Care Home: Barclay House

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Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barclay House 44 Bridlington Street Hunmanby Filey North Yorkshire YO14 0JP     The quality rating for this care home is:   two star good 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: Pauline ORourke     Date: 0 8 0 1 2 0 0 9 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 24 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Barclay House 44 Bridlington Street Hunmanby Filey North Yorkshire YO14 0JP 01723890761 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Christine Lawrence Hopkins Name of registered manager (if applicable) Mrs Marilyn Susan Bembridge 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: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP Date of last inspection Brief description of the care home Barclay House is a registered care home providing accommodation for a maximum of 10 older people. The home, which is located in the village of Hunmanby in North Yorkshire, is situated on the high street, close to local shops, pubsand a library. A GP surgery is nearby. There is public transport to Bridlington, Filey and Scarborough. All the bedrooms are for single occupancy, four having en-suite facilities. A one person Care Homes for Older People Page 4 of 24 care home 10 Over 65 10 0 Brief description of the care home passenger lift is available between the ground and first floor accommodation. The garden is accessible through two patio doors both of which have a step. Care Homes for Older People Page 5 of 24 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: two star good 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 Commission for Social care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website: www.csci.org.uk The key inspection has used information from different sources to provide evidence for this report. These sources include: -Reviewing information that has been received about the service since the change in ownership Care Homes for Older People Page 6 of 24 -Information provided by the registered person on an Annual Quality Assurance Assessment - A visit to the service by one inspector that lasted 5 hours. During the inspection six people who live at Barclay House, three members of staff and the registered person were spoken with. Care records relating to four people, three members of staff and the management activities of the home were inspected. Information about the services provided are made available in the homes Statement of Purpose, Service User Guide and through published inspection reports available from the home. The current charges at 8th January 2009 are three hundred and fifty pounds to three hundred and sixty pounds a week. Additional charges are made for hairdressing, chiropody, toiletries, papers and magazines. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 9 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking to move in to Barclay House are provided with enough information to make a choice about whether or not t move in. No-one moves in without an assessment of his or her needs. Evidence: The assessments seen of people who had moved in to the home since the new registered provider has taken over were brief and contained a pen picture of the individual. In discussion with the registered provider it was recommended that a more detailed assessment was carried out. This would give staff more detailed information from which to formulate a care plan. People spoken with had been to visit the home and where possible had been for a short stay prior to their decision to move in. One of the reasons they had picked the Care Homes for Older People Page 10 of 24 Evidence: home was because of its situation in their local community. Information about Barclay House is available on request and a copy of this information can be found in the entrance hall of the home. Care Homes for Older People Page 11 of 24 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. All people living at the home have a care plan that sets out how their needs will be met and are treated with respect. Evidence: The care plans seen were basic in detail, although they provided enough information so that people received the support they required. Evidence was also available that the information is reviewed every month. People spoken with were aware that records were kept and that staff had information about the help they require. They also said that the staff take care of their needs and treat them well. People spoken with said that they could see their own doctor on request and that staff would help them to go to the surgery if they wanted to. Evidence was also available to show that people accessed other health services as required. Medication was seen to be stored properly and a separate controlled drugs cabinet has Care Homes for Older People Page 12 of 24 Evidence: recently been provided. Staff who handle medication have completed a distance learning course in The Safe Handling of Medicines. The administration records seen had some gaps in the recording. It was also noted there was no indication of whose signatures were used and it is recommended that a key of signatures is provided. Throughout the day people were seen to be treated with respect and dignity in all interactions. Several people said the staff are wonderful Care Homes for Older People Page 13 of 24 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. People are given choice and are assisted to live their lives in a pleasant fulfilled way and to have control over their lives as much as they are able. Evidence: People spoken with during the inspection all said that they could follow their own routines during the day. The majority of people living at Barclay House choose to spend time in their own rooms. One person said it is nice and quiet here and you are left to your own ways another said you can choose whether you go downstairs or not, I prefer to spend time in my room An activities organiser works every Friday for group activities. Other activities include going out with staff on a one-to-one basis to local shops. There is a visitors policy in place and a record of visitors is kept. People in the home said that their visitors were welcomed at any time. The registered provider is looking to involve people in local groups that correspond with their interests. People are encouraged to remain independent and information is available about local Care Homes for Older People Page 14 of 24 Evidence: advocacy services. All of the people seen had brought personal possessions with them when they moved in to Barclay House. People are encouraged to retain control of their personal affairs, where this is not possible families or their solicitors assist them. The meals provided are all home cooked using fresh produce. Breakfast and tea meals are produced on demand as people can choose what they want. The lunch meal offers an alternative rather than a direct choice. Drinks and snacks are provided over a twenty four hour period on request. As a planned menu is not available a record of what people have eaten is usually kept. However this record has not been maintained and it is recommended that staff reintroduce this record. This will allow for peoples diets to be monitored. No special diets are catered for at this time. Care Homes for Older People Page 15 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service maintains an appropriate complaints policy and procedures are followed where necessary. People are protected from abuse. Evidence: There is a simple complaints procedure in place. People spoken with during the inspection knew who they would complain to if they were unhappy and they were confident that their concerns would be dealt with appropriately. A log is kept of complaints made and the result of any investigation carried out. There have been no complaints received by the registered person or the Commission since the registered provider has been in place. There is an adult protection policy in place and this is in line with local protocols. Staff spoken with were clear about their responsibilities where they suspected any form of abuse taking place. All staff undergo thorough checks prior to the commencement of their employment to ensure they are suitable to work with vulnerable people. Care Homes for Older People Page 16 of 24 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. The home is clean, safe and well maintained. Evidence: The home is clean, well decorated and odour free. Itis furnished in a domestic style which is in keeping with the family home approach. There is a dinning room/sitting room that can accommodate all the people who live here. There is a one person lift that can be operated by all the people who live in the home. As only one person can use the lift at a time people in the home must be independent to ensure they can get up an down the stairs. An open plan staircase leads to the upper floor. The home is centrally heated and has emergency lighting. All radiators are safe to touch and water is regulated to a safe temperature. Overall the home is pleasant, safe, well maintained and suitable for its stated purpose. The laundry meets the needs of the service. Care Homes for Older People Page 17 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service employs sufficient competent experienced staff to meet the assessed needs of people in the home and follows good recruitment procedures to keep people safe. Evidence: There are always two care staff on duty during the day and at night there is one waking member of staff and someone on call. The day time staffing levels are also supplemented by a domestic assistant and a cook. The current staffing levels have increased since the new registered provider has taken over. Staff spoken with said that they had more time to spend with people since the introduction of the new staffing levels. The home currently exceeds the recommended level of 50 staff to have an National Vocational Qualification level 2 in care. There is a thorough recruitment policy and all staff complete an application form nd provide two references. All staff are subject to a Criminal Records Bureau check prior to the commencement of their employment. Staff records seen contained the necessary documentation to show that proper checks had been carried out. Care Homes for Older People Page 18 of 24 Evidence: The new registered provider has joined a local training consortium in order to access training in a central place. It will also be cost effective and she has engaged Age Concern to provide National Vocational Qualification packages in the home. Staff have received training in health and safety topics and it is planned for them to access training in dementia care. Care Homes for Older People Page 19 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and systems are in place to protect their health and safety. Evidence: The newly registered provider intends to manage the home on a day-to-day basis. She is an experienced manager and has managed large nursing homes and a busy ward in a NHS hospital. She is supported by a deputy manager who it is intended will complete management training. A discussion was held about the quality of information provided on the Annual Quality Assurance Assessment (AQAA) form. More detail is needed in alls actions of the form and whilst it is noted the new provider has only had ownership of the home for six months the next AQAA document should contain more detail. The previous owners had a quality assurance system in place. This involved sending questionnaires to people using the service and their relatives. The new provider Care Homes for Older People Page 20 of 24 Evidence: intends to continue this approach. In discussions with her it was recommended that the questionnaires are extended to include social and health care professionals. This will give her an understanding of how the service provided is viewed by other professionals. When it is necessary people can leave their personal monies in the office safe. The records and cash held were checked and all tallied. Receipts are kept for all monies spent. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH, and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 22 of 24 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 The assessment information gathered prior to an admission should be detailed and enable staff to fully understand the support they require. It is recommended that there is a key to staff signatures in the administration records. This will allow staff to be clearly identified when an audit of the medication is carried out. The records should always be signed when medication is given this ensures that an accurate audit of the medications can be carried out. 2 9 3 15 It is recommended that a record of what people have to eat is kept, this will allow for their diets to be monitored. Care Homes for Older People Page 23 of 24 Helpline: 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 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 24 of 24 - 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!