Inspection on 27/08/08 for The Cyder Barn

This inspection was carried out on 27th August 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE The Cyder Barn West Pennard Glastonbury Somerset BA6 8NH Lead Inspector Jane Poole Unannounced Inspection 27th August 2008 10:00 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 Cyder Barn DS0000071260.V367752.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 Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cyder Barn Address West Pennard Glastonbury Somerset BA6 8NH 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) 01458 834945 The New Cyder Barn Ltd Mrs Donna Marie Nutt Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 25. N/A Date of last inspection Brief Description of the Service: The Cyder Barn is registered to provide care for up to 25 people, over the age of 65, who require assistance with personal care. Nursing care is not provided. It is situated on the main road in the village of West Pennard. The home is an older style property set in extensive grounds. The building retains many of its original features which gives it a domestic and homely feel. Personal accommodation is spread over two floors with a stair lift between. The home was purchased in February 2008 by a company called The New Cyder Barn Ltd. The registered manager is Ms Donna Nutt. Fees at the home range from £410 - £500 per week. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection was carried out over a one-day period. During this time the inspector was able to meet with people living and working at the home, observe care practices, tour the building and view records. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA.) This gave information about the service offered and the improvements that are planned in the coming year. Prior to the inspection 5 people living at the home and 4 members of staff completed questionnaires. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: The Cyder barn is very homely in appearance and has a relaxed atmosphere. People living at the home were very happy with the service that they received. One person said “I don’t think that you would find a better place” and another said “moving here was a very good move.” The home is well managed taking account of the views of people who live there and other interested parties. There was evidence that the manager is open and approachable, shares information and listens to the opinions of others. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 6 There is a stable staff team and people living at the home were very happy with the staff who assisted them. Staff were described as kind, patient and sensitive. Everyone has their needs assessed and is able to spend time at the home before deciding to move in on a permanent basis. This ensures that people are happy that it is the right place for them. People are encouraged to maintain their independence and to make choices about their day-to-day lives. People said that they continued to feel in control. There are good links to local healthcare services and professionals. People asked stated that the staff assisted them to attend appointments outside the home. What has improved since the last inspection? 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. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 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 Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have opportunities to spend time in the home before deciding to move in. Intermediate care is not provided. EVIDENCE: Anyone wishing to move into The Cyder Barn has their needs assessed by the manager to ensure that the home is able to meet their needs. Copies of these assessments were seen in personal files. The manager stated that prospective residents are encouraged to spend time in the home before deciding to move in. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 9 People spoken to during the inspection said that they, or their representatives, had been able to view the home. Some people said that they had stayed at the home for an extended period of time to ensure that it was the right place for them. In addition to full residential care the home also offers day care to a small group of people. This is another opportunity for people to get to know the staff and other residents to decide whether or not it is the right place for them. The Cyder Barn DS0000071260.V367752.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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are assisted to access healthcare professionals in line with their individual needs. Care plans would benefit from further development to ensure that people receive care in line with their up to date needs and preferences. EVIDENCE: People living at the home felt that staff treated them with respect and that their privacy was respected. People said that they were able to spend time in communal areas or in their personal rooms. It was said that staff knocked on doors and waited to be invited before entering. The inspector observed this during the day. People stated that staff assisted with personal care in a sensitive manner. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 11 The inspector viewed a sample of 4 care plans. The plans were very basic and did not always give up to date guidelines for staff to follow. However people spoken to stated that they received a level of care that was individual to them and that staff were aware of their personal preferences and needs. The home has good links with healthcare professionals. A local GP is retained by the home and visits on a weekly basis in addition to calls to individuals. The manager explained that anyone moving to the home is able to keep their own GP if they choose to. All appointments with healthcare professionals are recorded in personal files. People spoken with stated that staff assisted them to attend appointments outside the home and that nurses and a chiropodist visit the home regularly. The personal file of one person showed that they continued to visit healthcare professionals that they had been registered with before moving into the home. Some people who live at the home take responsibility for their medication administration and these people have been provided with secure storage in their bedrooms. Risk assessments have been completed and records show when medication has been passed to the person. Other medication is administered by senior care staff who have received training to carry out this role. The inspector noted that refresher training had been arranged for early next month. The inspector viewed the Medication Administration Records (MARs) These were well maintained and correctly signed to show the quantities of medication entering the home and when administered or refused. The home currently does not have a separate fridge for medication although one has been ordered and assurances were given that it would be delivered within the next two weeks. Medication that requires refrigeration was being kept in an unlocked kitchen fridge. The medication was not in a locked box and the manager agreed to address this as a matter of urgency. There are suitable storage facilities for controlled drugs. Records held in respect of controlled drugs correlated with stocks held. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 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. 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. There are organised activities and people choose what to join in with according to their interests. The home has links with the local community and visitors are always welcome. EVIDENCE: People living at the home stated that they were able to choose what time they got up, when they went to bed and how they spent their day. People generally felt that they continued to be in control of their day-to-day lives and were able to do as they wished. There are organised activities in the home on a daily basis and a notice of these is displayed in the home. On the morning of the inspection many people joined in a quiz and in the afternoon a singer came to the home. Both activities appeared to be enjoyed by a large group of people. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 13 Everyone who completed a questionnaire answered ALWAYS to the question “Are there activities that you can take part in?” The activities programme shows that regular activities include, gentle exercise, card games, bingo, poetry reading, knitting and some live entertainment. Holy communion is held on a monthly basis. People said that they choose what activities to join in with according to their interests. One person stated that they go out for a walk each morning and many said they often went on outings with family and friends. Everybody asked said that they were able to have visitors at any time. The home has links with a local social group and people attend functions and outings with other people living in the surrounding area. The home has a 7 week menu that gives a variety of meals. The main meal of the day is at lunchtime, there is a set meal and a vegetarian alternative. The inspector observed lunch. The food was well presented and portion sizes were ample. Vegetables and condiments were on tables to enable people to help themselves. People spoken to stated that they were not offered a choice of meal but if they did not like the main meal they could always ask for an alternative. One person said that “the food is good, they give people what they want and like.” Hot and cold drinks were available to people throughout the day and one person said “night staff are always happy to bring a drink and biscuits if you wake up during the night.” The menu for the day was not clearly displayed and people asked during the morning did not know what was for lunch. The home should consider providing a menu that allows people to make a choice about their meal rather than rely on people to ask for an alternative. One person told the inspector “A choice would make it more interesting.” The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home feel able to talk with staff about any concerns and are confident that they would be listened to. EVIDENCE: The home has policies and procedures on recognising and reporting abuse, making a complaint and whistle blowing. Staff spoken with were aware of the ability to take serious concerns outside the home. No complaints have been received by the home or the CSCI since the last inspection. Everyone living at the home who completed questionnaires all said that they knew how to make a complaint. All Staff answered YES to the question “Do you know what to do if a service user or advocate has concerns about the home?” People living at the home said that staff were approachable and they would be comfortable to speak to someone if they were not happy with any aspect of their care. Everyone said that they would be listened to. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 15 The inspector observed that people moved freely around the home and had unrestricted access to their personal rooms and all communal areas. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 16 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, 20, 24 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Cyder Barn provides a comfortable, homely environment for the people who live there, but some areas would benefit from re-decoration. EVIDENCE: The Cyder Barn is an older style building with accommodation arranged over two floors. All areas are fitted with a fire detection and call bell system. Communal areas consist of a large lounge/diner and a smaller lounge. Outside there are well kept gardens with seating. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 17 All areas are comfortably furnished but some areas seen would benefit from redecoration and re-carpeting. With the exception of one room, all bedrooms have en suite toilet facilities. People who move into the home are able to bring personal possessions such as ornaments, pictures and small items of furniture. This gives bedrooms a very individual and homely feel. There is a small laundry with domestic appliances, which is adequate for the home. Staff felt that the laundry would benefit from more industrial appliances rather than the domestic type ones currently being used. All areas seen by the inspector were reasonably clean and hand-washing facilities were available throughout the home. To promote good infection control practices the home should consider replacing open top bins in communal areas with foot-operated bins. The Annual Quality Assurance Assessment (AQAA) completed by the home states that plans for the next twelve months include, decorating communal areas, expanding the number of bedrooms, replacing the laundry, installing a lift and replacing the heating system. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. The home is adequately staffed to meet the needs of the people who live at the home. Recruitment procedures and practices minimise the risk of abuse to the people who live at the home. EVIDENCE: The home employs 25 care staff, 11 (44 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. A further 4 members of staff are working towards this award. Staff spoken with on the day of the inspection were well motivated and interacted well with the people living at the home. Everyone asked was complimentary about the staff who worked at the home. One person said “staff are very compassionate and they deserve praise.” Another said “staff are very approachable, if you want something they sort it out.” The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 19 Staff described the home as a very happy place to work and said that communication between staff was good. There are adequate numbers of staff on duty at all times. During the day there is always a senior carer on duty who co-ordinates the shift and gives guidance to less experienced staff. In addition to the senior there are 2 carers. Overnight there are two waking night staff. All ancillary staff hours are in addition to the care hours. The inspector viewed the recruitment files of the two most recently employed members of staff. These gave evidence of a robust recruitment procedure that minimises the risks of abuse to the people living at the home. New members of staff had undergone an enhanced Criminal Records Bureau (CRB) check and written references had been obtained before the person began work in the home. All staff who completed a questionnaire answered YES to the question “Did your employer carry out checks such as CRB and references?” There is an induction programme in place, which is in line with the ‘skills for care’ core standards. Staff spoken to during the inspection said that they had received a good induction and were happy with the ongoing training opportunities. All staff who completed questionnaires said that they received training appropriate to their jobs. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35 & 37. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed taking account of the views of people who use the service. Various systems are in place to maintain a safe environment. EVIDENCE: Since the home was purchased earlier in the year a management company has been employed to oversee the running of the home. The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 21 The registered manager of the home is Donna Nutt. She has many years experience of working with older people and is qualified to NVQ level 4 in both care and management. The manager stated that they are well supported by the management company in place. People living and working at the home described the manager as very approachable. Notes from staff and residents meetings show that she shares information with people and listens to the opinions of others. Various quality assurance measures are in place, these include satisfaction questionnaires, a suggestion box, in-house audits and meetings for staff and residents. The home does not act as a power of attorney or financial appointee for anyone living at the home. Small amounts of personal allowance can be deposited with the home for safe keeping ensuring people have access to their personal finance. The inspector viewed a sample of these monies. Records and receipts are maintained and these balanced with the amounts of money being looked after. There is a full time handy person employed who takes responsibility for day-to -day maintenance and maintaining a safe environment. A fire risk assessment has been completed and records show that the fire detection equipment is regularly tested in-house and serviced by outside contractors. All staff have received training in fire safety. All equipment in the home is regularly inspected to ensure that it remains safe. All accidents are recorded. The management audits these records to monitor the needs of individuals, and to establish if there are any implications for the service. There is a training plan for staff in the home, which includes up dates in health and safety issues. The Cyder Barn DS0000071260.V367752.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 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 3 N/A 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 3 2 3 x x x 3 x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP9 Regulation 13 (2) Requirement All medication must be securely stored. Timescale for action 27/08/08 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 2 Refer to Standard OP7 OP15 Good Practice Recommendations Care plans should be further developed to ensure that they provide up to date information about peoples needs and preferences. To ensure that people are able to make choices about the food they eat there should be more than one option available to everyone. The options should be displayed to enable people to make a choice. There should be a programme of redecoration to ensure the home is decorated and furnished to a good standard. 50 of care staff should have a National Vocational Qualification in care at level 2 or above. 3 4 OP19 OP28 The Cyder Barn DS0000071260.V367752.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Cyder Barn DS0000071260.V367752.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. 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