Inspection on 04/01/06 for The Willows Barton

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Willows Barton 12/12/06

The Willows Barton 18/02/05

The Willows Barton 01/09/04

The Willows Barton 18/02/04

Similar services:

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Willows Barton Willow Drive Barton On Humber North Lincolnshire DN18 5HR Lead Inspector Beverley Hill Unannounced Inspection 4th January 2006 09:30 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 Willows Barton DS0000002880.V276372.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 Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Willows Barton Address Willow Drive Barton On Humber North Lincolnshire DN18 5HR 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) 01652 632110 Barton Medical Services Limited Mrs Susan Brumpton Care Home 39 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (39) of places The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th February 2005 Brief Description of the Service: The Willows care home is situated in a quiet cul-de-sac close to the centre of Barton on Humber. The town is well serviced by local transport and has a variety of shops, pubs and restaurants. All areas of the home are accessible to wheelchair users. The home is registered to accommodate thirty-nine service users in the category of old age. The home can, within that number, admit up to twenty-one people with a dementia type illness. The home provides day care facilities for two people each day and has two designated respite care beds. The Willows is a single storey building divided into five units, each having two toilets and either a bathroom or shower room. The bedrooms are all for single occupancy. The home has three lounges and a separate dining room with individual tables and chairs set out. From the main corridors service users can access three secure patio areas, which have water features and garden furniture. An enclosed lawned area is accessible from unit five. The feel of the home is homely and clean. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A number of standards considered by CSCI to be ‘key standards’ were assessed at the last unannounced inspection in August 2005. The remaining key standards were assessed at this second unannounced inspection, which took place over one day. The Inspector spoke to the manager and four care staff members who were on duty at the time of the inspection. Throughout the day the Inspector spoke to nine people who either lived at The Willows, was receiving respite care or who attended for day care. The inspector looked at a range of paperwork in relation to care plans, the servicing of equipment, fire prevention management, supervision and training records, service users finances, policies and procedures. The Inspector also checked that people who lived in the home had the opportunity to suggest changes and were listened to. The Inspector completed a partial tour of the building and checked that all the things that needed to be done from the last inspection had been done. What the service does well: Some staff had worked at the home for a long time and knew the people who lived there well. The home had a low staff turnover. People spoken to said the staff team were, ‘lovely’, ‘kind and helpful when I want them’, ‘very pleasant and kind’, ‘I’m very friendly with them all’, ‘they’re very good’, ‘you get looked after well’, ‘they are polite and knock on doors’. They had enough staff on duty to care for the people who lived there and people spoken to said that their privacy and dignity was respected. The home made sure that people were able to make choices about their lives and have a say in things that happened in the home. The home provided day care and short breaks for people, which gave them the chance of visiting the home and seeing what it was like in case they had to move in permanently later on. The home was very clean and tidy and homely in appearance. People spoken to liked their home and stated that staff cleaned their bedrooms to a high standard. There were different lounges for people to sit in and a large dining room. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 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 Willows Barton DS0000002880.V276372.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 Willows Barton DS0000002880.V276372.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): 4 The home was able to meet service users’ needs. EVIDENCE: Service users were admitted to the home following an assessment and a letter was forwarded to the service or their representative stating the homes ability to meet assessed needs. Care plans were produced to meet assessed needs and staff members spoken to had received training for their role and tasks, including dementia care awareness. The home had sufficient aids and moving and handling equipment throughout the home, which had been assessed by an occupational therapist. There was evidence of specialist equipment such as mattresses and specific beds and district nurses and community psychiatric nurses supported with any nursing care required. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 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): 10 Improvements were noted in the updating of care plans and the return to pharmacy of medication. The home provided care to service users in a way that promoted their privacy, independence and dignity. EVIDENCE: Since the last inspection the home had developed systems to check that care plans were updated as needs changed. Care files were assessed in supervision and the manager was present during staff shift handovers. Verbal reminders to staff were issued at the handovers and care files were audited regularly as part of quality monitoring. In this way staff ensured that care plans were regularly updated. Since the last inspection staff had ensured that no service user had behaviour modifying medication on an, ‘as required’ basis and had clear guidance for staff. All medication returns to the pharmacy were recorded appropriately. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 10 Service users spoken to confirmed that care staff supported them in a way that promoted their privacy and dignity. They described staff as, ‘knocking on doors before entering’, ‘ they help you to have a bath and do this nicely’, ‘what you can do for yourself you do and they check to see if you are ok’, ‘they certainly do respect your privacy’, ‘they help me to open cards as I can’t read’, ‘they helped me get back some of my independence, they used to say you try and do it and they kept popping back, now I can do it myself’, ‘they are wonderful, caring staff’. Staff members described how they tried to make sure people could make choices and had their privacy protected. For example they would make sure they knocked on doors prior to entering, closed doors when assisting with personal care, made sure service users were covered with a towel when sitting on a bath hoist, encouraged people to do as much as they could for themselves but kept checking they were alright and made sure people with dementia made some choices for example with the clothes they wanted to wear. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 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): 14 and 15 The home provided an environment where service users were able to make choices about their lives and generally provided nutritious meals. A real alternative at the main meal would enhance the choices provided. EVIDENCE: There was evidence that service users’ made choices about aspects of their lives for example, management of their finances, choosing the colour scheme of their bedroom and communal areas, personalising their bedrooms, the routines and activities they wished to participate in and in some cases the staff employed within the home. Routines were flexible with no set times for rising, retiring and visitors. There was evidence that suggestions made were listened to for example on what to spend the comfort fund, activities and menu changes. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 12 The menus examined for the main meal of the day appeared a little repetitive and did not include a healthy option. There was some attempt at alternatives for example, jacket potatoes, omelettes and salads but service users were expected to alert staff to alternatives during the morning instead of staff enquiring whether the one choice on offer was acceptable. The menu indicated which desserts were not suitable for a diabetic diet. On closer examination this appeared to be mainly sponge puddings. This meant that those on a diabetic diet had to forgo this dessert. The cook should investigate recipes for diabetic sponge puddings to enhance the choice available. Service users and staff described the breakfasts provided as very good. Bacon was available with a selection of cereals, toast and porridge. Service users stated they had enough to eat and drink throughout the day. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 13 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): 18 The home had policies and procedures and staff training in order to protect service users from abuse. EVIDENCE: The home had a protection of vulnerable adults policy and procedure that linked to the multi agency policy and procedure. A senior care staff member had recently completed a ‘protection of vulnerable adults from abuse’ training course run by the local authority and had ensured that this knowledge had been cascaded to all staff during two training days. Staff spoken to were aware of what constituted abuse and what to do to report any incidents. The manager and senior staff were aware of referral procedures to social services as the lead agency for investigation. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 14 The Willows Barton DS0000002880.V276372.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, 20 and 24 The home provided plenty of space and a clean and tidy environment for service users. EVIDENCE: Since the last inspection there had been an improvement to one of the sluice areas and a closed sluice machine had been installed. The other sluice area was still in need of attention. The manager confirmed that coded locks had been purchased to make the sluice areas inaccessible. These were to be installed in the next few days. The home was generally well maintained inside and out with furniture and décor of a reasonable standard. Bedrooms were personalised to varying degrees dependent on choice and taste. Service users had lockable facilities and privacy locks to the bedroom doors. There was evidence that some people had brought in their own furniture. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 16 The home had three courtyards, which were accessible to all the service users and had water features, a barbeque and raised flowerbeds so service users could join in gardening activities if they wished. There were a number of communal lounges and a large dining room. Service users were free to choose any area of the home to sit in. Those spoken to were happy with the home and their bedrooms. The Willows Barton DS0000002880.V276372.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): 28 and 30 The home maintained training records and staff had access to training courses that enabled them to develop knowledge and skills. A plan of training needs for the forthcoming year needs to be produced. EVIDENCE: The home had a central training log in place that covered mandatory and some service specific training. The central training log stated that most staff had completed basic food hygiene, health and safety, infection control, first aid, dementia awareness and fire and all but two had completed moving and handling. All staff had completed adult protection training. The home recently provided two training days that covered adult protection and dementia awareness including role-play exercises for staff. Individual training records were maintained. One staff file examined in detail did evidence a range of training, however several certificates were out of date and refresher training was required. The individual training files need to match to the central training log with regards to evidence of participation in training. The inspector was unable to see a training plan and the manager confirmed that staff appraisals due in December had yet to be completed. These would establish the teams training needs for the next year. Induction was allied to TOPPS specification and new staff members worked through an induction booklet with support from senior staff. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 18 Ten staff had completed NVQ level 2 in care and a further twelve staff were progressing through the course. When completed the home will have over 50 of staff trained in NVQ. Staff members spoken to were keen to participate in training and felt supported and encouraged to do this. The Willows Barton DS0000002880.V276372.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, 35, 36 and 38 The manager provided leadership and guidance to staff and ensured the environment was a safe place to live and work. The inconsistency of supervision by senior carers meant that some care staff members were not monitored effectively and this could place the service users at risk of inadequate care. EVIDENCE: The registered manager had been in post for nearly nine years and had completed NVQ Level 4 in care and had one unit remaining in the Registered Managers Award. During the last year they had participated in various training, for example, fire, moving and handling, safe handling of medicines and dementia awareness. They had also attended a conference run by the local authority on access to equipment and a falls prevention seminar. The manager was an NVQ assessor and had updated the award. The manager explained that they liked to keep up to date with current practices. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 20 Finances were generally managed well. Individual logs and amounts were maintained and those checked were correct and receipts were maintained. However, two signatures were not consistently in place for all transactions and it was noted that clothes damaged by the laundry were replaced from the comforts fund. The latter needs to be reviewed to ensure that finances donated for the benefit of residents are not used in this way. The homes financial policy and procedure required updating. Supervision records for some care staff were excellent and showed a real commitment to the supervision process. Records detailed that care files were examined and instructions given to update them, training needs were highlighted and service user needs discussed and how they were met. However not all supervision records completed by senior care staff were up to date and some care staff had only received one or two sessions throughout the year instead of six. The inspector noted this was a minority of staff. The manager was proactive in promoting the safety and wellbeing of the service users who lived at the home and the staff who worked there. Service records were completed and fire prevention management in place including training, drills and equipment checks. Staff completed health and safety training. The Willows Barton DS0000002880.V276372.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 x x x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 3 x x x 3 x x STAFFING Standard No Score 27 x 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 2 2 x 3 The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 22 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 OP19 Regulation 23(2)(c) Requirement Timescale for action 31/01/06 2 OP15 12(1)(a) 3 OP30 18(1) 4 OP35 12(3) The registered person must address the one remaining open sluice area to ensure a hygienic and safe area for service users and staff (previous timescale of 30/11/05 not met) However coded locks had been purchased and these were due to be installed in the next few days to both sluice areas. The registered person must 10/02/06 utilise dietician advice in reviewing the main meal at lunchtime and provide a meaningful and healthy alternative. The registered person must 28/02/06 update the individual training logs, providing evidence that staff have participated in training and complete a training plan gained from information in staff appraisals and supervision. The registered person must 20/01/06 review the system of deducting laundry damages out of the residents comfort fund and update the homes financial policy and procedure to reflect DS0000002880.V276372.R01.S.doc Version 5.1 The Willows Barton Page 23 5 OP36 18(2) the way the home worked. The registered person must ensure consistency with supervision to enable care staff to receive at least six formal sessions per year. 31/01/06 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 2 3 4 Refer to Standard OP15 OP28 OP31 OP35 Good Practice Recommendations The cook should investigate expanding the desserts on offer for those receiving a diabetic diet. The home should continue to work towards 50 of staff trained to NVQ Level 2. The manager should continue work towards the Registered Managers Award. The administrator should ensure two signatures are in place for all transactions regarding service users finances. The Willows Barton DS0000002880.V276372.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Willows Barton DS0000002880.V276372.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. 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