CARE HOMES FOR OLDER PEOPLE
Butterhill House Near Coppenhall Stafford ST18 9BU Lead Inspector
Mrs Kathryn Marks Unannounced Inspection 12th December 2005 09:30 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 Butterhill House DS0000062760.V268299.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. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Butterhill House Address Near Coppenhall Stafford ST18 9BU 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) 01530 260285 Mrs Shivvajkunver Jadeja Care Home 28 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (9) Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13/06/05 Brief Description of the Service: Butterhill House is a twenty-eight bedded care home for elderly people situated in the Coppenhall area of Stafford. On arrival at the home residents were sitting in the dining and lounge areas having just had breakfast. Pleasantries were exchanged with residents, staff and the care manager who greeted inspector in a friendly manner. The home stands in extensive mature grounds with attractive patio areas and mature gardens. The patio area overlooks a large lawn with an ornamental pool at the far end. Resident’s accommodation is located on the ground and first floor of the home offering both shared and single bedrooms, with a variety of en/suite facilities. Bathrooms and toilets are appropriately sited around the home and offer a range of ensuite facilities. The home has three lounge areas for individuals to move around in as they wish. There is a large orangery that is used as a dining room and for social events, this area is light, spacious, and is currently decorated for Christmas. Secluded quiet rear walled patio areas have been created that are attractive and tranquil to sit in. Rear ground floor bedrooms open onto this area and could have tables and chairs outside if resident wished. The local primary health care team visit the home as required and are always available for advice. There is no public transport in the area so a car is necessary when going out. One resident has own car and goes out independently. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over half day on Tuesday 12th December 2005. During the inspection the inspecting officer received comments from residents About life at the home and how staff cares for them all were of a positive nature. “Like home from Home” “ whatever you want you only have to ask” “ Staff are kind to you”. Proprietor/Care Manager provided written information regarding staffing, staff training, menu and dietary provision that was observed by the inspector to be in place at the home. On arrival at Butterhill House residents had completed breakfast food is prepared fresh as individuals make their choice. Inspector was greeted in a friendly manner and invited into the orangery and offered a cup of tea. Residents accommodations is located on the ground and first floor observations of the inspector of areas that were visited were that the home was clean, very well maintained and free from odour. Resident’s bedrooms were personalised with favourite items they had brought into the home with them. Butterhill House has in place a Statement of Purpose and Service Users Guide to inform residents and relatives of the services and facilities provided. All service users have a full assessment of their needs carried out prior to admission to the home. Arrangements are in place for meeting the health and personal care needs of residents and details are recorded in care records. Social opportunities are organised for those residents who wish to be involved. The menu indicates that residents are provided with a choice of well-balanced and nutritious food. Records of food provided are maintained. The home has in place a complaints procedure that residents asked were aware of, this is given to relatives and resident on admission to the home. The complaints procedure is displayed in the home along with details of how to contact The Commission for Social Care Inspection. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 6 There is a nucleus of experienced staff at the home who are competent to care for older people and were able to discuss diseases associated with old age. Appropriate recruitment procedures are carried out and staff prior to employment has Criminal Records Bureau and Pova Checks carried out. In some cases where new staff are from European Countries then translated police checks are in place. The Inspector saw evidence of this at the time of the previous inspection. What the service does well: 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. Butterhill House DS0000062760.V268299.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 Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. The homes Statement of Purpose and Service Users Guide provides prospective residents with details of the services the home has to offer enabling an informed decision about admission to be made. EVIDENCE: The homes Statement of Purpose and Service Users Guide is given to residents and relatives clearly describing the services and facilities the home is able to offer. These documents are to be updated to include details of the new Care Manager. All residents have contracts of terms and conditions of residence at the home a copy of which is on resident’s files. A full assessment of individual needs is carried out prior to admission to Butterhill House to ensure that the needs of residents can be met. The prospective resident or their relative would visit the home where possible and staff would visit the individual in their own home or current surroundings. The outcome of the assessment is confirmed to individuals in writing.
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The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. The health personal and social care needs of residents are well met with evidence of good working practices taking place. The systems for the administration of medication are good with clear arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: All residents had an individual plan of care that has been updated. Risk assessments are carried out and included in care records. All contacts regarding health and personal care are recorded in care records. Lockable facilities are provided for residents for the safe storage of valuables and medication should they self medicate. Policies are in place to inform staff of systems and procedures in the home. Residents spoken to said they were treated in a dignified and respectful way and this was the observation of inspector in the home today.
Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 10 The home has in place a policy for death and the dying that is discussed with the resident or their families at the time of producing a care plan. Two residents were case tracked care plans were seen residents spoken to and bedrooms visited. Butterhill House DS0000062760.V268299.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): 12,14,15. The systems for resident’s consultation in the home are good with a variety of evidence that indicates that resident’s views are sought and acted upon. There was a relaxed and friendly atmosphere with residents moving freely around the home. The cooks at Butterhill House are providing a choice of traditional food at the home with fresh produce being used. EVIDENCE: Residents confirmed that they were content with their lifestyle at Butterhill although it was different with the change of proprietors but not in a negative way. Residents said various social opportunities are available and current plans include choir, classical music singer, visiting girl guides, Christmas carols, organist, facials, nails, visit to theatre, quizzes etc. There is open visiting at the home with the majority of residents being in contact with their families, one resident is accessing advocacy service. Another resident drives her own car and takes herself out as she wishes.
Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 12 Observations were made of staff consulting residents and encouraging them to make choices about their daily routines. Traditional menu is in place with a choice at all meals records of which are maintained. Care staff are going into the kitchen to make morning and afternoon drinks it is recommended that the cook make drinks to limit number of care staff in kitchen. Butterhill House DS0000062760.V268299.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): 16,17,18. The home has a satisfactory complaints system with some evidence that service users feel their views are listened to. EVIDENCE: There have been no complaints received about the home since the last inspection. Minor grumble recorded regarding laundry going to wrong bedrooms residents said this has now been resolved Butterhill House has a complaints procedure in place this is displayed in the hallway and contained in the service users guide. The home has in place a book to record any complaints and how they are dealt with. Discussions with some residents identified that they were aware of the complaints procedure and if unhappy about something they would talk to the care manager. All residents have family support and are assisted by families to maintain their legal rights. Residents are protected from abuse by staff awareness, observations, and training. Policies and procedures are in place at the home.
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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): 19,20,21,22,23,24,25,26. The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: The home generally is well maintained and suitable for its stated purpose. Programmes of routine maintenance are in place work carried out being identified. Externally there are attractive grounds with patio, walkways and seating. There is also a large pond in the garden and the care manager has carried out a risk assessment on this area, as it is unguarded. Quotes have been obtained to fence the area. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 15 Bathrooms and toilets are appropriately sited around the home with a variety of assisted facilities. Specialist equipment is provided, as residents require. Bedrooms have been individualised with favourite items residents have bought to the home with them. The home was free from offensive odour. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 16 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): 27,28,29,30. Morale of staff on duty today was observed to be high with the staff team working well together with residents to improve their quality of life. The atmosphere in the home was very calm and relaxed with positive interaction taking place. EVIDENCE: At the time of this inspection visit observations identified that staff on duty were as the rota and were sufficient in number to meet the observed needs of residents in their care. Appropriate recruitment procedures are in place with Criminal Records Bureau checks and Pova checks being carried out. The recently appointed Care Manager was on duty and the proprietor was also present in the home along with four care staff and a cook. Residents commented, “ that staff are lovely and look after you well” lots of banter and cheerful exchanges taking place. The Care Manager is reviewing all staff training and a matrix is to be put in place. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. The manager is supported by the proprietor in providing clear leadership throughout the home with staff on duty demonstrating an awareness of their roles and responsibilities. EVIDENCE: The Registered Manager is competent and experienced to run the home. For the last five years she has worked as Care Manager at three homes. Care Manager experience/Qualifications: She has the Registered Managers Award, NVQ level 4, D32, D33, Food Hygiene, Medication Training, and has attended courses for dementia care, care planning and risk assessments Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 18 Observations of the inspector were that staff were knowledgeable about the needs of residents in their care and were meeting those needs in a sensitive caring way. Robust recruitment policies and procedures are in place, Criminal Records Bureau checks, Pova checks, and two references are taken up prior to the appointment of staff. All new staff is subject to a six months probationary period. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 20 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. 1 Refer to Standard 15 Good Practice Recommendations Cook should make morning and afternoon drinks and staff should collect them from the servery. Butterhill House DS0000062760.V268299.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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