Care Home: Bartlett House

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Annual service review Name of Service: Bartlett House The quality rating for this care home is: The rating was made on: two star good service 1 0 1 0 2 0 0 8 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Alison Duffy Date of this annual service review: 0 2 1 0 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service Address of service: Bartlett House Old Common Way Ludgershall Andover Hampshire SP11 9SA 01264790766 01264791687 manager.bartletthouse@osjctwilts.co.uk www.osjct.co.uk The Orders Of St John Care Trust Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia learning disability old age, not falling within any other category Conditions of registration: Number of places (if applicable): Under 65 Over 65 0 0 0 13 3 33 The service user aged under 65 named in the application dated 22nd August 2006 may be accommodated at the home for a period of 3 months whilst the home is able to meet their needs. Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Bartlett House is a purpose built residential home offering accommodation and personal care to a total of 49 residents over the age of 65 who require care primarily through old age, although the home is registered to accommodate 13 residents with dementia and 3 with learning disabilities. Five of the 49 beds are also used for respite Annual Service Review Page 2 of 7 1 0 1 0 2 0 0 8 care. The home also provides day care facilities for a further 20 clients. The home is one of a number of care homes managed by the Orders of St Johns Care Trust. Mrs Julie Watts is currently the acting manager. Mrs Watts is in the process of registering with us. The home is situated in a residential area close to the centre of the small town of Ludgershall. Ludgershall is situated on the A342 between Andover and Tidworth. The home provides single accommodation, which is located on both the ground and first floor. There is a passenger lift giving easier access to the first floor. Staffing levels are generally maintained at 6 care staff including a care leader during the morning and 4 or 5 staff for the afternoon and evening. There are 3 waking night staff. The home also employs cooks, housekeepers, a maintenance person, an administrator and an activities coordinator. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection. This included: 1. The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. 2. Surveys returned to us by six people using the service, four health care professionals and four staff members. Five relatives helped people using the service to complete their surveys. 3. The previous key inspection, which took place on the 10th October 2008. 4. What the service has told us about things that have happened in the service. What has this told us about the service? We looked at the information within the AQAA, which was comprehensively completed. The AQAA stated that prior to admission, a comprehensive assessment and life history is completed, in conjunction with the potential resident, family members and other health care professionals. This information is utilised to ensure that a person centred plan of care for each resident is written and reviewed regularly. We saw that since the last inspection, improvements had been made to the standard of recording and care planning documentation. The staff were also more aware of the need for clear, accurate and complete recording. We saw that these areas were to be improved further. The key worker role was also to be developed to its full potential. We saw that half of the bedroom furniture and the armchairs in the day centre part of the home had been replaced. The main stairwell, corridors and any vacant bedrooms had been redecorated. The bathroom and sluice area had been separated and refurbished. A computer for peoples use had been purchased and a raised flowerbed had been built. A new fire alarm system, linked to the fire station, had been installed. There had been a new telephone system that included three dedicated mobile phones. The phones enabled people to take phone calls from relatives and friends. They also enabled staff to liaise with medical professionals, in emergency situations, without having to leave the person. The AQAA stated the Trust has a robust and open approach to complaints and in responding to complaints. There is a comprehensive policy and procedure in place and all staff are supported and trained to receive and respond to complaints in a non judgemental manner. We saw that the complaints received had been thoroughly investigated. The AQAA stated that a culture was being created where complaints were viewed as positive constructive criticism. We saw that staff training had been given high priority. Staff had regular formal supervision, which was fully documented. The AQAA stated staff are being developed to extend their roles and increase their understanding. We saw that there was now less agency staff usage. Within surveys, people told us that they were very happy with the care they received. One person said cares for all my needs. Dietary needs met well. I am very happy and Annual Service Review Page 4 of 7 well cared for. They said they always received the medical care they needed. Four people told us that staff were always available when they needed them. Two people said staff were usually available. One person said this home is very nice, if only there were more staff. Another person said a friendly caring home with staff who are committed and have time to talk (not just the carers but all staff.) People told us that there were generally social activities, which they could join in with. One person said that they appreciated the use of the computer to contact family. In relation to what the home could do better, one person said more activities and trips out. Two people told us that they always liked the meals. Four people said they usually did. One person told us they sometimes liked the meals. People told us that they were aware of how to make a complaint and felt that staff listened and acted upon what they said. They said the home was usually fresh and clean. One relative told us since Julie Watts took over as manager of Bartlett House there has been a complete turn around. When one enters the home there is a warm, happy atmosphere. Julie has succeeded, along with her new team, to pull the home together. Far more care and thought are now given to residents and their welfare. A member of staff is always willing to discuss any issues arising and keeps me well informed. XXs personal carer often goes beyond his/her call of duty with XXs interests in mind. Another relative told us we have been very impressed with Bartlett House and its staff. On our unannounced visits my XX seems to be happy, content and well looked after. It is also very good value for money. Within surveys, staff also commented positively about the service. They said they received regular training and supervision. They knew what to do if someone had a concern about the service and said there were always sufficient staff on duty to meet peoples needs. They told us their recruitment procedure was thorough and their induction covered what they needed to know. In relation to what the home does well, one staff member said makes sure its residents and staff are well cared for and supported with all their personal needs. The home is always a happy and relaxed environment for both staff and residents. Another staff member said the home has a relaxed style of running, very much fitted around the residents. There is a lovely atmosphere, which shows in the residents and staffs moods. Other comments were since the home has had a new manager, things have changed for the best, supports the clients needs and wishes. Keeps all staff training up to date and the home does always put residents and familys well being first. Staff and managers are supportive to residents and staff. In relation to what the home could do better, two staff members said more activities and outings for the residents. One member of staff suggested having a pool bus to enable trips out to be easier. Within their surveys, two health care professionals told us that peoples social and health care needs were always properly monitored, reviewed and met by the care service. Two health care professionals said they usually were. They said that staff respected peoples privacy and dignity and enabled people to live the life they chose, where ever possible. They said that managers and staff generally had the skills and experience to meet peoples needs effectively. One health care professional said many residents require full nursing care and the staff are not qualified nurses. In relation to what the home does well, one professional said liaise with our team. Team are very helpful and accommodate crisis respites when able to. Levels of care provided are excellent with positive feedback by clients that have been for respite care. Another professional told us, in relation to what the home does well, negotiate appropriate care Annual Service Review Page 5 of 7 plans based on service users needs, involving service users and their families. Consider the service users whole situation and potential triggers/contributory factors when their mental health presentation changes. Seek immediate advice and support, as appropriate. Other comments about what the service does well, included cares for all residents as well as possible - however many residents require nursing care and often psychiatric care, which staff are not trained for and do not have enough staff to cover these residents, sends frequent urine samples for testing and I have found staff at Bartlett House to be very kind, caring and professional. In relation to what the home could do better, one health care professional said improve communication between some staff members and encourage staff to familiarize themselves with changes in service users care plan. Promote additional training in dementia care/awareness. Another said better liaison between staff - often one member of staff will report a problem to a GP about a patient, which is already known about and if had been discussed with colleagues first would avoid this happening. More time needed to encourage residents to eat and drink, particularly if they choose to stay in their rooms for meals. Other comments were sometimes staff have difficulty accepting that a resident is dying and that little can be done specifically if they choose not to eat and drink and ensure that carers are aware of clients medical conditions. Carers may benefit from more courses on basic care. Since the last inspection, the manager and staff have kept us informed of incidents, which have affected peoples wellbeing. There has been one medication error and two incidents of people leaving the building unsupported. The manager has appropriately referred issues to the local safeguarding procedures. We received a letter from a relative complimenting staff on the care they gave to their parent during an illness. The relative stated the staff demonstrated a standard of care well above what we expected and to a very high Professional Standard indeed. Thanks to the care, consideration and commitment of the staff at Bartlett House, my XX received the care s/he was entitled to. Thank you to all the staff for knowing not just their residents names but their families and for giving older people who may not know what day it is, the dignity they deserve. Another letter showed that staff continued to monitor the progress of a person whilst in hospital. A relative wrote I have received many calls asking for progress reports and the staff really care about his/her future wellbeing. The standard of care is well above what is expected and demonstrates the consideration I believe all residents receive. Management and staff deserve our thanks for their professional care and the respect they give daily to the residents and families. What are we going to do as a result of this annual service review? The information available, gives evidence that Bartlett House is continuing to provide good outcomes for people. However, in the event of any incidents which affect the well being of people, we may consider undertaking an inspection of the service earlier than the anticipated date of 10th October 2010. 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