Inspection on 27/09/06 for Barton House Nursing Home

This inspection was carried out on 27th September 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 Nursing Home 09/02/06

Barton House Nursing Home 09/08/05

Barton House Nursing Home 17/03/05

Barton House Nursing Home 14/09/04

Barton House Nursing Home 09/01/04

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

CARE HOME ADULTS 18-65 Barton House Nursing Home 68 Cemetery Road Cannock Staffordshire WS11 5QH Lead Inspector Mrs Sue Mullin Key Unannounced Inspection 27 September 2006 10:00 Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 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 Nursing Home DS0000022311.V311353.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 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. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barton House Nursing Home Address 68 Cemetery Road Cannock Staffordshire WS11 5QH 01543 504139 F/P 01543 504139 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) Mr John Richard Mansell Mrs Ann Carol Mansell Mrs Jayne Lesley Kelly Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (15) Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 1 - Mental Disorder - for one named person only under Home Office Order Section 37 (41) Mental Health Act 1983 MD Minimum age on admission 18 years of age - 15 beds DE minimum age 50 years on admission - 15 beds DE minimum age 45 years on admission - 5 beds Date of last inspection 9th February 2006 Brief Description of the Service: Barton House is a 15-bedded care home that provides nursing care for younger people with enduring mental illness. The home also provides nursing care for people with dementia related illnesses from the age of 45 years and upwards. The home provides a safe, secure and stimulating environment for the people who live there. There is a welcoming, friendly and homely atmosphere. There are 7 single bedrooms and 4 double bedrooms, there are no en suite facilities but all bedrooms have a washbasin. The home is conveniently located close to Cannock town centre with amenities near by. The proprietors are closely involved with the day to day running of the home and actively promote training for all their staff. Prices range from £468 to £1200.00 per week. Additional charges are levied for personal items. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of one day and determined the core elements from the key inspection’ National Minimum Standards for ‘Younger Adults’. The methodologies used, incorporated assessment of the pre-inspection questionnaire, completed by the care manager prior to the inspection. Standards and scoring for this inspection were determined using the ‘Key lines of regulatory assessment tool (KLORA). The CSCI did not receive any completed comments cards provided for relatives and other health professionals. During the inspection process, records required for registration were scrutinized and discussions were held with staff on duty. The care manager for the home was not rostered on duty on the day of the inspection but had come in to enable the staff nurse to attend an appointment. The care manager stayed and was very helpful throughout the inspection process. A full tour of the home was undertaken. The home was very clean and tidy. One relative visited during the inspection and spoke very positively about the home with the inspector. She was very impressed with the way the staff had put themselves out for her mother. The inspector was able to engage three residents into conversation and generally they were all content with their residency. The overall impression of the care of the residents was good. All were dressed appropriately and attention was obviously paid to personal hygiene requirements. Observations were made of staff and resident interaction, eye contact was maintained and there was a real feel of respect and affection. What the service does well: Prospective residents are fully assessed prior to admission assuring that the home can meet their needs. The residents each have a contract which stipulates the terms and conditions of their residency. Following admission: comprehensive care plans and risk assessments are developed. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 6 The health and personal care needs of the residents are clearly identified and monitored. The residents are enabled to take appropriate risks and are encouraged to discuss any concerns with nominated key staff. The residents (where able) plan their activities together with the staff and individual lifestyles and routines are respected. Complaints and Protection of Vulnerable Adults concerns are addressed appropriately. The residents are protected by safe staff recruitment procedures and supported by a well-trained and supervised staff team. The facilities in the Home are domestic in style and afford the residents with a comfortable, homely environment. The staff were very helpful and constructive throughout the inspection. 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. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 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 Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 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): 1,2,3,5 Quality in this outcome area is “good”. Residents/ relatives are provided with information contained in the Statement of Purpose and the Service Users Guide. Prospective residents are fully assessed prior to admission guaranteeing that the home can meet their needs. EVIDENCE: The homes Statement of Purpose provides up to date information relating to the services and provisions available at the home. Information contained within this document was in compliance to Schedule 1, of the Care Homes Regulations, with the exception of the age of the registered client group. This amendment was currently being altered and will be checked on the next inspection. The homes admission procedure incorporated a thorough pre admission assessment, to establish whether the home would have the capacity to meet the individual’s identified care and social needs. Information derived from the pre admission assessment provided the foundation for the development of a care plan and a risk assessment. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 9 Discussions with the staff confirmed that prospective residents were able to visit the home prior to admission, having the opportunity to view the premises and meet the staff team. Discussions with the care staff identified that there were no residents with any specific cultural or religious needs. Residents would be able to continue to practice their religious faith if they so wished. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9,10 Quality in this outcome area is “good”. Care planning and risk assessment is comprehensive and covers all areas of the residents’ lives. The residents are enabled to take appropriate risks and have opportunity to discuss any on-going concerns with staff. EVIDENCE: Care planning and risk assessment continue to be high priority. Regular reviews are held for each resident, which includes the resident, their relatives, the key worker and the Local Authority. Care plans are reviewed and amended as and when needed. Staff are conscientious in completing detailed assessment of risk and any limitations or restrictions to a resident’s rights are justified within the risk assessment process. Three care plans were randomly selected for examination, information contained was detailed, relating to the specific care, physical and social needs of the individual person, providing information with regards to the degree of support and assistance required to enable the individual to live a fulfilled lifestyle. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 11 The examination of care plans and discussions with the staff confirmed, that the plan of care was reviewed on a monthly basis to reflect the changing needs of the individual person. Records were maintained of all healthcare professional intervention, residents had access to relevant healthcare services for routine health screening. All residents were registered with a General Practitioner. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15,16,17 Quality in this outcome area is “good”. The residents plan their activities together with the staff and individual lifestyles are respected. EVIDENCE: Individual social requirements/needs are developed for each resident. Appropriate levels of care staff are available during the daytime, which meets the various outings and activities. The activity programme is designed to meet individual needs. All residents are encouraged and supported to maintain family and other significant relationships. The residents have locks on their bedroom door and some locks are in the process of being changed. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 13 Menus are devised together with the residents and form a healthy eating plan. Alternatives are available. Special diets are catered for. Most care staff involved in food preparation have received food and hygiene training. Two members of staff are awaiting their course to commence. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is “good”. The health and personal care needs of the residents are clearly identified and monitored. The medication systems in place fully protect resident’s welfare. EVIDENCE: Personal care needs are clearly identified within the care records. Where possible the residents are encouraged to be independent and take responsibility for some of their own personal hygiene requirements. The residents are enabled to have flexible lives and this is planned into their activity plans. The present resident group is a mixed gender and the staff team assist them appropriately. A key worker system is in place. Each resident is registered with a local general practitioner and dentist. The residents receive additional professional support where required. Only qualified nursing staff are involved in medication administration. Medication systems were checked and it was identified that these conform the National Minimum Standards and were in line with NMC requirements. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 15 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): 22,23 Quality in this outcome area is “good”. The procedures within the Home safeguard the residents and staff. EVIDENCE: The care manager stated that all concerns raised, are listened to and acted on appropriately. A complaints register is kept in the home and no complaints were recorded since the last inspection. All the staff have received training in the Protection of Vulnerable Adults and all have free access to the appropriate company policies and procedures. This is introduced to all staff at the beginning of their employment and throughout their induction and NVQ training. Criminal Records Bureau and Protection of Vulnerable Adults checks are undertaken for all staff. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 16 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): 24,28,30 Quality in this outcome area is “good”. The facilities in the Home are domestic in style and afford the residents with a comfortable, homely environment. EVIDENCE: The Home is furnished and managed as a domestic family home. The residents have access to all areas of the house and are included in the day-today running of the home through regular residents meetings. Some residents are more able to contribute to this area than others. Relative’s views are also invited. Communal facilities include a domestic setting of two lounges/dining room kitchen, laundry, bathrooms and toilets. Bedrooms were pleasant and personalised. Two toilets were slightly malodorous but this was currently being investigated by the owners and will be checked on the next inspection. There is a small car parking area and pathways/ramps are provided. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 17 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): 32,33,34,35,36 Quality in this outcome area is “good”. The residents are protected by safe staff recruitment procedures and supported by a well-trained and supervised staff team. EVIDENCE: Over 50 of the current staff team have achieved NVQ 2 or above. This is a real commitment by the management of the home, to ensure that the care delivered to the residents is based on current good practice. 9 care staff hold current first aid certificates. The Home provides a good ratio of care staff on all daytime shifts and at night there are no ‘sleeping’ night staff. All staff on duty are alert and ready to meet individual needs. The recruitment records for two of the most recent staff were checked and are indicative of robust procedures. Criminal Records Bureau and Protection of Vulnerable Adults checks are made for all staff. Two written references were obtained and a medical overview was also sought. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 18 The care manager ensures that all new staff undergoes an induction programme with an experienced member of staff. The two new recruits were undertaking a newly introduced induction programme and this will be checked on the next inspection. Staffing records were examined and identified that all staff had undergone required mandatory and other beneficial training courses including: • • • • • • • • • • • Fire safety/fire drills (night staff are currently receiving 4 drills per year in line with the Fire Authorities recommendations). Basic food hygiene Manual handling Adult abuse Non violent intervention Dialysis Diabetes Palliative care Medication training Continence promotion Falls training The training programmes are commendable and illustrate the homes devotion to residents care. Discussions with the care manager and records inspected, determined that the staff receive regular support and two monthly supervision. These are currently being reviewed to draw together the six monthly appraisal and supervision records. There were sufficient staffing levels to support the resident’s needs and staffing rotas were completed in advance. There is an overlap of half an hour for the oncoming shift. Night staff undertake laundry duties and prepare the residents suppers. Agency staff are used where permanent/bank staff cannot cover. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 19 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): 37,39,42 Quality in this outcome area is “good”. The manager and her staff demonstrate a real commitment to maintaining the good standards in the Home. EVIDENCE: The care manager has recently completed her registered manager award. The pre-inspection questionnaire completed prior to this visit indicated that the Home and Health and Safety equipment are maintained appropriately. A random selection of the Health and Safety records was seen, including fire safety and testing of electrical equipment. There was a positive emphasis focused on providing a robust standard of care and a service that was diverse in meeting the specific needs of the individual resident. Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 20 Two members of care staff informed the inspector that the management team were supportive and that they were provided with the necessary support and training to undertake their respective roles and responsibilities. The care staff were observed throughout the course of the inspection to interact and communicate with the residents in a respectful and professional manner. The home records all accidents and incidences and these were seen on the day of the inspection. Resident’s finances are dealt with in accordance to resident’s wishes. A small safe is used in the office for any pocket monies held on the premises. A receipt is maintained for all expenditures. Key workers are vigilant in identifying any toiletries needed and ensure that any items required are purchased to maintain a good level of personal hygiene. Barton House Nursing Home DS0000022311.V311353.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 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 Standard No Score 1 3 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 22 NO 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. 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. Refer to Standard Good Practice Recommendations Barton House Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Nursing Home DS0000022311.V311353.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!