Inspection on 30/04/07 for Little Barn Lane Care Home

This inspection was carried out on 30th April 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Little Barn Lane Care Home 4 Little Barn Lane Mansfield Nottinghamshire NG18 3JE Lead Inspector Susan Lewis Key Unannounced Inspection 30th April 2007 10:00 Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 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 Little Barn Lane Care Home DS0000068820.V335516.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 Adults 18-65. 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. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Barn Lane Care Home Address 4 Little Barn Lane Mansfield Nottinghamshire NG18 3JE 01623 460 707 F/P 01623 460 707 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) www.mencap.org.uk Royal Mencap Society Mrs Susan Cox Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New service Brief Description of the Service: This is the first inspection under the homes new registration and as such there is no previous inspection report. The fees for 2007/08 are £329.52 per week information regarding fees is available from the manager and from Mencap. The home is in a residential area of Mansfield and close to local amenities such as shops and bus routes. The home accommodates up to five people with learning disabilities in single bedrooms. Two bedrooms are on the ground floor, there are adapted bathing facilites and up to two people with mobility needs can be accommodated. It is homely and well maintained providing the people who live there with pleasant accommodation. There is access to a small private garden at the rear of the property ensuring people have access to fresh air. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting residents and tracking the care they received through looking at their records and observing staff that provide their care. The inspection was unannounced and took place over 6 1/2 hours one Monday in April 2007, and was conducted by one inspector as part of the annual inspection process. A partial tour of the building took place and a selection of residents’ bedrooms was inspected. Only four residents currently live at the home, at the time of the inspection two were attending their day service. Due to their limited communication abilities the two people remaining at the home were unable to give their views on their experience of living in the home. Other information that was used to inform this report was the pre-inspection information provided by the registered manager, as well as accident and incident reports received by the Commission. What the service does well: Residents live in a homely and well-maintained environment where they are supported by staff who are well trained and are able to meet their needs. Some residents attend Day Centre and are encouraged to be part of the local community. They enjoy their social lives, which involves going out for evening meals and attending the local church and social clubs. At home there is a television, quiet room and small pleasant garden. Service users are involved in choosing and preparing their own meals where possible and individual bedrooms are comfortable and personalised. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 6 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. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. Prospective residents lack the information necessary to make an informed choice about where to live but their needs are assessed and they are assured that they can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As this is registered as a new service the service user guide was looked at. The manager did not have a copy available and it had to be sent to the Commission after the inspection. The guide does not provide sufficient information for prospective residents to make and informed choice. It lacks in formation regarding fees charged or what the service actually does. It does not mention qualification of manager only that staff have access to a variety of training including LDAF, NVQ level 2, 4, and 5. It does not indicate what LDAF stands for (Learning Disability Awards Framework) and it is not an accessible document. There is no indication that this document is available in any other format such as large print or easy read symbols. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 9 Three care plans were viewed as part of this inspection and all showed that assessments had been carried out prior to the residents moving to the home. Care plans were created from this information and provided staff with detailed Information about how to meet the residents assessed needs. Staff spoken with confirmed that they used the care plans to inform them in their day-today work in supporting residents. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. Residents are provided with the support they need to live full and active lives and where possible make decisions about how they live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As residents’ ability to communicate was limited information about their care needs was obtained through reading care plans and diary notes as well as talking to staff. Three care plans were viewed, currently plans are being changed over to Mencap’s format, which provides information in more user friendly manner, it is written in the first person, in plain language and indicates what the person is able to do and what they need support with. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 11 It is broken down into the individuals’ activities of daily living and includes a general over view of the persons care needs before moving onto more detailed information. This makes a more accessible document whether for carers or for residents if they want to view them. Some plans provided better information than others; the manager reported that staff are to receive training on how to create this new type of care plan. This was confirmed later when training records were seen. Staff spoken with said that they found the care plans informative and helped them know what to do in providing the correct level of support. Staff clearly understood the importance of involving residents in making decisions and taking control of their lives. Diary notes and care plans showed how staff supported residents to make choices about they spent their time. Choices were supported on what they did on a daily basis including whether they went to a daytime activity. Staff spoken with said that they knew the likes and dislikes of residents and so were able to ensure that they did things they wanted to do. This was observed during the day with staff asking residents about what they wanted to later when different staff came on shift. Residents care plans indicated that risk assessments took place to enable them to take part in a variety of activities. Staff spoken with are aware of the importance to promote residents abilities and to encourage them to be involved in outside events. Diary notes confirmed that residents were involved in a wide variety of activities. Records show that reviews take place regularly and plans are updated accordingly to ensure that they reflect the resident’s needs and that they can still be met by the staff. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. Residents are supported to live an active life that meets their cultural and spiritual needs. Healthy and nutritious meals are provided throughout the day. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed showed what the interests were for each resident and what support they needed to take part. During the inspection only two residents were at home as the other two people were taking part in their chosen daytime activity. Evidence was seen in care plans and diary notes that residents were supported to attend their local church and take part in monthly meetings held by the church. Diary notes showed that residents were supported to take part in a wide variety of activities including going to the pub, shopping, visiting local Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 13 parks for picnic as well as relaxing at home watching their favourite television programme. Care plans indicated which resident had relatives and diary notes showed how often they made contact and how staff supported them to maintain contact with family. It was clear from one care plan that where resident did not have family that currently staff do not support them with contact from an advocate service to ensure their views are represented independently. During the course of the inspection staff were observed only entering residents bedrooms after knocking and the residents had said they could enter. Care plans identifies where a resident was able to have a key this was after a risk assessment. It was also evident from observation that staff respected residents when they wanted to be alone. Care plans identified where residents needed support with housekeeping tasks and what jobs they were involved in keeping the home tidy. Diary notes also showed that where possible residents were supported to make their own sandwiches when they went to their daytime activity. Staff spoken with understood the importance of ensuring residents nutritional needs were met, and evidence seen whilst viewing the kitchen that sufficient food was available for residents. Staff also spoke of how they supported residents to be involved in making choices for meals and care plans indicated their likes and dislikes. The dining room was pleasant and homely providing an environment for residents to share their meal times together if they wanted to. Plans identified where residents were at risk of choking and what action staff needed to take to minimise the risk. Special dietary needs were identified and met. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. Residents receive their care in the way they prefer and health care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussion with staff it was evident that because the home was quite small there was quite a lot of flexibility in how residents were able to live their lives, such as what time they got up or went to bed. The only limiting factor was if a resident was due to attend daytime activity and so needed to get up in time to get the transport. Care plans identified the support residents needed and staff spoken with were able to talk about how they provided that support including how they maintained the person’s dignity and privacy. Staff were observed throughout Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 15 the day speaking with residents and providing care in a sensitive and caring manner. Care plans indicated that residents’ medical needs were being monitored and diary showed confirmed that where residents’ health or behaviour changed they liaised with the appropriate health care professional. They also showed that prescriptions creams were being applied as per instructions. Medication was checked and temperature of the room it was stored in was taken regularly to ensure it was stored correctly. A copy of the drugs error policy is clearly visible ensuring staff know what to do in the event of a mistake happening. Copies of staff assessments of competence to administer medication is stored on file, this shows staff have received training to administer medication and have been deemed competent to do so. All the medication looked at was recorded accurately and there were no errors, residents are therefore protected by the homes policies and procedures in medication administration. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Residents are supported to complain if they wish and are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission has received no complaints regarding this service. The complaints log for the home was also looked at and there were no recorded complaints. Staff spoken with asked how they would support a resident to make a complaint and they were able to give examples of what they would do to ensure that any concerns were raised through the complaints procedure. Staff also said that as they knew the residents well they could make an assessment as to whether they were upset about something and would follow it up that way and include the manager if necessary. Staff are also aware of what abuse is and their responsibility to protect residents from abuse or harm. Staff said that they had received abuse awareness training. The manager later confirmed the training formed part of the Learning Disability Awards Framework. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 17 The manager acts as appointee for residents however evidence in the way finances are managed was seen that there are clear financial controls in place to protect residents from any financial harm. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. Residents live in a well-maintained and homely environment, which is clean and pleasant. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Major building work is underway with bathrooms being altered to make them more suitable for people with mobility needs. The bathroom down stairs is being altered to create a shower room again making it more accessible for those with physical needs. The manager reported that the residents currently living in the home are growing older and are developing age related needs as well as those linked with their learning disability and the home is being adapted in the hope that they will not have to move to another home. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 19 All bedrooms seen were personalised by the resident with the support of staff. The laundry is domestic in style and is separate from the kitchen so soiled laundry is not carried through where food ids prepared. There is an infection control policy, which ensure the safety and well being of the residents, staff spoken with were aware of the policy and their responsibility to protect residents from infection. Staff were in evidence throughout the day ensuring the home was clean and pleasant. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. Residents are protected and supported by thorough recruitment practice and well-trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with said that they had filled out an application form and had had a Criminal Records Bureau check as well as references. Staff files indicated this however much of the information is stored centrally at Mencap headquarters and so references could not be confirmed. Information held on staff files indicated that staff had received LDAF (Learning Disability Award Framework) training and this was confirmed in discussion with staff. Training files showed that 7 staff have NVQ 2 and 5 staff have NVQ 3 one member of staff is nurse trained. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good. Residents and staff health and safety is maintained and they live in a home that is run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for over 2 years and has her NVQ 4. She undertakes training to keep herself up to date with practice. Staff spoken with said she was very supportive. Mencap has its own Quality Assurance system and it is referred to in their Service User guide, however no evidence was seen on the day as this is Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 22 registered as a new service. In discussion with staff it was evident that residents are supported to ensure that they live full and active lives and are able to express they pleasure as well as displeasure. Health and safety of residents is supported, staff receive mandatory training and Records showed that Fire Drills have been done regularly. Two EHO visits took place this year the first to look at Legionella 12/02/07 suitable controls to manage the risk of Legionella are in place however the COSHH assessment was said to be inadequate changes have been made to update this. The second visit was to look at the kitchen and food hygiene on 15/02/07. The manager showed that the requirements left at the time have either been met or are in the process of being met. All equipment is maintained and notifications are sent to the Commission of events affecting the residents. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 1 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 2 3 X Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 24 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 YA1 Regulation 4 (1-3) Schedule 1 5(1)(b) Requirement A statement of purpose must be created that clearly shows what fees a resident is to pay what the qualifications of all staff and the manager are and what the service actually does to meet the needs of the people who live there. All records required for the efficient running of the home must be available for inspection at all times, including all references for staff who work in the home. Timescale for action 01/07/07 2 YA41 17(3)(b) 01/07/07 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 YA15 Good Practice Recommendations Where residents do not have any relations, staff should support them to have contact with advocate services. Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Little Barn Lane Care Home DS0000068820.V335516.R01.S.doc Version 5.2 Page 26 - 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. 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