Inspection on 19/04/06 for The Barn House

This inspection was carried out on 19th April 2006.

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 12/09/07

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 Deavanand Ramdas Announced Inspection 19th April 2006 03:55 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.V290377.R01.S.doc Version 5.1 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.V290377.R01.S.doc Version 5.1 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 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.V290377.R01.S.doc Version 5.1 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)). 22nd November 2005 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 Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over a period of six hours. A partial tour of the premises took place, staff and service users were spoken to, and care records and documents were examined. The inspector would like to thank the registered manager, staff and service users for their contributions to the inspection. What the service does well: What has improved since the last inspection? What they could do better: The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 6 The home needs to review and update the statement of purpose, service user guide and other policies and procedures to reflect the CSCI (Commission for Social Care Inspection) as the regulatory body for the home. The information on the activity plan for service users needs to be in a format which is accessible to ensure service users understand the information and are able to make choices about activities. The home needs to develop a policy on staff recruitment and vetting procedures to safeguard the interests and welfare of service users. A policy on quality assurance and a development plan needs to be introduced in the home to ensure the home is run in the best interests of service users. The back garden needs a new fence to promote the safety and security of service users. The home needs to improve standards of cleanliness and hygiene in the kitchen by reviewing and updating policies and procedures in the home to promote the health and safety of service users. 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 Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 7 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.V290377.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 The homes statement of purpose and service user guide are good providing service users and prospective service users with the details of the services the home provides enabling an informed choice to be made about admission to the home. However, the service user guide is in need of updating. The arrangements for assessing needs are adequate ensuring service users and prospective service users’ needs are assessed and identified before admission to the home. EVIDENCE: The home has a statement of purpose and service user guide which was reviewed and updated in July 2005 and available in the nurse’s office. The information in the statement of purpose was well presented, written in plain English and covered the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home. The service user guide was in need of updating to reflect the change from NCSC (National Care Standards Commission) to CSCI (Commission for Social Care Inspection). The home has a joint needs assessment which covers the areas of health, personal care and social care needs. Assessments are completed by a qualified staff using a nursing model and dated and signed. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 9 The home does not provide intermediate care and this standard was not assessed. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 There is a care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. The arrangements for promoting service users health are satisfactory ensuring service users have access to health care services to meet assessed needs. The management of medications is satisfactory and promotes the health of service users. The arrangements for privacy and dignity are satisfactory ensuring service users are treated with respect and their right to privacy upheld. EVIDENCE: Service users have risk assessments and care plans based on an assessment of needs which cover health, personal care and social care needs. The inspector sampled care plans and noted they were reviewed monthly, dated and signed by staff. Service users were registered with a local GP for accessibility and dental, optical and chiropody services were provided by the local primary care trust. The home has contact with the district nurse and one service user who had gained weight was referred to a dietician for advice on management. A relative reported ‘‘I think my father is happy here although he does not socialise with people, he does say he is well looked after’’. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 11 Following a complaint about medications the CSCI (Commission for Social Care Inspection) pharmacy inspector visited the home and made a number of requirements to improve practice and management action has been taken in respect of this matter. The home has a policy statement on privacy and dignity and the inspector noted staff addressed service users by their preferred names and the manager knocked on doors before entering service users bedrooms. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 The arrangements for service users’ activities and community contact are satisfactory, however information on the written activity programme needs to be in a format accessible to service users. Autonomy and choice at the home is promoted ensuring service users exercise choice over their lives. Meals at the home are adequate offering variety and choice. EVIDENCE: The home had a daily activity programme which was in the nurse’s office for information. Service users’ interests were recorded in care plans and they were given opportunities for stimulation in leisure and recreational activities supported by staff. The inspector noted the written activity programme was not in a format suited to the capacities of some service users and action has been required in respect of this matter. The home had a statement on visitors to the home and service users were able to receive visitors in private using the designated private lounge area. The home had a policy on autonomy reviewed and updated in July 2005. Service users are supported to handle their own finances where appropriate and the inspector noted some service users had advocates and appointees. The home had a written menu plan and employed a contract cook who was responsible for cooking and preparing the meals at the home. The inspector sampled menu plans and noted meals offered variety and choice, and mealtimes were relaxed and unhurried. Hot and cold drinks The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 13 were available and one service user stated ‘‘ meals are palatable, nice and I like the chicken curry’’ The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 The complaints process at the home is satisfactory with complaints information available to staff, service users and relatives. The arrangements for protection are satisfactory ensuring service users are protected from abuse. EVIDENCE: The home has a complaints policy reviewed and updated in July 2005 and complaints information can also be found in the service user guide and statement of purpose. During a meeting staff stated they were aware of the complaints procedure and a service user commented ‘‘he is happy with things and has no complaints’’. A number of complaints had been made to the CSCI (Commission for Social Care Inspection) about the home which have been investigated and appropriate management action taken. The home had a policy on abuse reviewed and updated in July 2005 and during a meeting staff stated they had training in the abuse policy. One staff remarked any concerns would be raised with management who followed up all allegations promptly. The home had a whistle blowing policy reviewed and updated in July 2005 and training is being planned for staff in managing challenging behaviour and aggression by service users to ensure it is dealt with appropriately. One service user remarked ‘‘I am happy and feel safe’’. There is arrangements for managing service users’ money and the home has a ‘Residents Property’ policy to protect service users from financial abuse. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19&26 The arrangements in place for managing the premises are satisfactory ensuring service users live in a well maintained and safe environment, however the fence in the back garden needs replacing to promote the safety of service users and a development plan must be sent to the CSCI for information. The arrangement for hygiene and control of infection are satisfactory ensuring the home is clean and pleasant. EVIDENCE: On the day of the inspection the home was clean, nicely presented and free from mal odour. The gardens were tidy, well maintained and accessible to service users. The inspector noted the homes handyman was clearing the flower beds in the back garden to make it attractive for service users and one service user was walking in the back garden enjoying the outdoors. The home had a maintenance book and records were kept of work undertaken to maintain the safety of the environment for staff and service users. The inspector noted the back garden needed a new fence to promote the safety and security of service users and action has been required in respect of this matter. The home had a policy on infection control which was reviewed and The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 16 updated in July 2005 and a contract with an approved company for the management of clinical waste. Staff had training in infection control and observations confirmed good hygiene practice with staff washing their hands regularly. The home had laundry facilities sited away from the kitchen and washing machines had sluicing facility. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 The arrangements for staffing are satisfactory ensuring adequate numbers of staff with appropriate skills on duty to meet the needs of service users. The recruitment and vetting procedures for staff needs to improve to protect service users from harm or abuse. The arrangements for staff training are adequate ensuring staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection the home was adequately staffed with an appropriate skill mix of staff including the manager, deputy, registered nurses, senior care assistants, care assistants, a cook, a cleaner and handyman. The inspector sampled the duty roster and noted it reflected the numbers of staff on duty. The manager stated the home is committed to training and staff development and noted a number of staff are working towards the NVQ (National Vocational Qualification). The inspector noted the home did not have a policy on recruitment of staff and action has been required in respect of this matter. Staff recruitment files were sampled and had completed application forms, employees had POVA (protection of vulnerable adults) and CRB (criminal records disclosure) checks, references and a recent photograph. The inspector noted one staff recruitment file did not have the necessary references and action has been required in respect of this matter. The manager stated the home is committed to staff training and development and future training has been planned covering the areas of dementia care, challenging behaviour, aggression, planning of care and risk assessments. During a meeting staff stated they were happy with their training and The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 18 development and the home was an approved centre for adaptation students from Greenwich University. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 &38 The home has a qualified and experienced manager ensuring service users live in a home which is managed by a person fit to be in charge. The arrangements for quality assurance at the home needs to improve to ensure the home is run in the best interests of service users. The arrangements for service users’ money are satisfactory ensuring service users financial interests are safeguarded. The systems for promoting health and safety are satisfactory however the standard of hygiene in the kitchen requires further monitoring. EVIDENCE: The home has an experienced registered manager and deputy manager both of whom have a professional nursing qualification and has recently completed the RMA (registered manager award). The manager and deputy provides leadership and direction to the staff team and there are clear lines of accountability in the home. During a meeting staff stated ‘‘the management is supportive and helpful’’. The home uses questionnaires which are circulated The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 20 to service users, relatives and other professionals to obtain feedback about the home. A requirement made at the last inspection to make available the results of service users surveys have been carried out by management. The inspector noted the home did not have a policy on quality assurance or an annual development plan and action has been required in respect of this matter. Service users’ money is appropriately managed and the home has policies and secure facilities for safe-keeping of monies and valuables. The home has a policy on health and safety reviewed and updated in July 2005 and staff have training in health and safety. A requirement made at the last inspection to have an appropriate accident book to record accidents, injuries or illnesses has been carried out by the management. The inspector checked the kitchen and noted it was clean, fridge and freezer temperatures were within normal limits and food was appropriately stored. The home has taken a number of steps to improve the standard of hygiene in the kitchen as a result of an inspection by the EHO (environmental health officer) which requires further monitoring and action has been required in respect of this matter. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 21 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 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.V290377.R01.S.doc Version 5.1 Page 22 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 OP1 Regulation 6 (a) Requirement The registered person must ensure the statement of purpose and service user guide is amended to reflect the CSCI (Commission for Social Care Inspection) as the appropriate regulatory body. The registered person must ensure the information on the homes activity plan is in a format accessible to service users. The registered person must ensure the home has a staff recruitment policy and adequate vetting procedures to safeguard service users from harm or abuse. The registered person must ensure the home has a policy on quality assurance to ensure the home is run in the best interests of service users. The registered person must produce an annual development DS0000013355.V290377.R01.S.doc Timescale for action 05/07/06 2. OP12 16(2)(m) (n) 05/06/06 3. OP29 19(1)(a) 05/06/06 4. OP33 24(1)(a) (b) 05/06/06 5. OP33 24(1)(a) (b) 05/06/06 The Barn House Version 5.1 Page 23 plan for the home which includes renewal, refurbishment and decoration of the home to improve the environment for service users. 6. OP38 16(2)(j) The registered person must ensure the daily cleaning schedule for the kitchen is updated to include the requirements made in the EHO (Environmental Health Officer) report dated 8/3/06. The registered person must ensure a new fence is installed in the back garden to promote the safety and privacy of service users. The registered person must ensure the home has a policy on food safety and nutrition to promote the health of service users. 22/05/06 7. OP19 23(2)(o) 22/05/06 8 OP38 16(2)(1) 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Barn House DS0000013355.V290377.R01.S.doc Version 5.1 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. 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