Inspection on 05/02/07 for Barton Place Independent Care Hotel

This inspection was carried out on 5th February 2007.

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 Place Independent Care... 12/02/09

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

Barton Place Independent Care... 11/10/05

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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Fairfields Country Rest Home

Poldhu

Queensmount

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Didsbury Court Rest Home

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 10:00 5 February 2007 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 Place Independent Care Hotel DS0000030876.V322131.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 Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barton Place Independent Care Hotel Address Wrefords Link Cowley Bridge Exeter Devon EX4 5AX 01392 211099 01392 434605 kh.barton-place@btconnect.com 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. *** Post Vacant *** 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.V322131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2005 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 or dementia. 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 ownership of Barton Place Ltd changed hands 26th September 2006 and the previous owner/manager is no longer at the home. An experienced Nurse, the previous deputy manager, whose application for Registration is being processed by the Commission, is now managing the home. Current fees charged are between £650 and £700 per week. Inspection reports are available on request from the home manager. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the inspection site visit the Commission sent out questionnaires seeking the views of all residents living at the home, six to professionals with links to the home and fifteen to staff who work at the home. Fifteen residents, seven care workers and three visiting professionals returned completed and/or partially completed questionnaires. Others had completed some of the resident’s questionnaires on their behalf. The inspector visited the service unannounced on the 5th February 2007 spending about seven hours at the home. On the day of the inspection site visit, 29 people were living at the home and the inspector met with 10 of them. All but one of the residents met had some difficulty communicating their views. The inspector also spoke with one of the Registered Nurses, two of the care workers, two members of the house keeping staff, the laundry worker, the home manager and the new owner of Barton Place Care Ltd. The records relating to the care of three residents were looked at in some detail. Other records relating to the running of the home including policies, procedures and maintenance records were sampled. During the day all the shared areas of the home were visited and fourteen of the private bedrooms seen. What the service does well: The home does thorough pre-admission assessments which helps make sure that if someone is admitted, they can be provided with the care they need in the way they want. Once a person is admitted assessments are developed and detailed care plans drawn up which reflect resident’s needs and preferences, helping staff to provide individualised care. Staff help residents to stay as well as possible by monitoring their health carefully, communicating effectively with health and social care professionals and acting on the advice they provide. Medications are safely managed. Residents receive good food in pleasant surroundings and good support if they need help with managing their meals. The home employs a full time activities person who works with each individual resident to find out about and pursue their interests. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 6 Residents and visitors speak highly of staff variously describing them as acting in residents “best interests”, and as “respectful” and “marvellous”. Visitors to the home say they are made to feel welcome. Staff are supported to attend training, which helps them to develop their skills. They are employed in sufficient numbers to ensure they have time to give residents individualised care at a pace that suits the resident. The home manager is approachable and supportive of residents, their families and colleagues. The home has an open and clear complaints procedure. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and prospective residents can be confident that the home’s assessment and admissions arrangements will help to ensure that their needs can and will be met. This home does not offer an intermediate care service. EVIDENCE: All three of the residents records looked at contained pre-admission assessments, dated as having been completed before the person moved to the home. They provided a good description of the residents’ medical and social histories, their needs for support and information about their interests and preferences. For example, one person’s assessment highlighted their interest in sports and another persons identified a recent bereavement, which had had a significant impact on them. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 10 All three assessments had been developed once the person was admitted and the home staff got to know them better. These developed assessments contained detailed risk assessments (see Health and Personal Care) and other relevant information such as detailed “personal profiles”, which provided a biography of the resident’s life highlighting their significant life events and relationships. The manager said that she or one of the senior registered nurses visit all prospective residents before admission is offered. One care worker was asked what information they receive before they meet a resident. They confirmed that pre-admission visits are always done and that clear information about the needs of new residents is always provided to care workers. Of the seven care workers who returned Commission six answered “always” and one “sometimes” when asked “ before you begin working with a new service user does your manager give you clear instructions about the job you are expected to do…”. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 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. 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. Residents can be confident that they will be treated with respect and that they receive the personal care and health care they need. Systems for management and administration of medications help to ensure residents receive the medication they need safely. EVIDENCE: Up to date plans of care were available in all three resident files that were seen. All were dated as having been established during the first days of the residents stay at the home. They reflected needs and preferences of the residents identified during assessment and had been regularly reviewed and updated to make sure they remained relevant and accurate. Elements of some of the plans read did not specifically highlight residents needs as individuals, for example a plan read about a resident who had a specific mental health problem provided only very general guidance in how to respond to this condition, rather than how staff should respond to this Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 12 individual when they experience symptoms of the condition. The manager agreed to review the use of such “generic” care plans. However other elements of the care plans clearly reflected the very individual way the residents concerned should be cared for; for example within the same residents file a care plan describing how they should be supported to maintain their personal hygiene had been developed. This clearly reflected their individual needs and strengths, encouraging care workers to support the resident’s capacity to care for themselves as much as possible. Of the 15 returned residents questionnaires, 14 responded “yes” when asked “do staff listen and act on what you say” and one responded “no”. Asked “do you receive the medical support you need” 10 answered “always” and four “usually” and one “never”. Of the three visiting professionals who returned Commission questionnaires all answered “yes” to the questions, “do staff demonstrate a clear understanding of the care needs of service users” and “if you give any specialist advice is this incorporated into the care plan”. One of them added that they believe that the home “offers individual care and (that staff) tailor the care offered to each person”. All the residents able to comment confirmed that care staff are polite and respectful. All residents seen were individually dressed and two residents were able to confirm that their clothes are well cared for by staff. Throughout the day staff were seen addressing resident respectfully, greeting them warmly and stopping to talk with residents as they went about their work. The home uses professionally recognised risk assessment tools to assess resident’s risk of developing pressure sores, risk of falling and nutritional status. All three care files seen contained these completed assessment, which had been regularly reviewed by the Nursing staff. Where appropriate, visiting professionals, residents and family members are involved in these risk assessments. For example, an assessment had indicated that a resident was at high risk of falling from bed and that bed rails were not appropriate. There was a written agreement from the residents’ next of kin and GP that permitted staff to nurse this person on a mattress on the floor. (this resident was not able express their own view). As indicated earlier assessments and care plans seen demonstrated clear consideration of residents’ health care needs. Evidence that these plans were implemented was available in other records. For example a care plan written for a resident who has diabetes said that they should have their blood sugars checked weekly. Records that this was done regularly was available. Where the sugar levels were outside expected limits, records showed that the residents GP had been contacted, advice sought and followed. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 13 There is good management of medicines at the home. Medications are stored securely and appropriately. The medications fridge temperatures are monitored and appropriate action taken if the correct temperature is not maintained. Two eye drop prescriptions were checked and had been dated when opened, allowing staff to know when they should be discarded. Resident’s individual medications charts were properly completed providing clear record of when medications were administered or omitted and by whom. Medications received into the home are properly recorded as are those returned to the pharmacy. A complete and accurate record of controlled medications is kept. All of this means that residents needs relating to their medication are well attended to. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the support they receive to choose where and how they spend their time, being helped to take part in activities and entertainments and from contact with friends and relatives who are made to feel welcome. Good food is provided, served in a pleasant atmosphere, with individual support given discreetly as needed. EVIDENCE: The home employs one full time member of staff to arrange activities and to support residents pursue their interests. The manager said that this person has undertaken an NVQ3 (a formal care qualification) and is currently doing a course about caring for people with Dementia. Residents and staff spoke highly about the activities coordinator, one resident described him as “brilliant”. This resident said they enjoy the music events at the home and appreciate that they are reminded when significant sporting events are on the TV. Another resident commented that they enjoy the regular opportunity they have to go walking with staff in the gardens of the home. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 15 Asked, “are there activities arranged by the home that you can take part in” four people who returned Commission questionnaires responded “yes” six answered “usually” and four “sometimes”. Two people wrote on there questionnaires that they would like more opportunity to go outside and one person commented that they thought Christmas had been “especially well organised” All three residents records contained activity plans which described what residents would like to do and how home staff should help them achieve their goals. Diary sheets for all three confirmed regular one to one contact with the homes activity coordinator. Care staff confirmed that they have time to spend with residents on a one to one basis. Activities recorded included crafts, looking at magazines, listening to music, doing domestic tasks and general conversation. Activities residents were involved in reflected their interests and preferences, which had been recorded through discussion/assessment. Residents spoken with confirmed that they spend time where and with whom they choose. They also said that their friends and relatives are made to feel welcome. One relative wrote on a Commission questionnaire “I am always made to feel welcome when I visit my wife and I am always offered a coffee”. Asked, “ do you like the meals at the home”, six people who completed the Commission questionnaire responded “always” seven “usually” and one “sometimes”. Residents spoken with said that they think the food provided is good. The inspector sat in the upstairs lounge during lunch. The main meal was fish pie, which residents appeared to enjoy and an alternative was given to one resident clearly reflecting their preference. Most residents ate independently, and some were equipped with plate guards or easy use cutlery to promote their independence. Those who needed help to eat were assisted sensitively by staff who sat with them, helping them patiently and attentively. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 16 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. 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. There is a good complaints process meaning that residents can be confident that their concerns and complaints will be heard and acted upon. Residents can be confident that staff would act to protect them if they were being abused. Furthur training for some staff and more up to date policies in this area would further protect residents EVIDENCE: The Commission has not received any complaints about this service since the last inspection. In the pre-inspection questionnaire the manager reported that she had not received any formal complaints during the past 12 months. The home has a clear complaints procedure which is posted up in the entrance hall to the home and the inspector was shown the homes system for recording complaints, investigations and actions taken if complaints are received. Asked “do you know how to make a complaint” 14 people who returned Commission questionnaires responded “always” and one person said “usually”. Two of the three staff spoken with confirmed that they had done training about how to recognise and report abuse of residents. All three were clear that they should report any concerns, although one was not able describe signs that someone may be being abused and one person spoke about investigating concerns before reporting which is contrary to good practice advice. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 17 All seven of the staff who returned Commission questionnaires responded “yes” when asked “are you aware of adult protection procedures”. The home has a policy to guide staff on how to recognise and respond to concerns of abuse of residents but this did not fully reflect locally agreed multiagency guidance. For example it did not provide advice about handling confidential information when abuse is suspected nor did it mention that any suspicion of abuse should be reported to the local Social Services without delay. The home also has a “whistle blowing policy” to guide staff about their responsibility to report poor practice or threats to the safety and wellbeing of residents though this has not been reviewed since 2002 (see Management and Administration). Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a clean, comfortable and homely place for residents to live that meets their needs. EVIDENCE: When asked, “is the home fresh and clean”, seven people responding to Commission questionnaire answered “always”, seven “usually” and one “sometimes”. Three people added comments with two saying they think the home is always kept clean and free from odours. But one person reported that their relatives bed room “has often not smelt too clean”. All residents spoken with said they were happy with the standard of cleanliness around the home. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 19 The inspector walked around all shared areas of the home and looked in 14 private bedrooms. All areas visited appeared well maintained, comfortably furnished, were clean and no unpleasant odours were observed. Private bedrooms mostly reflected the individuals who occupied them, decorated with family photos and personal possessions. The inspector spoke with the two house keeping staff who said that they feel they get the time and equipment they need to keep the home fresh and that they are adequately supported by care staff and the manager. The inspector visited the laundry and spoke with the laundry worker. She confirmed that soiled linen is delivered to her in red soluble bags which go straight into the washing machine and was aware of the correct temperatures for washing soiled items, so helping to reducing the risk of cross infection in the home. The laundry room was clean and properly organised. Staff said that maintenance of the home had improved over the past couple of months as the home now employs a full time maintenance person. They said any maintenance issues are recorded for his attention and that he then ticks them off when done, ensuring problems aren’t missed. On the day of inspection the inspector noted that a radiator guard was broken, on referring to the maintenance book he saw that it had been recorded earlier that day. On speaking to the maintenance person was told of the intention to replace it with one from an unoccupied room. This shows that there are good maintenance arrangements at the home-, which means that residents can be assured of a safe and well maintained home. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 20 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. 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. Suitably skilled care staff, employed in sufficient numbers ensure that residents are treated with respect and receive the care they want and need. Recruitment procedures help to protect residents from people who are not suitable to work with them, though improvements need to made to ensure they are fully robust. EVIDENCE: When asked “are the staff available when you need them”, 13 people who returned Commission questionnaires responded “always”, one responded “usually” and one “sometimes”. One person wrote “my husband cannot communicate with people much, but the staff always act in…his... best interest”. Of the three visiting professionals who completed and returned Commission questionnaires all responded “yes”, when asked “is there always a senior member of staff to confer with”. Two wrote very positive comments about the qualities of the care staff with one person saying, “staff are always welcoming and respectful...” and the other commenting, “I have the up most respect for her (the manager) and her staff”. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 21 Staff spoken with confirmed that there is always a registered nurse on duty, that staffing levels are sufficient to allow them time they need to care for people properly and in an unrushed manner. All commented that a recent increase in staffing levels in the afternoons was helping them to offer residents more individual attention. The nurse in charge on the day of the inspection is a Registered General Nurse and a Registered Mental Nurse. She said she has many years experience, most recently working in a hospital with people experiencing dementia. One of the care workers spoken with had several years experience of caring for people with dementia and the third considerable experience in the care sector, though less in caring for people with dementia. Both care workers displayed a good understanding of their responsibilities, the importance of treating residents as individuals and promoting and supporting residents choices. All three confirmed that they are supported with funding and some paid time to attend training. The two more recently recruited (within the past 18 months) staff confirmed that they received a supportive induction when first working at the home. Staff employment files contained evidence that they receive ongoing training, for example during the past 12 months one care worker had done training about manual handling, first aid, food hygiene, protection of vulnerable adults and wound care. This person had also achieved an NVQ 3 (a nationally recognised care qualification). An analysis of the training needs and achievements of the whole staff team was not available for inspection though the manager said this is being developed showing the inspector the system being used (see Management and Administration). The recruitment records for three staff members were seen. Two contained all the required pre-employment checks, dated as having been done before the staff member started work. The third did contain all the required checks though two references had not been addressed specifically to the care home and could not be verified. Also the Criminal Records Bureau Check had not been received by the home until six months after they started in post. If CRB checks are not in place before a new member of staff starts, this can place residents at risk. All three of these staff had been recruited prior to the change in of manager at the home, at the end of September 2006. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some systems are in place to help monitor and improve the service residents receive. However a more systematic approach to quality assurance and to ensuring policies are kept updated would help to make sure that improvements that could be made to the service are promptly recognised and acted upon. The homes record keeping regarding safety training for staff could be better, however the organisations overall positive approach to maintenance and health & safety does help to protect residents from harm. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 23 EVIDENCE: The current manager took over management of the home when the four months ago. She has worked at the home for over two years as deputy manager, all of this time taking much of the responsibility for the day-to-day running of the home. Several people wrote very positive comments about the manager on Commission questionnaires, a typical example being “ the matron is always ready to help with any queries or problems”. A visiting professional wrote on their questionnaire that they think the manager “is an excellent communicator”. All seven staff who returned Commission questionnaires responded “yes”, when asked “does your manager meet with you regularly” and to the question “do you feel you have enough support from the care home to do your job well” The manager was observed to have built up a good rapport with many of the residents who greeted her warmly when they saw her through the day. The Commission is currently processing her application for Registration as manager. The manger said that the home no longer holds any money on behalf of residents and that any extras, such as hair dressing or news papers are billed for monthly to residents or more usually their representatives. Most of the homes policies were dated as having last been reviewed in 2002 and as mentioned earlier some of those read (see Health and Personal Care/Complaints and Protection) needed development to ensure they provide up to date and sufficiently detailed information for staff to follow. The manager and owner acknowledged that the home does not have a fully developed quality assurance system, saying that this is something in development. They have however recently sent surveys, about the quality of the service to residents’ representatives and the owners of the home carry out regular unannounced spot checks to the service. They will then speak with residents, staff and visitors about the quality of the service and prepare a report, which they provide, to the manager and the Commission. Records regarding fire protection showed that fire alarms are tested weekly and that a visual check is done on fire extinguishers weekly. This is more often than recommended by the fire service but the manager explained that as some residents are inclined to move and tamper with extinguishers checks are done more frequently. An external company had recently updated the homes fire risk assessment; the owner said this had been done in November 2006 though Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 24 the firm responsible had failed to date the assessment. The new maintenance person said that they had experience as a retained fire fighter and that they had taken on responsibility for ensuring all staff were up to date with fire training. Records of staff fire training did not confirm that all staff had received fire update training within the past 6 months, though the maintenance person said that all staff have attended. Two staff asked confirmed that they had received fire update training within the past six months. Maintenance certificates were seen for gas installations- dated 16/02/06, portable electrical appliances (PAT)- dated 06/02/07 and electrical installations-dated 01/02/06. On walking around the home the inspector saw that hot surfaces were suitably guarded and with one exception all upper floor windows checked had suitable restricted opening. The window, which did not have restricted opening, had a broken catch. The manager agreed to have this fixed immediately and to ensure all others are checked. Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 25 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 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 3 Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 26 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 Requirement To make sure residents are protected from people who may be unsuitable to work with them, the registered person must not allow new staff to work in the home until they have obtained all the information detailed in paragraphs 1 to 7 of Schedule 2; and that they are satisfied that this information is satisfactory. Satisfactory Criminal Records Bureau Checks must be received before a staff member starts work. Two written references, one of which should be from the applicants last employer, must be received and where appropriate authenticated. For example if written to “to whom it may concern” rather than directly to the home they should be followed up by a telephone call. Timescale for action 05/04/07 Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 27 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 OP18 Good Practice Recommendations To make sure residents are properly protected from abuse, all staff should have training about how to recognise the signs that a vulnerable adult is being abused and about the correct reporting procedures. The homes abuse policy/procedures should provide staff with all the information they would need to help the recognise and report abuse and should reflect Devon Protection of Adults at Risk multi-agency guidance to help make sure that they respond in a way that reflects agreed best practice. 2. OP33 To help make sure residents receive the best possible service, an effective quality monitoring system based on seeking the views of service users should be in place to measure the success in meeting the aims, objectives and statement of purpose of the home. An annual development plan for the home should be developed. Results of quality assurance process should be made available to all stakeholders and forwarded to the CSCI. 3 OP33 To make sure staff have correct, sufficiently detailed and up to date guidance about how to care for residents in the best way possible, the homes policies and procedures should be reviewed. To help make sure that all staff have the up to date training they need to care for residents safely and to a high standard, records relating to staff training should be kept up to date. This particularly relates to the need to have clear current records of staff fire training but should also be done with to reflect the whole staff team training needs. DS0000030876.V322131.R01.S.doc Version 5.2 Page 28 3 OP37 Barton Place Independent Care Hotel Barton Place Independent Care Hotel DS0000030876.V322131.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V322131.R01.S.doc Version 5.2 Page 30 - 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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