Inspection on 11/10/05 for Barton Place Independent Care Hotel

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Place Independent Care... 12/02/09

Barton Place Independent Care... 05/02/07

Barton Place Independent Care... 28/02/06

Barton Place Independent Care... 28/02/05

Barton Place Independent Care... 19/08/04

Barton Place Independent Care... 05/03/04

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Queensmount

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Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Barton Place Independent Care Hotel Wrefords Link Cowley Bridge Exeter Devon EX4 5AX Lead Inspector Stephen Spratling Unannounced Inspection 11th October 2005 12:00 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 Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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 Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barton Place Independent Care Hotel Address Wrefords Link Cowley Bridge Exeter Devon EX4 5AX 01392 211099 01392 498230 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) Barton Place Ltd. Nina Griffith Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30) Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The staffing notice dated 28 November 1990 of North and East Devon Health Authority continues. [Morning 1 RMN and 6 care assistants, afternoon 1 RMN and 3 care assistants, evening 1 RMN and 5 care assistants, night 1 RMN and 2 care assistants]. To admit one named person outside the categories of registration as detailed in the notice dated 10th August 2005 The maximum number of persons accommodated at the home, including the named service user, will remain at 30 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the conditions of registration will return to those held on 8th August 2005 28th February 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Barton Place is described as an independent care hotel and is a Home offering care, including nursing care, to people over the age of 65 years who have mental health problems; particularly those experiencing confusion, dementia or Alzheimer’s Disease. The stated aim of the home is to provide skilled, sensitive and understanding care to enable residents to achieve the highest possible quality of life whilst receiving the utmost quality of care and accommodation. The home is situated on the outskirts of Exeter in a grand Georgian house, which benefits from several acres of attractive and long established gardens. The Owner/Manager purchased Barton Place in July 2002. She has implemented many positive changes to the organisation and fabric of the Home and continues to carry out improvements, with planning permission for a large extension already in place. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector, Stephen Spratling, visited the home arriving at lunchtime. During the inspection he spoke with nine residents three of whom were able to converse with him. He met the relatives of two residents; spoke with six of the staff on duty and the home administrator. He looked at the care records of three residents and a variety of other records maintained at the home. The inspector returned briefly the following day to look at further records and speak with the home’s deputy manager. What the service does well: What has improved since the last inspection? What they could do better: Recruitment procedures need further tightening up to ensure all required checks are done before new staff start work. Staff must make sure that residents are always given choice of meal. Records should be kept of all medicines entering the home. Medication fridge temperatures should be better maintained. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 6 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 Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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 Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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): 1&3 Prospective residents and their families have access to clear and detailed information to help them make informed decisions about whether to move to Barton Place. Good assessment practice helps to ensure that residents’ needs can be met. This home does not offer an Intermediate care service. EVIDENCE: The Statement of purpose and service users’ guide are clearly presented and available in large print format; they provide all the information recommended. Since the last inspection views of residents have been added, as has a plan of the building detailing layout and sizes of rooms. The inspector looked at the care records of three residents all three contained detailed pre-admission assessment information; they also contained useful post admission assessments, completed each day for three days following admission. The relative of one resident confirmed that they are consulted about the care of their loved one. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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): 7, 8, 9, 10 & 11 Good care planning practice helps to ensure that residents’ needs are met in a consistent way. By providing good health screening/monitoring the staff at this home promote the good health of residents. Residents are treated kindly and with respect. By inviting people to say how they would like to be cared for at time of acute illness/deterioration in their health the home helps to ensure that residents preferences regarding end of life care are sought and acted upon. Good systems are in place regarding medication management though improvements could be made to ensure residents are fully protected. EVIDENCE: All three residents’ records seen contained detailed care plans, which reflected their assessed needs and that acknowledged their physical, health and psychological needs for care. All showed evidence of appropriate regular review. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 10 Records contained up to date, professionally recognised assessment tools e.g. risk of residents falling was assessed as was the risk of them developing pressure sores. Regular monitoring of residents weight, blood pressure etc was also evident. A relative commented on how pleased they were that their relative had been helped to regain their mobility by the home staff following a hip operation. All the residents able to comment confirmed that the staff are always kind and polite. Staff were seen addressing residents politely; a visitor commented that whenever they visit they always see staff addressing other residents patiently and respectfully. Residents or where they are unable to comment their relatives are asked if they would like resuscitation if they become very unwell and the registered nurse on duty said this is discussed with the GP if resuscitation is not wanted; a record of this was seen. The registered nurse was seen giving medication to two residents, staying with them so as to observe that it was taken and then recording on medication administration charts. Medications are securely stored, and administration charts seen were properly completed. Medicines received into the home are not signed, as they should be and medication fridge temperatures were not being properly monitored. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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): 15 Residents receive good food but some need more help to ensure they are aware of choices available to them and that their preferences are satisfied. EVIDENCE: The inspector observed lunch in the upstairs lounge where nine residents ate. The atmosphere was generally calm and relaxed, with carers mostly sitting with residents who needed help to eat. One resident said their meal was not hot enough and a carer did go and microwave it for them. There was not a choice of meal offered to residents though the deputy manager reported that there are usually at lest two choices available. Residents were offered a choice of pudding. Two residents told the inspector that they enjoyed the meal and that food is generally good. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 12 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 Service users can be confident that their complaints would be listened to. EVIDENCE: A clear simple complaints procedure is given to residents and relatives in the homes brochure. The staff member in charge on the day of the inspection was not aware of the complaints procedure being on display or the recording system if a complaint is received. The administrator said there had not been any complaints for some time. All residents able to comment and visitors spoken to expressed confidence that if they had concerns staff would take them seriously. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 13 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): None of these standards were assessed during this inspection. EVIDENCE: Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 14 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, 29 & 30 Staff are employed in sufficient numbers to meet the needs of residents. Since the last inspection the standard of vetting and recruitment practice has improved and with some tightening up would be fully satisfactory so as to protect service users. Training is provided which helps ensure staff know how to look after residents properly. EVIDENCE: All staff spoken with confirmed that staffing numbers are sufficient to meet residents needs in an unrushed manner in all but the most exceptional times. Service users able to comment and visitors confirmed that they think there are always enough staff available to provide help as and when needed. Detailed induction records were seen to have been or were being completed for new care staff. New care staff described being well supported by their colleagues confirming that they worked with senior colleagues when first at the home. Staff spoken with said they were given opportunity to attend training covering subjects such as dementia, mental health, 1st aid and infection control. Residents and visitors spoke positively about staff; one visitor praised the registered Nurse on duty saying he communicates “brilliantly” with residents; a resident told the inspector that they think “all the staff are kind and helpful always on hand to help”. The recruitment records of four members of staff were examined. One had only one reference but all other required checks others were satisfactory. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 15 The deputy manager said that where one reference had been received a verbal reference had been taken but that she had not made record of this, as she should. In one of the other files a CRB check from a previous employer had been accepted and though a repeat check had been applied for this person had started in post before the renewed check or a POVA 1st check had been done, as they should have been. Other records seen were satisfactory. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 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 Residents receive a good service as the home is well managed. EVIDENCE: Staff clearly indicated that the deputy manger is in day-to-day charge of the home and that the registered manger though available for advise does not work in the home. The registered manager confirmed that this is the case. Staff spoke highly of the deputy describing her as supportive and one person praising her saying she challenges questionable practice. She has maintained and developed the systems of the home, residents able to comment and visitors confirmed that she is approachable and responsive to them. Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 17 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X 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 2 X X X X X X X Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) (b) Requirement The registered person must not employ a person to work in the care home unless… he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2. (CRBs are not transferable. A new application to CRB and a new POVA 1st check must be received before a person is employed to work in the care home. Where a satisfactory POVA 1st has been received but not the full satisfactory CRB a person may work in the care home under supervision) Timescale for action 11/01/05 Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations Records should be kept of all medicines entering the home. Medication fridge temperatures should be kept between 2 & 8 degrees Celsius and action taken when their parameters are exceeded. Greater efforts are needed to ensure that residents are made aware that they have a choice of meal. 2 OP15 Barton Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Place Independent Care Hotel DS0000030876.V252987.R01.S.doc Version 5.0 Page 21 - 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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