CARE HOMES FOR OLDER PEOPLE
Barton Park 15 - 17 Oxford Road Southport Merseyside PR8 2JR Lead Inspector
Mrs Margaret Van Schaick Mrs Claire Lee Unannounced Inspection 11:00 15 March 2006
th 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 Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Barton Park Address 15 - 17 Oxford Road Southport Merseyside PR8 2JR 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) 01704 566964 01704 568454 Choice Classic Limited Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 60 OP Date of last inspection 5th July 2005 Brief Description of the Service: Barton Park is a large and extended detached building situated in a residential area of Birkdale close to Southport sea front. The home is registered to provide nursing care for up to 60 elderly residents. Barton Park has been upgraded to provide a number of Apartments comprising of lounge and kitchen facilities. The remaining bedrooms are all single. There are shared day areas on the ground floor and the home benefits from gardens to the front and rear. Choice Classic Ltd owns the home and the Responsible Person is Mr David Barton .The home is without a registered manager at present. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day and lasted approximately 4 hours. This was the second unannounced inspection carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. Two inspectors visited the home for the process of inspection. As part of the inspection process many areas of the home were viewed including residents bedrooms. Care records and other nursing home records were inspected also. Discussion took place with the nurse in charge, administrative staff, and general manager and care staff. One to one interviews took place with three staff. Several residents were also spoken with. Four residents were interviewed on a one to one basis and their views obtained of how the home was run and the care provided. The home had a very pleasant atmosphere. One resident stated, “the standards are very high, it’s an extension of my home, because it’s the standard I’m used to”. What the service does well: What has improved since the last inspection?
Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 6 All care plans viewed identified individual resident care needs. Relatives and resident signatures are evident to agree the care management. At the time of this inspection there were no residents with mental health care needs. Risk assessments are completed for residents who self medicate. Four staff files evidenced POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) checks. A structured programme of activities is now in place. A recent quiz proved very popular with the residents. Manual handling assessments are in place with detailed support identified. 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 Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP1 The information about the home needs to be developed further to meet the standard. EVIDENCE: Following a requirement from the last inspection inspectors were advised that a more detailed Statement of Purpose and Service User Guide had been forwarded to the Commission. Whilst both documents give a clear overview, there are minor shortfalls evident and therefore these shortfalls need to be added to the documents to fully meet the standard. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP7, 9 Care plans evidence detailed information with monthly reviews of care completed. This ensures that care needs are met. Medication is administered in accordance with the homes policy and records viewed were accurate. This ensures residents are protected and receive medicines safely. EVIDENCE: The inspectors viewed three care plans. Care needs have been identified and the planned care has been agreed and signed in the care plans checked. One by a resident’s daughter and two others by the residents themselves. Care plans include information with regard to personal hygiene, mobility, wound care, diet, pressure area care and social contact with relatives. Risk assessments were completed where needed with regard to self-medication and nutritional needs. The nurse in charge advised the inspectors that at present none of the residents living in the home have mental health care needs. Medications have been reviewed this year. Self-medication assessment forms are in place with dates and signatures of GP’s and RN’s (registered nurse) Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 10 Storage of medications shows good housekeeping and stock control. Aberdeens (medication sheets) clearly identify all medication prescribed and registered nurse signatures are evident throughout. Monthly and other medications received into the home have evidence of the RN’s signatures with dates and amounts logged on receipt of medication into the home. An external company (White Rose) are contracted with the home to arrange disposal of medication. The home has been using separate sheets for returns but a new hardback book viewed will be in use shortly. A Disposal kit is available for controlled medication disposal. A list of staff signatures and initials are in place. Photos of residents are attached to the Aberdeens. Temazepam records were checked and found to be correct. These are monitored daily by the nurse in charge. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP13, 14 The home welcomes relatives and visitors with no restrictions set. The routine in the home is based around the residents’ wishes and how they wish to spend their day. EVIDENCE: The home has an open visiting policy. Friends of the residents living in the home were observed to be visiting during the inspection. One of the visitors spoken with during the inspection stated, “I have visited this home previously and now again as I have another friend who is here, if I had to come into a home, I would choose here, the décor is lovely and there are no smells. I think it is lovely. The staff bring trays of tea and the staff are lovely”. Residents have relatives who visit on a regular basis. One other resident stated, “I have lots of visitors”. Visiting clergy and other church members are welcome in the home at any time. The routine is flexible. Meals are served in the dining room or bedrooms where wished. One resident stated, “I go downstairs for my main meal and have breakfast, tea and supper in my own room”. Through discussion with residents it is apparent that getting up and time of retiring at night is flexible. Residents are able to spend their time where they wish. One resident commented, “I like to spend time on my own and staff respect this”.
Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 12 Care files are available for residents to read if wished. A more formal programme of activities is being set up. Residents commented on how much they enjoyed the recent quiz. A hairdressing salon is also available. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a complaint procedure, which is made available for residents and their relatives. Policies and procedures are in place for the protection of vulnerable adults. EVIDENCE: The complaints procedure is displayed in the home and residents interviewed were aware of the procedure and who to speak with should they have any concerns. The home is currently investigating a complaint. A copy of the investigation and outcome should be sent to the Commission on completion. The home has a complaint log, which was viewed during the inspection process. The complaint log should evidence the staff signature that has entered the details of the complaint. The home has received the new Sefton Adult Protection Procedure in the post and has confirmed their receipt of the copy. The nurse in charge has attended the (POVA) Protection of Vulnerable Adults training locally. This is also included during staff induction. The home is responsible for three residents monies. Records were viewed. Residents interviewed stated, “staff are respectful in their address, no familiarity, just affection and kindness”. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed during this inspection. EVIDENCE: Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 15 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 The staffing rota needs to evidence all staff working in the home. Staff are employed following the necessary recruitment checks. The staff receive an ongoing training programme to equip them with the knowledge to care for the residents. EVIDENCE: The staffing rota for the week prior to the inspection and for the week of the inspection was viewed. The proposed Manager was not evidenced on the inspection week’s rota. All staff employed at the home need to be entered on the weekly rota with holidays and sick leave identified where needed. Residents confirmed that staffing levels were satisfactory in the home. One resident stated, “there are sufficient staff, no shortage of staff”. Two care staff have completed Level 2 in NVQ and four care staff are awaiting accreditation at Level 3. An ongoing programme of NVQ training continues. Four staff files were viewed and all CRB (Criminal Record Bureau) and POVA checks are in place. References are on file for all staff and all new staff received an induction. It is recommended that the starting date of all staff should be kept on file as some were missing form the files checked. The homes administrator did confirm that staff starting dates are kept on record in the office files. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 16 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 The home must appoint a proposed manager who will need to apply to the Commission for registration purposes. Quality assurance measures are in place to ensure the home is run in the best interests of the residents. Records are kept of all financial transactions, which ensure residents financial interests are safeguarded. EVIDENCE: The home currently does not have a registered manager. An application pack for the position of registered manager has been sent to the home for the proposed manager to complete. This needs to be completed as soon as possible to commence the registration process. The Investors in People (IIP) award has been achieved in March 2004. Satisfaction cards for residents and relatives have not been given out recently and this is therefore recommended as part of the homes quality assurance
Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 17 process. The inspectors were shown the Commissions comment cards completed following the last inspection. Responses viewed were complimentary. Polices and procedures were reviewed July 2005. Financial records were viewed and evidence regular entries with regard to hairdressing, newspapers and chiropody. There is evidence of the resident’s signature on receipt of the personal allowance. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 18 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 2 X x X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X X Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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. 3. Standard OP27 Regulation 18 Requirement The registered provider must ensure all staff employed at the home are identified on the weekly rota. The registered provider must appoint a proposed manager who will then be required to apply to the Commission for the post of registered Manager. Timescale for action 10/06/06 4. OP31 8 10/06/06 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. 2. Refer to Standard OP29 OP33 Good Practice Recommendations The inspector recommends that the starting date of all staff should be kept on file as some were missing form the files checked. The inspector recommends that satisfaction comment cards be given to residents and relatives to access their views on the home. Barton Park DS0000017225.V286399.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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