Inspection on 30/08/07 for The Old Haybarn

This inspection was carried out on 30th August 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 Old Haybarn 06/03/06

The Old Haybarn 11/08/05

The Old Haybarn 08/12/04

The Old Haybarn 01/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Old Haybarn London Road Crowborough East Sussex TN6 1TQ Lead Inspector Nigel Thompson Key Unannounced Inspection 30th August 2007 10:00 The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Haybarn Address London Road Crowborough East Sussex TN6 1TQ 01892 654057 01892 667457 baronsmedehomes@btinternet.com 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) Baronsmede Family Homes Ltd Mrs D J Tormey Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the maximum number of service users to be accommodated is seven (7). Service users will be aged eighteen (18) to forty-five (45) years on admission. That service users will have a learning disability. Date of last inspection 25th July 2006 Brief Description of the Service: The Old Haybarn is registered for a maximum of seven adults with a learning disability, with an additional condition of registration that residents should be aged between 18 and 45 years on admission. This home was first registered in October 2003. The home is situated in a pleasant semi-rural setting on the outskirts of Crowborough and close to the local shops, banks, public houses, cafes, takeaways and restaurants. The Old Haybarn provides a high standard of accommodation for seven residents. All bedrooms have en-suite facilities with a washbasin, toilet and either a shower or bath. On the ground floor there are three bedrooms, a bathroom, a sitting room, dining room, kitchen, laundry and an office/sleep in room. On the first floor there are four bedrooms. The home is well decorated, furnished and maintained. A day centre which residents attend is on the same site and is facilitated by the same staff team. This day centre is run by the homes provider and is also attended by residents from the providers two other homes close by. The home aims to provide services to people with learning disabilities, which would provide opportunities for them to develop a greater degree of independence. The current range of fees for The Old Haybarn, as of 30 August 2007, is £569 £853 per week. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in August 2007. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Residents observed and spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were seven residents living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with three residents, three members of staff, the Registered Manager (who is also the Registered Provider.) Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: Residents at The Old Haybarn clearly benefit from having an experienced manager and dedicated staff team who are evidently committed to providing a consistent level of care. Staff work closely with residents and have developed a sound understanding of their individual care and support needs. The relaxed, homely and welcoming environment has evolved over many years and reflects the commitment within the staff team and the open and inclusive management style. Residents are encouraged and supported to make decisions about their lives. They are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 6 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 Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents know that the home is able to meet their individual care and support needs. EVIDENCE: Although there have been no residents admitted to The Old Haybarn since the previous inspection, comprehensive information relating to the home is made available to all prospective residents, their relatives and associated care managers. Relevant documentation including an updated Statement of Purpose ‘ and ‘Service User Guide’ was examined and found to be satisfactory. The manager confirmed that the service continues to maintain a good working relationship with the local Community Learning Disability Team (CLDT), who consequently have a sound understanding and awareness of the suitability of the home and the range and quality of the services provided. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 9 A referral to the home from the CLDT consists of a thorough Social Care Assessment and any additional relevant reports. The manager will also visit the prospective resident and carry out a full pre-admission assessment, including any personal and emotional care and support needs, mobility issues, social and cultural needs and family involvement. Following discussion with the manager, it is recommended that the current recording format be reviewed and amended to form a more structured and concise assessment tool. In addition to establishing whether the individual’s care and support needs can be met within the home, the manager also stressed the importance of ensuring compatibility with existing residents. As well as being invited to visit the home to look around and meet with existing residents and staff, prospective residents have the opportunity to stop overnight before moving in. The manager confirmed that all new residents undergo a flexible trial period at the home, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and support needs are able to be met. In documents that were examined it was evident that individual agreements had been signed and dated by the resident themselves or a relative or representative on their behalf. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments reflect changing support needs. Systems for consultation and participation remain effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of certain residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting residents in a professional, sensitive and respectful manner. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 11 The manager confirmed that the individual resident themselves, their key worker and, where appropriate, a relative or representative have the opportunity to be involved in regular care plan reviews. In a sample of the high quality care plans that were examined, it was evident that recent reviews had taken place. Plans were found to be comprehensive and linked to the individual’s current assessments, containing detailed guidance for staff on how to meet their care and support needs in a structured and consistent manner. Independence and individuality is evidently encouraged and promoted within the home and is reflected in the personalising of residents’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. This was confirmed by residents, spoken with during the inspection: ‘I chose the colours for my room and my duvet cover and curtains’. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Residents benefit from generally appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of residents are identified and recorded in their individual care plan and they continue to be supported to access activities and facilities, reflecting their individual needs and abilities. A weekly activities programme has been developed and implemented for each resident and a copy is contained in their individual care plan. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 13 A day care facility, situated on the site, opens every day and occasional evenings, providing recreational and leisure activities such as table tennis and pool. Trips out are organised for weekends and evenings and a supported annual holiday is provided for those who choose to go. Community participation remains a focus in the home and residents are evidently encouraged and supported to visit the cinema, theatre, local shops and other amenities. The manager confirmed that, where appropriate, residents’ family links are encouraged and supported, however not all service users have regular family contact. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Menus examined were found to be varied and balanced and are evidently based on residents’ identified likes and preferences. An alternative to the main meal is always available. Residents spoken with during the inspection expressed satisfaction with the standard and variety of meals provided: ‘The food here is very good – I like it anyway’. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: The manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. Documentary evidence was in place to demonstrate that the health and emotional care needs of individual residents are continuing to be met within the home. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 15 In accordance with their care plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, staff were observed interacting with residents in a professional and respectful manner. All residents are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was evident, in care plans that were examined, that all appointments with, or visits by, health care professionals are appropriately recorded. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. The manager confirmed that, following risk assessments, no resident currently self-administers their own medication. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that residents, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Residents are protected, through policies and procedures relating to abuse and adult protection. EVIDENCE: A clear, simple and concise complaints procedure has been developed. All complaints are recorded and include actions taken and outcomes achieved. Close working relationships, effective and ongoing communication and consultation and regular residents’ meetings provide adequate opportunities for any concerns to be raised and discussed, before they become complaints. Residents and members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to: ‘She (the manager) is very approachable and always makes time for you and is always ready to listen’. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 17 It was noted that there have been no concerns or complaints recorded by the home since the last inspection. The home has produced detailed policies and procedures, recently reviewed, relating to adult protection and abuse, including a whistle blowing policy. These documents have evidently been drawn up in accordance with the multi agency guidelines for the protection of vulnerable adults (Safeguarding adults). The manager confirmed that all care staff have undertaken appropriate training regarding abuse awareness and adult protection procedures. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Residents benefit from pleasant accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the premises it was evident that the well maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for residents. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 19 The manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of residents’ rooms, reflecting individual preference and interests. It was noted that infection control policies and procedures are in place and clearly adhered to. Residents and their key workers are responsible for keeping bedrooms clean and tidy and on the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 &36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is always sufficient trained and competent staff on duty to meet the assessed needs of the residents. Residents are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: Through discussion with the manager, care staff and service users, it is evident that sufficient staff are employed to meet the current assessed support needs of residents and to ensure consistency and continuity of care. The manager confirmed that staffing levels are closely monitored and are directly linked to the residents’ identified levels of dependency. A duty rota has been developed and implemented to detail the staff on duty at any given time and their designation. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 21 Appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and evidenced by training records examined: ‘There is always plenty of opportunity for training here’. The manager confirmed that records of individual staff training are updated monthly and are kept in their personal file. Formal and structured staff supervision is provided on a regular basis and is appropriately recorded. The manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents benefit from a competent and experienced manager. They are protected by satisfactory health and safety procedures and their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: The experienced manager, who is also owner of the home demonstrated a high level of awareness and understanding of the residents at the Old Haybarn and was able to discuss in detail individuals’ current and ongoing care and support needs. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 23 Residents and staff, spoken with during the inspection, confirmed that the manager was: ‘very kind’’ helpful and ‘approachable’. Staff evidently feel ‘valued’ and ‘supported’ by her. The home has developed and recently improved a system for monitoring the homes performance, which includes satisfaction surveys for both residents and their families. Positive responses from a recent ‘Service Improvement Questionnaire’ indicated a high level of satisfaction with the home and the services provided: ‘…… remains extremely happy at the Haybarn and very well looked after. Thank you!’ ‘It is clean, comfortable and a very happy atmosphere’. ‘I feel he has everything that he needs living in the Old Haybarn. He is very happy there and I’m happy that he feels that way’. ‘Excellent! When I first came round to see the Haybarn, I was very impressed. If I was in need of residential care, that is the place I would love to be’. The organisation has achieved the ‘Investors In People’ and following a reassessment last year the award has been renewed. The manager confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is satisfactorily recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Fire alarm systems are regularly checked and records maintained. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Old Haybarn DS0000044188.V346261.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA2 Good Practice Recommendations It is recommended that the current recording format for pre-admission assessments be reviewed and amended to form a more structured and concise assessment tool. 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