Inspection on 22/11/05 for The Barn House

This inspection was carried out on 22nd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Barn House 09/09/08

The Barn House 12/09/07

The Barn House 19/04/06

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 Sarah Radlett Unannounced Inspection 22nd November 2005 09:00 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.V262815.R01.S.doc Version 5.0 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.V262815.R01.S.doc Version 5.0 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.V262815.R01.S.doc Version 5.0 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 July 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 20 single occupancy rooms and 5 double rooms. 23 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.V262815.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4½ hours and was the second inspection carried out by the Commission for Social Care Inspection for the year 2005-2006. Sarah Radlett carried out the inspection. Mrs Gungaloo, one of the Registered Providers, was present throughout the inspection. A tour of the premises took place and various written records were examined, including eight care plans and service user assessments, staff recruitment files, staff training records, the accident record book and a sample of the medication administration records. The inspector spoke to Service Users, and some of the staff on duty at the time of the inspection. The Inspector would like to thank the staff and Service Users for their time, assistance, and hospitality during the inspection. What the service does well: What has improved since the last inspection? The Registered Provider stated that some areas of the home had an odour of urine; however this was being addressed. A regular toileting routine was been initiated for a Service User in order to deal with their incontinence. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 6 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 Barn House DS0000013355.V262815.R01.S.doc Version 5.0 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.V262815.R01.S.doc Version 5.0 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 & 6 The information enabling Service Users to make an informed choice about where they live was available to all existing and prospective Service Users. EVIDENCE: The home has an appropriate Statement of Purpose and Service User Guide. The Statement of Purpose was located in the main office and the Service Users guide had been distributed to all Service Users. One of the Registered Providers assessed Service users prior to admission to ensure that the home can meet their needs. Samples of the Service Users assessments were seen and found to be comprehensive; however it was noted that one of these records did not contain a signature. Intermediate care was not provided at the home. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 9 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 Comprehensive care plans are in place, they clearly set out the Service Users health, personal and social needs. However Service Users had not always signed their care plans. Risk assessments were comprehensive, but several records were completed in pencil and contained ‘Tipex’. The accident book was examined; the style of book was not in compliance with the data protection act. The recording, administration and storage of medication were satisfactory. Care was provided in a dignified, respectful manner. EVIDENCE: Eight care plans and Service User assessments were randomly selected for inspection. The care plans set out in detail the action that needed to be taken to meet the assessed needs. There was evidence of regular review. The The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 10 Service Users had not always signed their care Plans, to evidence involvement in their care. One of the records examined did not contain a signature of the staff member who had completed the care plan. Samples of risk assessments were inspected. They were found to be comprehensive; however several were written in pencil and contained ‘tipex’, some of these records did not contain a date or a signature. The accident book was examined and was satisfactorily completed; however the style of book was not in compliance with the data protection act. The staff and Service Users accident books had multiple entries on one page; therefore anyone completing the book was able to view previous entries. At the previous inspection it was recommended that an audit of falls be carried out to determine whether there was a pattern to the incidents; this has not yet been completed. All Service Users were registered with a local GP. Service users had access to visits from other health professionals such as the chiropodist. The homes recording, administration and storage of medication were seen and satisfactory. No Service Users had chosen to self-administer their medication. Staff were observed to carry out their care duties in an appropriate manner. Service Users spoken with were complimentary regarding the home. Screens were available in the double rooms. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 11 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): 13 & 15 The home has unrestricted visiting times. Service Users were happy with the food. EVIDENCE: No visitors were present at the home during the inspection. The home has an open visiting policy; however it is preferred that visits do not take place during mealtimes. Many of the Service Users do not have visiting relatives; the home is therefore in the process of establishing links with Age Concerns advocacy services. Some of the Service Users were observed to eat lunch during the inspection, the food was met with positive comments and all Service Users spoken with stated that they liked the food. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 12 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 The complaints procedure was available to all Service Users. EVIDENCE: A copy of the homes complaints procedure was contained within the Service Users Guide, which was accessible to all Service Users. No complaints had been received since the last inspection. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 13 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 home was suitable in layout for its purpose. The home was found to be clean and tidy. Some areas of the home contained an offensive odour. EVIDENCE: The inspector toured areas of the home. It was seen to be clean and tidy. The Registered Provider stated that some areas of the home had an odour of urine; this was being addressed. A regular toileting routine was been initiated for a Service User in order to deal with their incontinence. The premises were well maintained with service users able to access all areas of the home. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 14 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 staffing arrangements in place on the day of the inspection were sufficient to meet the needs of the Service Users. Shortfalls were found in the homes recruitment process. The Registered Provider and Registered Manager ensure that staff receive appropriate training. EVIDENCE: The staff rota inspected demonstrated that the staffing numbers and skill mix were appropriate to meet the assessed needs of the Service Users living in the home. The Registered Provider and Registered Manager are both NVQ Assessors, the Registered Manager is currently completing the NVQ Internal Verifiers qualification. The home is committed to NVQ training, two staff members have currently completed level 2 and a further 9 are in progress. The home is also able to provide conversion training for overseas trained nurses. Samples of staff files were examined at inspection. They did not all contain the information specified in Schedule 2 of the Care Homes Regulations and staff members had been recruited prior to obtaining a CRB / POVA check and The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 15 without evidence of verification of NMC pin number. requirement was made. An immediate The home had a comprehensive training programme and there was evidence of on-going training for staff, including Service User specific training. The Registered Provider is a manual-handling trainer. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 16 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 Quality assurance questionnaires are completed; the results of which were not available to Service Users. Systems are in place to safeguard Service Users finances. EVIDENCE: The Registered Provider demonstrated good leadership qualities at inspection, all staff and Service Users observed to respond to her in a positive manner and appeared very pleased to see her. Both herself and the Registered Manager are completing the Registered Managers Award. Service User surveys had been completed, but the results of the Service User survey had not been presented in a report making the results available to Service Users and other interested parties. The provider informed the inspector that she is due to undertake another survey and will be collating the The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 17 results, making them available to Service Users and other interested parties, including CSCI. Systems are in place to safeguard the Service Users financial interests. Samples of receipts and invoices were inspected and in order. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 18 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 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 X The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14(1a)15( 1)17(1a& 3a) 12(23)15(1&2 c-d) Requirement The Registered Person must ensure that all Service Users assessments, care plans and risk assessments contain a signature. The Registered Person must ensure that care plans contain a service users signature or their representatives to indicate agreement and evidence their involvement. This is the second time this requirement has been made. The Registered Person must ensure that all Service Users assessments, care plans and risk assessments are not written in pencil and do not contain ‘tipex’, The Registered Person must ensure that the accident book is in compliance with the data protection act. The accident book must not contain multiple entries on one page. The Registered Person must ensure that staff are not be recruited prior to obtaining the information listed in Schedule 2. This is the second time this requirement has been made. DS0000013355.V262815.R01.S.doc Timescale for action 22/11/05 2 OP7 22/12/05 3 OP8 15(1)17(1 a&3a) 22/11/05 4 OP8 17(2-3ab) Sch4 22/02/06 5 OP29 19(1&4abi)Sch2(1 -9) 22/11/05 The Barn House Version 5.0 Page 20 6 OP33 24(1-2) The Registered Person must ensure that the results of the Service User survey must be presented in a report which is available to Service Users and other interested parties. This is the second time this requirement has been made. 22/02/06 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 OP8 Good Practice Recommendations An audit of falls should be carried out to determine whether there was a pattern to the incidents. The Barn House DS0000013355.V262815.R01.S.doc Version 5.0 Page 21 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.V262815.R01.S.doc Version 5.0 Page 22 - 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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