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Inspection on 14/08/06 for Barton Lodge Residential Retirement Care

Also see our care home review for Barton Lodge Residential Retirement Care for more information

This inspection was carried out on 14th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents` independence and choice is promoted within Barton Lodge. Residents are listened to both in having their views sought in questionnaires and through the home`s mapping process, which changes the focus from daily routines to give the residents a better outcome for each day. Residents live in a clean, safe and pleasant environment, where the service is maintained, decorated and furnished to a high standard with well-tended grounds. There is a commitment from the management to improving the standards within the home. A good standard of care is provided by well-trained, supervised and motivated staff team. Barton Lodge has a good staff-training programme. There was evidence that the staff team work well together.

What has improved since the last inspection?

The home`s quality assurance has improved with the use of questionnaires. Views expressed have been implemented, for example, providing terrines at lunchtime for residents to help themselves to the vegetables. Thermostatically controlled valves have been fitted at hot water outlets.

What the care home could do better:

It was discussed having a file for short stay residents with an exit questionnaire. The manager agreed to implement these as a way of improving the service the home offers.

CARE HOMES FOR OLDER PEOPLE Barton Lodge Residential Retirement Care Barton Common Road Barton-on-sea Hampshire BH25 5PR Lead Inspector Mr Rodney Martin Unannounced Inspection 14th August 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 Lodge Residential Retirement Care DS0000012392.V305506.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 Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barton Lodge Residential Retirement Care Address Barton Common Road Barton-on-sea Hampshire BH25 5PR 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) 01425 617111 www.lovingcare-matters.co.uk Manucourt Limited Mrs Pamela Mary Torr Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39), of places Physical disability over 65 years of age (4) Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th October 2005 Brief Description of the Service: Barton Lodge is located in a rural setting on the edge of Barton Common with extensive views over the Solent to the Isle of Wight. It provides residential care for up to thirty-nine elderly residents, four of whom may have a physical disability. The home is over two floors and there are two lifts between these. There are a variety of aids and adaptations to allow residents to move about more independently. The home is in the process of upgrading the home and has converted four single bedrooms into two larger single rooms, with en suite toilet and walk-in shower. Twenty-three of the bedrooms are single and seven are doubles, with some of the bedrooms having their own balcony. Although Barton Lodge is registered for up to thirty-nine residents the management regard the home full with thirty-one service users as six double bedrooms are occupied as single bedrooms. Twenty-four rooms benefit from having en-suite facilities. There are two spacious lounge areas, a television lounge, conservatory and separate dining room. There are large gardens to the front of the property with car parking facilities for several cars to the rear of the property. The current level of fees is £450 to £850 per week. This information was contained in the pre-inspection questionnaire received in the Commission’s office on 17 July 2006. There are additional charges for chiropody, and hairdressing. Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 10.15am and 4.12pm. An opportunity was taken to look around the home, view records and talk to two visitors, several service users and staff members, including the cook, the deputy manager and the registered manager. On the day of the visit twentynine service users were accommodated. Barton Lodge has two vacancies, as the management regard the home full with thirty-one service users as six double bedrooms are occupied as single bedrooms. In line with the Commission’s policy, all the key standards were inspected on this occasion. There were no previous issues identified at the last inspection that required following up. What the service does well: What has improved since the last inspection? The home’s quality assurance has improved with the use of questionnaires. Views expressed have been implemented, for example, providing terrines at lunchtime for residents to help themselves to the vegetables. Thermostatically controlled valves have been fitted at hot water outlets. Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 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 Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 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 Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 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): 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs assessed and are able to visit prior to admission to make an informed choice about whether or not the home is able to meet their particular needs. Barton Lodge does not provide intermediate care. EVIDENCE: Barton Lodge was accommodating twenty-nine residents, with two male and twenty-seven female service users, whose ages range from 82 to 100 years. One resident has been in the home since 1994. Since the last inspection the home applied for a variation to their registration to include the dementia category [DE(E)], to enable them to admit older people, over the age of 65 years, with a diagnosis of dementia. This was approved on 23 May 2006. On the day of the inspection, the home was accommodating eight residents who are in the early stages of dementia. There was evidence that the home is able to meet residents’ needs. Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 9 Since the last inspection, six new residents were admitted. The home has also provided a number of short respite stays. These are dependent on the home having a vacancy. The manager reported that a number of residents had short stay admissions, prior to making a decision to go into residential care permanently. There is a detailed procedure to be followed when greeting and welcoming new residents, which includes ensuring that fresh flowers or a bowl of fruit and a card are placed in the resident’s room. New residents are given a copy of the service users guide, statement of purpose and complaints procedure. The majority of referrals come from Bournemouth Social Services and Hampshire Adult Services [previously known as Social Services]. Following an inquiry a form is completed and a letter and brochure are sent with an invitation to visit the home. Although prospective service users can visit any time an appointment is preferred to ensure that the manager is available. Relatives usually visit first. The manager will visit the prospective service user in their own home or in hospital, to assess their needs. The majority of service users are local residents. Two residents came from north Hampshire, for a short stay holiday. The prospective service user can also spend some time in the home with a complimentary meal to see if Barton Lodge is the type of home they are looking for. The assessment process also enables the home to determine whether they can meet the care needs of any prospective service user. A comprehensive three-page pre-admission assessment is completed on each resident. The assessment detailed the prospective service user’s past medical history, current medication, mobility, activities of daily living, preferred activities, arrangements regarding death and also included the mental health of the individual. The inspector received eight comment cards, prior to the inspection, from relatives and ten from service users. One relative wrote, “We have been delighted with the care our mother is receiving. It is clear that the amount paid is not indicative of the standard of care received”. A resident wrote, “I get spoilt often”. The inspector spoke with several residents who stated that there were no restrictions in the home and that Barton Lodge was a very nice place to live. Barton Lodge does not provide intermediate care, although prospective residents can come for a short respite stay or longer stay, if necessary, if there is a vacancy. Short stay residents are assessed in the same way as permanent residents. Barton Lodge Residential Retirement Care DS0000012392.V305506.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for care planning are good, ensuring that the residents’ physical and emotional health needs are met. Medication practices and procedures ensure that residents are protected. Working practices in the home ensure the promotion of privacy and independence for service users. EVIDENCE: Each resident has an individual file, which contains the personal details of the resident including a photograph of the resident, personal history, various risk assessments, the care plan detailing an assessment including communication, mood, activities of daily living, activities, a scoring system for the resident’s mental state, mobility, nutrition and matrix, various risk assessments and a record of medical appointments, as well as a review of the care plan. The personal and oral hygiene of each service user is maintained and recorded. A record is kept of all health professional visits. Residents are registered with GP practices in Barton-on-Sea, New Milton and Highcliffe and also receive community psychiatric nurse support from the Becton centre. The manager Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 11 reported that there is very good medical support from the surgeries. Residents have a choice of attending surgery or other medical services with staff or family support. The majority of residents go out for dental care. There are domiciliary visits from a chiropodist, optician and hairdresser. Residents have access to all other health professionals on an as needs basis. The home has a relevant medication policy, which satisfactorily details the receipt, recording, storage, handling, administration and disposal of medicines. Residents are able to self medicate within the home’s risk management framework. Currently two residents are fully self-medicating and a further two more residents are partially self-medicating. The home operates a monitored dosage system for administering medication. This is kept locked in a securely attached drugs’ trolley. The home does not currently have any controlled drugs, apart from three residents who have been prescribed Temazepam. The drug administration sheets, which included a photograph of the resident, were found to satisfactorily recorded, with no omissions. The drugs’ trolley was found to be clean, tidy and safe. The home has a refrigerator for keeping certain medication at a cool temperature. The temperature of the refrigerator is recorded on a daily basis to ensure best practice. Relevant staff have received medication training. Staff members supported service users with kindness and sensitivity, using service users’ preferred names and supporting gently with care giving. Staff members knocked on service users’ door before entering. The ten service users’ comment cards received all indicated that their privacy was respected. Residents, spoken to, also confirmed that the home encourages their independence and this was demonstrated in the way they can get up and go to bed when they want to and can join in activities or spend time in their room, if they wish. Barton Lodge Residential Retirement Care DS0000012392.V305506.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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to engage in a variety of appropriate age-related activities in the home. Residents are supported to maintain contact and positive relationships with family and friends. Nutritional needs of residents are well managed and offer variety and choice. EVIDENCE: Barton Lodge operates a system of individual working with residents, called ‘mapping’. At the beginning of each shift in the morning and afternoon, staff sit down and ‘map out’ want they want to achieve with individual residents, via a link carer system [keyworker]. Two residents had indicated on their comment card that they felt the home only provided suitable activities “sometimes”. The inspector spoke at length with two residents who endorsed this by saying there are not the organised trips out that there used to be. Residents did have a trip to Poole, however, the purpose of ‘mapping’ is to tailor-make appropriate activities for each resident. Residents are taken out regularly to the duck pond at New Milton, to the ice cream parlour at Bartonon-Sea and out shopping. The manager reported that all activities per se are not just to occupy residents’ time but a means to provide fulfilment, this includes social and personal activities as well as activities of daily living. Since Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 13 mapping has been introduced residents have become more alert. The home has regular three-monthly residents’ meetings, in the afternoon, with relatives coming the same day, in the evening. All residents have friends or family visiting. Fifteen residents have their own telephone installed. Six residents can go out independently and one resident has a motorised scooter. Residents are encouraged by the staff to make choices in their daily life and these choices include choosing which clothes they will wear and what time they get up and go to bed, this information is contained in the care plans. On the day of the visit the inspector met two relatives and spent some time with them. They were very complimentary about the home, stating that the food was very good, with all home cooking and there was a very relaxed atmosphere in the home. A comment card from a relative stated, “My mother has been at Barton Lodge for some years. The standard of care has improved, the food is much better, the interior has been refurbished and all in all we are very happy with the manager and her team”. Residents are offered a choice for the midday meal. The inspector had lunch with the residents. Lunch was observed to be unhurried, with appropriate assistance being offered where necessary. The main meal and new potatoes were plated but residents could help themselves to a selection of vegetables from terrines on the table [the latter was as a result of the home implementing suggestions from residents in a questionnaire]. Residents had turkey in a white sauce with peppers or veggie burghers, red cabbage and mixed vegetables. Residents had rice pudding with jam for dessert, although alternatives were offered. Three out of the ten comments cards received from service users had recorded that they “sometimes” liked the food. However, residents, spoken to, enjoyed their meal and said that the food was good in Barton Lodge. Residents could choose from a selection of homemade minestrone soup, sandwiches, egg and chips for tea. Care staff were observed to go round and ask what residents wanted. The home is complying with the new food hygiene legislation that came into force on 1 January 2006. Refrigerator and freezer temperatures are recorded daily as well as the temperature of the main meal, to ensure food safety. On the day of the inspection there was a chef and kitchen assistant on duty. The chef had only worked in Barton Lodge for two months and was suitably qualified, having obtain NVQ [national vocational qualification] at levels 1 and 2 in catering and was enthusiastic about his role. The home has six-week menus. Following his appointment the chef had revised the menus, as well as producing a food survey for residents to respond to the questionnaire, with suggestions for meals et cetera. The menus indicated that the meals were varied and well balanced. Barton Lodge has a vacancy for a kitchen assistant. Barton Lodge Residential Retirement Care DS0000012392.V305506.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure, which protects and safeguards residents from abuse. EVIDENCE: The complaints procedure is included in each bedroom and is in the statement of purpose. The procedure includes appropriate timescales. The home has a complaints log and seven complaints were recorded, six relating to one specific resident. These had been satisfactorily dealt with in the relevant timescales. The eight comment cards received prior to the inspection indicated that relatives were aware of whom to complain to should they have a need to raise a complaint or issue. Two relatives had recorded that they had made a complaint but that these were dealt with. Residents, spoken to, were aware of the complaints procedure. Two residents said that they had “niggles” but that they were appropriately dealt with. The Commission has not received any complaints. Barton Lodge has all the relevant documentation relating to adult protection, including a whistle blowing and the adult protection policy. Staff, spoken to, were aware of the issues involved. Staff have received adult protection training and this is also part of the home’s induction core training package. Barton Lodge Residential Retirement Care DS0000012392.V305506.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, 23, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe and pleasant environment, where they have individualised their bedrooms, to meet their needs. The service is maintained, decorated and furnished to a high standard with well-tended grounds. There is a commitment to improving the standards within the home for both residents and staff. EVIDENCE: Barton Lodge is situated in Barton Common Road overlooking a golf course and the Solent, with commanding views of the Isle of Wight and Needles. The home is set in extensive well-tended gardens. A tour of the building was undertaken. Barton Lodge now has twenty-three single bedrooms and seven double bedrooms, although a married couple occupies one double bedroom, as the management have made a decision to use double bedrooms as single bedroom accommodation. Since the last inspection four single bedrooms have been converted into two larger single bedrooms, provided with an en suite toilet and walk-in shower. Currently only four bedrooms are not provided with en suite facilities. Bedrooms are routinely redecorated and new carpet laid Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 16 following vacation by the previous resident. Since the last inspection thermostatically controlled valves have been fitted at hot water outlets. As part of the management’s commitment to improving Barton Lodge the home is currently undergoing internally and external refurbishment. An orangery is being built in the front, which is to be provided with heating and air conditioning. The dining room is being extended with the provision of windows. A television lounge had been turned, temporarily, into a food storeroom as the kitchen, on the day of the visit, was out of action, as part of the dining room extension. A portakabin was erected as a temporary kitchen leading into the temporary storeroom. It is anticipated that the work will be finished by November 2006. Residents, spoken to, were looking forward to the new look dining room. The home has two lounges on the ground floor and a hotel-style reception area where certain residents like to sit and watch the comings and goings. Barton Lodge has a lounge upstairs overlooking the Solent with superb views of the Solent and the Needles. The home also has a courtyard where residents can sit. The manager reported that this is to have a partial cover to enable residents to sit out all year round. A bath and shower room on the ground floor is being converted into a wet room. The home has sufficient baths and communal toilets, for residents use. There was evidence of residents’ personal belongings in the rooms. There were no adverse smells noted. The home has a separate laundry room, which is situated away from food preparation. The home employs a laundry assistant for twenty-five hours a week, to relieve care staff from domestic duties. Barton Lodge Residential Retirement Care DS0000012392.V305506.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members who work in the home are employed in sufficient numbers to care for service users. Clear roles are being defined in the home, matching skills and giving suitable responsibilities to appropriately qualified and experienced staff members. The home has a rigorous recruitment procedure to ensure that staff members working in the home are suitable to work with service users. There is continuous monitoring of training requirements to ensure that staff members are suitably skilled and updated to meet the needs of people living at the home. EVIDENCE: Barton Lodge employs nineteen care staff, including a deputy manager as well as a cook, three kitchen assistants, a housekeeper, a domestic, a laundry assistant, a maintenance person and the registered manager. Since the last inspection the home has recruited four care assistants and a kitchen assistant. The home still requires a second cook. On the day of the inspection there were three carers and a care team manager on duty. The inspector was able to speak to all the care staff. The staff were very positive about their working conditions and enjoyed working in Barton Lodge. One carer summed up the mood of her colleagues by saying, “we get support here”. Staff were aware of the needs of residents with dementia. One Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 18 carer said, “we endeavour to promote their privacy and independence”. A relative had written on the comment card, “the daytime staff have been caring and courteous on all occasions that my wife and I have visited”. Four staff have obtained NVQ [national vocational qualification] at level 3 and a further three carers are awaiting confirmation of the result for level 3. One carer has NVQ level 2 and three staff members have started an NVQ level 2 course. There is a commitment to training within Barton Lodge, with evidence that over 50 of staff will have an NVQ certificate. The majority of staff have worked in Barton Lodge for some time and consequently there is a balance of experience and skills within the staff team. This is also reflected in the care given to service users. The staff file of the latest staff member appointed was seen. This contained the application form, which included a signed declaration under the Rehabilitation of Offenders Declaration, two written references, proof of identity and a copy of the interview questions and answers. The prospective staff member had completed a short written account of why they want to care for the elderly. The induction pack contained a copy of the applicant’s CRB [criminal records bureau], copies of certificates obtained and the home’s terms and conditions of employment. There was evidence of induction training with questions and answers to various video presentations. The home operates a comprehensive training programme for staff, which includes a comprehensive induction programme, fire safety, food safety, manual handling, first aid, health and safety and adult protection. Staff, spoken to, confirmed that they had recently had training on infection control as well as dementia. The home uses the training package from Jackie Poole as a means of a person centre care approach to help increase the staff’s knowledge and skills for working with people with dementia. The home uses an external source for medication awareness training. The staff members, on duty, confirmed that they were supported by the management and enjoyed working in Barton Lodge. Barton Lodge Residential Retirement Care DS0000012392.V305506.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, 31, 33, 34, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides good leadership, which ensures staff are supported and residents’ health, safety and welfare promoted through the home’s practices. EVIDENCE: Pam Torr, registered manager is suitably qualified to run Barton Lodge and has many years of working within various care settings. She has a degree in care home management from Bournemouth University, is an internal assessor for NVQ and comes from a nursing background. She communicates a clear sense of direction and leadership within the home. Barton Lodge has a deputy manager, who has only worked in the home for two weeks. She has various qualifications, including ‘train the trainer’ in manual handling, basic food and first aid. Although the manager has been able to cascade relevant training to the staff, with the appointment of the deputy manager with the necessary Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 20 trainer skills, the long-term plan is for her to take on this important function within the home. There is an open, friendly and transparent atmosphere within the home. The two visitors spoke warmly of staff and the way the home is run. The home is committed to improving the standards within the home for both residents and staff. This was evidenced by the management refurbishing the home and improving the facilities for residents with a larger dining room, the provision of a walk-in shower room, organery et cetera. As a part of the home’s quality assurance programme, questionnaires are used to ascertain residents and relatives’ views. The views are collated and changes put into practice as appropriate. An example of this was the way the lunchtime food is served by providing terrines for residents to help themselves to the vegetables. There are regular monthly visits by the proprietor under Regulation 26 [there is a condition that where the registered provider is not in day to day control there needs to be regular unannounced monthly visits to Barton Lodge, with a report made and to supply a copy of the report to the Commission]. The home is not appointee for any service user. The majority of residents are subject to power of attorney orders with relatives or solicitors as appointed representatives. The home is currently looking after seven residents’ money for incidentals such as hairdressing, chiropody et cetera. For the other residents, additional charges such as hairdressing and chiropody are billed direct to the relative(s) concerned, although the manager reported that the hairdresser and chiropodist does invoice some families directly. A system of supervision is in place, with the three care team managers, supervising the carers. Staff, spoken to, said they benefited from the supervision process, as it was another means of helping them to develop their skills and knowledge within the care setting. The fire log was inspected and the records indicated that the fire safety equipment had been tested and serviced within the guidelines. Staff have received fire safety training and new staff members receive fire induction training. The home had a fire drill on 1 June 2006. Staff, spoken to, were aware of what to do in the event of a fire. The manager ensures the safe working practices by planning courses on health and safety within Barton Lodge, including first aid, adult protection, manual handling, food hygiene, fire and medication. Risk assessments are in place. There are current and up to date contracts on electrical equipment as well as kitchen and domestic appliances et cetera. COSHH [control of substances hazardous to health] policies and procedures are in place. Window restrictors are in place on the windows above ground level, to ensure safety for residents. From a check of the records and practices observed in the home during the Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 21 inspection, the health and safety measures taken in the home ensure the welfare and safety of the residents. Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 22 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 3 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 4 X 3 3 3 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 3 3 3 X 3 Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Barton Lodge Residential Retirement Care DS0000012392.V305506.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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