Care Home: The New Barn

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What the care home does well The management and their staff try to find out what people living in the home like to do and try to arrange for them do it and they find out what they like to eat and try to make sure that is what they get for their meals. If someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them. If a person doesn`t like something they can complain to the managers or the staff who will look at the problem for them. If someone is upset and unhappy the managers and the staff will try to find out why. The home is clean and well decorated. Each person can keep their own belongings in their room and those rooms can be decorated how they would like them to be. The home has a pleasant and secure garden for people to sit and walk in. The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers are also cheerful friendly and helpful and do most of the things that help the staff to do their job. What has improved since the last inspection? No requirements or recommendations were made at the last inspection however, since then a small lounge area has been developed for people who live in this home to use if they want a quieter place to be. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 What the care home could do better: There were no recommendations or requirements made as a result of this inspection. Key inspection report CARE HOME ADULTS 18-65 The New Barn The New Barn Goldstone Market Drayton TF9 2NA Lead Inspector Mike Moloney Key Unannounced Inspection 13th August 2009 10:30 The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 2 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 The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The New Barn Address The New Barn Goldstone Market Drayton TF9 2NA 01630 661 583 0207 969 1881 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) LDCG Limited Mrs Emma Louise Shea Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) 10 The maximum number of service users who can be accommodated is: 10 14th August 2007 Date of last inspection Brief Description of the Service: The New Barn is situated in a quiet rural area of Goldstone, near Market Drayton, North Shropshire. The home is owned by LDCG, the principal shareholder being Mr Jabber Mir, who purchased the home in 2004. The home is registered with the Commission for Social Care Inspection to provide accommodation and personal care for up to ten people with learning disabilities. Since 2004 the home has undergone many environmental improvements and major refurbishment with positive receptions from not only staff and service users but also the community and service users families. The stated intention is to continue investing to make the home into a highly regarded Learning Disabilities care home. Due to the location of the home, access to community resources is limited and transport is a necessity. The home does have its own transport available to support service users. Further information is available in the form of a service user guide which is available in an easy read version. The current fees were not available in the homes service user guide. The New Barn DS0000065940.V377166.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 2 star. This means that the people who use this service experience good quality outcomes. A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. What the service does well: What has improved since the last inspection? No requirements or recommendations were made at the last inspection however, since then a small lounge area has been developed for people who live in this home to use if they want a quieter place to be. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 6 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. Nobody new has come to live in this home for some time therefore it was not possible to review the homes pre-placement assessment procedures. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Nobody new has come to live in this home for some time therefore it was not possible to review the homes pre-placement assessment procedures. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using the service experience good quality outcomes in this area. People who live in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The files of two of the people who live in the home were looked at and both showed that the care for each had been regularly reviewed. A number of charts and documents were seen that showed that the likes, dislikes and wishes of the people living in the home were systematically being established in a person centred way. Staff confirmed that they had completed this task with as much input as possible from the person that it was about. Throughout the inspection the staff were heard talking to and asking questions of the people who live in this home The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 10 about such things as what they would want to eat or drink or about what they would like to do or where they would want to go. One lady talked about how she had been able to choose how her room had been decorated and was keen to show it off. Where activities had been identified there were records in place that showed that the staff had looked to see if there were any hazards involved and had established ways in which the risks could be reduced. Other risk assessments were seen to be in place about such things as being in the home’s transport. Talking to the staff on duty at the time of the inspection established that they were familiar with what they said. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, cultural and recreational activities meet individuals expectations. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The records of two of the people who live at the home were looked at. Both were seen to have detailed care plans which had been developed with the individual in a way that puts their needs first. Talking to the staff and the manager confirmed that these had been developed by talking with the person concerned, watching which activities the person liked or disliked or asking other people such as friends or relatives for their views. A variety of activities were seen to have been arranged for people such as shopping, pedal power (an activity that takes place in Wrexham), going to the market, going out to lunch, going to garden centres, discos, karaoke, going out The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 12 for drives and walks. The staff said that all of these activities were popular with the people who live in this home. Records of the meals that had been prepared and eaten in the home were seen and these showed that people are offered a varied and nutritious diet. Those meals included such things as curry, fish pie, chilli wedges, chicken Kiev, sausage casserole, spaghetti carbonara and roast pork. One of the people who live in this home has special nutritional needs for cultural reasons and these were seen to have been met by the home. The records also said what name each person liked to be known by. Throughout the inspection staff were seen to treat everyone with dignity and respect and explained what they were doing when they did it. The way people reacted gave the impression that they were used to this and expected it. The home was seen to have vehicles that were available to transport people to the activities or appointments that had been arranged for them. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience good quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Listening to staff talking with the people who live in the home it was found that the staff talk and behave in a friendly but professional manner. Talking with the staff showed that they used discretion when discussing issues that were personal to an individual person. The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. These professionals included GPs, psychiatrists, psychologists, dentists and chiropodists. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 14 The arrangements for the storage and administration of peoples medication were looked at. Storage was seen to be appropriate and records correctly maintained. Staff said that they receive training in the safe handling of medication before they are allowed to give it out to people and their records confirmed this. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. People who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager confirmed that the home has received no complaints since the last inspection. A copy of the homes complaints procedure was seen and this contained the information someone would need if they wished to raise a problem with the homes managers. The deputy manager confirmed that no issues had been referred into the local procedures that are designed to protect vulnerable adults. Although the level of the disabilities of the people living in this home means that they are unlikely to be able to access these formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. The deputy manager also explained that some of the peoples monies are managed by the home. Full records were seen to be kept outlining any The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 16 transactions and those records are monitored by members of the proprietors head office staff. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience good quality outcomes in this area. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment which encourages their independence. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is set in a rural area and is a property that has been converted to its present use in a sensitive and practical manner. There are now three communal areas which include the main lounge with a conservatory leading from it, the dining room and a recently developed smaller lounge to the rear of the building that can be used for quiet activities. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 18 Walking around the home it was seen that everywhere was clean with the grounds providing a similarly pleasant but secure area for the service users to be. All of the furnishings and fittings were seen to be of good quality and in good condition. The home has its main laundry area situated so that access is through areas that are not used for food preparation or consumption thereby reducing the risk of cross contamination. A number of the service users’ bedrooms that were seen and these were all pleasantly decorated and had been personalised to the liking of each of the occupants although some had been modified to account for the heavy use by some of the residents. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using the service experience good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: During this visit the staffing rotas were looked at. These showed that there are appropriate numbers of staff on duty for the numbers of people living in the home. Talking to the staff as well as looking at what happened on the day of the inspection confirmed this. Looking at the records as well as showed that the home has a safe and transparent recruitment procedure which includes all of the background checks that identify whether or not someone is suitable to work with vulnerable people. Various members of staff was able describe what training they had been offered and undertaken. This included induction as well as foundation training The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 20 and the mandatory safety training that is necessary for someone working in this type of establishment. All of the staff spoken to said that they have access to a good range of professional training that is chosen to meet the identified needs of the people who live in the home. This was confirmed by looking at the training records. By talking with the staff and looking at their records it was also possible to establish that over 50 of the staff team had achieved at least National Vocational Qualification level 2. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: At the time of the inspection the Registered Manager was not at the home but the deputy manager confirmed that she has gained the Registered Managers Award, which is an appropriate qualification for someone running a facility such as this, and that the manager is currently working towards achieving hers. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 22 The deputy manager had attended training in the mental capacity act and its implications for any steps taken which might restrict peoples liberty. Formal assessments of the current resident group have not yet been undertaken. Part of the support that manager should receive is the regular completion of the monthly visits by a provider that are required by law which look at a range of issues that may affect how the needs of the service users are met. Records showed and talking to the staff confirmed that such visits take place. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans, equipment and activities. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Accident records were looked at and these showed that such incidents were monitored by the senior management. Hazardous materials were seen to have been stored in a locked cupboard. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene and fire prevention. Staff spoken to confirmed that these records were accurate. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.2 Page 24 The New Barn DS0000065940.V377166.R01.S.doc 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. Refer to Standard Good Practice Recommendations The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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). 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. The New Barn DS0000065940.V377166.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!