Inspection on 25/01/06 for Butterley House

This inspection was carried out on 25th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Butterley House 19/04/07

Butterley House 24/04/06

Butterley House 09/11/05

Butterley House 06/07/05

Butterley House 22/03/05

Butterley House 29/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Butterley House Old Coach Road Ripley Derbyshire DE5 3QU Lead Inspector Brian Marks Unannounced Inspection 25th January 2006 09:00 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 Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Butterley House Address Old Coach Road Ripley Derbyshire DE5 3QU 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) (01773) 745636 Mrs Patricia Diane Smith Ms Jean Fountain Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Plus Five (5) Day Care Places 1 PD Place. On a named person basis for the person named in the notice of proposal letter dated 9 August 2004. 9th November 2005 Date of last inspection Brief Description of the Service: Butterley House is a large detached building, which has been adapted and extended as a care home. The home is situated on the outskirts of Ripley, set back from the main road, bus route and local amenities, in a rural location. The home provides personal care for up to 37 people aged 65 years and over and is also approved for up to five day places. All bedrooms are single rooms, the majority with en-suite facilities. The home is on two floors and access to the first floor is by stairs and a stair lift. The three lounge areas, conservatory and dining room are on the ground floor. On-site laundry services are provided. The home has well set out garden areas, which are accessible to service users. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over a morning. Additionally, time was spent in preparation for the visit, looking at previous reports and other documents. At the home, apart from examining documents, care files and records, time was spent with the proprietor and manager and speaking to 2 of the residents and 3 staff. The staff were observed throughout the visit, looking after and dealing with residents and visitors. An important activity of inspection is the careful examination of residents’ individual care records, and 2 were selected for this purpose. The aim of inspection activity during the current inspection year is to assess a service against the ‘key’ National Minimum Standards and these are identified at the beginning of each section of the report. A number of these keys standards were examined at the last 2 inspections so, for a more complete picture of this service, this report should be read in conjunction with the report dated 6 July 2005 and 9 November 2005. What the service does well: What has improved since the last inspection? The poor situation in the home’s kitchen described at the last inspection has been considerably improved and standards have been raised to an acceptable level with organisation and record keeping restored. With the recommendations from a recent inspection by the Environmental Health Officer completed or in hand, the catering service is safer and operating with the needs of the residents and the law fully in mind. Staff training has continued and standards of safety and protection of the residents maintained through this and trough the general standards of health and safety activities. The checks made on staff before they can be employed are also contributing to the safety of residents and are now compliant with the law. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 6 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. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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 Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not specifically looked at this inspection, other than to note that the proprietor has purchased an ‘off the shelf’ set of care recording documentation that will replace those currently in use. The transfer of all assessments and care plans will commence shortly. For the full assessment of the key standards see the inspection reports dated 6 July 2005 and 9 November 2005. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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, 8 and 9 The care of all residents, including health care, is planned and given in ways that respect individuality and privacy. The administration of medicines at the home requires some improvements to ensure that it is safely organised. EVIDENCE: As reported above the manager is in the process of introducing a new system of documentation of recording resident care, and this should eliminate the problems identified at previous inspections. From discussion and examination of care records the health needs are residents are attended to and a number of specific areas are looked at as part of the process followed during admission to the home. These include Parkinson’s disease, diabetes, mobility problems and falls, diet and nutrition, mental health and medical issues linked to possible skin breakdown. Residents are encouraged to retain their own GP if practical, and the manager reported good relations with local practices and District Nurses. The latter was visiting residents during the morning of the inspection. Records indicated how residents are assisted to keep up appointments at outpatient clinics; this helps with continuity of care. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 10 The home operates the Monitored Dosage System for medicines management on behalf of the people living there and the examination of records and storage areas indicated this to be generally satisfactory, with procedures followed that ensured safety and consistency. For example, the record sheet of each person contains their photograph to make sure that administration of the medicines is to the right person. However some amendments to practice need to be carried out to ensure complete safety and proper administration: Instructions and protocols for the administration of occasional medicines (PRN) were not on the daily record sheets. Verbal instructions that had been given by the GP were not on the daily record sheets. There were unlabelled medicines in the storage cupboard that the manager stated were no longer needed. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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 and 15 Residents at the home enjoy a life that they find satisfying with good contacts maintained with family and friends. Arrangements in the kitchen have been much improved, and meals are an enjoyable part of life. EVIDENCE: From discussion with residents, staff and management and examining records, reasonably active lifestyles are encouraged, if not always achieved. A range of activities are organised and residents spoke of being able to follow their own interests and routines through the day. Those that were able to speak out were quite clear about being able to please themselves around the home. Contact with families is encouraged through an ‘open door’ policy, and good numbers have been seen at the home during this year’s inspections. Some community groups have been in contact with the home, particularly over festival periods, and there is a weekly church service that is popular with residents. At the last inspection considerable problems were identified with the kitchen arrangements at the home, and it was evident that this part of the home’s service lacked proper organisation, documentation and consistent supervisory control. Since that visit the Environmental Health Officer has also visited and similarly identified the kitchen as a problem area and has made a range of requirements to be followed. The proprietor and manager are to be Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 12 commended in the swift action they have taken to reverse this situation and all the requirements made at the last inspection have been addressed: A new 4-week menu has started to be developed and recently introduced; it is also displayed in the dining room on a daily basis. This includes a clear choice available and cooked option at breakfast and afternoon tea. Documents recording of meals served at the main mealtimes have been developed for use in the kitchen. A schedule of cleaning arrangements for the kitchen is in place. The report from the Environmental Health Officer is available for examination and all recommendations have been carried out or are in hand. Documentation itemising individual resident preferences, allergies or other diet management related issues are retained in the kitchen. The storage areas have been cleared of clutter The kitchen floor has been properly cleaned and estimates are being sought for its replacement. Despite these difficulties the observations of residents spoken to have been positive about the quality and quantity of food served at the home, and remain so. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 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 The managers of the home have a positive attitude to people raising concerns about the home and these are dealt with promptly and satisfactorily. EVIDENCE: The home maintains good records in relation to the concerns and complaints that are raised and those that had been looked at recently had all been resolved satisfactorily. People are informed of the procedure for making a complaint within the information that is given out at the time of coming to live at the home and a copy is on display in the home’s entrance. For the full assessment of the other key standard see the inspection reports dated 6 July 2005 and 9 November 2005. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 14 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 Standards of maintenance, cleanliness and hygiene of the home have been continued. EVIDENCE: The manager had consulted with the local Environmental Health Officer who had recently carried out an inspection and all the recommendations of that inspection have been carried out or are in hand. Work arising from a previous inspection by the Fire Officer was about to be completed. Estimates for the replacement of the carpet in the dining room and corridor had been received. For the full assessment of the key standards see the inspection reports dated 6 July 2005 and 9 November 2005. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: These standards were not specifically looked at this inspection, other than to note that the difficulties with staffing arrangements in the kitchen had been resolved, that NVQ training for care staff was ongoing and the targets should be achieved by this summer and that all the information on new staff, required by law, had been acquired in relation to the person most recently recruited. For the full assessment of the key standards see the inspection reports dated 6 July 2005 and 9 November 2005. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 16 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 and 38 The managers make sure that the home continues to be operated with the views of the residents in mind and continue to plan ahead. The residents’ money that is retained at the home is properly looked after. EVIDENCE: The manager demonstrated a number of examples of the questionnaires that had been used at the home with the residents and their relatives in order to formally obtain views on the running of the home, and how it might be improved. She was also able to give practical examples of how these surveys had changed staffing arrangements in the home to improve things, which demonstrated a positive approach to monitoring. The managers have also produced an action plan for this year that outlines the key areas for improving things at the home; this shows that they are committed to keeping the home moving forward and making sure that quality work is maintained. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 17 The examination of records indicated that the systems in place for looking after residents’ money are properly managed and mistakes are not made. The money that is kept at the home is limited to small amounts of spending money for 15 residents, and this is safely stored. A complete audit of health and safety matters had been carried out at previous inspections but it was noted that safer use of wheelchairs had been introduced. Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 18 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Timescale for action 30/06/06 2. OP7 15(2) 3. OP9 13(2) 4. OP9 13(2) The registered person must introduce the proposed new documentation that records the assessments of all resident needs at the point of admission to the home. The registered person must 30/06/06 introduce the proposed new documentation that records the care plans of residents and how service users needs are being met, including identified risks. They must be kept updated and regularly reviewed and must show the involvement of service users/relatives. Instructions and protocols for the 28/02/06 administration of occasional medicines (PRN) must be recorded in writing on the daily record sheets, and dated and signed by a responsible person. Verbal instructions in relation to 28/02/06 the administration of medicines that had been given by the GP must be recorded in writing on the daily record sheets, and dated and signed by a responsible person. DS0000019955.V279757.R01.S.doc Version 5.1 Butterley House Page 20 5. OP9 13(2) 6. OP19 16(2) 7. OP19 23(5) 8. OP19 23(4) 9. OP28 18(1) All medicines that are unwanted, unlabelled or surplus to requirements must be safely disposed of. The registered person must replace the carpet in the dining room and the adjoining corridor. (Previous timescale of 30/09/05 not met). The registered person must comply with the requirements made at the recent inspection by the Environmental Health Officer. The registered person must comply with the requirements of the inspection carried out by the Fire Officer. (Previous timescale of 30/09/05 not met). The registered person must ensure that 50 of care staff achieve a minimum of NVQ level 2 by the due date. (Previous timescale of 31/12/05 not met) 28/02/06 28/03/05 28/02/06 28/02/06 30/06/05 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 OP1 Good Practice Recommendations The registered person should combine the current documents entitled Statement of Purpose and Welcome to Butterley House as the new Statement of Purpose for the home. The registered person should review the arrangements for activities and social life at the home and consult with residents and their representatives about their wishes in this area of the home’s operation. The documentation recently developed for improving the catering service of the home should been fully introduced. DS0000019955.V279757.R01.S.doc Version 5.1 Page 21 2. OP12 3. OP15 Butterley House 4. 5. 6. 7. OP16 OP21 OP29 OP29 Establish regular meetings with residents/relatives to obtain their views about the care and services. Create a domestic appearance in the toilets and bathrooms. The application form for employment at the home should be amended to include a declaration about the applicant’s physical and mental health. Personnel files should contain documentary evidence that staff have received written terms and conditions of employment. The home’s management should include discussions with staff and relatives within the annual planning process. 8. OP33 Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Butterley House DS0000019955.V279757.R01.S.doc Version 5.1 Page 23 - 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!