Inspection on 27/04/05 for Whipton Barton House

This inspection was carried out on 27th April 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 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

Whipton Barton House 30/10/08

Whipton Barton House 30/10/06

Whipton Barton House 28/10/05

Whipton Barton House 14/12/04

Whipton Barton House 15/07/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whipton Barton House Vaughan Road Whipton Exeter EX1 3JN Lead Inspector Rachel Doyle Announced 27 April 2005 th 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 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. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Whipton Barton House Address Vaughan Road Whipton Exeter EX1 3JN 01392 467584 01392 469417 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Devon County Council Elaine Brown CRH PC Care Home providing Personal Care 33 Category(ies) of OP Old Age [33] registration, with number of places Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 14th December 2004 Brief Description of the Service: Whipton Barton House is a care home managed and operated by Devon County Council. It provides care for up to 33 elderly and/or frail service users. The rooms are in four self-contained wings designed to give a more homely, small group atmosphere. It also offers respite care for up to four service users. The building has two-storeys with a shaft lift and a wide staircase to access the first floor from the foyer. It is situated at the junction of Pinhoe Road and Vaughan Road in Whipton, Exeter close to local amenities. There is a small car park at the front and parking in the road. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out the Announced inspection due to the size of the Home. The manager and staff team were all very helpful and the inspectors were able to tour the Home freely and look at all relevant documents. The inspectors looked at 5 resident care files in depth, spoke to the manager and 4 care staff, a visiting District Nurse and 14 residents. CSCI received 5 comment cards from relatives and a further 5 from current residents at the Home. These were very positive in general. The Home does not provide intermediate care. What the service does well: What has improved since the last inspection? The Home have plans to ensure that external grounds are suitable and safe for use by residents and appropriately maintained and there has been recent decoration at the Home including carpets. The Quality Assurance system now includes monthly visits from the provider and reports are sent to CSCI to ensure that residents are receiving a good service. The Service Users’ Guide and Statement of Purpose are very informative and accessible to residents and relatives around the Home. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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 standard(s) 1, 3, 4, 5 The Home provides a Statement of Purpose and Service Users’ Guide, which enables residents and prospective service users to make an informed decision an admission to the Home. The Home’s assessment process is thorough and ensures that the Home can meet residents’ needs. EVIDENCE: The Service Users’ Guide is detailed and now includes the views of residents about the service the home offers. It is on display in the communal lounges and residents said that they knew what it was. Five residents’ care files were looked at and these showed a full assessment process had been completed. Residents all said that their needs were well met. Staff spoken to were clear about residents’ needs. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10, 11 Residents’ privacy and dignity are respected and their health care needs met. Improvement is needed in the care planning process to ensure that residents’ identified needs and required actions are clear. EVIDENCE: Care files contained a lot of good assessment information however residents’ needs which required actions and evaluations had not always been identified clearly such as diabetes, anxiety and breathing difficulties. Actions, full evaluations and health care professional interventions were either missing or written within the daily report system. This could result in inconsistencies in care giving. Staff said that they did have detailed verbal handovers, which gave them the information they needed to deliver care on a day-to-day basis and staff were able to describe residents’ needs. This knowledge was demonstrated in the conversations between staff and residents, which showed an individual approach and an emphasis on choice. Residents described the staff as ‘wonderful’. Plans are reviewed regularly and a lot of work has gone into compiling them. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 10 Medication files were up to date and recorded properly. They do not include identification photographs although regular staff and not agency/bank staff administer medication. Handwritten transcriptions onto the prescriptions are not always signed by two staff. Medication is not always identified as a controlled drug and although signed as administered by two staff on the MARS sheet the running balance is unclear. Residents said they had access to health care services i.e. chiropodist, which was recorded in their care records and in personal allowance records. There is a good bathing policy, which pays particular attention to privacy and supervision. Care plans are signed by residents, who said that they are involved in the process. Staff and residents confirmed that staff knocked on their doors before entering. Residents’ last wishes are recorded and the notes from the last residents’ meeting demonstrate that the death of a resident is acknowledged and time given to sharing memories. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15 Social activities at the Home do not provide daily variation and interest for all residents living at the Home on a regular basis taking into account residents needs and capacity. Residents are encouraged to maintain contact with their families and/or friends as they wish and are able to exercise choice at the Home. Meals cater for the individual likes of residents and provide a varied wholesome diet. EVIDENCE: Individual resident care records did not include details about meeting their social and leisure needs. A record is kept of any activities offered and who attended, which may not ensure that all residents’ social needs are met. All residents spoken to were vague about the activities offered in the home. A staff member could give examples but said activities were dependent on staffing levels and staff initiative. It was noticeable that the arrangements for a bingo session were ad hoc with some staff being unclear where it was being held and a more organised approach needed to inform residents. Throughout the inspection staff offered residents choices such as where they would like to sit, whether they would like an alternative meal and during Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 12 general personal care. The last residents’ meeting gave time for residents to discuss the forthcoming summer menu and contribute ideas for outings. Residents, who participated in the inspection, said they created their own routine in the home i.e. one person chooses to eat some meals in their own room. A number of residents and staff confirmed that visitors are welcomed and there are no restrictions. The kitchen is well organised with good health and safety practices and a staff group who have shown a commitment to training. Menus are in place with choices offered and staff demonstrating knowledge of individual likes/dislikes and specialist diets. Residents commented very positively about the quality of meals both during the inspection and in quality assurance questionnaires. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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 standard(s) 16, 18 The Home has a robust complaints procedure and residents feel that they can raise any issue of concern in the knowledge that they will be listened to and acted upon. The Adult Protection policy and training ensures that residents are not put at risk. EVIDENCE: Staff spoken to were clear about their responsibility to report complaints to management. Resident surveys showed confidence in the home’s ability to address problems. Complaints and concerns are succinctly recorded. There has been one complaint since the last inspection and the manager demonstrated a sensitive approach to the issue and was clear about how to achieve a positive outcome. Staff records contain current certificates of training in the protection of vulnerable adults and in conversation staff recognised their responsibility to ‘whistle-blow’ on abusive practice. Staff gave examples of abuse and shared how their training had given them a broader knowledge about recognising abuse. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 20, 22, 23,24,26 The Home is comfortable, clean and hygienic. The maintenance programme is ongoing although some structural issues need attention. EVIDENCE: Funding was made available on 1st April to address an outstanding requirement made to improve the safety of the patio area. The date for this work is currently being arranged. The skirting board and patio door surround and laundry floor still need attention, as do the home’s windows. The Home was clean throughout. The remainder of the home is decorated in a homely style, which some residents said they appreciated. There are a range of communal areas, although five people spoken to said they chose to spend most of their times in their rooms because they were either tired, did not like to mix or preferred being able to watch their own television. However, camaraderie was observed amongst residents at communal meals. Five residents said they were happy with their rooms, which were all personalised, and the standard of cleanliness. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 15 One person said, ‘Isn’t this place kept lovely?’ Another resident had a larger room to accommodate the equipment they needed. Staff were clear about infection control procedures, which was evidenced in staff supervision notes. Although staff are visible and pass through the lounges regularly residents are unable to reach a call bell in these communal areas as there are no call-bell leads. Two residents during lunch said that they just waited for staff to come to them. Four other residents did wear call pendants. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Staff are employed in sufficient numbers and skill mix to meet residents’ needs. The procedures for the recruitment of staff are consistent and protect residents. EVIDENCE: Four staff files were looked at and all contained the required documentation such as two references and police checks. Staff recruitment has been problematic for the home and currently agency staff are used on a daily basis. Permanent staff said that agency staff are part of the team, suitably skilled and that staffing levels are appropriate. Rotas confirmed this and residents felt that there were enough staff to meet their needs. Residents spoken to said that call bells were answered promptly. The home operates a robust recruitment based on the inspection of three staff files. Varied and relevant training is promoted, which was valued by the staff spoken to, as was the quality of their induction. Staff portfolios held comprehensive information on training and qualifications. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36, 37, 38 There are reliable systems in place to ensure the good health, welfare and safety of residents and staff. EVIDENCE: Regulation 26 visits to oversee the running of the home are now taking place and residents’ meetings are well attended. Quality assurance questionnaires are annually sent out to permanent residents in March and provided for each short stay resident. These can be anonymous. The manager said these are due to be collated and that feedback will be given at the residents’ meeting, although personal issues will be addressed privately with residents. Residents spoken to were aware of CSCI inspections and their purpose. An individual record is kept of each resident’s personal allowance with double signed entries and withdrawals. The overall balance was correct. Part of this Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 18 total is paid in one bank account named ‘service users’ and the manager ensures that interest is calculated to pay residents individually. Records indicate that fire drills and instruction, and regular safety checks and training take place with clear outcomes to address problems. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 x 2 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x 3 3 Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? 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 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. 2. 3. 4. 5. Refer to Standard 7 9 12 19 22 Good Practice Recommendations It is recommended that all care plans clearly and consistently identify residents needs and record actions. It is recommended that all handwritten transcriptions are signed by two staff and that drugs are clearly identified as controlled and appropriate records kept. It is recommended that regular and appropriate activities are offered and individual residents records kept to ensure that social and leisure needs are properly met. It is recommended that the windows, skirting board and laundry floor are maintained and timescales given within the maintenance programme. It is recommended that there is adequate systems in place to ensure that residents are able to access staff when using the communal areas. Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 Whipton Barton House D54 D06 S39159 Whipton Barton House V212988 270405 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!