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Inspection on 24/03/10 for Barons Park Nursing Home

Also see our care home review for Barons Park Nursing Home for more information

This is the latest available inspection report for this service, carried out on 24th March 2010.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All areas of the home inspected were clean, fresh, tidy, and warm. Staffing levels were good and the staff we met were helpful and professional. They were knowledgeable about the residents they cared for, understood their needs, and knew where to find relevant information in care plans. Residents were well turned out and their personal care needs had been met. We talked to two residents and asked them what they thought of Barons Park. Their comments included, `It`s very nice here and the food is wonderful`, `Everything is excellent`, and `The food is absolutely marvellous. I never send anything back to the kitchen.` Breakfast was being served during the inspection. Residents were offered a range of menu items and staff helped them choose what they would like. Some residents needed assistance to eat and staff provided this discreetly, allowing them time to enjoy their meals. The atmosphere was sociable and relaxed. Fluids were provided and residents were encouraged to drink them. We looked at staff inductions, as concerns had been raised about whether they were used or not. The home has two induction programmes, one for permanent staff and one for agency staff. Both provide the essential information staff need when they begin working in the home (although the former is more detailed). The General Manager told us that on rare occasions (for example when there was a staffing crisis due to sickness) there had not been time to induct agency staff, and they`d had to start work immediately on arrival at the heme. The General Manager told us that when this happened agency staff worked under supervision at all times, and, if they returned to work at the home again, did their induction as the first possible opportunity. This is acceptable under the circumstances. Concerns had also been raised about the high percentage of agency staff on duty at the home. Records showed that the majority of staff employed at Barons Park were permanent, and that agency staff were mainly used to cover periods of sickness/annual leave. We saw there had been a particular problem in February 2010 when many of the permanent staff had been affected by a `sickness bug`. This led to disproportionate numbers of agency staff being employed on some shifts. However this was not the usual practice in the home.We asked residents what they thought of the staff employed at the home. Those we talked to praised them. Comments included, `The staff are very good, all of them`, and `The nurses are excellent.` One resident told us that he liked the way staff cared for confused residents. `They (the residents) can`t speak out, but I can, and I would if they (the staff) were every rough with a resident, but this never happens.` Staff files were inspected. Records showed that staff were properly inducted, trained, and supervised. Any performance issues that arose were promptly addressed in writing and followed up. Staff were trained in moving and handling, and in treating residents with respect and promoting their dignity. During this inspection concerns about medication, infection control, pressure sores, and palliative care were predominately addressed by Health and Social Services staff, and the findings shared with CQC. No serious anomalies were found in these areas.

What the care home could do better:

When we arrived at the home (at 5.30 am) six residents were either up, or in the process of getting up. We discussed this with staff and looked at care plans. We saw there was an explanation for each of these residents being up so early, and none had been got up against their will. However none of the care plans we looked at had clear instructions for staff as to what time each resident wanted to get up. In addition, one carer in the `over 70s` unit told us, `We start getting them (the residents) up at six.` This implied there was a routine for getting residents up which did not necessarily meet their individual needs, however we could not check this as the information was not available in care plans. To ensure residents get up (and go to bed) when they want to it must be clear in their care plans what their preferences are, or what is in their best interests. For example, some residents may be naturally early or late risers, or like to be woken up at a set time. Care plans must reflect this so staff know when to get each resident up. (The same applies to bedtimes.) This will help to ensure there are no institutional routines in the home and residents are treated as individuals. Records showed that some staff worked at Barons Park as well as at other establishments. This resulted, on occasions, in them working long hours. This situation should be monitored to ensure that staff are never too tired to carry out their duties effectively. We discussed Regulation 37s (records of significant incidents in the home) with the General Manager. These have been promptly reported to CQC, as required. The General Manager told us that Regulation 37 records are kept in individual resident`s case files. It is recommended that a separate file of Regulation 37s is kept, as this will make it easier for them to be audited and for trends to be detected, if and when they occur.

Random inspection report Care homes for older people Name: Address: Barons Park Nursing Home Desford Lane Kirby Muxloe Leicester Leicestershire LE9 2BE two star good service 17/02/2009 The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Kim Cowley Date: 2 4 0 3 2 0 1 0 Information about the care home Name of care home: Address: Barons Park Nursing Home Desford Lane Kirby Muxloe Leicester Leicestershire LE9 2BE 01162387337 01162387976 info@baronspark.co.uk http/www.baronspark.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Thevamanohary Stanley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barons Park Nursing Home Limited care home 44 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 44 44 The maximum number of people to be accommodated is 44. To accommodate service users over 18 years with a primary diagnosis on admission of Dementia - Code DE or Mental Disorder - Code MD Service users aged 18-65 to be accommodated in The Lakes wing. Date of last inspection 1 7 0 2 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home Barons Park is a nursing home registered for people with mental health and dementia care needs. The home is situated in a rural area with views of open countryside. It is staffed by registered nurses and care staff. Accommodation is on two floors, with a passenger lift. Bedrooms are large and there is a range of communal areas. The home is surrounded by mature gardens with seating areas, and has a good-sized car park Further information about the home, including the fees, is available from the Registered Manager. Care Homes for Older People Page 3 of 8 What we found: The reason for this inspection was to ensure that residents were being properly cared for following concerns being raised about the home. The visit took place in conjunction with staff from Health, Social Services, and the Police. When we arrived at 5.30 am we were met by the person in charge, a senior carer. She took us on a brief tour of the premises, introduced us to several residents and staff, and made care plans available for us to view. Later we met with the General Manager who showed us the further documentation we requested. What the care home does well: All areas of the home inspected were clean, fresh, tidy, and warm. Staffing levels were good and the staff we met were helpful and professional. They were knowledgeable about the residents they cared for, understood their needs, and knew where to find relevant information in care plans. Residents were well turned out and their personal care needs had been met. We talked to two residents and asked them what they thought of Barons Park. Their comments included, Its very nice here and the food is wonderful, Everything is excellent, and The food is absolutely marvellous. I never send anything back to the kitchen. Breakfast was being served during the inspection. Residents were offered a range of menu items and staff helped them choose what they would like. Some residents needed assistance to eat and staff provided this discreetly, allowing them time to enjoy their meals. The atmosphere was sociable and relaxed. Fluids were provided and residents were encouraged to drink them. We looked at staff inductions, as concerns had been raised about whether they were used or not. The home has two induction programmes, one for permanent staff and one for agency staff. Both provide the essential information staff need when they begin working in the home (although the former is more detailed). The General Manager told us that on rare occasions (for example when there was a staffing crisis due to sickness) there had not been time to induct agency staff, and theyd had to start work immediately on arrival at the heme. The General Manager told us that when this happened agency staff worked under supervision at all times, and, if they returned to work at the home again, did their induction as the first possible opportunity. This is acceptable under the circumstances. Concerns had also been raised about the high percentage of agency staff on duty at the home. Records showed that the majority of staff employed at Barons Park were permanent, and that agency staff were mainly used to cover periods of sickness/annual leave. We saw there had been a particular problem in February 2010 when many of the permanent staff had been affected by a sickness bug. This led to disproportionate numbers of agency staff being employed on some shifts. However this was not the usual practice in the home. Care Homes for Older People Page 4 of 8 We asked residents what they thought of the staff employed at the home. Those we talked to praised them. Comments included, The staff are very good, all of them, and The nurses are excellent. One resident told us that he liked the way staff cared for confused residents. They (the residents) cant speak out, but I can, and I would if they (the staff) were every rough with a resident, but this never happens. Staff files were inspected. Records showed that staff were properly inducted, trained, and supervised. Any performance issues that arose were promptly addressed in writing and followed up. Staff were trained in moving and handling, and in treating residents with respect and promoting their dignity. During this inspection concerns about medication, infection control, pressure sores, and palliative care were predominately addressed by Health and Social Services staff, and the findings shared with CQC. No serious anomalies were found in these areas. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 12 Care plans must show 24/05/2010 residents preferences regarding getting up and going to bed times. This will help ensure that the care provided is individual to each resident. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 28 38 Staff who work long hours should be monitored to ensure they are able to carry out their duties effectively. A separate file of Regulation 37 incidents should be kept as this will make it easier for trends to be detected, if and when they occur. Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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