CARE HOMES FOR OLDER PEOPLE
Barton House 1 Barton Terrace Dawlish Devon EX7 9QH Lead Inspector
Peter Wood Unannounced Inspection 15 February 2006 09:45 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 Barton House DS0000064471.V278212.R01.S.doc Version 5.1 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. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Barton House Address 1 Barton Terrace Dawlish Devon EX7 9QH 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) 01626 864474 Mrs Sally Ann Child Mrs Sally Ann Child Care Home 11 Category(ies) of Dementia (11), Mental disorder, excluding registration, with number learning disability or dementia (11), Old age, of places not falling within any other category (11), Physical disability (11) Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Mrs Child to attain the qualifications required by CSCI within twelve months. 04/10/05 Date of last inspection Brief Description of the Service: Barton House is a care home providing personal care and accommodation for 11 Older People with additional physical and mental problems associated with increasing age. Mr Glen Child and Mrs Sally Child took over the home nine months ago, in May 2005. The home is a grade II listed building situated in a prominent end position of Barton Terrace in Dawlish. It is close to shops, a library, churches, doctor’s surgery, a hospital, pharmacies, communal gardens, public houses, a post office and a railway station. There is easy access into the city of Exeter by a regular bus or train service. The house has three floors plus a large attic. The attic is currently used for storage. The second floor is currently used as the owners’ office, together with accommodation for staff from overseas. The ground floor consists of 5 single bedrooms, 2 lounges and the kitchen. There are 6 single bedrooms on the first floor. Bathrooms and toilets are located on both floors. All the home’s bedrooms are for single occupancy. The home has gardens and patio areas with seating. At the rear of the property the garden and patio has level access from the house. The home provides many varied social activities in and out of the home. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in February 2006. The new owners had taken over the running of the home last May. The previous inspection was specially timed to allow the new owners time to “get their feet under the table” yet not yet “set in concrete”. Care and other records were then examined, in greater depth than might normally be the case. In contrast, the focus of this unannounced inspection was to consult as many residents as possible to ascertain their views of living in the home. All residents were consulted, at lunch, in the lounge or their own rooms. The new owners were not at the home during this inspection though the senior member of the care staff team assisted throughout the inspection. What the service does well: What has improved since the last inspection?
There were no requirements at the last inspection, though some recommendations. Prior to their purchase the new owners had identified areas they would wish to improve upon, and have implemented that programme of change. These include the planned purchase of food which facilitates a menu plan; an extended menu to include exotic dishes; staff restructuring; improvements to the rear garden and patio area; brighter lighting; some redecoration; proper medication cabinet and installation of a Dorgard. All these improvements benefit the residents’ safety and quality of life. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 6 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. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 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 Barton House DS0000064471.V278212.R01.S.doc Version 5.1 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): 1, 3, 4, 5, 6 Good information and systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: The home has an updated Statement of Purpose and Service Users Guide with information on services that are provided by the home. The registered owner / manager and senior carer now usually undertake a pre-assessment prior to a resident’s admission, followed by detailed assessments that generate comprehensive care plans. Visitors are welcome at the home. A friend of one of the residents joined the residents and myself around one large table for lunch. Some residents went into town later to do some shopping and meet old friends. The home does not offer intermediate care. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 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 the following standard(s): 9, 10 Residents are treated with respect and their right to privacy is upheld EVIDENCE: Residents were observed to be, and reported that they were, treated with respect by staff. The home has a competent and experienced staff team whom the service users described as being very kind and caring. Residents are encouraged to do as much for themselves as possible, subject to a satisfactory risk assessment. For example, they can take charge of their own medication. subject to a satisfactory risk assessment. While most residents enjoy eating together, those who prefer to enjoy their meals in the privacy of their rooms are able to do so. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents are able to maintain contact with their family, friends and the local community as they wish, and to exercise as much choice and control over their lives as possible. Some activities are provided. Meals are nutritious and varied, even exotic. EVIDENCE: Many residents lived locally and had some knowledge of each other prior to coming into the home. Such prior knowledge is sometimes re-lived during resident’s conversations and interactions with each other. Most residents retain contact with friends and family in the locality and / or visit local shops, churches, places of entertainment and the like independently. There are, however, various activities organised within and outside of the home. Some musicians visit the home on a regular basis during which the residents enjoy a song-song. Residents were quite vocal regarding the food, which has changed considerably under new management in terms of portion size, freshness, and variety, especially the introduction of more foreign dishes. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 11 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 Complaints and suggestions from residents, relatives or other visitors to the home, are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: Residents at this home are not shy to let their views be known, though any matter with which they are not happy is usually rectified before it reaches the stage of a formal complaint. The home has a good complaints procedure. A detailed and up to date policy on adult protection was available for staff, and indeed the owner / manager trains care staff in other home on abuse issues. Staff have demonstrated they are well aware of issues surrounding adult abuse. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The residents live in a safe, pleasant home that is comfortable and which provides sufficient facilities to meet their needs. EVIDENCE: Barton House is a safe, comfortable home which benefits from a passenger lift, to assist residents with mobility difficulties living on the first floor. It is recommended that the new owners continue their risk assessments of the building, and rectify any remaining hazards to enhance residents health and safety. The home boasts two small lounges allowing residents to choose where or with whom to sit. Resident’s rooms reflect their personality, some of which contain items of their own furniture as well as smaller personal items. All room sizes now meet the revised Standards. There are sufficient toilets and washing facilities. Redecoration and refurbishment throughout the building would benefit resident’s quality of life, is recommended and is programmed. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 13 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 Residents are cared for by motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable residents EVIDENCE: Numbers and competence of staff, by reason of experience and increasingly by training, is good at this home. The home uses a proper application form with a declaration of no convictions, undertakes CRB checks (which now include a check of the POVA list) and undertakes proper references, identity verification, induction and a probationary period. The home provides training in health and safety topics as required, and enables and encourages staff to undertake NVQs. Training is a particular interest of the owners as they also own a training company which specialises in training staff in care homes. Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 14 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 Residents live in a well managed home that is run in their best interests. EVIDENCE: The new owners have demonstrated their ability to operate the home professionally and for the wellbeing of service users. As well as managing this home Mr and Mrs Child continue to operate their care training business. Mrs Child’s background is as a registered nurse and trainer, and has also been a registered manager of two care homes. Mr Child’s background has been in business. The home has continued to hold the Investor in People Award, achieved by the previous owners. Comments from residents were very positive indicating that they were satisfied with the care and services provided by the home. The owners are determined to meet to the best of their ability the needs, wishes and aspirations of the residents in a safe, comfortable and stimulating environment.
Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 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 3 3 3 X X X X X Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 16 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. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that the new owners continue their review of client assessment - care planning implementation documentation so that it becomes a comprehensive system to enhance resident care. It is recommended that the new owners continue their assessment of the decoration and refurbishment needs of the home, and act accordingly, to enhance residents quality of life. It is recommended that the new owners continue their risk assessments of the building, and rectify identified hazards to enhance residents health and safety. 2 OP26 3 OP19 Barton House DS0000064471.V278212.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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