Care Home: Barnfield

What the care home does well People who are considering moving into the home are provided with helpful information to help them decide if the home will be suitable for them. A thorough assessment takes place before people move into the home to ensure their needs are understood and can be met. People who live in the home can be confident their care needs are understood and will be met. Care plans provide clear guidance for staff to follow.People are protected through safe medication administration and practice. They are cared for in a way that promotes their privacy and dignity. People enjoy a lifestyle that encourages and respects their individual social, religious and cultural needs. Families, friends and advocates are welcome at the home. People are supported to make choices in a way that promotes their independence. Mealtimes are unhurried and enjoyable with a good choice of wholesome and nutritious food. People who live in and visit the home are listened to and encouraged to offer comment or complaint. They can be confident their views will be taken account of. People are protected from abuse. They benefit from the spacious, safe and homely environment. Bedrooms are personalised, comfortable and well presented. Communal areas are clean, comfortably furnished and airy. All areas of the home are well equipped and nicely decorated. People who live in the home are cared for and supported by a well trained and competent staff team who understand their care needs. The home supports and encourages staff to obtain National Vocational Qualifications. Robust recruitment procedures ensure people are adequately protected. People can be confident the home is managed in their best interests, taking account of their views and expectations. The home is run efficiently by a well qualified, experienced and approachable person in charge who is in process of applying to register with the Commission. Effective quality assurance systems promote year on year improvement and development of the service. Efficient communication and the promotion of health and safety ensure that people are protected from harm. What has improved since the last inspection? A new comprehensive assessment process has been introduced prior to admission to ensure people`s needs ore more fully understood and can be met. Staff have been trained in the new assessment process. Nutrition has been improved witht the introduction of a fresh fruit platter in each unit everyday. The company has appointed a Care Specialist to support a consistent approach to Adult Protection, and ensure assurance processes are in place to monitor and feedback themes and lessons learnt. Infection control training has been incorporated with basic induction and health and safety training. Recruitment and selection training has been provided to for managers and deputies. All team leaders are qualified to NVQ level 3. What the care home could do better: There are no requirements. Key inspection report Care homes for older people Name: Address: Barnfield Barnfield 24 Upfield Horley Surrey RH6 7LA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ruth Burnham     Date: 1 1 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 26 Information about the care home Name of care home: Address: Barnfield Barnfield 24 Upfield Horley Surrey RH6 7LA 01293786798 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: ayo.adeluola@anchor.org.uk www.anchor.org.uk Anchor Trust care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 63 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) (Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP) Physical disability (PD) Date of last inspection Brief description of the care home Barnfield Residential Care Home is owned and managed by Anchor Trust. It is a substantial detached property that has been purpose built to provide accommodation Care Homes for Older People Page 4 of 26 Over 65 0 0 63 0 63 63 0 63 Brief description of the care home for 63 service users. The home is located in a quiet residential area of Upfield in Horley. Access to shops, church, public transport and other local services are within easy reach. The accommodation for service users is provided on two floors, in seven separate units. Each unit has a separate name; each has a lounge, dining room and kitchenette. All bedrooms are single and 12 of them have en suite facilities. There is a passenger lift accessing all floors. In addition to this there is a large communal lounge that doubles up as a day centre. The home is located in substantial grounds that incorporate a garden and a sitting area. The home has a parking area at the front for a number of cars and there is additional parking space on the road outside. The fee range is from 501 to 680 pounds per week. Care Homes for Older People Page 5 of 26 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: This inspection of the Service was an unannounced Key Inspection. The inspection included a site visit. We arrived at the Service at 09.15 and was in the Service for five hours during which time we spoke to a number of residents, staff, a visitor and the person in charge. A number of documents were examined and a tour of the premises was undertaken. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service manager and any information that the Commission has received about the Service since the last inspection. There are no Required Developments at the end of this Report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We would like to thank the person in charge, staff and people who live in the home for Care Homes for Older People Page 6 of 26 their hospitality and cooperation during this visit. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: There are no requirements. Care Homes for Older People Page 8 of 26 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 on page 4. 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 26 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 26 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 who are considering moving into the home are provided with helpful information to help them decide if the home will be suitable for them. A thorough assessment takes place before people move into the home to ensure their needs are understood and can be met. Evidence: People who are considering moving into the home are provided with helpfulinformation in the homes Statement of Purpose and Service User Guide. The last inspection report is also available. A copy of the service user guide is also placed in each persons bedroom. All the people who we spoke to felt they had received enough information to help them decide if the home would be suitable for them. Before moving into the home a thorough assessment of need is carried out by a suitably qualified member of staff. A new comprehensive assessment process has Care Homes for Older People Page 11 of 26 Evidence: been introduced prior to admission. Staff have recieved training in assessment. Assessment records are completed based on health and social care professional assessments. Assessment records seen were detailed and contained sufficient information to ensure the home understands and can meet the identified needs. These assessments enable the homes assessor to understand peoples individual needs before they move in. People are encouraged to visit the home and spend time with other people who live there. Some people come for respite care on a temporary basis. A Social Service care manager was visiting respite clients during the inspection, all these people wanted to stay at Barnfield rather than go home. The people we spoke to liked the friendly staff and homely, welcoming atmosphere and also the way in which all their questions had been answered. Care Homes for Older People Page 12 of 26 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 who live in the home can be confident their care needs are understood and will be met. Care plans provide clear guidance for staff to follow. People are protected through good risk management processes and safe medication administration and practice. They are cared for in a way that promotes their privacy and dignity. Evidence: People who live in the home have individual plans of care. The care plans are kept on each unit and cover the daily requirements essential to ensure their needs are met according to their wishes and expectations. Care plans include personal care needs, charts and the daily records of care. The care plans are regularly monitored and reviewed. Everyone we spoke to said they were satisfied with the overall care provided. People are protected from harm through good risk management systems. Each person has individual risk assessments recorded as part of their care plan, these provide clear guidance for staff on how to minimise risk. A number of staff have undertaken dignity champion four day training to promote dementia awareness People can be confident their health care needs are carefully monitored and the Care Homes for Older People Page 13 of 26 Evidence: appropriate health care practitioners are regularly involved. All residents are registered with a general practitioner. Further health care provision is obtained from the district nurse, community psychiatric nurse, occupational therapist, dentist, audiologists, physiotherapist and chiropodist as requested by the GP. Records of visits are kept and are available for inspection. People who live in the home are protected through the safe handling of medication.The home uses a monitored dosage system and records seen were up to date and well maintained. We were able to meet and talk to several people throughout the day who were happy to tell us about their experience of living in or visiting relatives in the home. All who were spoken to were very happy with the care provided and full of praise for the staff and the management. Throughout the visit staff were observed talking to people in a polite and respectful manner and supporting them in a way that promotes their dignity and privacy. People are able to receive visitors and health care practitioners in the privacy of their own rooms. Care Homes for Older People Page 14 of 26 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 who live in the home enjoy a lifestyle that encourages and respects their individual social, religious and cultural needs. Families, friends and advocates are welcome at the home. People are supported to make choices in a way that promotes their independence. Mealtimes are unhurried and enjoyable with a good choice of wholesome and nutritious food. Evidence: People who live in the home can be confident their social, religious and cultural preferences are understood. People are supported to attend in house religious services should they choose to do so. Religious preferences at the time of the visit were for Church of England worship. Ministers of religion regularly attend the home and services are held every week. There are two activities coordinators employed in the home and people can choose to take part in a variety of activities throughout the day. The Weekly activity planner is on main notice board and on notice boards on each unit. People are also able to access the multipurpose Day centre used for providing varied and stimulating activities on a daily basis including monthly visiting entertainers, and festive and important celebrations. People are supported to make good use of the grounds Care Homes for Older People Page 15 of 26 Evidence: surrounding the home. Regular residents and relatives meetings are arranged as social events. Relatives are encouraged to drop in and refreshments are made available. Visitors who were spoken to confirmed that the home supports and welcomes their visits. We were able to join residents for the lunchtime meal. Tables are attractively laid and there is a relaxed atmosphere at mealtimes. The meal was well presented and appetising. There was a choice of main meal and dessert. There is always a platter of fresh fruit on each unit prepared by the chef. People who were spoken to said meals are always very good and there is always a choice. The menu is displayed on each table. Special dietary needs such, as pureed food and diabetic choices are always available. Care Homes for Older People Page 16 of 26 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. People who live in and visit the home are listened to and encouraged to offer comment or complaint. They can be confident their views will be taken account of. People are protected from abuse. Evidence: People who live in and visit the home can be confident they will be listened to, those spoken to said the managemant and staff are approachable. People know who to talk to if they are unhappy about anything. There is a clear complaints procedure and records show that any complaints or concerns raised are addressed appropriately. People who live in the home are protected from abuse. Staff understand and receive training in protecting vulnerable adults. The home has an up-to-date copy of the Surrey Multi-agency procedure for the safeguarding of vulnerable adults in the office. The complany has appointed a Care Specialist to support a consistent approach to Adult Protection, and ensure assurance processes are in place to monitor and feedback themes and lessons learnt.Staff who were spoken to were very clear about recognising abusive situations. Care Homes for Older People Page 17 of 26 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 who live in the home benefit from the spacious, safe and homely environment. Bedrooms are personalised, comfortable and well presented. Communal areas are clean, comfortably furnished and airy. All areas of the home are well equipped and nicely decorated. Evidence: People who live in and visit the home appreciate the spacious and well maintained environment. A tour of the premises and grounds was conducted and all areas seen were clean, light and airy. Rooms have been nicely decorated. Peoples bedrooms are individually decorated and show individualised touches specific to each person. People are encouraged to bring their own items of furniture and personal possessions into the home when they move in. The home is divided into seven units, each with its own lounge and kitchen,dining area. People also benefit from access to the large day centre and reception area where people can sit and watch the comings and goings of staff and visitors. The home is well equipped to meet all the care needs of the people who live there. There are well equipped bathroom and toilet areas on each unit, adapted to assist those with mobility problems and physical disabilities. The home ensures that regular equipment checks are completed to ensure peoples safety. Care Homes for Older People Page 18 of 26 Evidence: People we spoke to were happy with the environment and satisfied with the facilities provided. The laundry room is clean tidy and there is an efficient laundry system in place. Safe systems for handling laundry ensure people are protected from risk of infection. Care Homes for Older People Page 19 of 26 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. People who live in the home are cared for and supported by a well trained and competent staff team who understand their care needs. The home supports and encourages staff to obtain National Vocational Qualifications. Robust recruitment procedures ensure people are adequately protected. Evidence: There are sufficient, suitably qualified staff on duty at all times to provide the care and support people in the home need. The staff team includes care staff, activities coordinators, housekeeping, maintenance and catering staff. All staff who were spoken to were enthusiastic about their roles and were clear about their responsibilities. People are protected from harm through sound recruitment procedures. Five staff files were examined, these contain documents such as; references, proof of identity and original job applications. All staff have been checked through the Criminal Record Bureau (CRB) and certification has been provided. All staff who are employed in the home at the time of the visit have received CRB clearance. Employment histories are in place and records of interviews are also kept on file. The home is currently seeking to recruit to a number of vacancies, There are good systems in place to ensure cover through secondments and the use of agency staff. Care Homes for Older People Page 20 of 26 Evidence: People who live in the home can be confident staff receive appropriate training for and supervision in the work they carry out. All care staff are encouraged to undertake National Vocational Qualifications. Additional training courses are also provided. Staff have regular one to one supervision sessions with their line managers and staff meetings are also held regularly. Good communication between shifts is ensured through handover sessions before each shift begins. Care Homes for Older People Page 21 of 26 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 who live in the home can be confident the home is managed in their best interests, taking account of their views and expectations. The home is run efficiently by a well qualified, experienced and approachable person in charge who is in process of applying to register with the commission. Effective quality assurance systems promote year on year improvement and development of the service. Efficient communication and the promotion of health and safety ensure that people are protected from harm. Evidence: The person in charge is well qualified to manage the home, she has attained, the Registered Managers Award. People who live in the home are benefitting from her leadership. The home is run in the best interests of people who live there. Residents and relatives have regular meetings every month and the person in charge promotes an open-door policy. The manager completed our Annual Quality Assurance Audit, the information provided Care Homes for Older People Page 22 of 26 Evidence: has been used as part of this inspection. It contained all the information we asked for and demonstrates the home has good quality assurance processes to monitor the service and recognises where improvements can be made. Families and advocates act on behalf residents in relation to their financial affairs. The health, safety and welfare of service users and staff are promoted and protected and staff are trained in safe working practices. Regular safety checks are carried out on all installations and equipment. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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