Inspection on 06/01/09 for Barnby Court Care Home

This inspection was carried out on 6th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Barnby Court Care Home 08/01/07

Barnby Court Care Home 19/01/06

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 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barnby Court Care Home Barnby Moor Retford Nottingham DN22 8QS     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Barnby Court Care Home Barnby Moor Retford Nottingham DN22 8QS 01777705902 01777719678 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Healthcare Services Limited care home 25 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Additional conditions: 25 0 The maximum number of service users who can be accommodated is: 25 The registered provider may provide the following categories of service only:- Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Barnby Court is a period building that has been extended and adapted to accommodate 25 older people. People 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. The manager said during the visit that the fees range from £294 - £453. Care Homes for Older People Page 4 of 29 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. Care Homes for Older People Page 6 of 29 The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 8 of 29 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to moving into the home to ensure their needs can be met. Evidence: The care file for on recently admitted person was seen. The person was admitted in an emergency and the file contained completed assessment information. There were some sections that had not yet been completed, however as the person had only been in the home for four days this was still being completed. Other care files seen included assessments and the manager said she will go out to assess anyone who requests to come to the home and will often take another member of staff with her. It was stated on the Annual Quality Assurance Assessment that staff who went on the assessment had a greater involvement with the person from the onset. It was also Care Homes for Older People Page 11 of 29 Evidence: stated that information about the home is taken along for them to see. Staff said that new people are always assessed to see if their needs can be met and were aware of the circumstances and needs of the person recently admitted. People living in the home spoken with could not recall when they moved into the home so were unable to comment. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and social needs are being met, but not always in good time. Evidence: A sample of five care plans were seen. Some of these had been recently audited by the manager and had stickers on pointing out areas needing attention. Some of the instructions given could be clearer, and risk assessments and care plans for people at risk of falls need to show how the risk of falling can be reduced. Staff said they recognised that some parts of the care planning system could be improved. The manager said that a new system is being tried where a care plan is updated each day by the staff on duty. Each care plan has an evaluation sheet where any information concerning that plan is Care Homes for Older People Page 13 of 29 Evidence: recorded. There were annual reviews of care plans which included the person concerned where able, and sometimes a relative. There is a section in the care file to record any medical appointments, and these showed people make use of a range of services. Staff spoke of promoting peoples well being, but said at times they are in a rush to get things done and may overlook some things, for example making sure people have their glasses. One person was seen sat in the main lounge not wearing any glasses, yet his care plan referred to him needing to wear them. A group of people spoken with said they felt their healthcare needs were suitably seen to. One person fell as he was leaving the dining room after breakfast. Staff promptly went to him and checked whether he was hurt or not. When asked if he was hurt the person joked, Only my pride. Three staff then helped the person to his feet and assisted him to sit down in the lounge. Part of the morning and lunchtime medication rounds were observed. Staff followed the correct procedures in administering and recording medication. One person refused to take a tablet and staff tried to encourage him to take it, but were unsuccessful, so recorded it as refused on the Medicine Administration Record. Staff said this occasionally happened, but on checking the persons care file there was not a care plan for this. However a member of staff said they knew there was one, and one was found in papers waiting to be archived. This was returned to his care plan. The morning medication round did not commence until 9.30 am. Staff said they knew this was a little late, but they had to assist those people who needed assistance with eating before they could do so. Medicine Administration Records seen were fully completed and where they had been handwritten for new people coming into the home they had been signed and checked as being correct. A group of people spoke with said they are given their medication when they should have it. One member of staff is preparing to be the dignity champion and is undergoing training before taking up this role. There were a number of cartoons displayed highlighting how peoples dignity can be compromised. Care Homes for Older People Page 14 of 29 Evidence: During a period of observation it was noted that none of the male residents had shaved, and some people did not have shoes or slippers on, although they were wearing them later on that morning. Staff said this was because there is so much to do first thing in the morning. A group of people spoken with said they felt they were usually respected, but sometimes staff walk through the lounge without speaking to them. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a range of activities available to them. People are provided with a wholesome and varied menu. Evidence: There is an activities coordinator employed for two sessions a week and the manager said she now has a budget for another three sessions, and was in the process of recruiting someone for this. The manager said a record is meant to be made when people take part in activities, but these were not seen in care files. The manager said this may have become overlooked and she will see that this is done in future. Staff said that the activities coordinator offers such activities as nail care, arts and crafts and organises trips out. There were some excellent three dimensional pictures displayed around the home. The maintenance man was fitting a digital box onto the television to increase the number of channels available. There were not any organised activities seen during the Care Homes for Older People Page 16 of 29 Evidence: morning, but there were some ball games taking place in the afternoon. A group of people spoken with said they enjoyed using the garden in good weather and recalled having been out for a Christmas meal, and visiting a garden centre over the Christmas holidays. Care files referred to people having visits from families and friends and a visitor was seen arriving during the day. Staff said they try to provide people with choices and said they can put their views and ideas forward in residents meetings. Staff gave examples of how they spend their time, what they wear and what they have to eat. Staff were seen asking people whether they wanted sausage casserole or jacket potato for lunch. There is a four week menu which provides a choice at each meal. Then main meal is at lunchtime and dishes include belly pork, cowboy pie and bacon, egg, sausage and roast potatoes. A lighter meal is had at tea time and dishes include soup, salads, assorted sandwiches and tea cakes. A pudding is had at lunchtime and there are usually home made cakes at tea time. It was stated on the Annual Quality Assurance Assessment that snacks and drinks are available throughout the day. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place for people to raise any concerns and staff know how to safeguard people. Evidence: There is a book in the entrance hall for comments and complaints. This had some compliments about food, activities and the pictures promoting peoples dignity. Minor complaints were recorded about food and not liking the bedding colour in one room. These showed prompt action been taken to resolve them. There is a book to record any formal complaints in the office. There were four complaints made. One is currently under investigation, two others were about fees charged and the fourth referred to a medication error. The Nottingham and Nottinghamshire safeguarding adults procedures were in the staff room and there is a whistleblowing policy. Staff were aware of the processes to follow but unsure of some of the terminology. A group of people spoken with said they felt perfectly safe in the home. It was stated on the Annual Quality Assurance Assessment that there have not been any safeguarding adults investigations in the last 12 months. It is also stated that there is a no blame culture which is designed to help staff come forward. Care Homes for Older People Page 18 of 29 Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortably and well maintained environment. Evidence: Areas of the home visited were clean, tidy and in good repair. There were some displays, pictures and murals around the home designed to stimulate peoples minds and memories. A handyman is employed in the home, who is also responsible for maintaining the grounds. There is a stair lift on the front staircase to help people go up and downstairs, but the four bedrooms in the extension cannot be accessed from here, and there is not a separate stairlift. One person has recently had to move out of one these rooms as she cannot manage the stairs anymore. A ground floor bathroom has been converted into a wet room making it easier for people to bathe. There was a cleaner on duty and staff were using protective clothing. A group of people spoken with said that their rooms are kept clean and they are warm enough. Care Homes for Older People Page 20 of 29 Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current staffing arrangements do not allow for people to have all their needs met in a timely fashion. Evidence: There were three care staff on duty at the start of the inspection. In addition there was the manager, cook, domestic and handyperson. The manager showed the staffing formula used by the provider for allocating the number of staff. This allows for three care staff in the morning and at night, with four in the afternoon. There have been some areas highlighted in this report where people could have received support in better time. Staff said they felt this would not have occurred if they had an additional member of staff on duty. A group of people spoken with said that staff dont have time to come and sit and talk with them. The manager said that three staff have completed National Vocational Qualification level 2 and a further five staff are planned to take this qualification. Care Homes for Older People Page 22 of 29 Evidence: Certificates for National Vocational Qualifications were seen in staff training records and a member of staff said she had completed level 2 and is now working towards level 3. A sample of three staff files were seen and these contained the correct recruitment checks and information, however one recently started member of staff was still waiting for her Criminal Records Bureau check to be returned, and was working in the home on the Protection of Vulnerable Adults check. This allows someone to work in the home as long as they are under direct supervision of another member of staff at all times. The person concerned was on duty and was seen in areas of the home with people without being under supervision. Staff training records showed that people receive regular training and updates are provided when they are required. Staff said they get onto courses and their training is kept up to date. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The manager has worked at the home for a number of years an d has been the registered manager since 2004. The manager has completed National Vocational Qualification level 4 and the Registered Managers Award. The manager showed the results of survey forms complete in October 2008. These showed a high level of satisfaction with services provided. Staff said they distribute survey forms on a regular basis for people to complete. There is a system for people to have assistance in managing their personal allowances. This is a computer based system and print outs can be provided upon request. The Care Homes for Older People Page 24 of 29 Evidence: system is regularly audited and this was last done in May 2008. A sample of entries were seen showing the records are kept up to date. It was stated on the Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other regulatory body. The fire safety records were seen and these showed the required tests are carried out at the correct frequency. Care Homes for Older People Page 25 of 29 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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, Care Homes 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 15 Care plans and risk assessments must clearly state how any assistance is to be provided and risks reduced. This will ensure people receive the care they require in a safe manner. 01/03/2009 2 8 13 Staff must ensure that peoples routine health needs are seen to in good time. This will ensure that peoples well being is promoted. 01/03/2009 3 12 16 Ensure a record is made of all social activities people take part in. This will ensure that everyone has the opportunity to take part in activities they wish to. 01/02/2009 4 27 18 Review the allocation of staff 01/03/2009 To ensure people have their needs met in good time. Care Homes for Older People Page 27 of 29 5 29 19 Staff who are working with a 01/02/2009 Protection of Vulnerable Adults check but have not got a completed Criminal Records Bureau check must only work under direct supervision. his will ensure people are not places at risk of abuse. 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 18 19 Staff should know the terminology used in order to ensure people are safeguarded. Consideration should be given to helping people be able to access the four bedrooms to the rear of the home. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!