Inspection on 12/09/07 for The Barn House

This inspection was carried out on 12th September 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 House 09/09/08

The Barn House 19/04/06

The Barn House 22/11/05

The Barn House 19/07/05

The Barn House 09/12/04

The Barn House 24/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE The Barn House Quality Street Merstham Surrey RH1 3BB Lead Inspector 6Lisa Johnson Unannounced Inspection 9:00 12 September 2007 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Barn House Address Quality Street Merstham Surrey RH1 3BB 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) 01737 643273 01737 644551 nigelgungaloo@hotmail.com Mr Permal Naidoo Gungaloo Mrs Gungaloo Mr Permal Naidoo Gungaloo Care Home 30 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (30) The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: OVER 65 YEARS Of the 30 older persons up to 12 can be in the catergory (DE(E)) and up to 12 can be in the catergory (MD(E)). 19th April 2006 Date of last inspection Brief Description of the Service: The Barn House is a detached, adapted property, registered for 30 Service Users, requiring support with mental health needs or assistance with nursing care. The home is situated in a quiet cul-de-sac in the village of Merstham. There are twenty single bedrooms rooms and five double rooms. Twenty three of the rooms have en-suite facilities. The garden is to the rear of the property and is laid mainly to lawn. There is limited parking to the front of the property and there is also on road parking. Mr Gungaloo is the registered manager and together with his wife are joint registered providers; both are registered nurses. The weekly fees range from £450- £550 The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of a key inspection. The visit was unannounced and took place over eight and half commencing at nine am and finishing at six thirty pm. Mrs. L Johnson Regulation Inspector carried out the visit and Mr and Mrs Gungaloo registered persons represented the service. The inspector spoke to four people who use the service and one relative to gain their views on the care provided. Communication with some people using services was limited due to communication difficulties. Therefore views were obtained through observations. Five surveys were received from people living in the service and one was received from a relative. Two surveys were also received from health care professionals and two care managers. Comments received are reflected in this report. Eight staff were surveyed and during this visit the inspector spoke with two members of staff A tour of the premises took place. Information was examined which was provided by the manager supplied in the Annual Quality Assurance Assessment (AQAA). Care plans, staff recruitment and training records, medication administration records and policies and procedures were sampled. The inspector would like to thank the people using the service and staff for their time, assistance and hospitality during this inspection. What the service does well: During this visit the home was observed to be welcoming providing a relaxed atmosphere. People using the service were supported to go out into the garden and were served afternoon tea. People were served a well-balanced and nutritious meal and choices are accommodated. People with spoken to said that they enjoyed their meals and one person smiled and nodded their head. The home supports people to maintain links with their family and friends and the home arranges a range of social events and one relative spoken with said the “Christmas party was very good and I can visit any time” One person in the service maintains his independence and said, “ I go out on shopping on the bus”. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 6 The home supports people with a range of complex needs and comments received from health care professionals included, “there is good liaison with our team”; “the service deals with mental health issues well and “the service has a good understanding of particular client groups and have a strong sense of advocacy respecting people to be themselves. What has improved since the last inspection? What they could do better: Care plans need strengthening to reflect any identified changes in need and ensure that any specialist advice is also incorporated in the care plan. Some care plans that have been reviewed have not been signed by the individual and or their representative to confirm their agreement. The manager must attend updated training on the Surrey multi- agency safeguarding adults from abuse procedure and all staff must receive up to date training. The homes safeguarding adult policy must also be reviewed and amended so that it is line with the local authority policy ensuring the welfare and safety of people using the service. A toilet seat that was broken in one person’s bedroom, which must be repaired ensuring the safety and wellbeing of people using the service. The induction training provided for new staff must be based on the skills for care common induction standards. It is also recommended that the present staff-training schedule be reviewed to identify when staff are due updated mandatory training. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 7 The General Social Care Code of conduct must be bought to the attention of staff ensuring that staff are aware of their responsibilities. During this visit a bathroom cupboard was observed to be unlocked which contained a cleaning material, which was bought to the immediate attention of the manager and this matter was attended to during this visit. 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. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that pre admission assessments are completed prior to admission to the home. The home does not support people for intermediate care. EVIDENCE: The home has a statement of purpose and service user guide in place, which has been reviewed, although the manager is advised to amend the contact details for the Commission for Social Care Inspection. During this visit Pre-admission assessments were sampled for three individuals. The home has a joint needs assessment, which covers health, personal care, emotional, social and culture needs. The manager has acquired community care assessments where these are required and health care professional reports. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person is provided with an individual care plan but need strengthening to reflect any change in needs. The health care needs of people living in the service are met and they are protected in the main by the homes medication policy and procedures and they are treated with respect and their right to privacy is respected. EVIDENCE: During this visit three care plans were sampled. Care plans were in place based on full needs assessments including health, nutritional, mobility personal, emotional, sensory, social, cultural and religious needs. Other areas of need identified including support for individuals who have a diagnosis of dementia, mental health and epilepsy. Care plans were reviewed monthly and had been signed by the author. The manager said that care plans are discussed with individuals, although care plans viewed during this visit had not been signed to confirm agreement. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 11 Daily notes referred to each individuals identified care needs, although one persons daily records indicated that they was suffering from a health related problem and was requiring a pressure area relieving care and this was not indicated in the care plan. Another individual had been assessed by a speech therapist and advice supplied in their report had not also been included in the individuals plan therefore it was required that care plans be updated to reflect any changes in need by providing guidance to staff ensuring that each individuals needs are met. A comment received from a Care manager stated that the service could improve by “ communicating informing them of any changes”. Risk assessments were viewed which included moving and handling and for those individuals identified at risk of falls. Outcomes were recorded in the care plan. One person required monitoring in respect of fluid intake and charts were in place to monitor this. Each person is registered with a General Practitioner and referrals are made to health care professionals where this is required such as the dietician and mental health services. One health care professional commented, “The home liaises with mental health professionals and they have good plans in place to manage challenging behaviour and they have a real understanding of this particular client groups histories and needs”. Five people surveyed who live in the service said that they receive the medical support that they need. Information supplied with the AQAA states that the community eye care and domiciliary dental practice visit annually on request and chiropodists visit six weekly and one person spoken with during this visit stated that their relative was receiving this service. Another survey, which was received from a health care professional states that the home works in partnership with them. During this visit staff were observed to speak to people using the service with courtesy and respect. The preferred name for each individual was recorded in their care plan. One individual told the inspector, “Staff respect my privacy and always knock on my door before entering”. Two care managers surveyed stated, “That the service respects individuals privacy and dignity and responds to the diverse needs of individuals living in the service. The home has a medication policy and procedure in place. The home maintains records for the receipt and disposal of medication. Individuals who may require paracetamol had their been dispensed their own supply. A list was maintained with the medication administration records of staff that are authorized to administer medication. All medication administered had been signed for. Fridge temperatures were recorded in the clinic room and all other medication was stored appropriately, although it was observed that there was one medication that had not been discarded as it was no longer required, The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 12 therefore it was required that this matter is attended to ensuring the health, wellbeing and safety of people. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that people living in the service have access to a range of recreational and leisure activities and maintain links with their family/friends and the local community. People are supported to make choices and individual preferences are respected and they receive well-presented and balanced meals. EVIDENCE: The home provides an activities programme, which was seen on display. Since the previous visit the manager has acquired a range of picture cards of the activities provided to assist people in accessing this information. The home provides exercise; reminiscence, quiz games, sing-along and entertainers visit the home occasionally. The manager stated that people are encouraged to pursue their interests”. One person told the inspector, “I go shopping to town on the bus and occasionally visit a club run by age concern”. During this visit people were assisted by staff to go out in the garden to enjoy the warm weather and were provided with their afternoon tea”. The home has a piano which one person was enjoying playing. One relative spoken with said that that home held “a very enjoyable party at Christmas. Information provided with the AQQA states that Birthday parties and a summer party is arranged. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 14 The home has access to a vehicle and the manager stated that some individuals go shopping with staff. The home provides monthly church services and the catholic priest visits every two weeks, which meets the religious needs of people using the service. Relatives and friends are encouraged to visit the service. During this visit one person’s relative visited and a friend visited another person. The inspector spoke with one relative who said that she is made to feel welcome when she visits and can visit anytime. One individual who lives in the home said that he has access to a phone so that he can maintain contact with his relative. People moving into the service are able to bring their own furniture and possessions, which were seen, on display. One person’s bedroom had been painted in colours that he had chosen and met his preference. The home has a policy on advocacy. One health care professional stated, “The home has a strong sense of advocacy in allowing people who use the service to be themselves”. The home provides a four weekly menu and choices are provided which were recorded enabling people to choose their preferred meals. Four out five people surveyed said that they enjoyed their meals and three people spoken with during this visit also indicated that they were happy. One person smiled and nodded their head when asked if they enjoyed their meals. The manager stated that during the week each individual’s favourite meals are included on the menu. The inspector spoke with the cook who said that fresh meat and vegetables are purchased. During this visit the lunchtime meal was observed to be well balanced and nutritious. The menu reflects the ethnicity of the people living in the service who are White British, marking English cultural by serving fish and chips on Fridays and roast dinners. The mealtime was relaxed and unhurried and the meal is served over two sittings where staff were observed to provided adequate support to individuals who require assistance with their meals. People were provided with refreshments with their meals and serviettes, although it was observed that some individuals were provided with clothes protectors’ that were not age appropriate and consideration should be given to this matter The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is a complaint s procedure and the views of people using the service are listened to. Improvement is needed to ensure that there is robust safeguarding adults procedure, also the staff training programme needs further development ensure people are protected from abuse. EVIDENCE: The home provides a complaints procedure, which is available with the service user guide. Since the previous visit the Commission has received one complaint, which was referred back to the manager to investigate, which was completed. The home maintains records of any complaints and records sampled indicated that the home has received one complaint, which has been responded to. Five people surveyed said that they knew whom they could talk to if they were not happy and that staff listen to their views and act upon what they say. One person spoken with during this visit said that staff respond to any concerns amd another individual surveyed said he had no concerns and that “the staff are very nice”. A survey received from one relative stated complaint if they needed to. that they know how to make a The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 16 The manager had a copy of the Surrey multi- agency-safeguarding adult from abuse policy and procedure and the home has their own safeguarding procedure and whistle lowing policy. This policy was detailed, although one area did not reflect the surrey multi- agency procedure. One matter was discussed which was reported to the care manager and to the Commission but this had not been initially reported to the local team, therefore it is required that the homes policy is amended to reflect the Surrey safeguarding adults from abuse policy and procedure. Two further matters have been investigated under the Local authority multagency procedures, which are now closed. The Responsible individual and registered manager have attended the Surrey multi- agency training but this had taken place four years ago, therefore it was required that this training must be updated. Two members of staff spoken with during this visit stated that policies and procedures were bought to their attention and were clear in their responses to the action that would take if they ever witnessed any abuse. One member of staff spoken with said that she had received safeguarding training, although the training record for a another member of staff indicated that she had not received any training, therefore the manager must ensure that all staff receive up to date training in this matter ensuring people using the service are protected. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service live in a well-maintained, clean, comfortable, homely environment. One Matter was identified that needs attention ensuring that the environment is safe. EVIDENCE: The home is situated in a residential area and is close to local shops. During a tour of the service the home was observed to be mainly well maintained, although a toilet seat must be repaired in one toilet ensuring the welfare and safety of people using this facility. There was a large sitting room/ dining room, which was provided with a piano. There is an accessible garden to the rear of the property, which was accessible and well maintained. The home has refurbishment plan in place. Grab rails and were provided throughout and call bells are provided in bedrooms. Bedrooms viewed during this visit were well furnished and comfortable and double bedrooms were provided with curtains to respect privacy. Some bedrooms are provided with ensuite facilities. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 18 During this visit the home was clean and hygienic. Discussion took place with regard to incontinence and the manager stated that a carpet had been changed in one bedroom. There was some minor malodour on the ground floor and the manager stated that regular cleaning of the carpets is conducted. The manager was aware that some further flooring replacement is needed and was advised to keep this under review. The home has an infection control procedure in place and staff complete training. Adequate hand washing materials were observed throughout and staff were provided with disposable aprons. The home provides separate laundry facilities, which is situated away from the kitchen. The manager has stated that the actions required by an Environmental Health visit have been completed and that the kitchen-cleaning schedule has been reviewed. Four people surveyed said that the home is clean and fresh, although one person said “sometimes” and a relative surveyed said, “The home is always clean and tidy”. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 &30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff on duty were adequate to meet the needs of people living in the service and they are protected by the homes recruitment policies and procedures. Further improvement is needed with staff training ensuring that people living in the service are in the safe hands of the staff that are competent and trained to do their jobs. EVIDENCE: During this visit adequate numbers of staff were on duty. Throughout the day there is one registered nurse plus four carers and the managers. Three waking night staff are provided at night time and the home also employs a cook and ancillary staff. Eight staff surveyed state that there is enough staff staff provided to meet the individual needs of people using the service. Four out of five people who use the service say that staff are available when they are needed, although one person said sometimes. A relative commented, “The staff are very good at catering for my relatives every need and they are always available when needed”. Information supplied with the AQQA states that two members of care staff hold National Vocational Qualifications (level 2) or above and eight members of staff are working towards these qualifications. During this visit the training records were sampled for two members of staff. Training takes place The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 20 internally and externally to the home and the responsible individual has completed train the trainer courses. Mandatory training had been completed in health and safety, infection control, first aid and moving and handling which two members of staff spoken with confirmed. It was recommended that the manager review the present staff training schedules to identify any shortfalls with mandatory training updates including safeguarding adults from abuse. One person spoken with stated that she had completed National Vocational Qualification (Level 3) and was now completing National Vocational Qualification (Level 4). Other training provided includes dementia awareness, mental health, catheter care, incontinence and wound care which meets the needs of people using toe service, The home also receives overseas students completing adaptation courses and assessors and mentors are in place. Two health care professionals stated that staff have the right skills and experience to meet the individuals needs of people using the service with one person commenting, “The home deals with mental health issues of people well and recognises change early”. Seven members of staff surveyed say they are provided with training, although one person stated that the home should provide more in house training to keep them abreast on current trends. The home provides induction to new staff and a copy of the induction pack was provided to the inspector, although this was not based on the Skills for Care common induction standards, therefore it was required that this matter is attended to. There is a recruitment and equal opportunities policy in place. The personnel files were sampled for three members of staff. All the required documents including two written references were available including enhanced Criminal Record Bureau Checks (CRB). One new member of staff had commenced employment and a POVA first check had been completed which was viewed on this individuals file and this individual was being appropriately supervised by the manager. During discussion with the manager staff had not been provided with a copy of the General Social Care Code of conduct, therefore it was required that this must be bought the attention of staff and that they aware provided with a copy to ensure they are aware of their responsibilities ensuring the wellbeing and protection of people using the service The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is able to demonstrate that they have the appropriate qualifications and experience to manage the home. One matter was identified needing attention to ensure that it is run in the best interest of people living in the service. The financial interests of people are protected and the health, welfare and safety of people is mainly protected with two identified matters needing attention. EVIDENCE: The registered persons are both qualified nurses and they have both acquired the Registered Managers Award. A relative surveyed said that the home keeps them up to date with important issues affecting their relative. Six members of staff surveyed state that the manager meets with them and discusses how they are working. During this visit two members of staff spoken with also The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 22 said that feel supported by the management structure and that they were approachable. During this visit the manager was observed to be accessible to people living the home, relatives and staff. The home conducts annual quality assurance surveys for people using the service and their relatives. Information was shown to the inspector that the outcomes of these surveys are analyzed. Since the previous visit the home has introduced meetings for people using the service and the minutes from these meetings were sampled. The home has a range of policies and procedures in place, which have all been updated, although improvement must be made with the homes safeguarding adults from abuse procedure. The home has a policy in place for the safekeeping of finances. The home does not maintain monies on behalf of people using the service and where individuals are unable to manage their own financial affairs they have an appointee or this is managed by family. The home uses an invoicing system and some of these records were viewed. The home has a health and safety and moving and handling policy in place. The fire book was examined which indicated that fire drills and fire alarm checks are conducted. Records were maintained of water temperatures, which are checked monthly, and bath temperature checks are recorded on every occasion. Information provided with the AQAA stated that all routine maintenance and servicing of equipment is completed. During a tour of the home it was observed that a cupboard was unlocked in one bathroom which contained cleaning liquid and an immediate requirement was made that this matter be attended to which the manager responded to during this visit. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X 3 X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 24 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. 1 Standard OP7 Regulation 15(2)(b) (c) Requirement a) Care plans must be kept up to date to reflect any changing needs. b) Care plans must be signed by people using the service and or their representatives confirming their agreement to their care plan 2 3 OP9 OP18 13(2) 13(6) 18(1)(c) (1) The discontinued medication 19/09/07 stored in the controlled drug cupboard must be disposed of. a) The registered person 12/12/07 must attend updated training on Surrey multiagency safeguarding adults from abuse policy and procedures b) All staff must receive up to date training in safeguarding adults from abuse. Timescale for action 12/10/07 4 OP18 13(^) The homes safeguarding adults from abuse policy must be DS0000013355.V349587.R01.S.doc 12/10/07 The Barn House Version 5.2 Page 25 5 6 7 OP19 OP29 OP30 23(2)(b) 18(4) 18(c) 1 amended to reflect the Surrey Multi- agency safeguarding adults from abuse policy and procedure. The broken toilet seat in one individual’s bathroom must be repaired ensuring their safety. The General Social Care Code of conduct must be bought to the attention of staff. The staff induction programme must be based on the Skills for Care common induction standards. 19/10/07 19/11/07 12/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations It is recommended that the manager review the present staff-training schedule to identify any shortfalls in mandatory training. The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 The Barn House DS0000013355.V349587.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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