Inspection on 06/11/07 for Baytree House

This inspection was carried out on 6th November 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

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

CARE HOME ADULTS 18-65 Baytree House 28 Chesswood Road Worthing West Sussex BN11 2AD Lead Inspector Ms B Tye Unannounced Inspection 6th November 2007 09:00 Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 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 Baytree House DS0000070061.V349461.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 Adults 18-65. 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. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Baytree House Address 28 Chesswood Road Worthing West Sussex BN11 2AD 01903 210800 01903 206869 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) Sutton Court Associates Ltd Annette Bishop Care Home 9 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1) of places Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection N/A Brief Description of the Service: Baytree House is a care home registered for up to nine service users in the category LD (Learning Disabilities 18-65 years). The establishment is a spacious converted premises situated close to Worthing town centre. Public transport services are easily accessible. Accommodation is provided over two floors, with office space on the third. The service is privately owned and the registered provider is Sutton Court Nursing Associates. Mr N Ramdin is the Responsible Individual on behalf of the organisation. Annette Bishop is the Registered Manager in charge of the day-to-day running of the home. The fees currently range from £326.00 to £455.00 per week. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection all relevant information and correspondence relating to the home was examined. This included a detailed annual quality assurance assessment from the manager, a staff list, rotas and training schedules, menus and notifications of significant incidents within the home. Eight feedback forms from residents and one relatives survey were received. All comments were positive and complimentary about the service. On the morning of the inspection, two residents were dressed and socialising with staff in the dining/living room area. During the visit three residents care files; risk assessments, Staff personnel and training files, medication records and all Health and Safety Records were examined. In addition, the inspector looked around the home and had the opportunity to see most of the resident’s bedrooms and the community living areas. The overall quality of care at Baytree House was found to be very good. This is supported by good administration systems, which were well ordered and up to date. This is the first inspection of 2006/2007. This is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: The service provides residents with opportunities to develop new skills and independent lifestyles, with in their own capabilities. People who live at Baytree House are respected and their needs are met through detailed assessment and care planning. Residents live in comfortable, clean and tidy accommodation. Residents are encouraged to pursue activities of interest and supported to make choices in their lives. Medication records are in very good order with no gaps or errors, demonstrating staff adhere to the homes policies and procedures. Staff were observed interacting with residents in a respectful way. An in-depth induction and staff training programme, enhances good practice in the home. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 6 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 be made available in other formats on request. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. All prospective residents and their families have access to relevant information and up to date information in order to decide whether the service can appropriately meet their needs. All prospective residents undergo a detailed pre-admission assessment prior to moving to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All current residents at the home were already in residence when the home was taken over by the current owners, in May 2007. The manager found that none of the residents had previously received a full pre-admission assessment prior to them moving to the home. Consequently, the manager is now in the process of working with the local Community Learning Disability team to track as much information as possible about each resident. From this, a full statement of need is being collated to form the basis of individual care plans. This work has been a slow process due to the lack of information about some of the residents. Work in this area will be on going until each resident has a full assessment in place. During the visit the inspector was able to view some of the assessments that had been completed and these were comprehensive and relevant to individuals on going need. Any future resident will only be admitted on the basis of a full assessment, with the prospective residents involvement. This will ensure the home is able to meet their needs appropriately. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 9 The home has a Statement of Purpose and Service Users Guide in place and both documents are informative and up to date. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents have the opportunity to contribute and review the care planning process. Reviewed documentation and feedback from residents confirmed that the home meets their changing needs and personal goals, promoting independent living where possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A person centred plan for each resident is in the process of being drawn up following completion of full assessments by the manager of the home and the Community Learning Disability team. Each resident is fully involved in this process and records show that individuals are provided with choice about how their needs are met. The plans in place reflect the resident’s involvement in decision-making, using a language or format they prefer and understand. Care plans cover all aspects of the resident’s health, personal and social needs. All plans are signed by the residents to reflect their involvement in the care planning process. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 11 Behaviour guidelines and management plans are in place. These give staff relevant information about how to respond appropriately to individuals, allowing informed choices to be made in supporting individuals to achieve independent living. New risk assessments are being devised as part of the care planning process, which promotes independence in line with the residents, assessed needs. Each resident participated in a care review in April 2007, on going reviews will occur on a three monthly basis or when significant changes occur. Where appropriate this will involve family members and professionals. Residents meet on a regular basis with their key workers and as a group to discuss issues and enable them to contribute to decision making within the home. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good A range of activities is offered within the home. The meals are nutritionally balanced and varied according to dietary requirements and preference. Residents are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents at Baytree House have a day care package in line with their assessed needs and preferences. Individual activities are timetabled over the week and include time at day centres, college courses, shopping, outings, community visits and leisure activities. The majority of residents are supported to attend religious services each week. One resident who is over sixty attends two classes a week at college to do cooking, music and dance. Each resident has a copy of their agreed timetable and a community activities plan and information board is displayed in the home. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 13 The visitor’s book shows residents have regular visitors to the home and this is supported by an up to date policy and procedure. A relaxed and friendly rapport between staff and residents was observed during the visit. This demonstrates awareness by staff, of how to communicate according to the individual’s needs and behaviours. Resident’s feedback confirmed that staff support them to maintain positive relationships outside the home. For example, residents have a list of birthdays in their files so they can be prompted to send cards to significant people in their lives. One family member fed back that prior to the takeover she had ‘a lot of anxiety about the changes’ but she states ‘my fears were unfounded and I am very happy with the care my daughter receives’. All information relating to contact is detailed and any trips out of the home are risk assessed (when needed) and agreed by the resident. Menus for the home were viewed and showed a balanced, varied diet was provided. Weight monitoring charts seen on care plans are kept up to date and specialist dietary requirements are catered for. Residents confirmed they met once a week to plan their menus and they all liked the food provided. Hot and cold drinks facilities are available for residents on request. Residents have the opportunity to assist staff in cooking and food preparation to promote independent living skills. Health and safety notices are posted in the kitchen area to protect staff and residents from hazards. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Observation, feedback and examination of the homes records showed residents receive care and support in line with their assessed needs and personal preference. Medication is stored and labelled appropriately. Medication administration records are in good order and staff are trained appropriately in this area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have access to community health care professionals such as GP, dentist, chiropodist, optician and a psychiatrist. Less mobile users have access to a wheelchair when required which enables them to participate more easily in community activities. The home provides gender appropriate personal support when possible. The local Community Learning Disability team supports all the residents with occupational therapy, speech and language, community nursing and other specialist healthcare needs. Some residents at the home have long-standing, complex health issues and care plans demonstrate they are supported to access specialist health care services within the community. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 15 The home has a key worker system to promote one to one contact and support for residents. Individuals also attend an advocacy service once a fortnight and have the opportunity to participate in independent counselling if they wish. Medication consent forms demonstrate residents have agreed to the staff supporting them with their medication. All staff has mandatory training in safe handling, storage and dispensing medication. Staff files seen held certificates to evidence this. Medicine records were examined during the visit and all were found to be up to date and in good order. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The home has provided residents with information in respect of complaints. Residents are aware of their rights and how to complain. Recruitment procedures in the home are robust and staff have received training in the protection of vulnerable adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure included in the Statement of Purpose and Service Users Guide. Residents fed back on surveys that they knew who to complain and felt confident to do so to should the need ever arise. Regular questionnaires and Quality Assurance surveys will be undertaken in the coming months to encourage residents and their families to comment on the standard of service. The Commission has received no complaints since the home was registered. The home holds a complaints log and appropriate policies and procedures in relation to complaints and protection. All staff have undertaken a full induction and Adult Protection training to ensure they respond appropriately to suspected abuse in the home. A copy of the West Sussex County Council Multi Disciplinary Adult protection Policy is kept in the office for reference. Records seen during the visit showed the procedures for recruitment of staff are robust and provide the necessary safeguards. Staff references and CRB checks have been carried out to ensure protection to the residents living in the home. Records in respect of incidents, accidents, complaints and staff training were found to be in place and up to date. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 17 Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The communal areas of the home and residents bedrooms were clean and homely providing the residents with a pleasant and hygienic living environment. Specialist equipment is provided to maximise the independence of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following a tour of the premises and examination of the homes records it is evident the home provides a homely, well-maintained and safe environment. Standards of hygiene and cleanliness are very good throughout the home. Records showed all fire, health and safety checks are regularly undertaken and up to date. All equipment is regularly serviced and certificates held on file. A policy and procedure for infection control is in place and staff have undertaken training to support good practice in this area. It was evident that residents felt their environment was comfortable and clean. Those spoken to expressed that they like their rooms and were able to Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 19 personalise them with pictures and items of furniture to achieve a sense of ownership. A cleaning schedule has been implemented with the resident’s agreement. Residents are provided with support to keep their rooms clean and tidy. Communal areas have been decorated and furnished to suit the resident’s preference. Handrails and easy ride steps have been fitted to the back exit to allow residents easier access to the large, mature garden. Risk assessments have been carried out for areas of the environment to reduce and/or eliminate risks for residents and staff. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The staff numbers are sufficient to meet the assessed needs of residents. Recruitment procedures in the home are robust. An induction and training programme for staff is provided, to ensure resident’s needs are met in full. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments from surveys, feedback from residents and relatives highlighted the good practice undertaken by staff in the home. One resident said ‘they really look after us’. A relative stated ‘I am confident that the home keeps me up to date when important issues effect my daughter. I have never had a reason to complain about the level of care she receives’. The home is sufficiently staffed, with one current vacancy for care staff. At present the team and manager is covering this. The post has been advertised. The majority of staff have been at the home for a number of years, which provides consistency of care for the residents. Since the takeover of Baytree House the recruitment records have been updated and each staff member has two written references on file in addition to CRB checks and relevant documentation. Recruitment procedures are robust and policies and procedures are in place to support this. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 21 Staff files showed the staff attend an induction at the start of employment, followed by a mandatory training, in addition to courses specific to the care needs of the resident group. Fewer than 50 of the staff have attained the National Vocational qualification at present. One staff member has completed The National vocational Training at Level 3, another at level 2 and the remainder are now enrolled to undertake NVQ Level 2. Staff attend meetings are held every 3 months to discuss issues relating to practice and enable staff to participate in the decision making at the home. The manager supervises the staff on a six weekly basis, providing on going support in their practice and on going professional development. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Resident’s benefit from a well run home and are safe guarded by the homes policies, procedures and record keeping. The management of the home is competent and committed to the best interests and welfare of the people who live and work there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the new manager has been in post there have been positive changes to the care provision and record keeping at Baytree House. Residents now benefit from a detailed care planning, risk assessments to promote independence and on going assessment of needs. Administrative records are well ordered and up to date. Staff are supported in their roles through training and supervision to provide a good standard of care to the residents. This demonstrates that residents live in a home that is run and managed by a person, who is experienced and able to discharge, her responsibilities fully. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 23 The home has comprehensive policies and procedures in place in line with current legislation to safeguard the interests and rights of the residents and staff. The homes insurance and certificate is up to date and displayed in an area accessible to residents and parties involved in the home. All care records are kept in a locked office to maintain confidentiality. The inspector examined all health and safety records including fire checks, incident and accident book, complaints, staff files and training records, maintenance checks, water temperatures, regulation 37 reports and risk assessments. All were found to be up to date and in very good order. The Registered Manager confirmed that the resident’s finances are currently being organised so that each resident has their own bank account and their receipt of benefits is appropriate and up to date. Prior to the take over the residents money was ‘pooled’ and distributed. This practice has been stopped and each resident now takes responsibility for their own monies, with support of their key worker. An annual development plan and quality assurance system is in place for the company, which includes contributions from residents and their families. Use of consultation with residents, staff and their families ensure those providing and receiving care have an input into how the home is run. A quality assurance report will be published on an annual basis. Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Baytree House DS0000070061.V349461.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection 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. 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