Inspection on 20/07/05 for Old Barn Close (5)

This inspection was carried out on 20th July 2005.

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

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

Other inspections for this house

Old Barn Close (5) 24/07/07

Old Barn Close (5) 29/08/06

Old Barn Close (5) 06/12/05

Old Barn Close (5) 11/03/05

Old Barn Close (5) 19/10/04

Old Barn Close (5) 16/09/03

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

CARE HOME ADULTS 18-65 5 Old Barn Close Gawcott Bucks MK18 4JH Lead Inspector Sue Smith Unannounced 20th July 2005 9:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 5 Old Barn Close Version 1.10 Page 3 SERVICE INFORMATION Name of service 5 Old Barn Close Address Gawcott, Bucks, MK18 4JH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01280 824799 Hightown Praetorian & Churches Housing Association Miss Fiona Hull Care Home 5 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 5 Old Barn Close Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2005 Brief Description of the Service: 5 Old Barn Close is a single storied residential Home for five people under the age of 65, with both Learning and Physical Disabilities.The Home is situated in the village of Gawcott, which is close to the town of Buckingham. Due to the size of the village the Service Users at 5 Old Barn Close access this town for shopping and G.P. services.The Home is managed by a suitably qualified and Registered Manager .The Home does not accept emergency admissions and doesn’t supply intermediate care services. Public transport in the form of a village bus service is accessible the home, and a mobility van is also provided to meet the needs of Service Users with staff vehicles, covered by business insurance, also used for transporting service users when necessary. 5 Old Barn Close Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 3 hours. The Manager was unavailable at the time of inspection due to a training commitment. The shift leader on the day was helpful and well informed; ensuring the day-to-day operation of the Home was maintained. Time was spent sitting with the Service Users observing interactions between them and Staff. Records were assessed which included Careplans and Health and Safety assessments and records. A full environmental tour took place of the internal and external environment. Due to the limited verbal skills of Service Users their opinions could not be sought, however as previously mentioned the Inspector spent time observing interactions between staff and Service Users and interacting herself with Service Users to obtain an overview of their thoughts and feelings. At all times staff showed a clear understanding of their individual needs and were patient and professional in their interactions. Service Users appeared happy and relaxed with an obvious trust in the staff that cares for them. The Home continues to be a well managed Home with a Staff team who show a commitment to meeting the needs of the Service Users. What the service does well: Service Users Careplans are maintained to a high standard ensuring they meet the holistic needs of Service Users. Risk assessments are written in a manner that supports the Service User to take acceptable risks and maintain their independence. Service Users are supported to access a variety of activities, which are based on their individual likes and dislikes. The Staff team continuously seek opportunities that would be appropriate for Service Users to build on their skills and abilities. Visitors are welcomed to the Home with Service Users supported to visit friends and families. Service Users are supported to take part in the day-to-day routines of the Home. The Staff team ensure the physical and emotional needs are met through a system of ongoing assessment. 5 Old Barn Close Version 1.10 Page 6 All medication is administered, recorded and disposed of in line with current guidelines. The Service Users privacy and dignity is maintained at all times during personal care with staff exhibiting a clear understanding of their individual needs. The Home ensures Advocates are engaged to support the Service Users. The environment is maintained to a high standard, is homely and welcoming. What has improved since the last inspection? What they could do better: There were no requirements or recommendations made from this inspection, the Home continues to provide individual support on a holistic level that enables Service Users to develop their skills in a homely and relaxed environment. 5 Old Barn Close Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 5 Old Barn Close Version 1.10 Page 8 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 Standards Statutory Requirements Identified During the Inspection 5 Old Barn Close Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x Standards 1-5 were not assessed during this inspection; they have been assessed as meeting the standards during the last announced inspection, which ensured the assessment and admissions procedure to the Home, met the current standards and regulations. EVIDENCE: There have been no recent admissions to the Home; the Home does at this time have one vacancy. The Manager and Organisation are ensuring any admission to the Home will be in line with the admissions procedure in place and that any prospective Service User would be compatible with the Service Users currently residing at 5 Old Barn Close. 5 Old Barn Close Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10. All Service Users have an individual plan of care, which ensures staff are able to meet assessed needs and personal goals. Service Users are supported to take part in the daily running of their Home, which maintains and builds on independent living skills. Individual Risk Assessments that minimise the potential risk to Service Users with any given task are in place, these assessments ensure Service Users are able to take reasonable risks and maintain levels of independence. Staff maintain records to a high standard in line with data protection to ensure all information held on behalf of Service Users remains confidential. EVIDENCE: The Careplans for all Service Users were assessed. Generally these were maintained to a high standard with minimal shortfalls, one Careplan required an update of the link worker’s plan and the special occasions page was out-ofdate. All were reflective of regular reviews with the exception of these two 5 Old Barn Close Version 1.10 Page 11 noted areas. Additional assessments take place as part of the review process with additional support plans put in place to ensure all care needs are met. Specialist appointments and findings are recorded with additional plans put in place in line with these instructions. Staff exhibited a clear understanding of the individual needs of Service Users and positive interactions were evident. Care is delivered to a high standard with staff showing a commitment to ensuring the needs of Service Users are met with clear documentation of any changes in care needs. Risk assessments are in place, these were reflective of review and changes made to the support plans as appropriate. All risk assessments are written to aid the Service User to maintain independence. All information held on behalf of Service Users is maintained in individual files and is stored in lockable facilities. Confidentiality is maintained with information shared on a need to know basis. 5 Old Barn Close Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16. Service Users take part in a variety of both internal and external activities, which enable them to build on their skills. Flexibility in visiting times and staff support to meet with friends and families ensures contact is maintained. Service Users are supported to carry out their activities of daily living, which enables them to maintain levels of independence. EVIDENCE: The Service Users residing at 5 Old Barn Close are supported to attend a variety of activities both internal and external to the Home. Planned day trips still occur in place of holidays (due to the assessed needs of the Service User group). Arts and crafts are still a large part of the Home’s activities with completed work displayed throughout the Home. At the time of inspection Service Users had recently returned from the Winslow Centre with some about to go for a walk around the local village. One member of staff was undertaking a hand and foot massage to support a Service User who was becoming 5 Old Barn Close Version 1.10 Page 13 distressed. Staff are committed to providing alternative activities, which are designed to support the Service Users in their environment. Staff provide support, which enables Service Users to visit families and friends as well as receive guests at their Home. Flexibility in visiting times is evident with all visitors welcomed to the Home by Service Users and Staff. Due to the limited abilities of Service Users when carrying out activities of daily living staff supports all Service Users. The way this is implemented ensures all Service Users are given the opportunity to build on their current skills. Staff have a clear understanding of individual needs, the routines of the Home are planned in a way that is complimentary. Service Users were relaxed throughout the Inspection with Staff interactions both positive and professional. The Inspector was introduced to Service Users and supported to interact with them. The way in which all activities and day-to-day routines are undertaken ensures Service Uses are included and able to express their wishes in their preferred method of communication. 5 Old Barn Close Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20. Personal support is given in a manner that ensures Service Users wishes are considered and their privacy and dignity is maintained. Physical and emotional health care needs are met through ongoing assessment, which ensures care is delivered at a level necessary for the individual. Medication systems in place ensure the protection of Service Users. EVIDENCE: Staff ensure the privacy and dignity of Service Users is maintained during all personal care. All care is implemented in the privacy of the Service Users own bedroom and communal bathrooms with the doors shut. All medical examinations undertaken in the Home are carried out in the Service Users own room with staff support. Staff support Service Users to attend appointments and examinations carried out by specialist therapists. Bedrooms are locked when out of the Home with Service Users having their own keys. Ongoing assessment is evident throughout the Careplans, additional information such as G.P, Nursing, Chiropodist and Specialist appointments is reflected in the Careplan with support plans put in place in line with the directions given. 5 Old Barn Close Version 1.10 Page 15 Suitably trained staff, due to the needs of the Service Users, administer all medication. A comprehensive medication policy is in place, which supports staff to ensure they are administering, disposing and storing medication in line with current guidelines. MAR (medication administration records) sheets were found to be appropriately signed with no gaps. Medication was stored appropriately in a secure lockable facility. All bottles and tubes had written dates of opening, there was no out-of-date medication held in the Home. The systems in place ensure a direct audit trail is available. 5 Old Barn Close Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22. All Service Users have an appointed advocate who ensures the views and wishes of individuals are heard. EVIDENCE: The names of designated advocates are reflected in the Careplans of all Service Users. Due to the limited verbal communication of Service Users at the Home this is an important and necessary role. Through the advocates the views of Service Users can be expressed, also any decision that may effect the welfare of Service Users or changes in service delivery are discussed with the Advocates to gain an independent view on behalf of the Service User. 5 Old Barn Close Version 1.10 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30. The interior of the Home is designed in a manner that ensures Service Users live in homely and comfortable surroundings, which also meet their physical needs. All bedrooms are single occupancy, which have been decorated and furnished to reflect the personalities and needs of the individual. Toilets and bathroom are fitted with adaptations to ensure privacy and meet the physical needs of Service Users. Communal space is sufficient to meet the needs of Service Users ensuring a homely and relaxing environment, which can be accessed by all Service Users. The Home is cleaned to a high standard by staff ensuring Service Users are protected from infection and live in pleasant surroundings. EVIDENCE: The communal areas of the Home are based on an open plan design. Service Users are able to access the lounge, kitchen and dining area with ease, these 5 Old Barn Close Version 1.10 Page 18 areas are very much the hub of the Home with staff found to be sitting with Service Users and including them in the day to day routines of the Home. The Home has a programme of redecoration in place with all cracks recently filled and awaiting painting. Individual adapted seating as well as a comfy lounge suite is situated in the Lounge, T.V, Video equipment are available for Service User use as well as a modern HI FI. Framed photos and Service Users artwork adorn the walls making the lounge a pleasant homely environment. Service Users all have single accommodation bedrooms, which are decorated in a manner that is reflective of their own personalities. All were found to be clean and tidy on the day of inspection. Toilet and bathroom facilities are placed within close proximity of the Service Users bedrooms. These contain adaptations and equipment necessary to support the individual physical needs of the Service Users. Bathrooms and toilets were found to be clean and tidy on the day of inspection and free from offensive odours. Staff oversees the cleaning of the Home as part of their daily duties. All items of C.O.S.H.H. are stored in lockable facilities with none left lying around the Home. The Home is cleaned to a high standard ensuring infection control measures and guidance are followed. 5 Old Barn Close Version 1.10 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36. Staff are supported by clear job descriptions, which enable them to meet the needs of the Service Users. The Staff team are efficient and clearly understand the needs of the Service Users, which ensures Service Users, are supported to reach their full potential. Staff benefit from a formal supervision system, which ensures all issues of practice can be discussed in a safe and professional manner. EVIDENCE: All staff are issued with clearly defined job descriptions. These are also available in the Home. The Home operates a link worker system to ensure the individual needs of Service Users are met. Staff spoken with at the time of inspection were clear on their roles. The shift leader on the day was competent and well informed in the daily running of the Home providing the 5 Old Barn Close Version 1.10 Page 20 Inspector with information and paperwork as requested, throughout the inspection she exhibited her knowledge of the Service Users needs. The Home uses Agency staff to cover gaps in the rota. These staff are familiar with the Home and the individual needs of the Service Users. The Agency staff member on duty on the day of inspection was well informed of the Service Users needs and was helpful and supportive to both the Service Users and Staff. All staff have a formal supervision on a monthly basis. The shift leader on the day of inspection felt these were helpful and could be increased should there be other issues of practice that need to be addressed. Supervisions are also used as a time to discuss progress with the NVQ training undertaken by staff. Recruitment records were not assessed during this inspector due to the Manger being away on Training. Service Users appeared relaxed and happy in the Home and were obviously trusting of the staff who care for them, there was evidence of positive relationships between staff and service users with a clear understanding of preferred methods of communication. 5 Old Barn Close Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 42. The Home is managed by a competent Manager, which ensures the safe operation of the Home and protection of the Service Users. The Home follows health and safety guidelines, which ensures the protection of Service Users, Staff and Visitors to the Home. EVIDENCE: The Manager is well liked by her team; staff appreciate her hands on approach to Management and the support she offers. The Manager undertakes training to support her in her role. The Manager operates an open door policy for all staff and ensures she is available to visitors to discuss any issues. During the inspection the health and safety policies and relevant paper work were assessed. The findings are as follows. Separate accident books are held for both staff and Service Users; the last entry was for 26/2/05. Accidents are varied with no apparent pattern. 5 Old Barn Close Version 1.10 Page 22 The Home has generic risk assessments, which are current and regularly reviewed. A separate Fire risk assessment is in place; this has been assessed by the Fire Authority as appropriate for the Home. In addition the Home undertakes weekly fire alarm testing to ensure equipment in place is functioning. These records were open to inspection. A Chubb equipment service certificate is in the Home dated 31/5/05. The recent Fire Authority inspection contained no recommendations for action. The Home has a health and safety file which contains copies of all service certificates this included a gas safety certificate 31/8/04, Vale Care Hoist servicing certificates 20/6/05. The Home has a thorough maintenance reporting system with all broken equipment or faults in the Home reported directly to the maintenance department for repair, the date these were repaired is also recorded on the reporting form. Weekly water temperature testing is taking place with records open to inspection. The Home also undertakes a quarterly health and safety audit with records of the findings found in the Home. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 5 Old Barn Close Score Standard No Version 1.10 Score Page 23 1 2 3 4 5 x x x x x 22 23 ENVIRONMENT 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x 5 Old Barn Close Version 1.10 Page 24 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 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. Refer to Standard Good Practice Recommendations 5 Old Barn Close Version 1.10 Page 25 Commission for Social Care Inspection 8 Bell Business Park Smeaton Close Aylesbury Buckinghamshire HP19 8JR 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 5 Old Barn Close Version 1.10 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. 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!