Care Home: Badgers Holt Residential Care Home

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What the care home does well The care plans are up to date and have a lot of relevant information about peoples assessed needs meaning the care is based on individual need. The staff are friendly and work together to deliver care to the people living in the home. Staffing levels are designed to meet people`s needs throughout the day and night.The Registered Provider is approachable and manages the home in a style that is open, positive, and inclusive for everyone living there and staff working there. Badger`s Holt is clean and hygienic. What has improved since the last inspection? Since the last inspection the Registered Provider has put together comprehensive care plans and files for each person living and Badgers Holt. This means that care plans are up-to-date and have a lot of relevant information about each persons assessed needs and what care they need. This information informs the staff what they need to do to ensure people are looked after in a way that is appropriate for them. What the care home could do better: Badgers Holt provides a family style residence for a small group of people who have lived together for a number of years. The Registered Provider has paid attention to recommendations of previous inspections and with the support of the staff team, she continues to maintain and provide a safe and caring home for the people who live here. During this visit the Registered Provider was advised that every staff file should have a photograph of the staff member, Also there should also be a photograph on each medication record of the person for whom the medication was prescribed. CARE HOMES FOR OLDER PEOPLE Badgers Holt Residential Care Home 63 Haddington Road Stoke Plymouth Devon PL2 1RW Lead Inspector Megan Walker Unannounced Inspection 26th September 2008 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Badgers Holt Residential Care Home Address 63 Haddington Road Stoke Plymouth Devon PL2 1RW 01752 569229 01752 500530 info@badgersholtcare.co.uk 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) Badgers Holt Residential Care Home Ltd Mrs Diana Derbyshire Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Sensory impairment (8), of places Sensory Impairment over 65 years of age (8) Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Age 18 plus. The home provides a service for people primarily with a hearing disability some of whom may also have a learning disability. A maximum of eight persons may be accommodated in the home at any one time. 1st October 2007 Date of last inspection Brief Description of the Service: Badgers Holt is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to eight people. People use this care service because both their care needs and significant sensory impairment needs, primarily hearing loss, can be met. People that use the service may also have a learning disability. Badgers Holt is not registered to provide intermediate care or nursing care. The home is situated in the Stoke residential area of Plymouth close to local facilities and transport links. The home is a large Georgian property and offers a communal lounge room, dining room and kitchen on the ground floor. There is also a communal conservatory on the lower ground floor with access to a small garden. All the bedrooms are single. There is one bedroom on the lower ground floor, one on the ground floor, and the other bedrooms are on the first and second floors. All the bedrooms are fitted with a wash hand basin. Three of the bedrooms also have en-suite toilet facilities. Bathrooms with a toilet are situated on the lower ground, first and second floors. The current weekly fees for the home range from £368.00 up to £468.00, and are according to assessment of the person’s personal care needs. Additional charges include hairdressing, chiropody, toiletries, newspapers, magazines, journals etc, all charged at commercial rates. All charges’ information was provided to the CSCI in October 2008. Information regarding the services provided at Badgers Holt can be obtained directly from the home. Although the home is registered to provide a service for people from the age of 18, those currently living at the home are all of, or are nearing, retirement age. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was a Key Inspection undertaken by one regulation inspector. The fieldwork part of this inspection was unannounced and took place on Friday 26th September 2008 between 11:15 and 15:45. This inspection included talking to people who live at the home and care staff working on that day, observation of interactions between staff and people using this service, a tour of the premises, and inspection of care plans, staff files, medication and other records and documentation. The Registered Provider was present during the day to provide relevant information such as the day-to-day routines as well as the management of the home. “Have Your Say About Badgers Holt” Care Home Surveys were sent out to people living in the home and to staff. Three people using this service and four staff completed and returned surveys to us by the time this draft report was sent to the Registered Provider. All the comments we received were complimentary about the care provided at Badgers Holt. One example “The service is run in a very family orientated way, promoting each individual’s rights and capabilities” In addition other information used to inform this inspection: • The Annual Quality Assurance Assessment (AQAA) completed by the Registered Provider. • The last Key Inspection report • All other information relating to Badger’s Holt received by the CSCI since the last inspection. Two “good practice” recommendations were made as a consequence of this inspection. There were no requirements. What the service does well: The care plans are up to date and have a lot of relevant information about peoples assessed needs meaning the care is based on individual need. The staff are friendly and work together to deliver care to the people living in the home. Staffing levels are designed to meet people’s needs throughout the day and night. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 6 The Registered Provider is approachable and manages the home in a style that is open, positive, and inclusive for everyone living there and staff working there. Badger’s Holt is clean and hygienic. 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. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that their needs will be assessed to ensure that these can be met when they move into the home. EVIDENCE: Everyone living at Badgers Holt has been there for a considerable period of time therefore there has been little change. The registered provider has written in the AQAA “We do not experience many changes in residents that when this occurs every new resident is assessed to ensure that we can meet his/her special needs”. Assessment documentation allows for a thorough assessment of a person’s needs prior to their admission to the home. Since the last key inspection there Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 9 have not been any new admissions so it was not possible to an example where this newly developed documentation had been used. Most of the staff have received training in British Sign Language (BSL) to facilitate communication with the people living at Badgers Holt. Not everyone uses this recognised sign language and during this visit we observed different people communicating with the staff by various methods. It was clear that for each person this was effective in ensuring that they were understood and that they had understood what was being communicated to them. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The practice regarding the planning and delivery of care means that people can be sure that their health and personal care needs will always be met. EVIDENCE: We looked at the care plans of three people living at Badgers Holt. They each had a full assessment of needs and a comprehensive care plan that was reviewed regularly. The information provided on each care plan was thorough in details including information such as hair colour, eye colour, the persons preferred name, and the daily log of all the things that the person had done and/or enjoyed doing. We saw from the files that where there was family contact with the person living at Badgers Holt, they were informed about any changes and these contacts were recorded. Accidents had been recorded and stored appropriately. Only one accident has happened since the last key inspection. There was also information to show that other health agencies were Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 11 providing a multidisciplinary input into individual peoples care including community psychiatric nurses, chiropodist, and GPs. The Registered Provider has conducted an extensive quality assurance survey including health care professionals who visit Badgers Holt. We saw some of these completed surveys and comments included: I believe people are able to choose what they do “Badgers Holt cares for clients, respect their wishes, The care needs of individual residents are always met. The residents are happy and well cared for. Medication is supplied by Boots pharmacy. All the staff have completed a handling and administration of medication training course either as part of their NVQ training or on a course run by the Boots pharmacy. At the time of this inspection no one required any controlled drugs. Those people who were receiving medication had morning and/or teatime medication and therefore there were not a lot to administer on a daily basis. One person was selfmedicating ointment and eye drops; however the staff supervised this and prompted her as needed. The medication was seen kept in a lockable cupboard. We checked two peoples medication and it was found to be correct. The medication administration records were also completed correctly, signed and dated accordingly. The records we looked at did not have a photograph of the person. The Registered Provider was advised to ensure all the medication records had photographs to assist staff when administering medication. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 12 Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People living at Badgers Holt are encouraged to exercise choice and control over their lives. People are supported to continue to enjoy familiar supportive relationships with family and friends, and within the local community. EVIDENCE: The people living and Badgers Holt are able to choose how they spend a day and the activities they would like to participate in. One person likes to go out daily for a walk around the local area and is known around the community. From the care plans that we looked at, daily records showed that one person enjoys ironing and baking, and someone else enjoys spending time pottering in the garden. The Registered Provider told us that board games and dominoes were popular, and one person goes with her once a month shopping. On the day of our visit people were seen helping with clearing up after the lunchtime meal. The Registered Provider told us that this was usual, pounds people living at badgers holt are encouraged to participate in the living activities such as Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 14 washing and clearing up after meals. Throughout our visit in people was seen around the home making use of the conservatory, sitting room, and time alone in their bedrooms. Contact with family and friends is encouraged by the Registered Provider where this is possible and practicable. Contact details for family and friends were recorded on each of the care plans. There is a choice of meals and flexibility around times of meals. At tea time people “say what they fancy”. There is also regular consultation about menus and preferences to suit individual tastes. Snacks and drinks are available in at any time. One person goes out regularly once a week to a local club and therefore takes a packed lunch provided by the care staff. There is a list of likes and dislikes for each person in the kitchen. Any food allergies as well as other allergies were seen recorded on individual care plans. The home’s quality assurance surveys completed by the people living at Badgers Holt all confirmed that the food was good or excellent. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The people living at Badgers Holt and their families and friends can feel confident that any issues of concern or complaints raised by them will be dealt with appropriately. People are protected by the home’s policies and procedures, and by a robust recruitment process. EVIDENCE: Since the last inspection neither the home nor CSCI has not received any complaints. The Registered Provider is very open and keen to resolve any issue before it becomes a full-blown complaint. The ‘Complaints, Concerns and Compliments’ Procedure was displayed in the hallway next to the home’s registration certificate. The training records showed that all the staff had received training about the protection of vulnerable adults. This means that they will be competent in recognising any signs of abusive or neglectful behaviour. They know how to take appropriate measures to prevent any harm coming to the people who use this service. We made a random selection of staff personnel files and found that all the required checks including police checks and references had been completed correctly. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 16 Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25, 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people living at Badgers Holt have a comfortable and safe environment that maximises their independence and meets their needs. EVIDENCE: Each room is decorated in a domestic style. People’s rooms seen were personalised with furniture, pictures and photographs and were homely. There are toilets and bathrooms throughout the home, with adaptations to meet the needs of the people currently living at Badgers Holt. The home is laid out across three floors. There is no chairlift or mechanical lift so anyone considering moving into Badgers Holt would need to be able to climb up and down stairs. There is one bedroom and a bathroom at the rear of Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 18 the home with two steps down to them. At the time of this visit somebody was temporarily using this room because their health needs meant they were unable to climb the stairs. There is a bathroom on each floor, and one bedroom in has an en-suite with a walk-in shower. The back garden is accessible to the people living in the home, and seating is provided. The home was clean and tidy with no offensive odours. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s needs are met at all times by trained and competent staff. EVIDENCE: At the time of this visit seven people were employed to work at Badgers Holt, caring for five people living in the home. We looked at four staff files, three of which were relatively new employees. Each file showed that the correct recruitment checks had been completed. Everyone had a job description and a statement of the main terms of employment that they had signed. Each file had a training record and for those newer employees there was evidence of induction training based on Skills for Care induction training. None of the files we looked at had a photograph of the staff member however the registered provider confirmed she would arrange for photographs to be taken and added to each file accordingly. According to the AQAA three of the seven staff members has a National Vocational Qualification (NVQ) Level 2 or above. Each shift is six hours so that no one works an excessive number of hours at any one time. The overnight shift is a sleep-in duty. The Registered Provider lives adjacent to the care home and is on call when she is not at the home. At the time of this visit everyone working at Badgers Holt was female. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The Registered Provider shows a responsible attitude and continues to implement changes and improvements in order to keep improving and achieving positive outcomes for residents and staff. EVIDENCE: The Registered Provider is pro-active about ensuring that the home provides a service that meets the care needs of the residents. She is actively involved in the day-to-day running of the home and responsible for staffing and overseeing the provision of care. Her management of the home was transparent and honest. Throughout this visit the Registered Provider was found to be approachable and keen to promote the welfare and general well Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 21 being of the people living at the home with no discrimination or pre conceptions. She encouraged residents and their families to raise their concerns or worries about any matters. Throughout this visit we observed her engaging with everyone as she went about her work around the home. The registered provider has undertaken a comprehensive quality assurance survey, including visiting health and social care professionals. She had asked an independent advocate to assist the people living at Badgers Holt with completing these forms, and this was being done on the day of this visit. The Registered Provider confirmed that all the necessary maintenance checks as reported in the AQAA were correct and up to date. She also confirmed that the last environmental health officer inspection was in September 2006. We looked at the report and there was no action required. The Environmental Health Officer had written “Very clean, good standards being maintained”. Smoke detectors, emergency lighting and fire alarms were last serviced in June 2008. The Accident Book was seen and accidents had been recorded correctly. The CSCI had been notified of any incidents affecting the health, safety or well being of any of the residents. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 3 X X 4 4 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 23 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 2 Refer to Standard OP9 OP29 Good Practice Recommendations The Registered Provider should ensure that each medication record file has a photograph of the person for whom the medication is prescribed. The Registered Provider should ensure that each staff file has a photograph of the person. Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Badgers Holt Residential Care Home DS0000067028.V372289.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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