Inspection on 05/07/05 for Barton Park

This inspection was carried out on 5th July 2005.

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 Park 23/05/06

Barton Park 15/03/06

Barton Park 01/03/05

Barton Park 17/08/04

Barton Park 31/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Barton Park 15-17 Oxford Road Southport Merseyside PR8 2JR Lead Inspector Mike Perry Unannounced 05/07/2005 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 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 F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Barton Park Address 15-17 Oxford Road Southport Merseyside PR8 2JR 01704 566964 01704 568454 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Choice Classic Limited Mr Gary Stuart Partington Care Home 60 Category(ies) of Older Persons - 60 registration, with number of places Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 60 oplder people Date of last inspection 7.4.05 Brief Description of the Service: Barton Park is a large and extended detached building situated in a residential area of Birkdale cose 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 individual living units 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. The home is owned by Chioce Classic Ltd and the Responsible Person is Mr David Barton Naidoo. The Registered Manager is Gary Partington who is a Registered General Nurse. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day [7 hours in total]. It was an unannounced visit and was carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. The home has undergone a number of additional inspection visits over the past 6 months in order to monitor care standards following a complaint received by CSCI in November 2004. The additional inspection visits have highlighted the need to improve on how the home assesses and plans the care for residents as well as meeting the needs of some of the more vulnerable and dependant residents. For this inspection a partial tour of the home was conducted. Care records and other nursing home records were inspected. The manager, 1 trained member of the nursing team, administration staff and two care/ ancillary staff were spoken to. 9 Residents were also spoken with and their views obtained. What the service does well: Barton Park provides a high standard of attention to environmental issues such as décor and furnishings and this contributes to the quality of life for many of the residents who feel positive about living in such surroundings. Those living in the more independent living units or apartments were pleased that they were able to maintain their independence for as long as possible but were reassured that nursing staff were available if needed. Residents spoke of the way that they are treated by the staff who were described as courteous and respectful of their privacy. The staffing in the home is consistent with no use of agency cover. Residents felt that staff were concerned about them and were also described as helpful. Staff receive training in order to carry out their role and the manager carries out supervision and appraisal so that they feel supported. Many residents felt able to come and go as they pleased in the home and were able to join in some of the activities provided as they chose. The standard of meals in the home were universally acknowledged to be high and this was well appreciated by residents spoken to. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The information guides given to prospective residents which describe the homes philosophy and facilities needs to include more detail in order to meet standards. The additions needed are detailed in the body of the report. The assessment and planning of care for residents has generally improved but the inspection highlighted the need to pay careful attention to those residents who may have existing mental health needs or are displaying new or current needs. These care needs must be addressed and included in the plans of care. The home encourages residents to self medicate if possible but this must be within a framework that assesses the risk and monitors self-medication through the care plan. The plan of care is a document that should be drawn up in partnership with the resident and although it is apparent that residents are now more included in the care assessments those spoken to still did not have a grasp of the meaning of this document or said that they had seen one. Recommendations are made in the report. The more dependant residents in the home such a those with some confusion or frailty receive good personal care but do spend a lot of time without stimulation or activity. For example on the day of the inspection there were no planned activities for these residents and staff contact was observed to be limited to carrying out personal care tasks. Recommendations are made to try and target activities for this group. One of the new staff members has commenced work without being cleared in terms of the required check that must be made by home to ensure that staff are fit and safe. A requirement is made that all staff must not commence work without a clear check being available from the Protection Of Vulnerable Adults register [POVA]. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 7 The manager carries out assessments on all residents for the purpose of moving and handling especially for those who need assistance with mobility. The assessments are not complete however in that they do not detail what the staff need to do in terms of the tasks needed such as walking or transferring from a bed to a commode. 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 F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 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 standard(s) 1,3 The information about the home needs to be developed further with more detail so that prospective residents can be further enabled to make an informed choice about where to live. The assessments carried out by the home are good and help ensure that the home can meet the needs of residents admitted. EVIDENCE: A copy of the ‘Statement of Purpose’ and the ‘service user guide’ was seen and a copy taken. Both are easy to read although rather brief. The philosophy of care in the home is described very well but there are areas that need to be developed further to meet the standards laid down in the regulations and standards. For example there is no information on disability access and equipment [home now has new ramped access], details of the Registered person or the manager or staff qualifications. Other information such as the complaints procedure is not clear [the address and contact of the Commission needs to be included]. Reference to the day space available and bathroom facilities is also needed. The assessment of residents both prior to and following admission has improved since previous inspections. Two new residents care files were seen Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 10 and the preadmission assessments were more detailed so that it was more clear how the home could meet the needs of these individuals. One resident spoken to felt that the admission to the home had been smooth and comfortable although the resident had previous knowledge of the home as a relative was already being cared for. Another resident stated that a family member had chosen the room for her and that she was very pleased with all the arrangements. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7,8,9,10, Health and personal care needs of residents are planned for and met. Some of the more challenging behaviours and needs of residents who may experience mental health needs are not routinely met and these need to be addressed so that residents are not isolated and left without support. The home encourages residents who wish to self medicate but his must be managed with reference to risk assessment and care planning so that residents are better protected. The attention paid to aspects of privacy and dignity is well managed ensuring that residents feel comfortable and respected. EVIDENCE: All residents in the home have a plan of care. The manager has developed the organisation of this over the past 6 months so that more of the nursing staff are now involved in writing of the care plans. The care plans seen gave very good descriptions of the personal care needed by residents and how this was to be carried out. Care plans are drawn up from the assessments completed. Not all care needs were included on care plans seen. For example one resident assessed as having behavioural and emotional problems and whose daily care notes describe occasional episodes of agitation did not have any of this addressed on the care plan. Another resident interviewed who has a history of Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 12 mental health problems was clearly concerned over a number of issues that needed further assessment and prioritizing in the care plan. Residents spoken to felt that they were included in the care in general terms in as much as they could all relate to their key worker and felt this was helpful. Also the care files display some evidence that residents are involved including input to social assessments and risk assessments in some instances. A ‘summery care plan sheet’ is also signed by residents and in some cases the relative. However, when spoken to some of the residents had no knowledge of a care plan and the care plan itself does not display any evidence of the residents input. Perhaps residents having a copy of the care plan or signing the actual care plan so that it is clear that it has been discussed with them could address this. Discussion at this level will better enable all care needs to be addressed. Care notes of residents contain good evidence of referral and attendance to health care support such as General Practice [GP], chiropody, opticians and audiology. Resident’s interviewed spoke about visiting physiotherapists and appointments on a regular basis for health care support. One resident had just attended for an over 75 check up with his doctor. Medicines were reviewed with respect to the outstanding requirements and recommendations from a previous pharmacy visit and all of these are now met. One resident spoken to was clearly self-medicating but the care plan contained no reference to this in terms of a risk assessment or ongoing monitoring which would help ensure that the resident is properly protected. This needs to be addressed for all residents who self medicate. Residents spoke in very positive terms regarding the input by the care staff and the way that care was approached. A resident said, “the staff are very attentive.” They felt that privacy was well respected and that staff were always very polite. They thought that the key worker system involving named care staff was a good idea and residents generally felt that they could relate to staff. The more dependant residents were observed to be appropriately dressed and there is good attention to personal hygiene for these residents. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 12,15 Residents interviewed feel positively about their life in Barton Park and are satisfied with the structure of their day. Some of the more dependant residents would benefit from more consistent planning around activities in order to improve their quality of life. Daily choices of meals are available and nutritious meals are provided, to ensure residents received a wholesome balanced diet. EVIDENCE: Residents interviewed were very positive about their life in Barton Park. The quality of the surroundings plays a large part in resident’s perception of their quality of life in the home. Some are able to use kitchen facilities and these are provided in some of the living units or apartments. Others have their own lounge and can live fairly independently with the reassurance that nursing assistance is at hand if required. Such residents who have low nursing needs are particularly pleased and one commented ‘ I could not be anywhere better’. A resident stated that she was generally happy with the routine in the home however asked if she could retire at a later time and this was brought to the manager’s attention. The home does provide some activities for residents who were able to talk about a recent social evening. There was a ‘cream tea’ advertised for the weekend and some residents were looking forward to this. There is no structure to activities in that there is no daily activities programme. Activities Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 14 are arrange fairy flexibly and residents interviewed felt his was OK. Some of the more dependant residents and those with confusion can be left for long periods without activity and perhaps this area of care needs more thought in order to improve their quality of life. For example on the day of the inspection there were no planned activities for these residents and staff contact was observed to be limited to carrying out personal care tasks. The social profiles completed on each resident are a good idea and should contribute towards this process. There was universal praise for the quality of the food and residents were pleased with the choice offered. Dining arrangements are flexible and the more dependant residents are assisted to eat. Both dining rooms are well arranged and pleasant. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 15 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 standard(s) not assessed. Not assessed at this inspection. EVIDENCE: Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 16 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 standard(s) 19,26 Barton Park is well maintained and is clean so that residents live in a safe environment that meets their needs and also contributes to their quality of life. EVIDENCE: The general environment of the home is maintained to a high standard and this was evident in all areas seen. There have been improvements since previous inspections in that a new semi permanent ramp has been fitted to enable disabled access and recommendations for handrails in corridors have also been addressed so that elderly people can move around the home safely. Special mattresses and pressure relieving aids are provided for residents. Some bedrooms are currently subject to decoration and this is ongoing in the home as need arises. A resident spoke favourably regarding the décor of her room and the comfortable furnishings. The laundry was not seen on this inspection. All areas that were seen were very clean and hygienic. A resident said, “ my room is cleaned very well and Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 17 the staff keep everything tidy.” Another resident likes to do some cleaning however the staff are there to assist when needed. Residents spoken to were very pleased with the way the home is maintained and feel that living in such high environmental standards contributes to their quality of life. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staffing is consistent in the home and provides enough minimum numbers to meet resident’s needs satisfactorily. A training programme is provided for staff so that they are equipped to carry out their role and meet general care needs of residents in a safe manner. The procedures for the recruitment of staff do not include necessary Protection of Vulnerable Adult checks prior to employment on all staff, which are needed to help ensure protection to people living in the home. EVIDENCE: For 32 residents in the home at the time of he inspection there were 2 trained nurses [including the manager], 6 care staff, 2 kitchen staff, a laundry assistant and administration support. The duty was available and confirmed that these figures are maintained. Two care staff have commenced employment since the last inspection and these were spoken to. They felt that they had undergone a suitable induction to the home and felt supported by the induction process. Staff interviewed felt that their training needs were being addressed and were able to talk about a recent study day on dementia care and another on infection control. Staff interviewed had also received updates in manual handling. The manager holds small seminars at the handover period to discuss specific care issues and staff report that supervision/ appraisal sessions are also conducted frequently so that staff feel well supported. One staff member had only just commenced employment and was being supervise by a more senior member of the care staff until the routine check from the criminal records bureau [CRB] had been received. This member of Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 19 staff had not received a clearance from the Protection of Vulnerable Adults [POVA] register, which is a requirement prior to employment in order to protect residents from known abusers. [In discussion with the administrator it may be that she has been in receipt of incorrect information from the umbrella body responsible for completion of the check]. This needs to be addressed in all cases of future staff employment. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Staff are prepared and trained so that they are aware of fire safety issues and are able to carry out the manual handling of residents. EVIDENCE: Fire records were seen and were found to be up to date including staff training. A fire risk assessment for the home is also available. Manual Handling training for staff is regular and consistent so that all staff have received updating. All residents seen had received an assessment by the manager regarding any manual handling / lifting needs but the records did not show instructions how staff should carry out task specific procedures [for example moving residents from bed to commode or assistance needed when walking]. Staff interviewed were aware of how to manage the moving and handling of residents. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 3 Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 22 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. 1. Standard 1 Regulation 4 Requirement The statement of purpose for the home must be developed with better detail and include all of the factors listed in scedule 1 of the Care Home Regulations. The service user guide must be developed to include all of the factors listed in regulation 5 of the Care Home Regulations. Care Plans for residents must identify all care needs with particular reference to mental health care needs. Residents who self medicate must have a risk assessment completed and the ongoing monitoring arrangments must be included on the care plan. All staff must recive a POVA first check and clearence prior to commencing employment in the home. Timescale for action 30.8.05 2. 1 5 30.8.05 3. 7 15 30.8.05 4. 9 13 [4] 30.8.05 5. 29 19 ongoing RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Barton Park Refer to Good Practice Recommendations F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 23 1. 2. 3. Standard 7 12 38 The residents care plan should be made available to them [copy given] and /or include a signature of the resident or advocate. The more dependant residents and those with dementia would benefit from more specific and better planned activities in order to benefit quality of life. Manual handling assessments for residents should include specific instructions for each task of handling such as walking, transfering etc. Barton Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Burlington House South Wing, 2nd Floor Crosby Road North, Waterloo Liverpool L22 0LG 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 Park F53 F03 S17225 Barton Park V238069 050705 Stage 4.doc Version 1.40 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. 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