Inspection on 18/11/05 for Butlin House

This inspection was carried out on 18th November 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

Butlin House 12/01/10

Butlin House 04/10/07

Butlin House 22/06/06

Butlin House 06/12/04

Butlin House 28/07/04

Butlin House 27/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Butlin House Beaverbrook Court Bletchley MILTON KEYNES Bucks MK3 7JS Lead Inspector Mrs Caroline Roberts Unannounced Inspection 18th November 2005 10:30 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 Butlin House DS0000042542.V267500.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. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Butlin House Address Beaverbrook Court Bletchley MILTON KEYNES Bucks MK3 7JS 01908 376049 01908 630534 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) Printers` Charitable Corporation Mrs Barbara Dorothy Lofters Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 35 Service users Nursing Care 5 (five) beds dually registered That the home may provide care for 1 (one) service user under the age of 65. That this condition relates to a single, specific service user and that should this service user, for whatever reason, leave the home this condition will cease to apply and the home is required to notify CSCI immediately. Date of last inspection Brief Description of the Service: Butlin House is a purpose built care home owned by the Printers Charitable Corporation. It is set in a small close in a residential area close to local amenities and is served by local bus services, in Bletchley. It can provide care for up to 40 elderly service users who have care and nursing needs. Accommodation is provided over two floors. All bedrooms are single occupancy with en-suite facilities. There are two communal bathrooms on the first floor and one on the ground floor which provide disabled bathing facilities. The home has a shaft lift and a stair lift. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Each care home that is registered with the Commission for Social Care Inspection, receives one announced and one unannounced inspection each year and further additional visits as necessary. All inspections, both announced and unannounced are followed by a written report, which eventually become public documents. It is a requirement that inspection reports are made available within the home. This inspection was unannounced and took place on the 18th November over a three-hour period. The inspector present was Mrs Caroline Roberts (lead inspector). The focus of the inspection was to monitor care practices and review staffing levels and deployment in the home. The homes care planning process was also reviewed. A number of additional visits have been undertaken by the Commission for Social Care Inspection following a complaint made to the Commission back in September 2005, the provider has been working very closely with the Commission to address the issues identified during these visits. The inspector found a relaxed informal atmosphere in the home. Residents consulted expressed satisfaction with the care provided. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. The inspector would like to state that the registered manager is on extended leave, a temporary manager has been appointed by the organisation to cover this period, so reference to the manager within this report refers to the temporary manager. What the service does well: Residents spoke highly of the staff and comments included: “The staff are wonderfully kind” “The food is good” A number of visitors were noted in the home during the inspection, one commented on being made feel welcome. Another commented that she had noticed changes in the home, and felt they were for the better” The home is clean and free from any offensive odours. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 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. Butlin House DS0000042542.V267500.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 Butlin House DS0000042542.V267500.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): 3,6 Residents are not admitted to the home unless they have had their needs assessed and the home is satisfied that they can meet those needs. Intermediate care is not provided in this home. EVIDENCE: The home has not had any recent admissions, however through discussion with the temporary manager it was ascertained that any potential resident would have an assessment of need conducted by the manager or one of the senior nurses prior to admission. The manager has developed her own pre admission assessment, which covers all aspects of the individuals needs; in addition to this the home may have a care manager assessment for those funded by the local authority. The manager stated that no residents would be admitted to the home unless she was sure that the home could meet their needs. Intermediate care is not provided in this home. Butlin House DS0000042542.V267500.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): 7,9, Residents health, personal and social care needs are not clearly detailed within the current care plan. Care plans are not subject to regular review and as a result do not provide staff with the information they need to satisfactorily meet resident’s health care needs. Storage of medication was adequate, however gaps on mar sheets were noted, this creates a potential risk to the health and welfare of residents. EVIDENCE: A requirement was served at the last inspection that Care plans must be in sufficient detail to provide clear guidance to staff on the actions to be taken to meet their health and welfare needs. Residents care plans must be kept under review. The manager was in the process of devising a new care plan format and was able to show one care plan that she had commenced for one resident, this care plan contained detailed information, concerning all aspects of the individuals needs, moving and handling assessments, and risk assessments. Advice was given to the manager on the development of the care planning system and the need for very specific information and guidelines in meeting identified needs. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 10 Progress with changing to a new care plan format will be monitored during the next inspection. A requirement will be served that the new care planning system be fully implemented by 1.3.2006. Medications are appropriately stored, the practice of administering medications was observed by the inspector this was conducted according to the homes policies and procedures and in a safe manner. It was noted however that a few unexplained gaps were evident on the medication administration sheets this is not acceptable practice. The manager is asked to review the MAR sheets on a regular basis to ensure they are fully completed. Fluid balance charts in residents rooms are still not being completed by all staff this was discussed with the manager. Butlin House DS0000042542.V267500.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): 12,13,14,15 Activities are not always taking place, therefore residents social and recreational needs are not being met. Residents are able to maintain friends and family contact as they wish. Routines in the home may impede on the choice and control residents have over their own lives. Residents receive a nutritionally balanced diet that reflects their individual preferences and dietary requirements and meals are taken in clean, comfortable surroundings. EVIDENCE: Activities have previously been displayed on the notice board, it was clear that on previous welfare visits these were not always taking place. The manager has employed an activities organiser; once the necessary pre-employment checks have been conducted a new programme of activities will be arranged in consultation with what residents want. The home does not have specific visiting times however; night visiting would need to be pre-arranged with the manager. The home has a small lounge upstairs that can be used for visitors, one visitor commented on how welcome she is made feel by the staff of the home. The manager has developed staff routine sheets, although direct guidance and leadership is required for the staff, the inspector is concerned that individual Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 12 choice will become second to routines, this cannot be allowed to happen and the manager is required to monitor the routine sheets to ensure that residents have choice and control over their lives. The inspector had the opportunity to observe lunch being served, residents were consulted with about portion size and plenty of staff were available to assist residents if needed. A number of residents were taken away from their meal as the Doctor had arrived to conduct his surgery, some residents refused to leave the table wanting to finish their lunch; staff commented that the Doctors rounds were at a difficult time. The manager is asked to discuss this with the Doctor to see if a solution can be found. The dining room is comfortable with adequate space for residents to take their meals. The tables were nicely laid. The home has rotating menus that are adjusted to reflect the season. Special dietary requirements are catered for. Refreshments are served throughout the day and residents are able to have a drink or snack as they wish. Residents spoken with commented on the food being good. The chef has worked at the home for a number of years and has effective routines and systems in place. The kitchen is spacious well equipped and clean. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Complaints have not been taken seriously and acted upon previously in line with company policies. This has now been reviewed to ensure that residents can feel confident that their concerns will be listened to and acted upon. Robust procedures are not in place to ensure residents are protected from abuse; staff training in this area will strengthen the homes policies and procedures. EVIDENCE: The home has a complaints policy and procedure in place however, it has become evident that this has not been followed, complaints have not been documented fully and no evidence of investigation available. The manager was not able to comment on this due to this issue being prior to her commencement. A complaint was made to the Commission for Social Care Inspection in September 2005, relating to care practices this was investigated in line with Milton Keynes Adult Protection Policy and up held, the providers have taken action to ensure that this does not happen again including internal investigations in to staff conduct. The providers are in the process of arranging Adult Protection Training for all staff, a higher awareness of what is constituted as abuse is needed by staff therefore a requirement is served that all staff should have received this training by 1.2.2006 Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 14 Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 15 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): 19,22,26 Residents live in a safe well-maintained environment, residents live in safe, comfortable bedrooms with their own possessions around them. The home is clean, pleasant and hygienic. EVIDENCE: The layout of the home is suitable for its stated purpose. It is well maintained, comfortably furnished and presents a homely atmosphere. The homes employs a general maintenance worker, records of maintenance and repairs are kept. The home has a large lounge and dining area on the ground floor, with a small lounge on the first floor. All bedrooms have en-suite facilities, comprising of toilet, washbasins and showers. Grab rails and raised toilet seats have been provided according to individual needs. Radiators have been covered with low surface temperature covers; hot water temperatures are monitored and recorded by the maintenance worker. The home was found to be clean and free from any offensive odours during this visit. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 16 Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 17 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 Resident’s needs are met by the numbers and skill mix of staff. Residents are not protected by the recruitment procedures undertaken recently by the manager. The training provided to staff will help ensure they are competent and confident to undertake their duties fully. EVIDENCE: The provider has recently reviewed staffing levels; the outcome was an increase in care staff throughout identified busy periods. Staff on duty during the inspection comprised of two nurses and 7 care staff, plus one nurse on an administrational day. Staffing appeared adequate with residents appropriately dressed, drinks within reach and those residents being cared for in bed looking clean, comfortable and warm. The recruitment files for two recently appointed staff were examined it was very disappointing to note that the recruitment of these staff had not been in line with company policy and legislation. One carer had only a character reference on file, no professional reference a POVA first check had been received however CRB clearance was not in place, this staff member had been working unsupervised and indeed was witnessed by the inspector providing care to a resident alone. The second carer had only one reference, and had commenced prior to the POVA first date, no CRB disclosure was in place again this staff member was observed working un-supervised. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 18 The recruitment procedures were discussed with the manager. A requirement is served that all recruitment of staff should be in line with Regulation 17(2) Schedule 4 The Care Homes Regulations 2001. A number of training courses have taken place over the last 6 weeks including: Diabetes care Moving and Handling Updates Infection Control Food Hygiene Dementia Care Induction Training A number of other training courses are planned after Christmas. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 19 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): 33,35 Effective quality assurance monitoring is not undertaken at the home; therefore actively seeking the views of residents and visitors is not undertaken. A systematic cycle of planning, review, and objective setting does not happen. Resident’s financial interests are safeguarded. EVIDENCE: The registered manager is on extended leave; a temporary manager has been employed by the organisation to cover this period. Requirements have been, made previously with regards to quality assurance monitoring within the home, this is still not being undertaken a further requirement will be made in this report. Residents can pay monies into the Butlin House Pocket Monies Account; this account is managed by the administrator who ensures that all transactions are well detailed with receipts maintained for any expenditure. Monthly Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 20 reconciliations are undertaken to ensure all transactions are accounted for. The home has a separate account with Barclays for this facility. The Deputy Director of the organisation can audit this account. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 3 X X x Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 22 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 OP33 Regulation 24(1) Requirement The provider is required to ensure that a quality assurance monitoring system is developed and implemented in the home. The provider and manager are required to ensure that all recruitment checks are in place prior to the commencement of any new staff. The provider is required to ensure that all staff have received adult protection training by 1/2/06. The provider is required to ensure that all complaints are fully documented and investigated. The manager is required to monitor the medication administration sheets to ensure correct procedures are followed when staff administer medications including signing the charts. The provider must ensure the new care planning system is fully implemented by 1/3/06 Timescale for action 01/05/06 2 OP29 17(2) 01/12/05 3 OP18 13(6) 01/02/06 4 OP16 22(3) 01/12/05 5 OP9 13(2) 01/12/05 6 OP7 15(1) 01/03/06 Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 23 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 OP14 Good Practice Recommendations The manager is to include within the quality assurance system, questionnaires that check whether or not the routine of the home is impeding on residents individual choices and wishes. Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Butlin House DS0000042542.V267500.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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