Inspection on 20/12/06 for Hill Barn

This inspection was carried out on 20th December 2006.

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

Hill Barn 10/01/08

Hill Barn 26/01/06

Hill Barn 26/05/05

Hill Barn 08/03/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Mabbs Hall Nursing Home

Henrietta House

Firstlings

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hill Barn Church Lane Sparham Norwich Norfolk NR9 5PP Lead Inspector Maggie Prettyman Unannounced Inspection 20th December 2006 09:15 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 Hill Barn DS0000062383.V325027.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. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Barn Address Church Lane Sparham Norwich Norfolk NR9 5PP 01362 688702 01362 688040 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) Mr Richard Shand Smart Dr Maria Smart Mrs Tracey Joanne Woolnough Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (1) of places Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26th January 2006 Brief Description of the Service: Hill Barn is a care home providing residential care for twenty-five older people and one older person with a physical disability. The home is located in the village of Sparham. The home is an adapted barn with later extensions including a newly opened ten-bedded wing. All accommodation is located on the ground floor. There are twenty-four single rooms and one shared room. Twenty-one of the bedrooms provide en-suite facilities. The home also offers a choice of sitting in three locations and ample assisted bathing facilities. There is a delightful garden that those service users who choose to, can access very easily. It also provides sheltered areas where people can enjoy the garden. Current Fees are £400 - £450 per week Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the provider, some residents and their relatives as well as other who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and current judgements for each outcome group. What the service does well: What has improved since the last inspection? The home continues to improve and update its systems and practice. The Statement of Purpose is being updated. The medication administration procedure has been simplified. The MUST system of nutritional screening is being implemented. Audits are now being implemented of concerns, falls, medication and care plans. Significant improvements in health and safety have been made. A new system of supervision is in place. Repairs, redecorations and renewals of the environment have been undertaken. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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 Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, and 6. Quality in this outcome area is good Prospective service users have the information they need to make an informed choice Each service user has a written contract with the home Service users needs are properly assessed before they move in to the home Short stays are not normally provided This judgement has been made using available evidence including a visit to this service. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 9 EVIDENCE: The statement of purpose is comprehensive and is the process of being further improved. Evidence of contracts was seen in individual service user files. Inspection of service user files demonstrated that the manager or her deputy complete a pre admission assessment. Service users are normally interviewed in their own homes, and are encouraged to visit prior to admission. The manager stated that short stays are not normally accommodated by the home Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9 and 10 Quality in this outcome area is good. Service users health and personal care needs are set out in an individual plan of care. Service users health care needs are met. Service users are protected by the homes’ system of medication administration. Service users feel they are treated with respect and their privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Inspection of service users personal care files demonstrated that comprehensive individual plans of care are in place. These include up to date notes in appropriate format risk assessment and evidence of regular review. Evidence in service user files as well as discussion with service users and their representatives demonstrated that health care is properly met by the home. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 11 Pressure area risk is assessed. The manager described good relationships with local GP surgeries. The new MUST nutritional monitoring tool is in the process of being implemented. Appropriate health care professionals are consulted when needed. Inspection of the medication cupboard and records as well as observation of part of a medication round demonstrated that the home has a safe system of storage and administration of medication. Recent changes in procedure have benefited both service users and care workers. Observation of service users and care staff as well as interviews with service users and pre inspection questionnaires demonstrated that service users are treated with respect and dignity at all times. Interaction observed was warm and friendly, and a relaxed atmosphere pervades the home. Service users privacy is promoted. Private telephones are available in individual rooms and post is given out unopened. Name of choice is clearly noted on service user records and clothes are clearly labelled for laundry. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 and 15. Quality in this outcome area is excellent. The lifestyle of the home meets the social cultural and spiritual needs of its users. Contact is maintained with families and the local community Service users are enabled to exercise choice and control in their lives. Service users receive an appealing and balanced diet in pleasing surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities board details regular and upcoming events. Service users expressed satisfaction with the variety of activities available to them. Routines are flexible. Contact with the local church is good. A volunteer attends to support a service user with visual impairment. Personal plans include details of social and cultural needs. The inspection feedback as well as observation and discussions on the day of inspection demonstrated that contact is maintained between service users and their families and the community. Local community contacts are strongly maintained by the home. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 13 Discussions with service users and their representatives as well as observation during the inspection demonstrated that service users are encouraged to maintain choice and control in their lives. Some service users fully manage their own financial and personal affairs. Residents meetings are held with outcomes implemented by the home. Individual rooms are comfortable and homely with many personal possessions. An enthusiastic and involved team of staff in the kitchen provide food which is appealing and of a good standard. Menus of meal choices are clearly displayed in the comfortable and homely dining areas. Service users are consulted twice daily about their choices and preferences. Special nutritional requirements are noted on the meal choice records to ensure that they are met. The new MUST nutritional screening tool is `being implemented to further improve nutritional services offered by the home. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Service users comments and complaints are listened to and acted upon. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a suitable complaints policy. Day to day minor complaints are dealt with as they occur. The home has recently instituted a process for recording concerns to monitor patterns and trends. Compliments about the service are also recorded. Staff records demonstrated that adult protection training is ongoing. New staff receive training in recognising signs and symptoms of abuse. Training in the management of behaviour that challenges has been given in the past. This is in the process of being updated. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 Quality in this outcome area is excellent. Service users live in a safe and well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. The home is clean pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises demonstrated that the home is accessible and well maintained meeting individual and collective needs in a comfortable and homely way. A programme of maintenance is in place. Requirements made by the HSE have been implemented. A full fire risk assessment has been undertaken. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 16 Shared facilities were observed to be pleasant and homely. All seating and lighting is domestic and furnishings and décor are of a good standard. The grounds are well laid and attractive. Service users were observed sitting outside enjoying the sunny frosty winter morning. The home is spotlessly clean, pleasant and hygienic. The laundry facilities are good and washing is well organised, appropriately sorted and done to a high standard. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. The numbers and skill mix of staff meets Service users needs. The home continues to work towards its NVQ targets. Service users are protected by the homes recruitment procedures. Staff are trained and competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A well-planned rota is in place. Minor staff shortages are covered in house by managed overtime. Staffing levels are sufficient to ensure that service user needs are met. The home has not yet achieved high levels of NVQ training. The manager continues to encourage staff to achieve this qualification. It is recommended that the home continue to encourage its staff to achieve NVQ qualifications. Inspection of staff files demonstrated that good standards of vetting are in place. Evidence of appropriate references, application forms and interview records were seen. An ongoing programme of training is in place in the home. Some of this is in house, some provided by external sources. The home is a member of a cluster group of homes where different providers share training resources. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 18 Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. The home has a caring and professional manager. Quality assurance systems in the home are in development, but could be improved. Service users financial interests are safeguarded. A system of supervision is now in place. The health, safety and welfare of service users and staff are protected. This judgement has been made using available evidence including a visit to this service. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager of the home is an experienced, caring and enthusiastic professional, who has the interests and development of the home and its staff and service users as the focus of her work. The home is instituting monthly audits of medication, care plans and falls. Annual questionnaires are being given to service users and staff. The home is clearly working positively towards being fully self-auditing, but needs to develop and integrate its audit process to fully meet this standard. It is recommended that the home continue to develop and integrate its quality assurance process. Small amounts of money are held on behalf of some service users. Accounts were checked and found to be complete and accurate. The home is now implementing a sound system of regular supervision for the team. Supervision agreements are in place and written records are kept. Following an inspection by the HSE and voluntary a fire safety audit, the home has recently taken action to significantly improve the health and safety of its service users and staff. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 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 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 X X X X X 4 STAFFING Standard No Score 27 4 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N0 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. 2. Refer to Standard OP33 OP28 Good Practice Recommendations It is recommended that the system for monitoring quality be further developed with records of actions made. It is recommended that the home continue to encourage its staff to achieve NVQ Qualification. Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. Extracts may not be used or reproduced without the express permission of CSCI Hill Barn DS0000062383.V325027.R01.S.doc Version 5.2 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. 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