made by residents in relation to their lunchtime meals had not been recorded for the two days prior to the visit. This needs to be recorded so if there are any dietary issues clear information can be given to the appropriate professional. One service user when asked a question about breakfast replied ‘was very nice’. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Staff work in a way that provides personal care to meet the needs of service users and respects the choices that they make. The physical and emotional needs of service users are met. The home generally has good systems in relation to medication although the inspector identified some areas that need to be improved. EVIDENCE: During the inspection staff were observed to provide support in a discrete and respectful way that also recognised individual choices. It was evident that each service user had belongings and behaviours that were important to them, and these were respected and recognised by the staff on duty. Service users had aids to assist them with their daily lives. One service user told the inspector ‘I have it very good’. The service users at the home have variable levels of healthcare needs. These were being supported and met by staff. Each service user is registered with the local GP and dental practice. A chiropodist visits to home. Prior to the inspection one of the GPs responded in a comment card sent out by the commission that the home communicates clearly with him, that medication is 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 12 appropriately managed, that staff have a clear understanding of the care needs of service users and that he was satisfied with the overall care provided to service users in the home. During the inspection, medication was found to be appropriately stored and well organised. Records in relation to the review and administration of medication and return of unused medication to the pharmacy were satisfactory. All service users are supported with their medication by staff. Three areas were identified that need to be improved. The first relates to the disposal of medication. On the morning of the inspection, the record recorded that a tablet was dropped on the floor and disposed of. In discussion with the staff member concerned the inspector was told that the tablet had been wrapped and put in the rubbish. This is contrary to good practice and to Macintyre’s own medication procedure. MacIntyre’s procedure states: ‘Remember never dispose of medication in the home, by putting it in the rubbish or down the toilet. Always return unused medication to the pharmacy and keep records of what was returned’. At the back of the individual service user’s file that contained his medication administration sheet, was a record entitled ‘Medication not given, wasted or refused’. The member of staff on duty was not aware of this sheet and had not recorded the dropped tablet on this record. He did so, when the inspector brought it to his attention. The manager must ensure that all staff receive appropriate training, and follow MacIntyre’s policies and the home’s systems and procedures in relation to medication. On the evening prior to the inspection the records showed that one resident who was prescribed ‘as required’ medication that could be given up to four times a day, had been given twice the prescribed dosage at one time. Although no other doses were given, the inspector is concerned that the prescribed dose had been doubled. This issue needs to be investigated and clarified by the manager of the home. Following the inspection, the manager clarified that a GP had been consulted on the dosage and this was recorded on the service user’s file. However, staff on duty during the inspection were not aware of this record. During the inspection the inspector found some items in the first aid box and some homely remedies that were passed their use by date. These were then removed by a member of staff in duty. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Standard 22 was assessed at the inspection in July 2005. The home has appropriate systems in place to protect service users but staff need to be aware of local guidance. EVIDENCE: At the inspection in July 2005, a requirement was made that the home’s complaints procedure be updated by 30 September 05 to include the name, address and telephone number of the commission. A copy of the complaint’s procedure was not easily available during this inspection, and the manager needs to supply a copy of the updated procedure to the commission so a judgement can be made if the requirement has been met. One of the staff members on duty explained to the inspector that all staff had to complete induction training which included guidance on adult protection. Although a copy of Oxfordshire’s Multi-Agency codes of practice for the protection of vulnerable adults was available in the staff office, one staff member on duty was not aware of these codes. The manager needs to ensure that staff are aware of the local guidance that relates to a home in Oxfordshire. A risk assessment in relation to service users monies was seen and this had been reviewed on 1 August 05. The inspection of recruitment records in July 05 indicated that staff are recruited appropriately with the required checks being undertaken to protect service users. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All of the core standards were inspected in July 05. The comments made in this section relate to observations made and not to a full assessment of the environment. The home is comfortable, clean but some maintenance issues need to be addressed. EVIDENCE: During the July 05 inspection the inspector raised concerns about the carpeting in the hall being held together by duck tape. The inspector was told that this was about to be replaced. At this inspection the duck tape was still in evidence and the carpet had not been replaced. In the kitchen a number of tiles above the cooker were missing, as were tiles in the downstairs toilet. The carpet in the hall and missing tiles, in the inspector’s view, detracted from what otherwise was a pleasant and well maintained environment. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were assessed in the July 05 inspection. EVIDENCE: - 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Service users are confident to express their views and these are valued by the staff. Generally the health and safety of service users is promoted, although some practice needs to improve. EVIDENCE: The service users at Bartlett Close have different ways of communicating their choices and emotions with staff. One service user was very happy during the inspection, and spent his time walking around the house laughing and giggling. When he needed staff he came to them and his needs were then appropriately met by staff. Staff were observed to recognise these signs as well as verbal communications. Staff gave time to the service users to respond and did not rush them. The inspector did not ask for the annual development plan for the home and is therefore unable to comment on its content. The inspector was told that families and other professionals come to service user’s annual review meetings and give feedback to the home. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 17 Staff have been trained in fire awareness, First aid, food hygiene and manual handling. The systems for health and safety in the home are generally good. Risk assessments in relation to various activities were seen to be in place and to have been reviewed. Systems are in place to test the fire system, and one of the service user’s agreed to assist a member of staff with the testing of the system during the inspection. The manager has informed the commission that checks of the gas installation and electrical wiring have both occurred this year. During the inspection, the inspector observed that the cupboard under the sink in the kitchen and in the laundry were both left unlocked. Both cupboards contained substances that could put service users at risk. One member of staff told the inspector that they should be locked, but practice in this area needs to be consistent and improved. One of the ways that service users’ health and safety is promoted is by having sufficient staff on duty with the ability to summon additional support as required. At the inspection there were two staff on duty. The inspector was informed that usually there would be three staff. The staff member tested the on call system and it worked correctly. During the inspection three service users remained with one staff member in the home, while the second member of staff took someone to an activity. In the risk assessments file in the home the inspector found guidance on lone working. This guidance was useful. In the guidance it stated that each staff member will have a card which contains a list of emergency contact numbers. This seemed to the inspector to be a good system. However, the staff member on duty did not have such a card. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Bartlett Close Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 X DS0000013063.V256255.R01.S.doc Version 5.0 Page 19 Yes 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 YA17 YA20 Regulation 17(2) 13(2) Requirement The manager must ensure that records are kept of all meals served to service users. The manager must ensure that staff receive training and work in accordance with the correct systems for disposal of medication, the keeping of medication records and ensure that any out of date items are appropriately disposed of. It is required that MacIntyre update its complaints procedure and include in it the name, address and telephone number of the Commission. (Outstanding requirement – previous timescale of 30.09.05 not met) Timescale for action 06/10/05 30/11/05 3 YA22 22 30/11/05 4 YA23 13(6) 5 YA24 23(2)b The manager must supply a copy of the updated complaint’s procedure to the Commission The manager must ensure that 01/01/06 staff are aware of the local guidance in relation to protecting vulnerable adults from abuse. The manager must provide 30/11/05 details to the commission including dates as to when the DS0000013063.V256255.R01.S.doc Version 5.0 Page 20 1 Bartlett Close carpet in the hall and the missing tiles in the kitchen and bathroom are going to be replaced. 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 YA23 Good Practice Recommendations The manager should insure that staff have a copy of the card detailing emergency contact numbers as detailed in the home’s guidance on lone working. 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 1 Bartlett Close DS0000013063.V256255.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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