Inspection on 18/06/07 for PIA - Barnfield

This inspection was carried out on 18th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

PIA - Barnfield 04/07/06

PIA - Barnfield 12/01/06

PIA - Barnfield 14/07/05

PIA - Barnfield 26/01/05

PIA - Barnfield 22/06/04

PIA - Barnfield 12/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Pia - Barnfield Church Lane Gaydon Warwickshire CV35 0EY Lead Inspector Kevin Ward Key Unannounced Inspection 18th June 2007 08:00 Pia - Barnfield DS0000004279.V337928.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 Pia - Barnfield DS0000004279.V337928.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. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pia - Barnfield Address Church Lane Gaydon Warwickshire CV35 0EY 01926 640521 02476 640146 dbadger@people-in-action.co.uk 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) People in Action Mrs Denise Badger Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Denise Badger must successfully complete the NVQ Registered Managers Award or a qualification equivalent to a diploma in management studies (NVQ 4) and a qualification equivalent to NVQ 4 in care by 1st July 2007. Denise Badger must inform the Commission for Social Care Inspection when she has achieved these qualifications. 4th July 2006 2. Date of last inspection Brief Description of the Service: The home is a large domestic bungalow in a small village setting, providing accommodation and care for 5 young adults who have severe learning disabilities and/or physical disabilities. South Warwickshire Primary Care Trust owns the property. People in Action manage the home. Two of the five bedrooms have en-suite facilities. The current charge for the service (18/6/07) is £1334 per week. The people living at the home are required to pay for their personal toiletries, leisure activities, holidays, fuel, aromatherapy and drinks/meals out. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection which addresses all the essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for people. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. The inspection also included case tracking the needs of three people that live at the home. This involves looking at people’s care plan and health records and checking how the person’s needs are met in practice. Two people were on holiday with staff at the time of the site visit and were not seen on this occasion. Due to the high communication needs of the people that live at the home it was not possible to gain their direct views of the service. A relative and an advocate returned questionnaires giving their views of the service and a National Vocational Qualification Assessor was spoken to at the site visit for her opinion of the work of the home. Discussions took place with two staff and a team leader as well as the manager. The manager also completed an annual quality assurance assessment as part of the inspection process, providing the manager’s view of how the home meets the required Standards. A number of records, such as care plans, complaints records, staff training certificates and fire safety records were also sampled for information as part of this inspection. What the service does well: Care plans are in place for people at the home containing good levels of information about people’s needs and how they like them to be met. Most of the staff have worked together for several years and have a good understanding of needs of the people at the home. People’s needs are risk assessed and support is provided to help people to go about their lives safely. The home makes good use of health professionals to assess people’s needs and to provide training at the home, e.g. PEG feed and epilepsy training. Staff are trained to give out medication and complete a workbook to check they understand the procedures. Staff are then observed giving out medication to assess that they are safe to do so. The home is comfortable and well equipped to meet the needs of the people that live there, including hoists and specialist bathing equipment. The home provides good wheelchair access including ramped access to the garden via electronic patio doors. A specialist garden swing is situated in the rear garden that is designed for use by wheelchair users. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 6 There have been no complaints about the home during the last year. Relatives are told how to complain so that they may raise any concerns they hold. Staff are provided with prevention of adult abuse training and shown procedures for reporting any suspicions of abuse so that people are protected from harm. Staff are properly vetted as part of the recruitment process and provided with good training opportunities so that they are equipped to meet the needs of the people at the home. Staff are provided with equality and diversity training to encourage them to recognise people as individuals with their own distinct needs. Good monitoring systems are in place to ensure that the home is operating properly. This includes checks by shift leaders, the manager and the line manager. What has improved since the last inspection? What they could do better: It is recommended that staff record that they have reviewed all aspects of the care plans every 6 months to make it clear that all the information is still relevant to meeting people’s needs. The manager said that the care plans would be written in a new format shortly. Overall people are supported to go out and engage in activities that interest them. There has been a delay in making arrangements for a new person to be supported to pursue their personal interests whilst risk assessments are completed. The manager said that she aims to speed up the risk assessment process so that the person concerned can do the things they enjoy doing as soon as possible, in a safe manner The manager explained that there are plans to replace the lounge carpet and decorate this room later this year. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 7 The manager said that she would arrange for staff to receive nail care and skin care training to support their work with people at the home. The quality assurance system would be improved by setting up a process for surveying the views of people’s relatives and visiting professionals so that they can pass comment on the work of the home. 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. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are provided with information and supported to visit the home before moving in so that they are able to make an informed decision to live there. EVIDENCE: Discussions with the manager and information on the home’s records indicate that appropriate procedures were followed when admitting a new person to the home recently. The home has sought referral and assessment information from the person’s social worker and met with the person’s representative so that they were able to view the home and ask questions before agreeing the placement. The manager and the team leader confirmed that the new person visited the home before moving in to meet with the other people that live there and to support a gradual introduction process. This also offered an opportunity to further assess the person’s needs. The admission records were not available on the day of the site visit and the manger believes they had been locked away in a cabinet for safekeeping by a member of staff. The manager undertook to ensure that this information is held on file for future inspections. Information was seen confirming that the person’s placement needs were reviewed with the social worker as part of the admission process. The manager explained that the home does not currently use a standard assessment form, which would provide structured headings for assessing people’s needs fully prior to Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 10 their admission but said she intends to adapt an organisational assessment format used to assess the needs of people entering their supported living services. People’s files were seen to contain copies of an illustrated Statement of Purpose, containing helpful information about the home. Comments in a relatives questionnaire (of a new person admitted to the home) indicates that appropriate information the relative has been provided with satisfactory levels of information about the home, as part of the admission procedure. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. People’s needs are planned for and reviewed so that they can be supported and cared for in a safe and appropriate manner. EVIDENCE: Three people’s care plans were sampled. The care plan of a new person was seen to contain the essential information required to meet their personal care needs and the file contained evidence of further ongoing assessments involving health professionals, to add to the plan. Two people’s care plans contain good levels of information to enable staff to meet people’s needs. This includes information about people’s personal histories, likes and dislikes and favoured routines so that staff are able to support people in the way they like. This information is particularly important, as the people living at the home are not able to communicate verbally and cannot easily express their choices. People’s care plans were seen to contain evidence of people’s communication needs and the means by which they may be assisted to make choices, e.g. using objects of reference or personal signs and sounds that people use to express their Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 12 feelings about things. Staff have been trained in communication and makaton training to help them to appreciate and understand the communication needs of people at the home. Comments by staff indicated a good understanding of people’s individual modes of communication and of their personal routines and preferences. People’s care plans have been dated in places, as people’s care needs have changed, indicating that the care plans are kept under review. The manager said that the care plans are to be re written shortly in a new format that has been devised by the organisation. The manager agreed to introduce a review form for managers to sign every six months to confirm that all the information in the care plans is still relevant and has been reviewed. Entries in people’s records and review notes indicate that the home seeks to involve people’s relatives and representatives in planning their care. Risk assessments are in place covering a good range of everyday hazards associated with people’s personal needs, e.g. moving and handling assessments, showering, bathing, swimming etc. Protocols are in place to inform staff of the safe procedure to follow in the event that people with epilepsy have seizures so that they receive the necessary assistance and support they require. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. Delays in the development of risk assessments have impaired the ability to enable a person at the home to continue their preferred leisure pursuits, which are necessary for their stimulation and enjoyment. People are provided with a reasonably balanced diet, in keeping with their preferences so that they enjoy their meals. EVIDENCE: Entries in people’s records and comments by staff indicate that people have been provided with the following activities, e.g. crafts, cookery, puzzles, DVD’s, videos, sensory sessions, bowling, swimming, shopping, walks, parks, garden fete and eating out. Two people files indicate that they get a reasonable level of activities whereas one new person has to date received limited access to the activities he enjoys. Concerns have been raised by a Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 14 person’s relative regarding delays in supporting him to exercise his choice to engage in activities that may be regarded as risky e.g. swimming. The manager indicated a strong commitment to speeding up the risk assessment process, where possible, so that person can be undertake his preferred leisure interests in a safe manner soon. This is necessary so that the persons need to be kept safe is balanced with their need to retain their independence and enjoy a more stimulating lifestyle. One person was assisted to see the goats at the bottom of the garden and staff were seen to engage people with soft sensory toys during the course of the morning. A specialist garden swing is situated in the rear garden that is designed for use by wheelchair users. At the time of the site visit two people were on holiday with staff. The manager confirmed that plans were being made for the two people to go on holiday later in the year and for one person to go a number of day trips, in keeping with his needs. Two people are being supported to attend a local church on a regular basis and assistance is provided for people to go out shopping to purchase personal items, such clothes and toiletries, with support from staff. One person has an advocate involved from Warwickshire Advocacy Alliance to help him to manage his finances and two people receive regular contact from relatives. The manager explained that a local person has started to visits the home with a view to taking on a low key advocacy role for people who do not have regular contact from their relatives. The manager agreed to keep a record of written feedback from the advocate and of any issues raised. A 4 weekly choice menu is in place at the home based on peoples’ known food preferences that was seen to offer a good variety of meals for people. A record is kept of people’s food intake so it is possible to monitor what they like and dislike. Comments by staff and entries in staff training records confirm nutrition training has been provided over the last year. Fresh fruit was seen in bowls in the home and the menu was observed to be well balanced and include side salads. A good stock of fresh vegetables and tinned pulses were also available in the home. The manager agreed to keep more detailed recordings of the meals taken by a person with an assessed need for a high fibre diet, to more fully demonstrate that this need is being properly met. Guidelines are in place on people’s files for supporting people to eat in a safe and manner. A team leader explained that no one at the home has swallowing difficulties that would place them at risk of choking. The home provides a large dining table with sufficient space available for wheelchair users, so that everyone is able to eat together in a sociable manner. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal care and health needs are planned for and monitored with the involvement of health professionals and safe medication procedures are in place so that they the receive the appropriate care and health support they require. EVIDENCE: Staff were seen to be friendly and sensitive to the needs of the people at the home and to approach them in a caring manner. Comments by a team leader demonstrated a very good understanding people’s needs and their individual methods of communication. Comments by an advocate in a questionnaire indicates that staff show a satisfactory regard to people’s privacy and always knock before they enter people’s bedrooms. This was also observed during the site visit. One person was allowed to sleep in later, in accordance with preferred routine and staff were seen to support people in an unhurried and relaxed fashion throughout the morning with people taking breakfast when they were ready to do so. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 16 staff confirmed that people are encouraged to choose the clothes they wish to wear with assistance from staff and are taken to shop and choose new clothing. The people living at the home were all well groomed and dressed in age appropriate, clean clothing, indicating they are supported to maintain a good self image. An NVQ (National Vocational Qualification) assessor who is independent of the home spoke very highly of the person centred care that she has witnessed during her visits to assess staff at the home. Two people have PEG tube feeds in place and protocols were seen containing relevant advice for staff to follow safe practice. The protocols have been appropriately signed and validated by health professionals, in accordance with good practice. The manager explained that she is in the process of seeking training and advice from a “homeward” nurse (Peg feed manufacturers nurse) and a hospital dietician to support safe procedures when re-siting a new type of PEG tube for a person that lives at the home. The manager said she would only allow staff to carry out this work on the basis of protocols signed by the dietician and following proper training and assessment by a suitably qualified health professional. People health records demonstrate that the home makes good use of the advice and support of health professionals to assess and meet people’s needs, such as speech and language therapist, learning disability consultants, occupational therapist and physiotherapist. Similarly people are supported to gain access to local community health services, such as GP, opticians and chiropodist. Staff confirmed that they had been provided with pharmacist medication training and some staff have undertaken a more in depth distance learning course. Staff training files also contained medication workbooks that staff have completed to demonstrate that they have a sound grasp of medication procedures, prior to being allowed to give it out. Comments by a team leader giving out medication on the morning of the inspection demonstrated a good understanding of safe medication procedures. A suitable cupboard is in place for the safe storage of medication. The contents of the cupboard were seen to be tidy and well ordered. Photographs are in place in the medication file in front of people’s medication records as an extra safeguard for ensuring that medication is given to who it is intended. The shift leader checks the medication sheets at the end of each shift to check that all the medication has been given out and signed for correctly, a record of which is kept on the shifty handover sheet. Records were also seen confirming that the manager also checks the medication records each month to satisfy herself that safe medication practices are being carried out. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 17 Since the last inspection the home has introduced a record to keep track of people’s “as required medications” so that they can be more effectively accounted for. Helpful information is in place informing staff of the reasons and circumstances under which PRN (as required) medications are to be given to people and side effects to look out for. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 18 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. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place for respond to people’s concerns and complaints and staff are being trained to recognise and respond to suspicions of abuse so that people are protected form harm. EVIDENCE: There have been no complaints made to us since the last inspection. The manager also confirmed that there have been no recent complaints made at the home. This was verified by an examination of the complaints log. The complaints log has recently been signed by the line manager as evidence of monitoring. A complaints procedure is available at the home and in the home’s Statement of Purpose. The manager explained that the complaints procedure is given to people’s relatives as part of the admission procedure. This is confirmed by a relative’s comments in a questionnaire. Comments by staff indicated a satisfactory awareness of the adult protection and whistlblowing procedures that are available in the home. Two staff confirmed that they had been provided with vulnerable adult abuse training by the organisation to help them to recognise and report any suspicions of abuse. This was also verified in a sample examination of staff training certificates. Staff confirmed that they have been provided with challenging behaviour training so that they are equipped to respond sensitively to people’s needs / challenges. Psychology input has previously been used to support staff with a common approach to the specific needs of one person at the home. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 19 The manager explained that she does not act as an appointee for anyone at the home. Where people’s relatives or advocates are not available to take on this role it is carried out by the organisation’s finance director. Two people’s expenditure records were sampled. The records indicate that suitable arrangements are in place for recording and accounting for people’s money properly. A monitoring record is completed by the manager each month to demonstrate that she checks people’s expenditure records and periodic audits (seen on file) are carried out by a finance officer within the organisation. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. People are provided with comfortable, clean and well-equipped accommodation so that they benefit from a homely environment that meets their needs. EVIDENCE: All the rooms in the home are at ground floor level and provide reasonable wheelchair access. Overall the home is well decorated and airy. Since the last inspection good work has taken place to redecorate the bedroom corridor. The front hallway was also in the process of being redecorated at the time of the inspection site visit. The manager said the lounge carpet would be replaced shortly as it has faded in parts. Positive improvements were made to aid access to the garden, with the addition of automatic patio doors and low gradient wheelchair ramping, last year. The gardens are well maintained, providing a pleasant area for people to relax in. and are well equipped with garden furniture and a wheelchair swing. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 21 Discussions with staff and the manager indicate that people are making good use of the garden since the new doors and ramping were put in. The home is well equipped with specialist equipment, such as hoists and adjustable bath to appropriately meet the individual needs of the people living at then home. One person’s has a particularly well equipped en suite shower room to meet his disability related needs. People’s bedrooms are pleasantly decorated and efforts have been made to personalise these areas, e.g. with pictures, electrical equipment, mobiles, etc. The home has a spacious open plan kitchen dining area with suitable space and seating arrangements to enable people to eat together. A member of staff explained that the home has recently had a new cooker and fridge to improve the kitchen facilities. The manager explained that funds have been identified for the renewal of kitchen cupboard doors and other minor kitchen improvements later this year. The kitchen surfaces were renewed last year. The home was clean and free from any unpleasant odours. Discussions with staff demonstrated a good understanding of infection control practices and confirmed that suitable cleaning procedures are in place, supported by a cleaning schedule. Discussions with staff confirmed that they had been provided with infection control training. Staff were seen to make use of protective clothing where necessary and stocks of gloves and aprons were seen in the home. Suitable boxes and bags are in place for carrying continence laundry to the laundry room and the home has clinical waste contract. Disposable continence management products are used where necessary. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 22 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 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and appropriately vetted to ensure they are properly equipped for their roles and safe to work at the home. EVIDENCE: A team leader explained that there are typically 3 or 4 staff on duty in addition to the manager when she is at the home. This was verified by entries in recent rotas and in discussions with the manager. Staffing levels had been reduced to 2/3 staff at the time of the site visit as two people were on holiday with staff. Following a management restructuring the manager now manages another home run by people in action in addition to The Barnfield. An extra team leader has been employed to provide extra cover to keep on top of the day-to-day management duties and responsibilities. Comments by the manager and staff indicate that this is not currently presenting any management shortfalls at the home. The manager explained there has been only one new starter in the last year and most of the staff team have worked together for a number of years providing consistency of care for people, underpinned by a good knowledge of their needs. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 23 The recruitment file of the most recent starter was checked. The file contained a completed application form and evidence to demonstrate that staff are interviewed and provided with proper contracts of employment. The file contained evidence to confirm that appropriate checks are carried out to ensure that people are suitable to work at the home, including Criminal Record Bureau checks and two references. Comments by three staff on duty indicate that they are provided with a satisfactory range of training opportunities. This was further verified in comments by the manager and by viewing a sample of training certificates. Staff are being provided with access to Health and Safety related training courses, such as fire, food hygiene, moving and handling, first aid and adult abuse. Challenging behaviour training has also been so that staff are equipped to respond with sensitivity to any challenges where they may occur. The organisation employs a training officer to review and plan people’s mandatory training needs. Training reminders are sent to the home and the manager is informed of any training dates that are missed by staff, a sample of which were seen on the home computer. Staff also attend a good range of care courses to equip them to meet the needs of the people at the home, examples include equality and diversity, epilepsy and the administration of diazepam, mental health, death blind awareness, nutrition, makaton and communication training. The manager said that all with the exception of the newest member of staff have received Learning Disability Award Framework training. In the annual quality assurance assessment that was completed by the manager as part of the inspection process, the manager reports that approximately 33 of staff have completed National Vocational Qualifications and this will rise to 66 when the current round of staff have completed this training. An NVQ assessor said that this would be achieved in the next few weeks. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 24 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the work of the home is managed and monitored in a manner that supports the development of the service and supports a safe environment for people to live and work in. The quality assurance system would be improved by opportunities for relatives and professionals to comment and contribute to the development of the service. EVIDENCE: The organisation has recently had a management reorganisation and managers have changed the homes for which they hold responsibility. A senior manager has recently confirmed that the organisation is currently in the process of applying to us to register their managers for their respective services. The manager has completed the Registered Manager Award. The manager also already holds the National Vocational Qualification (NVQ) level 3 and has a Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 25 number of years care homes experience. In the annual quality assurance assessment the manager states an intention to achieve the NVQ in care during the next 12 months. The manager carries out regular monthly audits of various aspects of the home’s practices, such as, medication system, people’s money and Health and Safety matters, records of which were seen on file at the home. The manager reports that periodic environmental audits of the premises also continue to take place involving the manager and the landlord to identify and resolve any maintenance issues. The line manager for the home routinely carries out monitoring visits and copies of the reports were seen on file in the home. The manager reports back on the progress she has made to address points raised in the monitoring report, which is then reviewed by the line manager at subsequent visits. There is still no formal process in place for surveying the views of relatives and professionals regarding the performance of the home. This is particularly necessary where people have high communication support needs and cannot easily comment on the service provided them. The manager said that she intended to address this matter this year. Information provided by the manager in the annual quality assurance assessment for the home indicates that the essential Health and Safety checks are being carried out at the home. The fire records were sampled. The log indicates that the fire alarms and lights are being tested at the correct frequencies and that fire safety equipment is being checked and maintained so that it remains safe to use in the event of a fire. A hot water log was seen, indicating that hot water temperature is being monitored to ensure that it remains at safe temperature levels at outlets accessible to the people living at the home. Stocks of cleaning materials are kept in a locked cupboard so that they present no hazard to people and a range of other recorded checks were seen including checks of first aid stocks and vehicle safety checks. Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 26 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 x 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 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 2 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 x 3 x Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 27 Yes 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. 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 YA2 Good Practice Recommendations It is strongly recommended that an assessment tool is devised for assessing people’s needs prior to their admission to support staff to gather all the essential information required to meet the persons needs. Proceed with plans to speed up the risk assessment process for the new person to enable them to pursue their chosen leisure interests in a safe manner. Keep detailed records of the food intake of the person with an assessed need for a high fibre diet to demonstrate more fully that these needs are met. It is recommended that arrangements are made for surveying the views of relatives and professionals involved at the home so that they may contribute to the quality assurance measures and the future development of the home. 2 3 4 YA12 YA17 YA39 Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Pia - Barnfield DS0000004279.V337928.R01.S.doc Version 5.2 Page 29 - 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!