Inspection on 13/06/05 for Butterhill House

This inspection was carried out on 13th June 2005.

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

Butterhill House 05/06/07

Butterhill House 03/05/06

Butterhill House 12/12/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Butterhill House Butterhill Lane Coppenhall Stafford Staffordshire ST18 9BU Lead Inspector Kathyrn Marks Announced 13 June 2005 08:00am 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 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 E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Butterhill House Address Butterhill Lane Coppenhall Stafford Staffordshire ST18 9BU 01530 260285 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Shivraj Jadega Mrs Caroline Ward CRH 28 7 28 9 Category(ies) of DE(E) registration, with number OP of places PD(E) Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 10 February 2005 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 lounges waiting to go into breakfast all had cups of tea. Pleasantries were exchanged with residents, staff and the Care Manager who greeted inspectors in a friendly manner. The home stands in extensive mature grounds with attractive patio area with newly planted pots and containers. New patio furniture has been purchased and this area overlooks a large lawn with an ornamental pool at the far end. Residents 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, smoke free and overlooks the garden. Secluded quiet rear walled patio areas have been created that are attractive and tranquil to sit in. Rear ground floor bedrooms open into this area and could have tables and chairs outside if residents 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 their own car others rely on the Care Manager and proprietor or relatives to take them out. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over one day on Monday 13th June 2005. Prior to the inspection the inspecting officer received responses to seven comments cards from three relatives and four from residents. Generally comments were of a positive nature, one comment from a resident relating to the choice of sandwiches and a comment from another resident’s relative relating to management is being addressed by the proprietor. Comments cards provided written evidence of how the residents who had responded felt about the home and the care provided for them. 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 were waiting to go into breakfast where food is prepared fresh as individuals make their choice. Inspectors were greeted in a friendly manner and invited to the home. During breakfast residents decided on how they wished to spend their day. Residents accommodations is located on the ground and first floor observations of the inspector were that the home was clean, very well maintained and free from odour. One of the residents made an unsolicited comment about a domestic staff “When she cleans, she cleans” this shows when walking around. 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. Arrangement 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. However, the menu is not being strictly followed and no records are being maintained of food provided, this will be a requirement of the report. There were no complaints about food from residents who enjoyed their lunch today. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 6 The home has in place a complaints procedure that residents asked were aware of, this is given to relatives and residents on admission to the home. The complaints procedure is displayed in the home along with details of how to contact The Commission of Social Care Inspection. There is a nucleus of experienced staff at the home that 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 Record 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 that time of this inspection. What the service does well: What has improved since the last inspection? Good care practices are in place supported with the care plans that had been updated by the new proprietor/Care Manager. The Care Manager has now commenced formal supervision of staff. Staff training is taking place and training records are in place along with a training plan. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 7 The deputy is going on a trainer’s course for moving and handling. Infection control training is booked to take place. Risk assessments now included in care records for residents. Risk assessment in place for pregnant member of staff. Holiday and sickness records are in place Staff and residents now have photographs on files. All staff administering medication has been trained to use the system in the home. Three staff working through the distance learning training on management of medication. There is now the provision of an office in the home. Metal trolley has been provided for the storage of medication this is situated in the locked office that provides a double locked facility but trolley will be secured to the wall. The proprietor is looking at the provision of a metal wall cabinet to provide further storage. A number of carpets have been replaced. What they could do better: Records of food provided must be maintained along with alternative choices available. Review of staffing be carried out and staff deployed evenly over the week and weekends. Senior staff should share the on call. Unused mediation must be returned to the pharmacy. Cats and dog must be kept out of areas where food is prepared and eaten. Hazardous substances must be securely stored. Risk assessment to be carried out on the 5ft deep garden pond to ensure safety of residents. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 8 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 E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 9 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 Standards Statutory Requirements Identified During the Inspection Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 10 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 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. 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 at their own home or current surroundings. The outcome of the assessment is confirmed to individuals in writing. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 by the new Care Manager. 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. Detailed records are in place for the administration of medication, however, short life drugs need to be dated, medication should be stored in original containers, and unused mediation must be returned to the pharmacy. Policies are in place to inform staff of systems and procedures. Residents spoken to said they were treated in a dignified and respectful was and this was the observation of inspectors in the home today. 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. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 12 Two residents were case tracked care plans were seen residents spoken to and bedrooms visited. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 13 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 standard(s) 12,13,14,15. Residents were consulted about routines in the home. There was a relaxed friendly atmosphere with individuals moving freely around Butterhill House. The food observed in the home today was nicely presented and looked appetising although no recent records had been maintained of food provided. EVIDENCE: Residents confirmed that the home was different with the new ownership but that they were content with their lifestyle and like the Care Manager. Residents said recent entertainment had included the Morris Dancers, music, bingo, visit from guides and games. 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. Observations were made by staff consulting residents and encouraging them to make choice about their daily routine. Menu in place but this is not strictly followed, there are no recent records of food offered or provided or of alternative choices, this is a requirement of this report. Breakfast and lunch today did look nicely presented and portions were generous, residents said they enjoyed their food. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 14 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 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. Butterhill House has a complaints procedure in place this is displayed in the hallway and contained in the service user 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 one resident said she would talk to her daughter if unhappy about something and another said they would talk to the Care Manager. All residents with the exception of one have family support and are assisted by families to maintain their legal rights. One resident is seeking an advocate to act on her behalf. Residents are protected from abuse by staff awareness, observations and training. Policies and procedures are in place at the home. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25,26. The standards of the environment in the home are generally good providing residents with an attractive and homely place to live. Areas in the kitchen need to be addressed. 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 been asked to carry out a risk assessment on this area, as it is unguarded. Bathrooms and toilets are appropriately sited around the home with a variety of assisted facilities. Specialists 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 E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 16 Observations were made in the kitchen of dirty fly screen and fly catcher, brown sealant around the sink, no food temperature records, food in the fridge that required dating, not current food temperatures. Observations were also made of cats and dog wondering around areas where food is prepared and eaten. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. Staff morale, although improving remains low resulting in some staff turnover and sickness that disrupts consistency of care to service users. EVIDENCE: At the time of this inspection visit observations of staff identified that staff on duty were as the rota and were sufficient in number to meet with 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 although the home is experiencing long delays in these checks being carried out and this has resulted in staffing difficulties. Since February when the new proprietor took over there has been 86 days of sickness amongst staff. The Care Manager and deputy have covered a lot of hours between them. The Care Manager has been doing 7 nights on call most weeks. On call must be shared between senior staff. The staffing rota is unevenly balanced with 6 staff on duty some weekdays and 2 at weekends. A review and redeployment of staff rota of duty to cover 7 days evenly must be carried out. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38. 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. She has 20 years experience caring for the elderly. She has completed training courses in Care of the Elderly, Working with Frail Elderly, Understanding Dementia, Effective Management, Internal Quality Audit, Quality Audit Standards, NVQ Assessor D32/33, Teaching Certificate, Safety Compliance, Safe Handling of Medicines. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 19 There were issues in the kitchen where food in the fridge was not labelled or dated. Safe working practices are in place staff training taking place and an ongoing training plan in place. Relevant legislation is in place with policies and procedures to inform staff of practices at the home. Appropriate risk assessments are carried out and form part of the resident’s care record. A formal quality assurance system is being put in place at the home. Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 x STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 2 Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? 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 9 Regulation 13 (2) Requirement The registered peron shall make arrangements for the recording , handling, safe keeping, safe administration and disposal of medicines received in to the care home. Records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the residents a) ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents. A review of the deployment of staff hours of work to be carried out. The registered person shall ensure that all parts of the home to which residents have access Timescale for action 7 Days 2. 15 & 38 17 (2) Schedule 4 para 13 7 Days 3. 27 18 (1) 2 weeks 4. 19 13 (4) (a) & (c) 7 Days Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 22 are so far as it reasonably practicable free from hazards to their safety; unncecessary risks to the health or safety of residents are identified and so far as possible eliminated Risk Assessment to be carried out on pond. The dog and three cats to be kept under control and away from food preparation and eating areas. 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. 2. Refer to Standard 27 19 Good Practice Recommendations On Call to be shared between senior staff Risk Assessment to be carried out on the garden pond Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - 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 © 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 Butterhill House E51-E09 S4925 Butterhill Hse V233894 13.06.05 Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!