Inspection on 07/11/06 for Balgowan Nursing Home

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Balgowan Nursing Home 06/11/08

Balgowan Nursing Home 18/10/05

Balgowan Nursing Home 12/07/05

Balgowan Nursing Home 19/01/05

Balgowan Nursing Home 05/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Balgowan Nursing Home 46 Bartholomew Lane Hythe Kent CT21 4BX Lead Inspector Lisbeth Scoones Unannounced Inspection 7th November 2006 09:30 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 Balgowan Nursing Home DS0000026077.V303600.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. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Balgowan Nursing Home Address 46 Bartholomew Lane Hythe Kent CT21 4BX 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) 01303 266782 01303 230329 Premium Healthcare Limited Ms Penelope Jane Selby Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users with a physical disability are restricted to one (1) whose DOB`s are 21/07/1951. Service users receiving palliative care number no more than three (3). Service users under the age of 65 to be restricted to one (1) whose DOB is 28/01/1944. 18th October 2005 Date of last inspection Brief Description of the Service: Balgowan Nursing Home is owned by Premium Healthcare Ltd, which also owns Hythe Nursing Home. It provides nursing care for 33 Older People and also cares for one resident with a physical disability who is under 65. There are 25 single and 4 shared rooms. Four of the single rooms have en-suite facilities. The home is a large detached two-storey house with accommodation on two floors. It is situated in an elevated position in Hythe. There are car-parking facilities in front of the home as well as off street parking. The home and garden are well maintained. The registered manager is Mrs Penny Selby. Mr Tony Barnes is the responsible person in partnership with Mr Phil Barker. The home’s email address is: premiumhythe@btconnect.com. The inspection report is freely available. Current weekly fees are in the range of £600 to £700. Additional charges are made for hairdressing, chiropody, dentist, newspapers and toiletries. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 7 hours and comprised discussions with the directors, manager, deputy manager, other staff, 11 residents and a visiting relative. The inspection included a tour of the premises and the examination of care and other records. The inspection was further informed by a pre-inspection questionnaire completed by the provider and a number of comment cards received from residents, their relatives and visiting health professionals. Contact was made with a number of care managers to ascertain their view on the service provided. Comments received were favourable. What the service does well: What has improved since the last inspection? The home now obtains written confirmation evidencing that residents occupying a shared room have chosen/agreed to do so. A new care-planning format had been introduced and wound care documentation improved. The documentation provides staff with up to date information to care for the residents. New moving and handling equipment has been purchased. The entrance hall has been decorated and provides a welcoming environment. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 6 A comprehensive training programme is in place and individual staff profiles maintained. Staff receive regular supervision. 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. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 7 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 Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. Residents are provided with the home’s Statement of Purpose and Service User Guide, which provide them with the information they need to make an informed choice of the services provided. No resident is admitted to the home without a comprehensive preadmission assessment thus ensuring that his or her needs would be met. EVIDENCE: The directors said that residents have access to the Service User Guide and recent inspection report. Few residents expressed a wish to have an individual copy of the guide but these are freely available. From documentation seen, it is evident that all residents have a pre-admission assessment carried out to ensure that their needs would be met. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. The care planning system provides staff with the information they need to care for the residents but would benefit from additional detail in respect of continence management and oral hygiene. Residents are protected by the home’s policies and procedures for dealing with medicines. Residents are treated with dignity and respect. EVIDENCE: Since the previous inspection, a new care-planning format has been introduced. The manager said she likes the clarity and layout of the new system. Wherever possible, residents and/or their relatives are encouraged to be involved with planning and review of care. A sample of care plans was examined for case tracking purposes. Whilst this contained comprehensive information and was informed by risk assessments, the recording of continence Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 10 management, personal care in respect of oral hygiene and action taken when weight loss has been identified needs further enhancement. Wound care documentation is more comprehensive and evidenced regular evaluations. A “key worker” and “Named Nurse” system is in place There was evidence of multi- disciplinary input from specialist nurses, continence advisors and other professionals both for advice and training. Appropriate referrals to other specialist are made when residents’ needs change. The manager said she had recently been introduced to a new nutrition risk assessment and was in the process of accessing training. GP visits and those of other professionals are well recorded. Residents are assessed for the purpose of risks of developing pressure ulcers and a range of pressure-relieving equipment is available to treat or prevent these. New moving and handling equipment has recently been purchased. Medication records were well maintained. In respect of “as required” medication, it was recommended that the criteria for administration be recorded. Residents said that staff treat them with courtesy and respect. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. Residents are provided with social activities in accordance with their wishes and preferences. Residents maintain contact with their families and friends as they wish. Residents are encouraged and enabled to have choices and control over their lives. A choice of wholesome varied meals is provided. EVIDENCE: Since the previous inspection, an activities co-ordinator is employed for 5 afternoons a week. Communal and individual activities are provided and recorded in residents’ care plan. The inspector met with the activities coordinator who, at that time, was reading a book to a resident. The resident said he enjoyed her visits. Activities organised would include handicrafts, stories, pictures, games, exercises, trips out to the pub, walks out with the staff or visitors and local church services. Visits from a vicar and priest are arranged. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 12 The inspector met with a visiting relative who said that she is kept informed of her relative’s condition. The manager said that relatives are encouraged to visit and be involved with residents’ care. Residents are provided with choices in respect of mealtimes, menus and times of getting up and retire. The inspector met with the chef who, as before, demonstrated a real commitment to provide the type of meals the residents prefers. Many residents need a soft diet, which are appetisingly presented. Staff undertake nutritional assessments and weigh the residents regularly to ensure an adequate weight. The environmental health officer visited the home in February and March 2006 and no requirements or recommendations were made. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. Residents know that their concerns and complaints will be listened to, taken seriously and acted upon. Residents are protected for abuse. EVIDENCE: It was evident from talking to residents, staff and the manager that all complaints are taken seriously and that opportunities are provided to discuss these. Complaints are well recorded and demonstrated the action taken to address the issues complained about. Staff spoke to confirmed that they are trained in adult protection issues. The training matrix identifies training sessions planned and undertaken. The adult protection policy and procedures were reviewed in March 2006. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. The home provides a well-maintained and clean environment for its residents. EVIDENCE: The home looked clean, well maintained and decorated and provides a pleasant environment for its residents. The entrance hall has recently been decorated and rooms are repainted on a rolling programme. The home has 25 single (4 of which have an en-suite) and 4 shared rooms. A handyman is employed who ensures that all fire safety and health and safety checks are carried out in a timely manner. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. Skilled staff are provided in sufficient numbers to meet the needs of the residents. The home operates according to sound recruitment procedures. Staff are trained and competent to do their jobs. EVIDENCE: Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 16 The home provides a stable workforce with little staff turnover. The inspector spoke with one of the two deputy managers and another trained nurse. On the day of the inspection and most days, in addition to the manager, there were 2 trained staff and 6 care workers. The home is accredited to provide placements for 1st year student nurses and is a registered training centre for staff undergoing adaptation. One of the deputy managers is a trained mentor. A sample of staff files was examined and this evidenced that the home operates according to sound recruitment procedures. These include two references and enhanced CRB and POVA checks. Staff spoken to said that they welcome any training provided. NVQ training is encouraged. Since the previous inspection, the manager has reviewed the training and developed a training programme for her staff. Individual staff training records are maintained. New staff are provided with a Skills for Care induction programme. In addition to the statutory training staff have been given opportunities to attend study days on continence management, muscular dystrophy, Parkinson’s disease, Diabetes, Nutrition and adult protection. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 The quality in this outcome group is good. This judgement is based on information available at the time, which includes a visit to the service. The home is managed by an experienced manager who discharges her responsibilities effectively thus ensuring that residents benefit from the home’s ethos and leadership approach. The home regularly reviews its performance through effective quality assurance systems, which include the views of the residents, staff and relatives. Residents’ financial interests are safeguarded. Staff are appropriately supervised. The home ensures that the health, safety and welfare of residents and staff are protected. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 18 EVIDENCE: The directors, staff and residents praised the manager’s skills and clear sense of direction. There is a clear managerial structure and various tasks have been delegated to senior staff. Staff are aware of their roles and responsibilities. Residents said that the home is well managed and that the manager and staff speak to them daily. In addition to comprehensive handovers, staff meetings are held regularly. The directors visit the home daily and produce a formal monthly report. The report includes the residents’ views on the service provided. All policies and procedures were reviewed in April 2006, as was the annual development plan. Currently the home does not deal with the management of any residents’ personal allowances. Since the previous inspection, formal staff supervision has been introduced and carried out by the manager and her deputies. Staff receive statutory training in respect of health and safety, fire safety awareness, first aid, food hygiene and infection control. The home has its own moving and handling trainer and in-house as well as external training is provided. The directors are aware of recent changes in the Fire Safety Regulations and have carried out a fire safety risk assessment. Accident records are well recorded and graphs used as a monitoring tool. As a result, risk assessments would be reviewed. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 19 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 x 3 3 x 3 Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 20 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 OP7 Good Practice Recommendations That care plans record in more detail how continence management, nutritional risk and oral hygiene is addressed. Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 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 Balgowan Nursing Home DS0000026077.V303600.R01.S.doc Version 5.2 Page 22 - 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. 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