Inspection on 30/10/08 for Whipton Barton House

This inspection was carried out on 30th October 2008.

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

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

Whipton Barton House 30/10/06

Whipton Barton House 28/10/05

Whipton Barton House 27/04/05

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 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whipton Barton House Vaughan Road Whipton Exeter Devon EX1 3JN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea East     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Whipton Barton House Vaughan Road Whipton Exeter Devon EX1 3JN 01392467584 01392469417 helen.seldon@devon.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Devon County Council Name of registered manager (if applicable) Ms Elaine Elizabeth Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Whipton Barton House is a care home managed and operated by Devon County Council. It provides residential 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 community atmosphere. It also offers respite care for up to three 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. A new non-smoking policy has recently been introduced for any new residents. The average cost of care is #306 per week at the time of inspection. Additional costs, not covered in the fees, include hairdressing and personal items such as toiletries, newspapers and magazines and private chiropody and taxis. Current information about the service, including CSCI reports, which are accessible at the Care Homes for Older People Page 4 of 27 0 Over 65 33 care home 33 Brief description of the care home Home, is given to prospective residents/their representatives. The Service Users? Guide and Statement of Purpose are available and a copy given to all residents on admission. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection site visit was carried out over a day in the home. We spoke with staff assistant managers and the manager. We also spoke to people living at the home in private or in the communal lounge area. We also spoke with relatives of people living at the home. We looked at a range of documents in the home such as care plans and policies and procedures. We also looked at the homes Annual Quality Assurance Assessment (known as an AQAA) and surveys from staff and the people using the service. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service were confident that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided do not include intermediate care Evidence: Four files containing a range of documents about peoples individual care and assessment were examined. Three files contained detailed clear assessments including information from health and social care professionals which had been used to formulate an initial assessment and then ongoing assessments. Assessment information included peoples personal preferences and how they wished to be cared for, manual handling assessments and details of people past history. Care Homes for Older People Page 11 of 27 Evidence: The fourth file examined included the same documents for assessment and care. However these documents had not been as well completed, with gaps in information and some documents left blank. This meant that staff did not have access to written records to refer to in trying to meet peoples needs. Staff said that this file had been collated for someone entering the home on a short stay basis so the same level of information had not been obtained. The short stay had then been extended and this information had not yet been collected. This meant a delay in obtaining information that could be helpful to staff in caring for that person. People said that they had a chance to visit the home and speak to staff and some of the people living at the home before moving in. Staff said that people were offered the opportunity to visit the home for the day on a short stay or just to look round before they came into the home on a more permanent basis. Staff said that assessments were also completed with the person while in hospital or at home so that information was available on how to care for people before they came into the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service had their health person and social care needs met and this was set out in an individualized plan of care. Care records for people on short stay at the home could be improved. People medication was stored recorded and administered safely and people were supported to manage their own medication. People were treated with dignity and respect. Evidence: Care plan and assessments overall were well completed with a range of information on how health and personal care needs would be met. People said that they felt well cared and that all the staff were helpful kind and respectful. Care Homes for Older People Page 13 of 27 Evidence: The homes Annual Quality Assurance assessment said that the home, ensures all service users have up to date care plans which are reviewed and updated monthly. Staff surveys said that staff were always given the information about the needs of the people they were supporting. One survey said very good daily reports. One staff survey said that service users are well looked after at all times. Three out of eight surveys from the people using the service said that they usually received the care and support needed. Two surveys commented on the numbers of staff on duty affecting care. They said they have to wait when they are busy as they can not see to every one at the same time and more staff on duty would help. Medication administration storage and recording was good with good polices and procedures in place that staff were fully aware of. This meant people received medication safely in line with guidance from their doctors. Staff also had systems in place to refer to in supporting people to look after their own medication. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples lifestyles in the home met their expectations and satisfied their needs. People who used the service were able to make choices about their life style and were supported to develop skills. This was not always clearly evident in people care records. Social educational and recreational activities met peoples expectations. People enjoyed a varied choice of diet and menu in areas that were pleasant and clean. Evidence: The homes Annual Quality Assessment Audit (AQAA) said that information was gathered about peoples preferences and lifestyles before they came into the home. It said we contact relatives and friends regarding life history profiles. Profiles were stored in peoples individual files. The AQAA also said that social in house activities took place on a regular basis with a member of staff designated on a daily basis. People said that they had a choice of Care Homes for Older People Page 15 of 27 Evidence: activities to participate in if they wanted to. Some people chose not to take part in activities. Surveys completed by the people living at the home said that there were usually or always activities available that they could take part in. One survey said that people were not always informed of when activities took place. The extent of activities and the choices people make in the time they spend in the home was not always record for everyone. This makes it difficult for the person in charge to be sure that people have had a choice in how they spend their time and the activities available. People enjoyed a range of foods and said that the meals and snacks provided were very good and just like home cooking. Meals were served in the homes large dining area which was a clean bright and pleasant area. People said that they had a choice of meals and menus were discussed with them. Surveys from people living at the homes said that people always or usually liked the meals. One survey said you have two choices which is nice and another said we usually have alternatives. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were confident that their complaints and concerns would be listened to and acted upon and people were protected from abuse. Evidence: People said that they felt confident that all the staff including the managers of the home would address their concerns positively. They said that they felt listened to and that they were aware of a complaints procedure even though they had never had to use the procedure. There were no complaints recorded in the complaints book and several recent incidents had not been recorded as per the homes guidance. A possible safeguarding issue had not been discussed with the safeguarding team or any other outside agencies until the date of the inspection site visit. Poor recording and reporting means that the manager of the home does not have the information needed to monitor and improve practice. We (the Commission) had received one complaint about the management arrangements in the home which had been brought to our attention after concerns raised by staff to senior managers had not been addressed. The homes AQAA states that Devon County Council has a complaints procedure which is accessible to every and that a complaints book is held in they duty office for Care Homes for Older People Page 17 of 27 Evidence: recording of all complaints. Seven out of eight Surveys from people living at the home said that they knew how to make a complaint. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a safe well maintained environment that was clean personalized and welcoming. The toilet and bathroom facilities could be improved by refurbishment and redecoration. Evidence: On touring the premises the home appeared clean tidy and free from offensive odors. Each person s room had been personalized to their taste with flowers plants ornaments and personal belongings. Toilet and bathroom areas were clean and tidy but were in need of some redecoration and refurbishment. For example on bathroom had tiles missing and toilet areas were scuffed and shabby in appearance. Domestic staff described good cleaning routines and safe hygiene practices and documents such as cleaning rosters and health and safety guidance were in evidence all around the home. This meant staff had the information they needed to keep the home clean tidy and safe. Surveys from people living at the home said the home was always fresh and clean. people said that the cleaning staff worked hard and the home was always kept nice. Care Homes for Older People Page 19 of 27 Evidence: The homes AQAA states that equipment is maintained in good order and fire regulations and training were kept up to date. There were a range of documents available to staff on health and safety issues and guidance including maintenance of equipment, what to do in an emergency and risk assessments for the premises. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number of staff and their level of skills and experience is sufficient to meet peoples needs and expectations. Affective recruitment and training procedures were in place so that staff had the skills and knowledge to care for people safely. Evidence: People said that staff were kind considerate and helpful and that they appeared knowledge and capable. Staff training records showed that staff had received a range of training in key areas such as health and safety manual handling and first aid. This meant that staff had the skills and knowledge to care for peoples individual needs safely. Staff surveys said that there was good training and support in place. There were good recruitment procedures and practices in place that included reference checks police checks and the suitability of staff to work with older vulnerable adults. The complaint we received raised concerns about the numbers of staff on duty Care Homes for Older People Page 21 of 27 Evidence: particularly the management of staff rosters to ensure the numbers of staff were maintained. The concerns were that should staff be sick or go on holiday not enough staff cover was available. The complainant was concerned not at the current impact this had on care but the impact it may have for the future. Surveys from staff said said that more staff was needed to ensure good manual handling practices were always carried out to ensure peoples safety. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We are unable to confirm that the manager of the home is fit to be in charge as they have not been registered with us. This means we have been unable to confirm recruitment details such as qualifications training and police checks. There was clear management and leadership structures through the manager and assistant managers. The home was run in the best interests of the people living there and the peoples health and safety were protected. Peoples finances were protected. Evidence: Since the last inspection the manager registered with us had left the organization and the employment of the home. A new manager had been appointed but had not been registered with us. This means that we are unable to determine the fitness of the person managing the home as we have been unable to complete reference medical Care Homes for Older People Page 23 of 27 Evidence: and police checks. The manager said that she had a range of experience skills and knowledge in managing care homes and in caring for older people. The manager had also previously worked at another care home with Devon County Council and had not be registered with us at that time. The complaint we received raised concerns about the overall management of the home and how the manager would respond to concerns about staff numbers staff routines procedures and practice. Those concerns were being addressed through Devon County Council internal complaints procedures. The home had a system of management that included assistant managers who were responsible for the day to day running of the home. This meant that the concerns had not yet impacted on peoples care. However the lack of consistent management had started to impact on staff in that some staff had not had appraisals or formal supervision. There were good practices procedures and routines in the home to ensure peoples safety and well being. This included detail quality audits looking at all aspects of care and life in the home including health and safety. Overall there were good financial procedures and polices in place for monitoring and safeguarding peoples finances and personal belongings. One person had moved into the home on a temporary basis and the same procedures had not been followed. This meant money being sorted into an envelope and locked in a draw which was not in line with Devon County Council guidance for staff or safe practice. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 29 19 You must ensure that all staff 30/11/2006 have the documents specified in Schedule 2 prior to starting employment. This refers to staff whose CRB checks are taking time and they are being supervised, having at least POVA First checks on commencement of employment. Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Complete assessment and care plan records for those people on a short stay s at the home. So that they are completed in the same way as people intending to stay permanently. This will help to ensure that staff have the information they need to care for everyones needs. Develop systems to ensure that their is recorded evidence of how people are supported in making choices and control over their lives. complete refurbishment of bathrooms and toilets The manager of the home is registered with us so that we can determine they are fit to be in charge of the home. ensure people finances are safe and secure recommence staff supervision and appraisals 2 14 3 4 5 6 19 31 35 36 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!