Inspection on 22/05/07 for Butterpark Residential Home

This inspection was carried out on 22nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Butterpark Residential Home 30/10/06

Butterpark Residential Home 21/03/06

Butterpark Residential Home 12/07/05

Butterpark Residential Home 11/01/05

Butterpark Residential Home 06/07/04

Butterpark Residential Home 10/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Butterpark Residential Home Brook Road Ivybridge Devon PL21 0AX Lead Inspector Margaret Crowley Unannounced Inspection 22nd May 2007 10:00 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 Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Butterpark Residential Home Address Brook Road Ivybridge Devon PL21 0AX 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) 01752 891025 01392 385136 paula.hannaford@devon.gov.uk www.devon.gov.uk Devon County Council Mrs Paula Ann Hannaford Care Home 30 Category(ies) of Dementia (9), Old age, not falling within any registration, with number other category (30), Physical disability (30) of places Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. In Harford View, a total of 8 older people who may also have a physical disability may be accommodated to receive intermediate care. In Harford View, people who are aged 55 and over, and who may have a physical disability may be accommodated to receive intermediate care In Brooklands, a total of 13 older people who are aged 65 and over who may have a physical disability may be accommodated to receive long term or respite care In Stowford, a total of 5 older people who also have dementia may be accommodated to receive intermediate care In Stowford, people who are aged 55 and over who also have dementia may be accommodated to receive intermediate care In Erme, a total of 4 older people who also have dementia may be accommodated to receive respite care In Erme, people who are aged 55 and over who also have dementia may be accommodated to receive respite care 30th October 2006 Date of last inspection Brief Description of the Service: Butterpark is a care home registered to provide care for 30 older people, which is owned and managed by Devon County Council. It is located within the town of Ivybridge and has easy access to the town centre and community facilities. The premises are a two-storey detached building that has a large enclosed garden at the rear. Accommodation is provided in single rooms. The home is comprised of four units, which are accessed through the main entrance. These have lounge, dining and bathroom/toilet facilities, and a small kitchen for the preparation of drinks and snacks. There is also a large shared lounge that is used for social events. The four units are: Harford View, a self-contained unit on the ground floor and which provides intermediate care for eight older, frail people and who may a physical disability. Stowford, an assessment unit for five people who have dementia and which is situated on the ground floor. Erme, a respite unit for four people who have dementia. Erme adjoins Stowford and the units share some communal facilities. Brooklands, which provides long term care and respite care for thirteen older people who are frail and who may have a physical disability. It is situated on the first floor. The fees vary according to the role of the units. These range from no charge Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 5 for intermediate care, and up to a maximum of £556 for residential care. Written information is provided for people considering using the services and those who are resident. A copy of the most recent CSCI inspection report is displayed in the reception. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 10 hours on 22nd and 23rd May 2007. Paula Hannaford, the registered manager was present in the home on both days. A tour of the premises was made and most rooms were seen. Records were inspected, including care, medication and staff records. Many of the twenty-three people staying in the home were spoken with, which included people in each of the four units. Six people spoken to in more depth, regarding the lifestyle in the home and the care services they were receiving. In addition, 3 relatives were spoken to. Staff were observed in the course of their daily duties and 7 were spoken with. Feedback questionnaires were received from 4 residents, 3 relatives, 4 staff, 2 general practitioners and 2 social services care managers. What the service does well: People in all four units were pleased with the care that they were receiving. Staff were described as “ fantastic”, “always cheerful”, “always helpful”, and a comment made that “they always come quickly if I have to call, even at night”. Relatives said “Butterpark has given my wife all the support and encouragement she could wish for” and “my mother seems very happy in this home”. Butterpark provides a valuable multi-purpose resource for older people. People in the intermediate care units, relatives and care managers said they valued the assistance provided. This enables people to return home, or to make decisions about alternative care. Butterpark also provides respite services that benefit both older people living in the community and their carers. A support group is held at the home for the carers of people with dementia. The home continues to provide a warm, homely environment for a small number of people who have lived at Butterpark for several years. People receive a good standard of care. They have clear care plans, which are reviewed to ensure that they receive the care that they need. Harford View and Stowford benefit from having specialist services in the units such as physiotherapy and occupational therapy. There is good liaison with the community health and psychiatric teams. The premises are comfortable, clean and homely. There are pleasant communal areas and safe, spacious gardens that people enjoy using. The meals provided were described as “ just as good as home cooking” and “ always good, with plenty to choose from”. A balanced and nutritious diet is provided. The home is well managed and has clear, efficient systems in place. There is a good balance of trained and experienced staff working in the home. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 8 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 Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3,6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is clear information available and admission procedures in place for all the four units to ensure that the needs of people who chose to use the services can be met EVIDENCE: People who had been admitted recently were spoken with in all four units. They said that staff were kind and welcoming. Written information is available for each unit. Some people had received the information before coming to the home, but not all those people in Harford View intermediate care unit who had been admitted from hospital. Social Services care managers have been supplied with the information and asked to ensure that it is given to anyone considering using the intermediate care and respite services. The assessment processes and tools used vary in the four units, partly because of their different functions. The records inspected showed evidence of good assessments, which had also involved multi-disciplinary colleagues. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 10 Since the last inspection the manager has initiated liaison meetings with referral agencies to improve pre-admission assessments undertaken by them. This has been particularly important regarding admissions to Harford View because of previous issues about inappropriate admissions of people who were medically frail. From an inspection of records it was clear that the unit is working hard to address this and is monitoring admission information and feeding back any concerns to the referrer. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People staying at Butterpark have clear care plans, which enable their health and personal care needs to be met. EVIDENCE: People in all units said that they were being well cared for and praised staff for their attention to their needs. Relatives also said they were very satisfied with the care. One relative described the service in Stowford dementia unit as “A” plus. People receiving re-ablement in Harford View were very appreciative of the quality of the assistance they were receiving to enable them to return home. A minority of people said that staff were very busy at times, but also said that they received attention promptly. The inspector observed staff interacting with residents in an appropriate and friendly manner. People said that staff assisted them with their personal care sensitively and always respected their privacy. Records inspected contained clear care plans to enable health and personal care needs to be addressed. Care plans are reviewed at a frequency that varies according to the unit’s function. There were clear review processes in place in all units. In the intermediate care units reviews are held more frequently to Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 12 enable plans for discharge to be put in place. Daily records showed that peoples’ care is monitored and any concerns are recorded and dealt with. There are clear systems and instructions for the storage and administration of medicines. Each unit has a storage facility for medicines. Medication records were inspected and found to be in order. Where a person wishes to administer his or her own medicines this is subject to risk assessment. A training programme in the safe handling of medication is provided for all staff that administer medicines. Only senior staff administer medicines and they are not allowed to carry out the task until they are assessed as competent. At the time of the last inspection the home was experiencing difficulties in obtaining general practitioner cover from local g.p. practices for people who were registered with general practitioners in other parts of the area. The issue has now been resolved and the cover being shared by four practices in rotation. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are enabled to live a flexible lifestyle with activities available to provide interest for them. EVIDENCE: Routines within the home are flexible to ensure that people can choose how they spend their time. Various activities take place within each unit. This includes artwork which had recently been produced and was displayed in Stowford /Erme . Events such as coffee mornings, bingo sessions and themed events and are advertised and shared between the units. During the inspection musical entertainment took place in the large main lounge, which people said they enjoyed, including the opportunity to sing and dance. Some people liked sitting outside in the pleasant garden enjoying the good weather. Others went out for a walk with staff. Some people said they prefer to spend time in their own room and like individual time spent with staff when this is available. One person said he enjoyed listening to the radio and another said he liked reading, but there was a lack of suitable large print books. The manager said she would address this. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 14 People are encouraged to maintain their skills and their independence, for example one person was seen helping in the garden. In Harford View re-ablement unit people are given the opportunity to prepare food and drinks as part of the assessment and preparation for their return home. Staff in Stowford dementia unit also like to provide this opportunity, but said that the higher levels of needs of people coming into the unit and the staffing implications, mean this now takes place less frequently. There is an open visiting policy. Visitors to the home said that they are always made welcome. People in all units praised the quality and range of the meals available. Individual choices and special diets are catered for. Meals seen during the inspection were of a good standard. Fresh produce was seen and a nutritious and well-balanced diet provided. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16,18.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People staying at Butterpark can be confident that procedures are in place to enable them to complain and to protect them from abuse. EVIDENCE: The home has a written complaints procedure that is on display and is included in the residents’ guide. People spoken with said they would raise concerns with the manager or senior staff, either by themselves or ask their relatives to do it on their behalf. The manager said that no complaints had been received since the last inspection and none were recorded in the complaint book. The Commission for Social Care Inspection has not received any complaints since the last inspection. There is a safeguarding adults policy and procedure which is accessible to staff. All staff attend training in this as part of a rolling training programme by Devon Social Services Department. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,24,26.Quality in this outcome area is adequate . This judgement has been made using available evidence including a visit to this service. People stay in accommodation that is comfortable and homely. EVIDENCE: Butterpark is decorated in a homely style and has pleasant communal areas and attractive gardens for people to enjoy. The home has its own maintenance worker and routine work is attended to systematically. Since the last inspection the bathroom in Brooklands unit has been completely refurbished and upgraded and the shower in Stowford unit has been completed which provide better facilities for people staying in those units and staff assisting them. The premises were very clean, hygienic and free from unpleasant odours throughout. The plans to provide major refurbishment of Brooklands unit to bring the accommodation in line with National Minimum Standards have not proceeded Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 17 because Devon County Council plans to sell the premises. The bedrooms in Brooklands are small and have insufficient electrical sockets. The unit has only one bathroom for 13 bedrooms. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27.28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by staff that are recruited appropriately and are trained and experienced. EVIDENCE: Communication seen between staff and people living in the home during the inspection was friendly and positive. People said that staff were kind and helpful, and relatives and visiting professionals confirmed this. Although staff were regarded as accessible and available without delays, comments were made that staff “were busy”. Staff spoken with and feedback from staff questionnaires showed that staff generally are positive about their work and the standard of care provided. Some staff said they would like more time to spend with residents. Staff value the training opportunities available and said they work together well. There have been staff shortages due to long term sickness and vacant posts. Staff are transferred between the units when necessary to provide assistance. Staff rotas were inspected and the registered manager said that staffing levels are maintained at an appropriate level. Cover for senior posts has been managed within the unit and agency staff are used only if necessary. The manager is addressing an issue regarding more even distribution of domestic help across the unit, which can impinge on care staff’s time. The home has good working relationships with services for people with dementia and a psychiatric nurse is to be attached to Stowford/Erme unit. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 19 There is a good level of skills, training and experience within the staff group. 64 of care staff currently hold the National Vocational Qualification in Care at level 2 or above, and there is a rolling programme of staff attending this training. Staff value their access to training opportunities. There is a systematic process to identify and address staff training needs, including mandatory training in safe working practices and first aid. Staff have recently received a programme of training in working with people with dementia, which took place within the home. Staff receive regular supervision, which is recorded. There are comprehensive recruitment policies and procedures, and staff records inspected showed that the necessary references are obtained. Criminal Records Bureau disclosures and Protection of Vulnerable Adults checks are processed centrally and the manager is notified when enquiries are complete. Records were well organised and stored securely, to ensure confidentiality. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from staying in a care home that is well managed and where attention is given to their health, welfare and safety. EVIDENCE: Paula Hannaford, the registered manager, holds the Registered Managers Award and NVQ 4 in Care. She has many years experience in working in the care of older people including several as a manager. Butterpark is managed efficiently and there are clear systems in place. The manager and staff team work together well to create a homely and open environment. Although the impending change in ownership causes uncertainty, the manager endeavours to keep staff well informed. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 21 The views of people using the services are sought by and recorded and acted on. This includes a satisfaction survey when people leave. People staying in the home are encouraged to control their own money, if possible. Any money held on their behalf is kept in an interest- bearing account. Records inspected showed that clear processes were in place. Routine health and safety maintenance processes are managed well and records inspected were maintained up to date and accurate. Accidents are recorded appropriately and accident levels monitored. Fire risk assessments and prevention measures are in place and records of tests and drills maintained. An assistant manager has the delegated responsibility for this. She and the maintenance person have received training to enable them to carryout regular fire safety training for all staff. Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 22 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 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 3 x x x x 2 x 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 x 3 x 3 x x 3 Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Butterpark Residential Home DS0000032410.V334580.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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