Inspection on 03/12/07 for The Barn

This inspection was carried out on 3rd December 2007.

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

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

Other inspections for this house

The Barn 24/07/06

The Barn 13/03/06

The Barn 04/08/05

The Barn 11/02/05

The Barn 13/08/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Barn (The) Holton Lee East Holton Holton Heath Poole, Dorset BH16 6JN Lead Inspector Tracey Cockburn Unannounced Inspection 3rd December 2007 10:30 Barn (The) DS0000026821.V355885.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 Barn (The) DS0000026821.V355885.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. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barn (The) Address Holton Lee East Holton Holton Heath Poole, Dorset BH16 6JN 01202 631063 01202 631063 barn@holtonlee.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) East Holton Charity Ms Elizabeth Ann Jones Care Home 4 Category(ies) of Physical disability (4) registration, with number of places Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One or more Service Users, who will have a physical disability, may also be over the age of 65. 24th July 2006 Date of last inspection Brief Description of the Service: The Barn at Holton Lee offers accommodation for holidays, activities, retreats and relaxation for up to 10 people with a physical disability, although at any one time only 4 will require personal care. 4 rooms are registered with the commission. New accommodation has been built and includes single en-suite rooms. Family members, friends or carers can accompany guests and accommodation is provided to support this. The Barn is a modern building set within 350 acres of varied landscape with views towards Poole Harbour. The building is fully wheelchair accessible and designed to meet the needs of people who have a physical disability. The house provides single or double room accommodation. Other facilities include adapted bathroom and toilet including overhead hoist in a shower room, mobile hoists, Apollo bath, alarm call systems and electrically operated beds. Communal areas consist of a resource room fitted with computers with internet access, lounge with TV, a sitting room and a large dining room. As well as the main kitchen where staff prepare the meals there is a guest kitchen for snacks and drinks. During the day people can use power chairs and scooters to go around the grounds, for bird and deer watching. At extra cost guests can book additional services such as counselling, reflexology, massage/aromatherapy and carriage driving. The home is not particularly close to community resources being in a rural area, however this is in keeping with the expectations of this service. Fees vary according to support needed. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place without any warning. This was a ‘key inspection’ where the home’s performance against the key National Minimum Standards was assessed alongside progress in meeting a requirement made at the last inspection. At the time of the inspection 3 people were at the service, all were leaving that day and the service was closing for the remainder of the week. A total of 2.5 hours were spent at the service. A further 2 hours was spent reviewing paperwork received from the service mainly the annual quality assurance assessment. Methodology used included a partial tour of the premises, review of records and discussions with guests and staff. What the service does well: What has improved since the last inspection? At the end of the inspection in July 2006 there was 1 requirement and 6 recommendations. The service continues to ensure that all staff gain a National Vocational Qualification (NVQ) at level 2 or above. Care plans contain more detail so that care staff know what they need to do to support people who use the service. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 6 People who use the service sign their risk assessment forms. For people who administer their own medication the service ensures that a risk assessment has been completed. Staff undertake safeguarding training so that people who use the service are protected. All staff that have completed fire training sign to confirm this. The service keeps a record of all the regulation 26 visits completed by the provider. 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. Barn (The) DS0000026821.V355885.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 Barn (The) DS0000026821.V355885.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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The particular needs and aspirations of guests are assessed by suitably qualified people, discussed with all parties involved and agreed prior to arrival at The Barn. This means that guests can be confident that the care they receive will be tailored to meet their individual needs. EVIDENCE: Prior to arrival at the Barn guests are asked to complete a requirement form detailing care needs and aspirations during their respite period. In addition care needs assessments are obtained from funding authorities. Two guest files were seen which were detailed and comprehensive. The annual quality assurance assessment completed by the provider states that guests are only invited to stay if their needs can be adequately met. The service does not have any waking night staff so would not accept anyone who required that service. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 9 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): 6,7,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A person centred approach means that people are able to articulate clearly their changing needs, however this information is not always written down. People who use the service are able to make decisions about their daily life. People are supported to take risks as part of their lifestyle. People have access to information held by the service; further clarification needs to be sought on where and how this information is held. EVIDENCE: During the inspection 3 guests were enjoying respite care at The Barn. Prior to their arrival they indicate on the guest requirement form specific levels of assistance and support needed during their stay. Of the 2 care files reviewed 1 included a “client handling forms” to be used in circumstances where support with movement is required. All 3 people spoken to were very happy with their stay. Comments included: Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 10 “Very good care in a very peaceful place” “The food is very good” “The staff are excellent” However the care plans were not updated and changes had been recorded but not on the care plan. Care must be taken to ensure that up to date information is available on each guest to reflect their current and changing needs. Staff work very closely with guests and verbal instruction is an important part of the person centred approach, which leads to very positive outcomes for people on respite. The absence of written detailed information however could potentially leave staff and guests vulnerable without good documentation to refer to. All 3 guests had only the highest praise for staff. Information on resources available at the Barn is kept on both the resource room and in guest rooms. There is a wide range of activities to enjoy and risk assessments are in place to minimise any risk of harm to guests and staff. Guests spoken to choose how to spend their day and receive as much or as little assistance from staff that they require. When guests come to stay their individual information is held in the kitchen so it is accessible to staff and guests should they need to either write in the daily log or just see what is written. This information is not stored in a confidential way. It would be useful for the provider to consult with the people who use the service about how they would like this information stored. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to participate in activities, which interests them if they wish. People are able to maintain the relationships they want to while on respite. The focus of the individual’s rights is an important aspect of the service. People are supported to maintain a healthy diet. EVIDENCE: There is a wide range of activities for guests to enjoy at The Barn. A number of adapted motorised vehicles and bikes allow access to the beautiful heath and woodland. There is a pony and trap available and occasionally organised walks. The resource room includes a computer, which guests can readily access and there are lots of games, jigsaws and books. A variety of different workshops and events are available. Alternatives therapies such as massage and reflexology are also available. Each week the service offers a ‘sacred space’ Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 12 spiritual/quiet time for guests. Bird hides are also very accessible. All of the guests spoken to felt that there was more than enough to occupy them at The Barn and there was a good balance between rest and activity. Guests are able to bring with them partners, or friends to either care for them or to enjoy a holiday alongside them during their period of respite stay. Family and friends are also able to visit at times which are flexible and are welcome to stay for meals should they choose. Daily routines although regular are not strictly adhered to. All guests spoken to said that they could choose how to spend their day and that although they chose to go to bed and get up at regular times and take communal meals that this was not expected. All said that their right to privacy, choice and independence were safeguarded. Meals are generally a communal event and are taken in a pleasant dining room. Much of the fresh produce is grown at Holton Lee and care is taken to include organic vegetables in each meal. Food is varied and nutritious and without exception each guest spoken to say the food was “excellent” or “good”. Special dietary needs are well catered for, as are personal likes and dislikes. In the annual quality assurance assessment the service are planning to recruit a cook who will increase the variety of meals and free up care staff to spend more time with guests. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 13 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): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are treated as individuals and as such are in charge of their care routines. People are supported with their physical and emotional needs as they wish. The medication policy and proactive support people who manage their own medication. EVIDENCE: Care is delivered in line with individual wishes and in a way that allows guests to feel respected. 1 person spoken to on the day of the site visit said that staff were very good and providing the support needed. The service is person centred so people are able to clearly state their preferences for the way they are supported. 1 person said they had been on respite before and staff were very supportive in ensuring they did everything with regard to personal care exactly as the guest wished. This person said they are also able to make their own choices about who supports them and they are able to stipulate when they want to get up and go to bed. Information about any changes to individual health needs is identified before anyone is admitted for respite. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 14 The new bedrooms have overhead tracking hoists and aids and adaptations to suit people’s physical needs. If requested guests may access aromatherapy massage and reflexology although there is an additional cost for that service. Lockable storage is provided and medication brought into The Barn is recorded. All staff have received training in the safe handling of medicines. The service has good links with the district nursing service that provides training for staff. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 15 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): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Barn has a clear and effective complaints procedure, which enables guests to feel confident that their views are listened to and acted on. Written policies are in place at The Barn to safeguard people who use the service. The policy needs minor revision. EVIDENCE: A suitable policy and complaints procedure is in place at The Barn and each guest receives a copy with their welcome pack. There is a formal record of complaints. No complaints have been received during this inspection period. The Barn has a safeguarding adults policy and procedure in place and staff have received training. In the annual quality assurance assessment the home recognises that they need to ensure all staff are up to date with this training. Guests spoken to commented on the high levels of sensitivity and respect afforded to them by staff on a day-to-day basis and when delivering individual care. The policy needs some minor changes to reflect that it is social service responsibility to decide who instigates an investigation. They also need to change the references to the commission to the commission for social care inspection and not the national care standards commission. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 16 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): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Barn provides a safe, homely comfortable environment, which is well suited to the needs of the current guests. The Barn is clean and hygienic and promotes safe working practices. EVIDENCE: The charity has completed the building of a new 10 bedded fully en-suite facility adjacent to the current accommodation, since the last inspection. The accommodation arrangements at The Barn are well suited to the needs of the guests. The new accommodation continues to offer an interesting environment with a resource room, which enables access to the internet and a range of information services. The new bedrooms are situated in the new building, which is clad in wood and is linked to the old building by a gently sloping corridor. The rooms all have patio doors leading to a seating area. Each of the 4 rooms, which are registered, has en- suite facilities, which are fitted to a Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 17 very high standard. The rooms are designed to be flexible to meet individual need. All contain an overhead-tracking hoist and the en-suite facilities have the appropriate aids and adaptations. The overhead-tracking hoist leads from the bed to the shower. There is a seating area in the new building with doors leading to a patio. At the time of the site visit there had been heavy rain and there was significant pooling of water around the building, which the manager said was being dealt with. There was also some leakage from the glass skylight over the seating area, which again was being addressed by the builders. The new building has all the appropriate certificates from building control. People in respite on the day of the inspection commented very positively about the standard of the new accommodation. The kitchen and dining area are spacious and well maintained. There is a good range of up-to–date reading material, games and videos and the premises are accessible to all guests. The Barn is bright and airy and meets the requirements of both the local fire service and environmental health department. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 18 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): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Guests are supported by a sufficient number of staff that are suitably trained and qualified, offering consistency of care at The Barn. Recruitment practice ensures that people are protected. Minor changes to ensuring gaps in employment are recorded would further enhance practice. Service users’ individual and joint needs are met by appropriately trained staff. EVIDENCE: Staff at The Barn have a wide range of qualifications and experience, which makes them well placed to work with all guests. There is a structured induction in place, which provides training in a range of Health and Safety topics and all staff receive equal opportunities training. Training and development are linked to The Barn’s aims and to service users needs. NVQ training remains ongoing although the requirement that 50 of the staff team are trained to at least NVQ level 2 had not been achieved by the end of 2006. One staff file was seen. A member of staff confirmed that they had the opportunity for regular training and were well supported by the registered Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 19 manager. Proper recruitment procedures are adhered to and files evidenced that all relevant documentation is in place to ensure the safety and well being of guests. A gap in employment was not explored. During the site visit staff were observed supporting people who use the service; they were very discreet, respectful and skilled in communicating. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 20 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): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Barn is well run and the views of the people who use the service are incorporated into the development of the home. The health, welfare and safety of people are promoted and protected. EVIDENCE: The registered manager has the qualifications and experience necessary to manage the service. Following their stay all guests are asked to complete an evaluation form, which is reviewed both by the registered manager and the director. Any areas of concern are followed up as a result of this by letter and results are incorporated into the charity’s strategic yearly review. Family members also complete evaluations although at the current time care managers and other Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 21 stakeholders are not included in the quality assurance programme. There is a five-year management plan in place and the views of guests strongly influence, decision making. People are asked questions such as: Were the staff helpful? Did you enjoy the food? What facilities did you visit? What did you most enjoy about your stay? 1 person said in their evaluation form that they wanted a notice on the door of their room telling them what to do in case of a fire. Another person said they enjoyed the friendliness and the peace and quiet of their stay. Mandatory training including moving and handling and fire safety is completed for all staff working in the service. All appropriate certificates for the new building are complete and in place such as building control and the fire service. Safety procedures are posted around the home. The fire risk assessment had been completed. The fire checks had been completed as necessary and the last fire drill was on 26/11/07. The passenger lift was serviced in November 2007. A new gas boiler was installed in June 2007 and certified by a Corgi registered person. Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 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 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 2 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 X 3 X Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The registered provider should make sure that care plans for guests hold up to date information about their personal and health care needs. The registered provider should consult with people who use the service about the storage of confidential information about guests being held collectively in the kitchen. The registered provider should update the safeguarding adults policy to clearly reflect that the provider does not instigate an investigation. They should also change any reference to the national care standards commission to the commission for social care inspection. The registered provider should ensure that any gaps in employment are explored and the information recorded as part of the interview process. 2. YA10 3. YA23 4. YA34 Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Barn (The) DS0000026821.V355885.R01.S.doc Version 5.2 Page 25 - 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!