Care Home: Barton Park

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What the care home does well What has improved since the last inspection? We found that the activities offered have greatly improved since we last visited. This has included key staff receiving training and peoples care records being developed to include how they would like to spend their time. Any concerns or worries that people may have are being recorded which helps to show how diligent staff are in ensuring people are content who live at the home. The rear garden has been altered to include a putting green for people to use in warmer weather. Consultation with people who live at the home has greatly improved. This has included introducing an "employee of the month" award, which encourages people to vote for their chosen member of staff, production of a monthly newsletter and a yearly survey, which seeks people`s views. All of this helps people to feel as though their opinion matters. Staff continue to receive training to ensure that they have the skills and expertise to promote peoples health and welfare. What the care home could do better: We found that some people require the use of bedrails to help to keep them safe. We saw that this equipment was fitted correctly however records could be improved to show why the equipment is in use and that the person`s safety has been considered. Recent changes in how nurses are professionally registered have meant that an annual check on all nurses pin numbers is required (rather than the previous three yearly check). Systems need to be developed to ensure that these checks are regularly carried out. CARE HOMES FOR OLDER PEOPLE Barton Park 15 - 17 Oxford Road Southport Merseyside PR8 2JR Lead Inspector Mrs Joanne Revie Key Unannounced Inspection 09:30 3 September 2008 rd 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 Barton Park DS0000017225.V363253.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. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barton Park Address 15 - 17 Oxford Road Southport Merseyside PR8 2JR 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) 01704 566964 01704 568454 Choice Classic Limited Maya Vijayan Nair Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 60 OP Date of last inspection 23rd May 2006 Brief Description of the Service: Barton Park is a large and extended detached building situated in a residential area of Birkdale close to Southport sea front. The home is registered to provide nursing care for up to 60 residents over the age of 65. Barton park has been upgraded to provide a number of apartments, which comprise of a combination of lounge, bedroom and bathroom facilities and in some cases kitchens. The remaining bedrooms are all single. There are shared communal dining and lounge areas on the ground floor and the home benefits from gardens to the front and rear. Choice Classic Ltd owns the home and the Responsible Person is Mr David Barton. Barton Park DS0000017225.V363253.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 The visit was unannounced. Prior to the visit taking place we (the commission) asked the manager to complete a document called an AQAA. This document provides information on the services strengths and weaknesses and any future plans to develop the home. The AQAA gave us lots of information and showed us that management at the home have a good understanding of the legislation that governs care homes. Surveys were sent out to relatives of the people who live at the home and staff who work there. Six relatives surveys and nine staff surveys were returned which all reflected positively on the staff’s ability to provide care and support to the people who live there. During our visit we spent time looking at records which told us about the care and support that people need and receive and how the management of Barton Park ensure that the home is a safe place to live and work. We also looked at the records that the home keeps about the staff team. These showed us how staff were recruited, what training they have had and how many staff are available to support the people who live at Barton Park. We also looked at any new information we had received about the home since we last visited. We knew that the registered manager wouldn’t be available during our visit as she was taking a planned absence. (Each care home has to have a nominated person who is registered with us. This person is known as the registered manager). We knew that the provider (Mr Barton) also employs a general manager who works alongside the registered manager and that a deputy manager was also available. We met with the general manager during our visit and they provided most of the information that we required. We had discussions with seven people who live at the home, a visitor, two chefs, the general manager and the nurse in charge. Comments from the discussions held and the surveys received have been included in this report. The cost of staying at the home is £426.00 to £1,300.00 per week dependant on whether people choose to occupy a single bedroom or an apartment Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 6 What the service does well: People who live at the home and their relatives believe that Barton Park provides an excellent standard of care and support. Relatives told us “They could not possibly do more” and “its above and beyond expectation” and “Its 100 first rate, I cannot praise them highly enough”. The home employs a stable and dedicated staff team who are proud to work at Barton Park. Staff told us that “Barton Park offers the residents the best care possible within beautiful surroundings - nothing is ever too much trouble. The resident’s wishes are catered for and the whole home is exceptionally clean” and ” Barton Park is a very lovely nursing home, we always keep it clean and tidy. It provides a high standard of nursing care and residents are always happy with the care.” We found that people receive care and support which matches their expectations. Staff are quick to respond to changes in peoples health care needs and have an excellent understanding of the importance of treating people as individuals and promoting their dignity and privacy. A visitor told us when talking about the staff team that “ It’s the little things that make all the difference, making people feel valued and respecting their dignity is so important. Even though shes 85 ( visitors friend) she stills like to look nice, its so important to her. I never feel like Im visiting a nursing home. I feel like I ve come to a lovely family home. Staff are very welcoming but very professional, also, they’ve got it just right.” Relatives told us that they felt involved in the care and support which is offered to the people who live at the home. Their comments included ” Although my aunt is no longer well enough to keep in touch the staff always contact us” and “We are always informed of Mum’s progress and we are always informed immediately of any problems”. People who live at the home feel in control of their own lives. Their comments included “ I’m asked my opinion about even the smallest things and staff always act on what I prefer” and “ I’ve always been in charge of my own life and the staff understand how important that is to me and of course they respect my wishes”. We found that Barton park is an exceptionally comfortable and clean home that is furnished with quality fittings and fixtures. All areas are maintained to a high standard and people are encouraged to feel at home by personalising their living accommodation with their own belongings. We saw that all bedrooms and apartments have a different décor scheme which helps to add to a homely atmosphere. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 7 We asked a relative what they thought the home did well. They responded by stating ” Everything! They provide total care and attention, excellent food, Beautiful surroundings, it’s always spotlessly clean”. People are offered a variety of quality home cooked food, which they enjoy. People told us “ the kitchen staff are first class, nothing is too much trouble” and “ the food is excellent”. We found that the management team are involved in the day to day running of the home and that a number of systems have been developed to check that peoples expectations are being met. People who live at the home praised the home in general and told us “ Management are excellent, I wish all nursing homes were like this one”. Relatives told us “I cannot recommend Barton Park Nursing Home highly enough” and another stated that “There are undoubtedly similar establishments that do not offer the same impeccable standard of care as Barton Park.” Staff told us that “after working in other care homes I am completely confident that Barton Park offers the very best care that can possibly be given. The food is excellent and the surroundings are beautiful and kept exceptionally clean.” What has improved since the last inspection? We found that the activities offered have greatly improved since we last visited. This has included key staff receiving training and peoples care records being developed to include how they would like to spend their time. Any concerns or worries that people may have are being recorded which helps to show how diligent staff are in ensuring people are content who live at the home. The rear garden has been altered to include a putting green for people to use in warmer weather. Consultation with people who live at the home has greatly improved. This has included introducing an “employee of the month” award, which encourages people to vote for their chosen member of staff, production of a monthly newsletter and a yearly survey, which seeks people’s views. All of this helps people to feel as though their opinion matters. Staff continue to receive training to ensure that they have the skills and expertise to promote peoples health and welfare. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 8 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. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 9 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 Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 10 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 excellent. This judgement has been made using available evidence including a visit to this service. People are reassured that the staff at the home will care for them properly and People receive enough information and support to help them to decide whether the home is the right place for them to stay. EVIDENCE: We looked at care records that belonged to someone who had recently moved into the home. We met with this person and discussed their experience and we discussed how assessments are carried out for new people with the general manager of the home. The person who had recently moved in told us “The staff are marvellous, my daughter insisted I had the best and she certainly found it. They came to see Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 11 me in hospital and that really put my mind at ease. As soon as I moved in staff came to greet me and took care of my every need, I can’t recommend them highly enough”. The general manager explained to us that each new person is given the opportunity to meet with senior staff who work at the home.This includes a qualified nurse and the general manager. The qualified nurse focuses on peoples health needs and the general manager focuses on their social needs. This means that people are given the opportunity to discuss their needs, wishes and expectations and staff are able to plan for their arrival. We saw that the staff at the home have to complete a check list to show that all preparations for a new persons arrival have been made. This is good practise as it reduces the risk of a persons need or wish being forgotten. This can help reasure new people at what can be an anxious time. We looked at the records that staff complete following a visit with someone who is interested in moving in. We saw that staff complete comprehensive records which contain details of the persons medical needs, past and present and also details of the care and support they wish to receive. Consideration is also given to peoples equality and diversity needs which helps to show that the home recognises that each person is an individual.Examples of this is recording of food preferences, spiritual beliefs etc. Efforts are also made to find out about the persons past life such as occupation, family, etc. This can highlight what is important to someone and is good practise. We looked at the homes AQAA which told us that each new person is allocated a Key Worker on arrival to the home. We saw a copy of a letter which had been sent to someone telling them who their keyworker was. This is good practise. This means that people are provided with a link staff member whose role is to ensure that they are happy with the service offered. The AQAA also said that due to changes in the Mental Health Capacity Act the assessment records may be developed further to consider peoples capacity to make decisions. We saw that part of the assessment process includes consideration to peoples mental health needs and their ability to make decisions which helps to support this.This is good practise and shows a willingness by the home to stay abreast of changes in legislation and to promote peoples rights. The general manager explained that anyone who is interested in moving into the home is supported to visit and are welcome to stay for a meal if they wish. This helps people to experience a “ taste” of what life is like at Barton Park. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 12 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. People recieve indivualised care and attention from staff who understand the importance of respecting their right to privacy and dignity. EVIDENCE: We looked at the homes AQAA. This showed us that people could expect to receive the care that they need in a way that they would choose. Relatives told us via surveys that they were delighted with the care offered by the home. Comments included “ The care is 100 , first rate, I cannot praise them highly enough” and” Staff are excellent”. The surveys also asked relatives if they believed staff had the right skills and expertise to care. One relative stated” Absolutely! My mother wants for nothing!” Another relative said,” The care staff are wonderful, kind, friendly and extremely courteous, nothing is too much trouble”. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 13 When we visited the home we saw that two local G.P’s had completed surveys giving their view of the care and support offered. One had written, when asked their opinion by the home about any improvements that could be made ” continue with the same caring, clean, friendly and professional environment. This is an excellent home” and the other had written “ This is the highest standard that I have encountered as a G.P.” We saw that each person who lives in the home has a plan of care, which gives staff clear instructions on how to provide care in a manner, which people preferred. We saw that staff had the skills to care for people properly by providing them with specialised equipment to reduce the risk of their health deteriorating and by consulting with doctors and other health care professionals when their needs changed. When we read one persons records we saw that they had been unable to walk when they were admitted to the home. A letter from a consultant confirmed this to be true and stated that it was unlikely that this person would regain this ability. We met with this person during our visit. They were able to explain that after receiving support and encouragement they could now walk short distances with staff and at times independently with a walking frame. They commented that “ I couldn’t walk but now I can, Im so gratefu,- The care in this home is second to none, they are all excellent.”. We had discussions with two other people who also live in the home. One person has an ongoing health problem which means that some days they require more care and attention than others. They explained that “ If Im having an off day the doctor is here without hesitation”. This view was also held by another person who told us that “If (persons name”) is ill the staff will get her anything she wants, nothing is too much trouble”. We saw when we walked around the home that everybody looked well cared for and smartly dressed. People had been supported to dress in coordinated clothing and attention had been paid to jewellery and applying of makeup. We met with a visitor who explained that her friend had been very poorly and had appeared to have given up on life. This visitor believed that the staffs attention to this persons care encourged her to get better and to start living life again. We met with this person who confirmed that this was true . They also told us that staff had supported her to do a little more each day until “ I was back on my feet again”. We noticed that the atmopshere in the home is quiet and that staff go about their duties in an unhurried and calm manner. Staff were seen knocking on peoples bedroom doors before entering and people who live in the home explained to us that they were called by their chosen name and not by one that the staff had decided to use.This is important as its shows that staff respect the people who live in the home. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 14 We saw that one lady is supported to wear trousers so that a medical device is hidden from view. We saw that staff had recorded this in this persons plan as a specific care need. This is good practise and shows further evidence of the staff teams ability to promote peoples dignity. We looked at how the home manages people’s medications. We saw that in some cases people are supported to manage their own medications if they prefer and if they are able. Nursing staff manage the medications for the other people who live in the home and we found that medications were managed safely. Regular checks were occurring to ensure that staff were giving people their medication how they should which is good practise. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 15 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 feel in control of their lives and are offered interesting and varied activities and a choice of nutritious food. EVIDENCE: We looked at the homes AQAA which told us that the provision of activities had greatly improved since we last visited the home. The AQAA also told us that the general manager had completed training in this area . When we visited we found this to be true. We saw that peoples care records had been developed to include how they liked to pass their time, what their interests (past and present) were and whether they preferred their own company or to mix with others. We saw that a variety of activities are available on a daily basis for people to join in if they choose. We saw that the activities offered incuded visiting entertainers, gardening board games, quizzes and debates. In particular people who live in the home Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 16 are encouraged to give talks on their favourite topic or pastime. This is very good practise as it helps people to feel valued which promotes self esteem. Craft activities have taken place such as a lace making demonstration and on the day that we visited we were able to see photograph frames which people had decorated themselves . Many of these were displayed in peoples bedrooms. The general manager told us that as this was a particularly successful activity. Plans have been developed to support people to make greetings cards at a later date. People told us that they enjoyed the activities that were available . Comments included” Oh Yes, there’s always something going on” and “ I enjoy the debates and talks, it keeps my brain ticking over and gives me something to think about”. People confirmed that they were encouraged to join in but never felt pressurised to do so. One person commented” choice is paramount in everything that they do here”. We saw that some people are supported to attend local events and to continue with their personal interests such as visiting the golf club, rotary club and local Probus group. We also saw that some people are supported to take part in individual activities outside the home such as visiting local events , trips to the garden centre etc. People told us that they went out with their family and friends if they choose and that they simply made sure that staff would be aware of wether they would be eating at the home or not. We found that peoples cultural and spiritual beliefs had been considered and that care and support was provided which matched these. Visit from different denominations of clergy are available for those who choose ,and support can be provided for those who would like to attend services. We met with the chefs who work at the home and found them to be enthusistic and knowledgable about each persons needs. We saw that menus are displayed and that people are consulted through residents meetings about their opinion of the food offered. The chefs told us that they had recently introduced a monthy chefs special to provide a further variety of dishes for people to choose from. This is good practice as if the meal offered was successful then this could be introduced to the menu at a later date. We saw that the home has two lounges which are also furnished to provide dining facillities. One dining room is furnished for those people who do not require staff support so that the meal time becomes a social occasion. We observed this dining room discreetly and saw that staff provide dignified support which was not intrusive. The tables were set nicely with linen and good quality cutlery, condiments and pleasant table settings. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 17 We saw that the home also has another lounge which also contains a dining table. This room is used for those people who require greater staff support. We saw that people are encouraged to sit at the table if able and if not are supported to sit comfortably in an armchair. We watched staff providing support to one lady in an unhurried manner. The staff member stayed with this person throughout the meal and we heard the person and the staff member chatting comfortably to each other. The person recieving support confirmed that it had been a positive experience by telling us “ I enjoyed that, the staff are very kind you know, they work very hard”. People told us that they thought the food served was “ excellent” and “ first rate”. They also confirmed that they were always offered a choice of meals and that the kitchen staff would also provide a light snack if they weren’t feeling very hungry“ nothings too much trouble”. The chefs explained to us that they try to source quality local ingredients and that the management of the home support them with this. For example one supplier is going to be changed in the near future as the chefs are not as happy as they were with the quality of some ingredients provided. One chef told us that they had planned to visit suppliers in the town later that day to explore this further. This helps to show that the home is committed to providing a quality service to the people who live there. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 18 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. People know how to complain and believe staff will take action to address any concerns that they may have. EVIDENCE: We looked at the homes AQAA. This told us that all staff have had training in how to protect peoples rights and that training had also been given about the homes complaints policy. Staff confirmed this to be true on the surveys that they sent us before we visited and we saw certificates, which showed us when the training had taken place. We saw that since we last visited, the home has developed a system for recording all verbal concerns. We read these and saw that staff were recording these in detail and had included worries that people had had and what staff had done to alleviate them. For example we read that one person was worried as they had been unable to contact their relative by phone. Staff had persevered with this on their behalf and the outcome was that contact had been made and the person was no longer worried. This is very good practice and shows the staff teams willingness to support people with any problems. We saw that copies of the homes complaints procedure are displayed in the Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 19 home and in the staff break area. This means that people who live in the home can easily access instructions on what to do if they are unhappy and staff are reminded of how to support people if they wish to complain. People who live at the home told us that they knew how to complain and who to complain to. People commented “ management are very attentive, I never have reason to complain about anything, however I’m sure they would address it right away if I did”. Relatives told us via surveys that “There has never been the slightest need to complain” and” Management and staff are always available and details are on display in the office, but I have never had to make a complaint”. When we looked at the information that we have about the home we saw that no complaints or concerns have been made to us since we last visited. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 20 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): 19,23,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in comfortable, clean well, maintained home which has a variety of accommodation to suit their needs. EVIDENCE: We looked at the homes AQAA that told us that the environment continues to be maintained to very high standard and that improvements such as new televisions, dining furniture etc have been provided since we last visited. We walked around the home and viewed some bedrooms, some apartments all communal areas, the kitchen, the laundry and bathrooms and toilets. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 21 We saw that the standard of furnishings in the home are of a high quality and that efforts have been made to display these in a homely way. For example bedrooms and apartments have their own décor schemes. Pictures and ornaments are displayed in key areas. A variety of lighting has been used effectively to provide well lit areas including standing lamps etc in corners of rooms which helps to promote a comfortable and relaxed atmosphere. We saw that the home is maintained inside and out to very high standard. Garden areas were tidy and well kept. A putting green in the rear garden has been introduced since the last visit for people to enjoy who live in the home. The home provides a variety of living accommodation according to peoples needs and wishes. For example some people have a bedroom and use the homes communal areas but other people have apartments, which can comprise of a sitting room, bathroom and bedroom. Some people have bathrooms that are fitted with showers whilst other have specialised baths. One person has a bedroom and their own kitchen. This shows that efforts are made to provide people with accommodation, which suits their needs and expectations. We found that all areas that we looked at were clean and tidy and the home smelt very pleasant. People who live in the home told us that they were pleased with their accommodation and that they believe the standard of cleanliness was very good. We saw that staff understood how to reduce the risk of infection occurring or spreading which helps to promote peoples health and welfare and we also saw that staff had had training on this topic. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 22 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 excellent. This judgement has been made using available evidence including a visit to this service. People receive care and support from skilled staff that they like EVIDENCE: We looked at the homes AQAA which told us that a variety of staff are employed to provide care and support to the people who live at the home and that these staff are recruited correctly. We found this to be true. Stringent checks are carried out before staff are employed to ensure that they are suitable to work with people who may be vulnerable. The home employs some nursing staff that have recently been required by law to re register annually to their professional nursing body. This used to be required every three years. The management were unaware of this change however they rectified this shortfall before the end of our visit and ensured that all nursing staff were legally registered to nurse. Systems should be developed to make sure these checks are carried out on a regular basis. This will help to reduce the risk of someone working as a nurse who is not legally registered. We found that staff are provided in sufficient numbers to meet people needs and people who live in the home told us that they believed this was true. People told us that if they ask for help this is provided ” almost immediately” Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 23 and that they believed that the “ staff are excellent, you cant fault them” and that “ they are very kind and caring”. Staff told us “Yes there are enough staff. Staffing levels are sufficient to ensure that a high level of nursing care is maintained” and “ We have a large number of staff working well together as a team.” Relatives told us via surveys that they found the staff to be “ very approachable” and “ helpful and competent in all that they do”. We saw that almost all the care staff supplied have achieved a national vocational qualification in care. This shows that staff have had formal training to carry out their role and is above the expectations of the national minimum standards. We also saw that senior management in the home have undertaken training in Equality and Diversity and in the recent changes in the Mental Health Capacity Act. We know that management are actively involved in the day to day running of the home and staff told us that they would consult and be guided by management regarding any Equality and Diversity issues or advice regarding new legislation. However it would be good practise to provide care staff with these skills through suitable training for their own personal development and this should be considered. We saw that a number of care staff that are employed in the home are from overseas and are in fact qualified nurses in their country of origin. This means that often extra nursing staff that are employed as carers, are available to care for people in the home. People spoke highly of the fast response that they receive from staff if changes occur in the health needs. We saw that staff training is ongoing and that all staff have completed mandatory training in key subjects. This means that all staff have been given the skills to promote peoples health and welfare. We also saw that nursing staff are encouraged to undertake refresher training in key subjects such as medication administration to keep their skills up to date. Staff told us via surveys that “Yes, we receive regular training in house as well as externally” and “ There are many different training courses available both in house and external. We are asked during our staff supervisions and staff meetings if we would like to attend any specific training courses. We have many courses booked this year.” Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 24 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. People live in a well managed, safe home where their opinion matters. EVIDENCE: We know that the registered manager for the service is taking planned leave and has not been in post for several months. Her return is expected in the coming months. In her absence the general manager has continued to keep us informed of any events which may affect the health and welfare of the people who live in the home. These events are called notifications and they are a legal requirement. During our visit we concluded that the home continues to operate with in the legislation that governs care homes. This shows that senior Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 25 management (i.e. general manager and the provider) have a good understanding of the responsibilities of managing a care service. We saw that a nurse is in charge of each shift to give directions to the care team about the support and care needed by each person who lives in the home. We viewed records which showed that an annual check is carried out on all systems used in the home which support people with their needs and care. This incudes records , processes etc. A bi annual meeting is held to discuss progress with implementing any new ideas or rectifying any shortfalls. This is good practise and shows a commitment from the home to provide a good service. One person told us “ (general managers name) is marvellous, shes always in and out making sure that we are okay”. A visitor told us that “Barton Park staff, both nursing and management, really care about their residents and family and friends. Everyone is so kind and helpful. There is always a happy atmosphere”. A relative told us via a survey that “I have been visiting Barton Park very regularly (once or twice weekly) for about five years. The quality of care, nursing and management has never been anything short of first rate, also lots of effort is made to provide entertaining and interesting pastimes i.e. musicians, singers, speakers, crafts and quizzes. Attention to all aspects of care is already first class, its impossible to improve”. We looked at how people are supported to manage their weekly personal allowance. The home actively encourages people to manage their own financial affairs however in some instances some staff support is required. We found that in these cases senior management and administration staff over see the management of such affairs. We found that clear records and receipts are kept showing what transactions had taken place and how money had been spent. We looked at how people who live in the home are consulted about the service. We saw that improvements have been made in this area. Regular residents meetings are being held and topics, which affect people’s lives such as provision of food and meals, are discussed. Key staff such as Kitchen staff attend these meetings also so that people can consult with them as well. We saw that since we last visited the home has introduced surveys for the people who live at the home, the staff and any visitors to the service to complete. The information from these surveys is gathered into a summary and a graph produced showing peoples level of satisfaction. If necessary, action plans are drawn up by management to address any concerns. The information Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 26 from this task is displayed in the home’s library so that people who live at Barton Park are involved and aware of the homes progress. We looked at the information that had been gathered and we saw that overall 95 of people who live at the home are “very satisfied “ with the remaining 5 being “quite satisfied”. A 100 target had been achieved in the delivery of personal care and support, premises, facillities, cleanliness and management. A 100 target had also been achieved for management attending to things quickly. This helps to demonstrate that the people who live at Barton Park are very satisfied with the service provided. On the day that we visited we saw that people had been provided with a monthly newsletter. This has been introduced since we last visited. This includes events that have recently happened or are about to happen in the home. People who live at Barton Park are given the opportunity to tell everyone about their own news. For example one person showed us that the marriage of their grandson had been published at their request. This is good practise as it promotes consultation and helps people to feel involved and valued. We also saw that an ” employee of the month” reward has been developed since we last visited. Only people who live in the home can vote for who they think should win this award. This is further evidence of good practise as it helps people to feel as though their opinion matters. One person discussed this award with us and was very pleased that her nomination had won the award. We looked at how the home manages the health and safety of the people who live there and the staff who work there. We found that regular checks are taking place on all equipment (including fire fighting) and that outside contractors also visit the service regularly to make sure that equipment is functioning correctly. We also saw that regular necessary checks are carried out on the services to the building. We saw that some people are supplied with bedrails to reduce the risk of them falling from bed and possibly injuring themselves. We saw that these were fitted correctly and that steps had been taken to ensure that people did not injure themselves from entrapment. Although the outcome showed that these rails were safe and secure and peoples health and welfare had been promoted we would suggest that the record used to identify any risk is developed further. This would help to show the process that staff had used to identify the need for bedrails in the first place. Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 27 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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 4 X X X 4 X X 4 STAFFING Standard No Score 27 4 28 4 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 3 Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 28 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 Refer to Standard OP29 Good Practice Recommendations Annual checks should be developed to ensure that all nurses remain legally registered with the Nurse and Midwifery Council to practise. This would help to reduce the risk of a nurse practising who is not qualified to do so. Care staff should receive training on promoting Equality and Diversity for their own personal development. Bedrails risk assessments should be developed further so that a record exists to show that consideration has been given regarding the risk of entrapment. 2 3 OP30 OP38 Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Barton Park DS0000017225.V363253.R01.S.doc Version 5.2 Page 30 - 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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