Inspection on 19/01/06 for Barnby Court Care Home

This inspection was carried out on 19th January 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

Barnby Court Care Home 06/01/09

Barnby Court Care Home 08/01/07

Barnby Court Care Home 23/09/05

Barnby Court Care Home 16/03/05

Barnby Court Care Home 02/12/03

Barnby Court Care Home 08/07/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Barnby Court Care Home Barnby Moor Retford Nottingham DN22 8QS Lead Inspector Steve Keeling Unannounced Inspection 19th January 2006 09:00 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 Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 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. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barnby Court Care Home Address Barnby Moor Retford Nottingham DN22 8QS 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) 01777 705902 01777 719678 Southern Cross Healthcare Services Limited Margaret Greaves Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 1 named service user may be admitted in category DE/E Old Age not falling within any other category (OP) Maximum number registered 25 Date of last inspection 23rd September 2005 Brief Description of the Service: Barnby Court is a period building that has been extended and adapted to accommodate 25 older people. Service Users have access to well maintained landscaped gardens and there are adequate parking facilities. The home is situated in the village of Barnby Moor. Located in a rural area the village has a public house and hotel. The home has access to a minibus and hired transport when necessary to access a wider range of amenities and promote social interactions beyond the immediate environment of the home. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 4 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting service users within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the service users identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. Also as part of the case tracking process, staff members and service users within the home are informally interviewed to further evidence the quality of care afforded to the service users. At the time of the inspection a total of 19 residents were accommodated at the home. The manager of the home was on annual leave at the time of the inspections thus the administration officer helped facilitate the inspection process. It was evident that the administration officer and care staff within the home are very committed to providing a high standard of care for the service users. All staff within the unit was very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. What the service does well: The inspection process allowed for the partial examination of the home. It was evident that the internal environment of thehome is well maintained and safe. Service users are encouraged to personalise their rooms with pictures ornaments and small items of furniture and all rooms inspected were clean odour free and pleasantly decorated. The staff at the home maintains a safe environment, internally the floors are free of tripping hazards, potentially dangerous substances are stored in locked cupboards to prevent ingestion by service users. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 6 Service users spoken with described the staff as helpful and friendly and the inspector observed several interactions between staff and residents, it was evident that good relationships are promoted on mutual respect and dignity. What has improved since the last inspection? What they could do better: The gardens, although well maintained and accessible to residents had uneven surfaces and trip hazards present which presents a potential risk to service users when they utilise the areas in the summer months. Service users spoken with stated that they enjoyed their meals but it was evident that only a limited choice of main courses was available on the day of the inspection and it was established that the limited menu is normal practice within the home. All service users documentation contained pre-admittance assessments but it was evident what care plans had not been formulated to meet the identified needs of the case tracked service users. The evaluation of care plans were somewhat unspecific in nature and did not always address all elements identified within the care plans. An Activities Coordinator is employed for five hours on Mondays and five hours on Thursdays, it was evidenced that service users, on occasion, feel bored due to the lack of stimulating activities provided within the home. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 7 Training opportunities provided to care staff at the home could not be fully evidenced and as such it was not fully established if care staff were appropriately trained to form health-promoting interventions effectively. 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. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 8 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 Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 9 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): 3. 6. All service users are admitted to Barnby Court only after having a thorough needs assessment and assured that their identified needs can be met at the home. Barnby Court does not provide intermediate care services. EVIDENCE: The pre-admittance assessments within the two case tracked notes were detailed in identifying the specific needs of the service users to maintain optimum independence within the home. The pre-admittance assessment documentation for both case tracked service users was provided by the social services team, the documentation was clear, concise, signed and dated by the assessor. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 10 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. 9. 10. The case tracking procedure established that the care plans examined did not fully address the health needs identified in the pre-admittance assessments and as such it could not be established that health needs were being fully met at the home. No service users within the home are responsible for the administration of their own medication at the time of the inspection, although facilities for selfadministration of medicines are available should it be required. Service users spoken with stated that staff at the home maintains respect and dignity at all times. EVIDENCE: A comprehensive documentation format has been supplied by Southern Cross, which gives the opportunity to perform a comprehensive insight into the holistic needs of the service users. Unfortunately elements of the documentation had not been filled out effectively which compromised the evaluation process. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 11 One case tracked service user had no entries within the brief medical history section, together with the medication of arrival section and the record of the service users belongings section. One case tracked service user had been assessed as “at risk of falls” but no care plan was evident to effectively address/manage this potential risk. A service user who was at risk of pressure ulceration formation and was admitted with “small sores” on the buttocks did not have a care formulated to address this potential complication even though her daily information records stated that she had recently developed sore areas to her groin. The home maintains daily progress documentation for all service users in which elements of care identified in care plans should be evaluated effectively. It was evident that the evaluation process was not effective. The daily evaluation of the care afforded to both case tracked service users was recorded as “intervention on issue 3, 4, 5” which is not an effective evaluation of the care plans. At the time of the inspection no service users were responsible for the selfadministration of medicines. It was established that should a service user wish to be independent in the administration of medicines the manager in conjunction with members of the multidisciplinary team would perform a risk assessment, if the service user was deemed as being safe, the service user would be supported to be independent with self medicate. It was evident that service users are afforded appropriate privacy, dignity and respect within the home environment. Service users spoken with were very complimentary about the way staff spoke to them. It was evident that staff always knocked on the resident’s bedroom door before entering. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 12 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, 15 Barnby Court employs an Activities Coordinator for 10 hours per week over two days, which is insufficient to provide a stimulating home environment for the service users. Barnby Court operates an open door policy and relatives and friends are encouraged to visit service users as they wish. The home does not formally offer the service users an alternative of meals at lunch time and as such the service users ability to choose from a varied menu is being compromised. The dining area at the home would benefit from new flooring, as the present carpeted area is stained and shoddy. EVIDENCE: An Activities Coordinator is employed for 5 hours on Mondays and five hours on Thursdays only, it was evidenced that service users, on occasions, feel bored due to the lack of stimulating activities within the home. One service user spoken with stated that the days could seem very long due to the inactivity in the home, the service user believed that increasing the social activities provided at the home would benefit all the service users. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 13 Service users spoken with stated that they enjoyed their meals but it was evident that only a limited choice of main courses was available on the day of the inspection. It was established that the limited menu is normal practice as confirmation was established from other service users and staff alike. To aid the process of choice for the service users a menu should be displayed at a prominent position within the home to allow for service users perusal, this function was not being performed on the day of the inspection, resulting in the service users ability to choose from a varied menu to be compromised. The inspection process identified that the carpet in the dining area is stained and shoddy although it was established that the carpet had been cleaned only days before the inspection, as such it would be advisable to replace the carpet with an alternative flooring to ensure the area is aesthetically pleasing for the service users. It was established that no restrictions are in place in relation to visiting times. The relative of a service user was spoken with and it was confirmed that the home operates an open policy in relation to visiting times. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 14 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. Barnby Court utilises an effective complaints procedure that is displayed and promoted appropriately. Staff interviewed at the time of the inspection were not fully conversant with actions and procedures to be taken if they suspected that a service users was being abused EVIDENCE: The manager of the home utilises the complaints procedure supplied by Southern Cross Health Care Services and ensures that the complaints procedure is on display at the entrance hall to the home. A copy is also supplied at the time of admission so as to allow service users and their family and friends the confidence to report any concerns appertaining to the care afforded to the service users at the home. All service users spoken with were confident that the manager and the care staff would always address any complaints in a sensitive and professional manner and the service users would not hesitate to discuss any concerns in relation to the care afforded to them within the home environment. It was established that the manager of the home was not investigating any complaints and the Commission for Social Care Inspection has not received any complaints. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 15 The manager also utilises a quality audit tool in the form of a “comments slip” to further promote the services at the home. Service users and relatives can fill out the comments slip and forward them to the manager of the home so she can address any concerns that the questionnaires might highlight. Service users within the home all stated that they felt safe and protected. The inspection process identified that some staff were not conversant with the homes policies and procedures in relation to the protection of vulnerable adults and were not particularly confident in the identification of what actions would be required it they suspected abuse was happening within the home setting. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 16 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. Internally Barnby Court provides a safe well-maintained environment for service users. The home is in excellent decorative condition, very clean and smelt fresh. It was evident that the garden area has some uneven services which is a potential falls risk to service users. EVIDENCE: A partial internal inspections of the home evidenced that Barnby Court benefits from an exceptionally clean and well-decorated environment for service users enjoyment. The gardens, although appropriately maintained and accessible to residents, had several surfaces which are uneven thus constituting a trip hazard and falls risk to service users when they utilise the areas in the summer months. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 17 A maintenance technician is employed for 30 hour per week. The role of the technician is to perform routine maintenance within the home environment together with comprehensive safety checks. It was evidenced that the technician performed appropriate hot water outlet checks, staff call system checks, automatic door releases checks, emergency lighting and fire drills, bed rails checks, window restrictor checks and visual checks on the home environment both internally and externally which include fire exits. The technician also performs appropriate procedures in an attempt to control Legionella contamination at the home with the support of external contractors. The Southern Cross facilities manager performs Portable Appliance Tests (PAT) an electrical equipment in the home to ensure the equipment is safe. It was also evidenced that outside contractors perform appropriate maintenance on all equipment designed of aid mobility such as hoists and specialist baths. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 18 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): 28. 30. Staff training opportunities could not be fully evidenced in relation to adult protection protocols and as such the safety of the service users could be compromised. EVIDENCE: An examination of the staff training documentation could not fully evidence the training opportunities for care staff employed at the home regarding the protection of the vulnerable adult. It was established that a new “training matrix” was being formulated at the home and the homes administration officer was in the process of correlating and recording all training opportunities provided to staff at the home in the year 2005. The Commission for Social Care Inspection will require a copy of the training matrix so that appropriate training opportunities can be evidenced, the commission will also require evidence of training events planned for 2006. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 19 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. 33. The manager of the home was on annual leave at the time of the inspection and as such this standard could not be evaluated on this occasion. The manager of the home utilises effective consultation processes to ensure that the home is run in the best interests of the service users. EVIDENCE: In attempting to run the home in the best interests of the service users the manager has initiated service user and relatives meetings, which are performed on a three monthly basis within the home. This consultation forum identifies any issues of concerns relating to the care and facilities provided to service users so that any concerns can be openly discussed. The manager also ensures that time is made available to promote the consultation process with service users and their relatives in the form of a “open surgery” which is performed on a weekly basis on Thursdays mornings. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 20 The manager of the unit also utilises “service users comment slips” to gain an insight into the service users needs, concerns and aspirations within the home. Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X X Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 22 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. 1 Standard 7 Regulation 15 (1) Requirement Timescale for action 28/02/06 2 12 16(2) (m) 3 15 16 (2) (i) 4 18 13 (6) The registered person shall ensure after consultation with the service user, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met The registered person shall 28/02/06 consult service users about their social interests, and make arrangements to enable them to engage in local social and community activities and to visit or maintain contact or communicate with their family and friends. 28/02/06 The registered person shall provide in adequate quantities, suitable wholesome and nutritious food which is varied and properly prepared and be available at such time as may be reasonable required by the service users. The registered person shall make 28/02/06 arrangements by training staff or by other measures to prevent service users being harmed of DS0000008626.V275163.R01.S.doc Version 5.1 Barnby Court Care Home Page 23 5 19 23 (2) 6 28 30 18 (1) (i) suffering abuse. The registered person shall ensure that the premises to be used as a care home are of sound construction and kept in a good state of repair externally and internally. The registered person shall ensure that staff receive training appropriate to the work they are to perform. 28/02/06 28/02/06 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 Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Barnby Court Care Home DS0000008626.V275163.R01.S.doc Version 5.1 Page 25 - 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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