Inspection on 19/07/05 for Barton Brook

This inspection was carried out on 19th July 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 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

Barton Brook 22/11/07

Barton Brook 10/11/06

Barton Brook 18/01/06

Barton Brook 24/03/05

Barton Brook 22/06/04

Barton Brook 07/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Barton Brook Trafford Road Eccles Manchester M30 0GP Lead Inspector Elizabeth Holt Unannounced 19 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Barton Brook Address Trafford Road Eccles Manchester M30 0GP 0161 787 8437 0161 707 9855 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BUPA Care Homes (CFH Care) Limited No. 2741070 Responsible Individual - Mrs Sue McLean Mrs Judith Rolfe CRH Care home N Care home with nursing 120 Category(ies) of OP Old age 113 registration, with number PD Physical disability 7 of places Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 88 service users requiring nursing care may be accommodated. Up to 30 service users requiring personal care only may be accommodated in Monton House. 1 named individual who requires respite nursing care and is below 65 years of age may be accommodated for up to 2 weeks in any of the nursing units during each period of respite. 5 named individuals who are below 65 years of age may be accommodated in specified areas on Brindley House. When these service users leave, the area will revert to being for the use of service users over 65 years of age. 1 named individual who is below 65 years of age may be accommodated in Moss House. When this service user leaves, the area will revert to being for the use of service users over 65 years of age. Staffing levels as specified in the Notice issued in accordance with Section 25(3) of the Registered Homes Act 1984 on 5th June 1999 shall be maintained for those service users receiving nursing care. Date of last inspection 24 March 2005 Brief Description of the Service: Barton Brook is a care home providing nursing care, personal care and accomodation for up to 120 residents of pensionable age (65 years and over). The home is set in its own grounds in the centre of a residential estate in Eccles, Manchester. The accomodation is provided in four single storey units, each unit housing up to 30 residents. Each unit has access to level garden areas. A number of the bedrooms have personal patios accessed by French windows. The home has all single bedrooms of which none are en-suite. Parking is available to the front of the premises. The home is close to local amenities with the Trafford Centre shopping complex within a two minute drive. The home is readily accessed by local public transport and the motorway network is within close proximity. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted on 19 July 2005. During the course of the inspection time was spent talking to a number of residents, visitors and staff on duty. Examination of records, care plans, medication records, staff files, policies and procedures relating to the home took place The key standards not assessed during this inspection will be assessed during the next inspection. Throughout the inspection the inspectors observed a pleasant atmosphere around the home with conversation taking place between residents, staff and visitors. What the service does well: What has improved since the last inspection? What they could do better: However, these documents did not identify all aspects of residents’ needs and wishes. Several admission assessments were found to be incomplete and risk assessments were found to be in need of reviewing and updating. Requirements have been made in this report that all care plans contain up to date information relating to all aspects of residents needs and wishes. Care plans that contain insufficient or out of date information could result in residents not receiving the care and support they require. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 6 The standard of recording of information relating to individuals needs to improve, for example, care plans were reviewed on a regular basis, however some statements written in the reviews did not link to the plans of care. Another example of poor recording was that of a significant incident that had taken place for one resident, staff had documented only some of the relevant information. The failure to maintain up to date concise notes could result in individual’s not receiving the appropriate care. The home needs to fully identify individual’s recreational needs and wishes and develop a programme as how these needs are going to be met. The management of the home need to ensure that the homes adult protection procedure is easily understood and that all staff receive adult protection awareness training. Only some staff were aware of the procedure. Several bathrooms doors did not fit into their recess, making it impossible for individuals to use the facilities in private. Staff require regular formal supervision to ensure their needs in relation to their role are met. There was documentary evidence on one unit that staff received regular formal supervision. However, supervision sessions were not taking place in other unit within the home. 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. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 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 standard(s) 3, 5 and 6 Prospective residents are admitted after a needs assessment. Relatives and or friends are able to visit the home prior to making the decision to stay. EVIDENCE: Pre admission assessments were present on those residents files examined. Copies were held on the individual files. Referral information was available from Social Services for those residents funded by the authority. Where possible prospective residents, their family or representatives were encouraged to visit the home prior to making a decision about Barton Brook. All new residents are forwarded a copy of the service user guide and a ‘covering’ letter which includes the house name and the room number they will occupy. The home did not provide intermediate care services. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 9. Some progress had been made on improving care plans to ensure the health care needs of residents accommodated are identified and met, however, the shortfalls identified do have a potential to place residents at risk. EVIDENCE: A sample of residents’ care plans were examined. Some were detailed and personalised. It was pleasing to see the level of detail provided in the nursing assessment and care plans for a resident who had only been accommodated for two days. The records for a service user who was admitted for respite care were poorly completed. The nursing assessment on admission was poorly completed. A number of risk assessments were not completed appropriately. An example of this was a resident’s manual handling needs risk assessment which discussed the use of the lap strap for this resident, however at the time of the inspection this resident was being nursed in bed. Risk assessments available included those for falls, nutrition and pressure sore monitoring. The recording for two hospital acquired pressure sores were detailed with evidence of wound mapping and showed regular liaison with the tissue viability nurse. Care plans were reviewed on a regular basis. In some of the houses daily statements/evaluations of some of the care plans were linked to the plans of care however others were not. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 10 Care plans devised and implemented for residents living in Monton House, the residential unit, were examined and found to contain clear, concise information regarding all aspects of individuals’ daily needs. The storage, administration and recording on the medication administration records were accurate. A significant event had not been well recorded in the care plan in relation to the recording and reporting of a potential Vulnerable Adult Investigation. This was discussed with the nurse in charge and the manager during the inspection and follow up action was requested. Residents are at risk of not being fully protected from abuse if the records do not detail the action taken and the channels of communication are not maintained. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Activities provided at the home did not appear to meet the needs of all residents. Meals appeared to be varied, nutritious, healthy and well balanced. EVIDENCE: Care plans showed the home provided spiritual leaders to visit the home and residents could receive Holy Communion as requested. A requirement made at the last inspection was that residents are encouraged and assisted to follow activities of their choice and have these recorded. This had not been addressed. Few care plans demonstrated that residents received recreational stimulation, nor did the inspectors observe any recreational stimulation during their visit. The activities organiser attended the home three times a week. One service user told the inspector that; ”the staff are very kind and polite. We had a barbecue recently. The food is excellent and we always get supper and they always come quickly when I buzz for them.” Records showed that some of resident’s had watched a film the previous day. One activity report for a named service user was held by the activities organiser and one of the unit managers discussed how this made it difficult to then talk with the relatives about activities their relative had undertaken because this information was not Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 12 accessible to the staff. A discussion between the manager and the inspector took place regarding activities records, and that this information is made available to staff and held within the resident’s personal file. Friends and families were encouraged to visit the home. The home’s menus indicated that a varied and wholesome diet was available and alternatives were available as requested. Kitchen cleaning, fridge, freezer and core cooking records were up to date Four residents commented that the meals were good. The lunch was enjoyed by the residents and looked and smelled appetising. The kitchen was clan and tidy. Staff were observed to be courteous and sensitive with residents who required assistance with feeding. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents are aware of the home’s complaints procedure. Safeguards are not adequate to protect service users from abuse. EVIDENCE: The home had a comprehensive complaints procedure that was readily available throughout the home. One incident of a potential allegation of abuse of a service user was discussed in depth with the unit manager. The recordings in the service users plan were poor and the homes Adult Protection procedure was not clear for the staff to follow. It was pleasing to note that training sessions in Adult protection had been booked. Some staff could explain the procedure they would follow in the event of an allegation of abuse. Whistle blowing procedures were available for staff to access and staff who expressed a view stated they felt comfortable to do this. A copy of Salford Social Services joint agency policy on adult abuse was available in the home. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24, 25, and 26. Service Users live in a clean, odour free environment with a satisfactory standard of furnishings and fittings. EVIDENCE: A sample of bedrooms were seen, these were personalised with photographs and mementos. None of the bedroom doors had locks fitted. The majority of the home was found to be clean and free from odours. Two areas of the home were found to be odorous. Communal areas around the home were pleasantly decorated and furnished to meet the needs of the residents. Dining rooms were pleasantly laid for mealtime. Several bathrooms were in need of redecoration. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 15 Several bathroom doors failed to fit in their recesses, making it impossible to shut and lock the door. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Residents’ needs were met by the numbers and skill mix of staff. EVIDENCE: Duty rotas were examined and staffing levels on the day of the inspection met minimum requirements. Residents confirmed that staff were friendly, kind and helpful. The inspector spoke to two staff members working in Monton House. Both staff demonstrated a good knowledge of their role and a thorough awareness of residents needs and wishes. Staff where observed throughout the inspection supporting residents in a positive, supportive manner. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36, 38. The manager is able to fully discharge her duties. The health and welfare of residents are promoted and protected. EVIDENCE: The registered manager was due for retirement the month after the inspection. It was pleasing that plans had been made to transfer an experienced manager from another BUPA care home to manage Barton Brook. Relatives and staff spoken to said they could raise concerns with the manager and they considered these issues to be dealt with appropriately. There was documentary evidence in Monton House that carers received regular supervision sessions with their supervisor and these sessions were recorded. However, formal supervision of staff was not consistent throughout the home. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 18 Copies of BUPA’s policies and procedures, relating to the wellbeing and health and safety of all were readily available. Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x x 2 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x x x x 2 x 3 Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 20 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. Standard 7 Regulation 15 Requirement All care plans and risk assessments must include a detailed assessment and set out in detail all actions that are required to ensure that all aspects of health and personal care needs are met. Recording in the care plans must be in line with NMC guidelines. The plan of care, where possible, with the involvement of the resident in a style accessible to the resident. Once agreed it must be signed by the resident or their representative. Care plans are required to contain detailed records of what care and support has been given to the individual on a daily basis. Adequate levels of social activities must be provided in consultation with the residents accomodated. These must be reflected in the care plans. Timescale for action 28/02/06 2. 12 13 28/02/06 Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 21 3. 18 12(1) 4. 19 23(2) 5. 6. 19 24 23 12(4) 7. 36 18(2) The staff must be aware of the procedures for responding to suspicion or evidence of abuse. The procedures must clearly reflect the Dept of Healths No secrets guidance.Staff must receive training in the action to be taken in the event of an allegation of abuse. The ongoing programme of redecoration must include the bathrooms, which require redecorating. All doors are required to fit into their recess and be fitted with privacy locks. Doors to residents private accomodation must be fitted with locks and keys suited to their capabilities unless their risk assessment suggests otherwise. All staff are reuired to have regular formal supervision. 3/01/06 17/02/06 1/03/06 1/03/06 30/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 22 Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Barton Brook F55 F05 s6695 barton brook v235495 190705 stage 2.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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