Inspection on 21/11/06 for Barton House

This inspection was carried out on 21st November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 House 14/12/07

Barton House 15/02/06

Barton House 04/10/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Barton House 1 Barton Terrace Dawlish Devon EX7 9QH Lead Inspector Peter Wood Unannounced Inspection 21 November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 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 Mr Glen Russell Child and 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.V309850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04/10/05 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 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, doctors 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 homes 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. Fees range between £287 and £363. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken over one day in November 2006. The focus of this inspection was to inspect all key standards and to seek the views of residents, staff, relatives and professional visitors to the home, the latter mainly using comment cards and survey forms. At the time of writing this report six staff returned the “Care Workers Survey” form. No “General Practitioners Comments Cards” were returned. No “Health and Social Care Professionals in Contact with the Care Home” returned a form with that title and no “Relatives/ Visitors Comment Card” was returned. Ten survey forms were received from residents, and all residents who were home at the time of the inspection were consulted, as was a visiting relative. Considerable time was spent with the Registered Providers / Manager and the Deputy Manager examining documentation, particularly that relating to client assessment and care planning, staffing and health and safety. A full tour of the building was undertaken, and a Pre-Inspection Questionnaire received. What the service does well: Quality in all seven outcome areas is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Thorough and comprehensive systems for admission allow residents and their relatives to be confident that their needs can be met. Residents’ health, personal and social care needs are met and they are treated respectfully. The home’s practices relating to medication administration protect them from risk. Social activities provide daily interest for the residents. Contact is maintained with friends and families. Residents are encouraged to exercise choice and meals are nutritious and varied. Complaints and suggestions from residents, relatives or other visitors to the home, are treated seriously. Residents are listened to and issues resolved promptly. The residents live in a safe, pleasant home that is comfortable and warm and which provides sufficient facilities to meet their needs, though could benefit from on-going refurbishment and decoration. 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. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 6 Residents live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects residents’ rights, best interests, and wishes What has improved since the last inspection? What they could do better: The home meets virtually all the National Minimum Standards as far as the outcomes are concerned. Prior to purchasing the home the new owners identified many areas of the operation of a care home which they wish to improve upon. These include the fabric of the building, which would benefit from redecoration and some refurbishment throughout. The new owners are currently reviewing client documentation which will hopefully result in a true system of assessment – care planning - implementation documentation. The revised documentation should be more meaningful and helpful for the staff, and ultimately residents should receive care better targeted to their individually assessed needs. Unfortunately, owing to the long illness of one of the owners, who also acts as manager, the planned improvements have been delayed. Now that she is back at work, these areas need attention. The owners now need to implement their “Schedule of Process” listing the priorities to be undertaken each month, together with those that need reviewing every month. The new owners already run a successful care staff training business and have plans to improve NVQ and in-house training and staff supervision. This should better equip staff to undertake their caring task in a more professional manner to the benefit of the residents. Whilst part of the charm of this home is the informal “lived-in” feel, the home could benefit from continued updating of furniture, furnishings and decoration to enhance the residents’ quality of life. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 7 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.V309850.R01.S.doc Version 5.2 Page 8 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.V309850.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Thorough and comprehensive systems for admission allow residents and their relatives to be confident that their needs can be met. EVIDENCE: The registered owner / manager and / or senior carer undertake(s) a preassessment prior to a resident’s admission, followed by quite detailed assessments that generate reasonably comprehensive care plans. Visitors are welcome at the home. Every week the home hosts a luncheon club for a few clients who know the residents very well, and who take their lunch with the residents all together around one large table. These clients can therefore experience life at the home before deciding whether or not to apply for permanent residence. The home does not offer intermediate care. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents’ health, personal and social care needs are met and they are treated respectfully. The home’s practices relating to medication administration protect them from risk. EVIDENCE: Residents have quite good care plans, generated from the assessments of care management staff, supplemented by the manager or her deputy who visit each client prior to admission. These assessments document clients’ personal care needs. The assessment and care planning documentation has been revised and will undergo further revision by the new owners to become more efficient and accurate tools which will help enhance the care given to residents. Appropriate arrangements are in place for meeting the personal and health care needs of the residents. The home has good policies, procedures and practices for the proper administration of medication. The owners have bought a proper medication storage cabinet which enhances the security of medication. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 11 Residents are able to self-medicate on the basis of risk assessment and their own wishes. Risk assessments are also undertaken with respect to moving and handling. Residents were observed to be, and reported that they were, treated with respect by staff. “I have found all staff to be most caring and supportive.” Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Social activities provide daily interest for the residents. Contact is maintained with friends and families. Residents are encouraged to exercise choice and meals are nutritious and varied. EVIDENCE: Prior to their admission, 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. Residents were quite vocal regarding the food provided in the home, which has changed considerably under new management in terms of portion size, freshness, and variety, especially the introduction of more foreign dishes. Most residents were usually complimentary about such changes. “The food it first class”. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 13 Some musicians visit the home on a regular basis during which the residents enjoy a sing-song. “There are various activities taking place at the home.” Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Complaints and suggestions from residents, relatives or other visitors to the home, are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: The home has a complaints policy, process and notice, which includes the contact details of the Regulation Inspector should a resident or visitor to the home have a wish to contact the Commission. There is also a Complaints Book, though nothing is recorded in this, reflecting the informal nature of this home. There have been no complaints. The home follows the good practice promoted in the National Minimum Standards that issues are resolved before they escalate to become complaints. Residents consulted reported that they were listened to and expressed confidence that appropriate action would be taken if they were to make a complaint. The provider / manager and her deputy demonstrated that they knew how to respond appropriately should there be a suggestion of abuse. 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 at this home are therefore well aware of issues surrounding adult abuse. “Staff do listen and carry out any requests.” Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. The residents live in a safe, pleasant home that is comfortable and warm and which provides sufficient facilities to meet their needs, though could benefit from on-going refurbishment and decoration. EVIDENCE: Barton House is an end terraced property close to all local facilities in Dawlish. The home benefits from a passenger lift, which facilitates residents with mobility difficulties living on the first floor. Aids and adaptations as required are provided, though few are necessary for the current residents, and the home does not have a hoist, partly because such a large piece of equipment would be difficult to use in many bedrooms, many of which are quire small, though all now meet the revised Standards. The house is unsuitable for people with major disabilities. The rear patio and garden are popular areas where Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 16 residents can, as they say “chill out or have a smoke”. The home boasts two small lounges, one recently redecorated, 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. There are sufficient toilets and washing facilities. The home is safe, homely, and clean. Most of the outside of the house has been repainted, as has one of the lounges and some bedrooms. However, redecoration and refurbishment throughout the building would benefit resident’s quality of life and is programmed. As one resident put it: ”This house is not the smartest I looked at but is always clean and well maintained, and the staff and owners’ caring and dedicated attitude puts it well above others I looked at. Also the food it first class”. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. 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: The home implements a system of key worker, whose responsibilities include “to get to know your client well, make a connection.., be aware and record any changes on social, emotional, health, religious, or sexual needs of your client“. The home uses a proper application form with a declaration of no convictions, undertakes CRB checks (which includes a check of the POVA list) and undertakes proper references, identity verification, induction and a probationary period. The owners are fastidious as to the staff they employ, and many are not offered contracts at the end of their probationary period which has resulted in considerable staff turnover. Only one or two staff remain from the time before the new owners took over. Of the nine care staff employed, six have left since the last inspection. This is disruptive to residents in the short term, though the owners’ insistence on recruiting only motivated staff will benefit residents in the long term. Training is a particular interest of the owners as they also own a training company which specialises in training staff in care homes. Unfortunately, owing to the long illness of one of the owners, Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 18 who also acts as manager, the planned staff training has been delayed. Now that she is back at work, these areas need attention. In the past twelve months the home has provided training in health and safety topics, such as Fire Safety, Protection of Vulnerable Adults and Medicine Management, though no current staff hold a current First Aid certificate, which needs to be rectified. Future training planned includes First Aid, Manual handling, Food Hygiene and Skin Care. The home enables and encourages staff to undertake NVQ’s. Currently four of the nine care staff have NVQ level 2 or above, which is just short of the 50 target, though both owners (one of whom is a nurse and is “hands-on”) and the deputy manager are undertaking the Registered Manager’s Award. Care staff consulted reported that they were well supported, took a pride in their work, that the clients are well looked after, and that they were appreciated. Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects residents’ rights, best interests, and wishes. EVIDENCE: As well as managing this home Mr and Mrs Child continue to operate their training organisation which specialises in delivering care and associated training mainly to staff in care homes. 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 Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 20 owners. Both owners and the deputy manager are undertaking the Registered Manager’s Award, which indicates their commitment to on-going training for themselves. 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.V309850.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 x x 3 Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation Reg 18 (1) (a) (c) Requirement The registered person shall ensure: that at all times suitably qualified…. persons are working at the care home, and that they receive training appropriate to the work they are to perform; and suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. (This relates to the requirement that a minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) is achieved by 2005). The Registered Person shall make suitable arrangements for the training of staff in first aid. (This relates to there being no care staff with a current first aid certificate). Timescale for action 21/02/07 2. OP38 Reg 13 (4) 21/02/07 Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 23 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 OP3 Good Practice Recommendations It is recommended that the 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. 2. OP19 Barton House DS0000064471.V309850.R01.S.doc Version 5.2 Page 24 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 © 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 House DS0000064471.V309850.R01.S.doc Version 5.2 Page 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. 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