Inspection on 10/05/05 for Barnes Court Nursing Home

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barnes Court Nursing Home 09/07/09

Barnes Court Nursing Home 17/03/09

Barnes Court Nursing Home 17/03/09

Barnes Court Nursing Home 18/07/07

Barnes Court Nursing Home 13/07/06

Barnes Court Nursing Home 28/09/05

Barnes Court Nursing Home 16/09/04

Barnes Court Nursing Home 07/05/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Barnes Court Wycliffe Road High Barnes Sunderland SR4 7QG Lead Inspector Tom Moody UnAnnounced 10 May 2005 10:00am 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 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 and Care Homes for Adults 18 – 65*. 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. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barnes Court Nursing Home Address Wycliffe Road High Barnes Sunderland SR4 7QG 0191 520 2000 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 520 2622 Ashborurne Homes Limited Care Home with Nursing 89 Category(ies) of OP Old Age (41) registration, with number DE(E) - Dementia over 65 (20) of places MD(E) Mental Disorder - over 65 (20) PD Physical Disability (15) Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 September 2004 Brief Description of the Service: Barnes Court Nursing Home is a 89 place facility, which consists of three floors. The top floor provides nursing care for older people. The middle floor provides nursing care for people with mental health needs. The ground floor has a 15 place nursing unit for people with a physical disability.Barnes Court opened in 1991 however the function of the home has changed over time resulting in a different client group being cared for in some of the units than when the home first opened. The owners are aware that work still need to be completed to make some areas fully accessible to those people who have a physical disability. The home is near Barnes park and five minutes from Sunderland Royal Hospital. The home has been built in a residential area and is opposite to a local school. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by two inspectors on the 10 March 2005. Care practice was observed and service users and relatives were spoken to. Discussion with staff members also took place. The home has three floors with three different client groups housed on each. The philosophy and care practice differs on each floor. All of the floors were inspected and inspectors took a meal with service users on the first and second floors. Inspectors found better care practiced on the ground and second floors. Feed back was given to the manager at the end of the inspection, including any matters that inspectors felt required urgent attention. What the service does well: What has improved since the last inspection? The home manager has gained greater experience in dealing with adult protection issues. The home is cleaner and tidier than during the last inspection. Some aspects of décor have improved, such as the carpeting in the downstairs games room. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 6 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. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5, Although some assessments matched the needs of service users, not all of the assessments would ensure their needs were met. Relatives and some service users confirmed they were able to visit the home and look at the accommodation and exercise some choice over their placement. EVIDENCE: The lower floor is registered to provide places for people with a physical disability. Relatives of service users with physical disability, who live on the lower floor, confirmed that they had been able to visit the home before their relative was placed there. Some service users also confirmed that they had been able to do this. Service user’s relatives also stated that there were few homes that could provide places that would meet the needs of their relatives. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 9 This would indicate that choice may be limited by the scarcity of this type of care home. Some care plans contained good assessments and details of clinical information. There were some exceptions to this. The assessments in some care plans were undated and it was not clear if they were still relevant. Some assessments of service users needs were not matched to the care provided to them. For example some service user’s assessment indicated they needed writing material to communicate but this was not present. Some assessments contained conflicting information, such as service users being “chair-fast”, yet having “no limit on mobility.” Inappropriate terms were used in some of the assessment of service users. The use of terms such as “awkward” and “childlike” are not acceptable and could lead to the negative “labelling” of service users. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. Some aspects of service users care plans are too vague to guide staff in providing care that will meet the service user’s needs. Much of the care practice in the home was good but not all of the planned care is being carried out by care staff. Drug storage and administrations systems are satisfactory although some of clinical areas are cramped. Although many aspects of care practice were satisfactory windows in bedroom doors did little to enhance dignity and privacy. The way some service user’s are addressed may be problematic if it diminishes their dignity. EVIDENCE: Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 11 Service user’s care plans contain much useful clinical information. Some of the life histories were well recorded and detailed. Some recording was rather vague. One service user’s care plan recorded their “inappropriate behaviour of a sexual nature.” This phrase was unhelpful and did not guide staff as to what this behaviour was, who it was directed towards and how it was to be managed. Services users have access to their own GP and they receive appropriate healthcare services. They have access to specialist healthcare services at the home and outside of the home as well. Records showed that service users have seen Continence Nurses, Tissue Viability Nurses, Speech and Language Therapists, and Infection Control Nurses. As noted in the previous section not all assessments are linked to service users needs. It was apparent that one service user’s challenging behaviour was not being managed appropriately and in accordance with his care plan. Some elderly service users had not had their toe nails cut or hearing problems addressed. Some challenging behaviour was not being managed according to the service user’s care plan. The kitchen staff were aware of elderly service user’s nutritional and dietary needs and the cook makes her own high calorie / high protein drink to supplement elderly service users diet. This awareness did not extend to all staff and it was observed that, on the 1st floor, some service users meals went uneaten and no attempt was made to encourage their consumption. It was evident from some care plans that service users had been involved in the care planning process and their needs and wishes were being taken into account. Medication systems were appropriate and self-medication can be accommodated if service users are able and willing to do this. Medication storage was generally adequate although the clinical room on the ground floor is very cramped and staff have difficulty in moving around in this area. Although drugs are kept in appropriate cupboards the practice of retaining and storing used trans-dermal patches, in the controlled drugs cupboard, seemed a not altogether hygienic practice. When staff were asked about the logic of this they stated that it was “company policy.” Records are well kept and stock balances of controlled drugs are recorded accurately. Service users and relatives generally commented positively upon staff attitude toward them and used phrases such as “the girls are lovely.” One service user did comment that although most of the staff were alright they had been “bawled out” by a member of staff, although they had made no complaint about this when it happened. Staff were observed to respect service user’s privacy and they knocked at bedroom doors before entering. A few bedroom doors still have windows in them and some service user’s are observable through these. It is not clear how this is compatible with the principle of privacy for these service users. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Service users are able to engage in organised activities and there are opportunities for them to pursue individual interests and leisure activities. Visiting is unrestricted and service users go on excursions which enables then to keep contacts with the family and the wider community. Although the homes policy is to allow service users choice and control over their lives there are some restrictions on service users, due to environmental or design problems, and care practice in the home. The quality of meals is good and kitchen staff are committed to the provision of good nutrition, however, a small number of service users were not adequately supported in taking meals and they may not be having their nutritional needs met. EVIDENCE: Service users and relatives on the ground floor spoke of excursions outside of the home, to entertainments and shopping expeditions. One relative, speaking about excursions, told inspectors that staff, “take them out in their own time.” Older persons did not seem to have as many opportunities but there is a social programme within the home. This seemed a little repetitive with carpet bowls Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 13 and bingo featuring twice each week. Staff feel this is service users preference and service users said that they enjoyed these sessions. Some service users were engaged in individual activities, such as computer games, others had evidence of individual interests, such as music, in their rooms. There is a fulltime activities co-ordinator. Service users have choice and control over rising and retiring to bed times. Relatives praised care staff and said that “they were lovely.” There is a garden area but this is accessible from only one floor and it is not clear that all service users have equal access to this. Some aspects of the homes design restricts service users with mobility problems and limit their control over their movements. On the first floor it was cold, for a period of time, due to the high number of windows being opened. Service users were not happy with this and it was obviously beyond their control. Service users, on the first floor, were sat down for their meals long before they were ready to be served. This provoked episodes of challenging behaviour that other service users found disturbing. One service user had a cup of coffee thrown over them by another service user. Fortunately this did not result in injury. Carers on this floor seemed to have little support from qualified nurses at this time, Some service users did not receive their meal because staff did not feed them or give them sufficient assistance. Other service users had to wait too long for attention. The kitchen staff make a nourishing drink to be taken in the afternoon but this should not be regarded as a substitute for service users having a proper meal. The pattern of meals in the home results in a light lunch being served as the midday meal. This is entirely appropriate because some service users are late risers and may not require a large meal so soon after their breakfast. This would prevent waste and ensure that the evening meal is enjoyed and service users have an appetite for it. The variety of meals available at lunchtime included broth and dumplings, sandwiches and baked potatoes with a variety of fillings. Some service users were able to make other choices and staff were serving omelettes and, in one case, egg and chips. A desert choice of iced cream or orange sponge and custard was available. Service users told inspectors that they enjoyed the food. The meal sampled by inspectors was palatable apart from the “orange sponge.” This tasted strongly of orange essence and the cook latter confirmed that, although she would have preferred to use natural oranges, the ingredients were not available on the day and she had to resort to flavourings. This is unfortunate in that, in every other respect, the quality of the meal was good. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Although the majority of training and care practice would protect service users, in some areas of the home, service users are vulnerable to physical and verbal abuse from other service users. EVIDENCE: The service users and their relatives confirm that the manger and staff are approachable and that they would be happy to raise concerns with them. There is evidence from current and past practice that the home uses the Multi Agency Protection Panel for Vulnerable Adults Procedures (MAPPVA) developed by Sunderland Social Services Department. The home’s staff have received training on the role of the “alerter” and “lead officer” within MAPPVA procedures. Sunderland Social Services training department provided this training. Unfortunately some of the conditions on the first floor, such as residents assaulting or insulting each other, leave service users vulnerable to abuse. Care practice that results in service users missing meals and having overgrown toenails, could be interpreted as “institutional abuse or neglect.” Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. Most communal areas are well decorated, maintained and suitable for service users but all fire precautions need to be observed to ensure service users are safe. Access to the garden is limited and some communal space does not meet service users needs. There are sufficient and suitable toilet and washing facilities to meet service user’s needs. Although the home is well equipped for caring for the elderly service users, specialist equipment and environmental modifications for physically disabled service users is limited and therefore may not meet every service user’s needs. A minority of bedrooms do not promote independence because of their size or bad design and some rooms are unsuitable for those with a physical disability. The home is largely maintained in a safe condition and most of the accommodation is comfortable and suited to service users needs. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 16 The home is clean, tidy and free from odours so that service users live in suitably clean and hygienic conditions. EVIDENCE: The home is a relatively modern design and is light airy and pleasantly decorated in almost all areas. Most of the bedrooms are of an adequate size and design although there are some exceptions. Service users have chosen soft furnishings and decoration to match their own taste. Rooms are pleasantly furnished and there are personal possessions, such as sound systems, in rooms. One service user on the lower floor was quite unhappy with the limitation of their room and it’s location in the home and inspectors found this understandable and justified. Some aspects of the homes design meant that it could not meet the assessed needs of service users. The lower floor is registered to provide places for people with a physical disability. Although most of the ground floor was of a suitable design, some rooms were too small, some corridors were too narrow and some doors were inappropriate in an environment housing disabled service users. One visitor pointed out that environmental limitations prevent their relative using their powered wheelchair. Most communal areas are pleasant and roomy but some sections are not. Access to the “games room” and some bedroom space is via a narrow corridor with right angled bends. The games room itself is gloomy because of the high level windows and the design of the door also restricts access to wheelchair users, unless it is fully open, whereupon, it wedges itself on the carpet and contravenes fire regulations. The ventilation is reliant on a large extractor fan that produces high noise levels. There is no loop system in any part of the home for service users who have hearing problems. Some aspects of the ground floor of this home do not meet the needs of service users and do meet the needs of the Disability Discrimination Act, as well as the Care Standards Act. The home does have a secure garden at the back of the home. This is well laid out and it is a pleasant and useful facility. Unfortunately it is only accessible from the 1st floor, although staff state that all service users can be taken out to this facility. The top floor of the home housing elderly frail service users was spacious and reasonably well equipped. Hoists and other moving and handling equipment, were available and were used properly. It was noted that one shower room did not have a safety handrail next to the toilet. On the first floor almost all call bell pulls were tied up. If service user tampering and multiple false alarms are a problem the alarm system should be reviewed and a more suitable system installed. Most of the home was pleasantly warm, well lit and well ventilated but, as noted in a previous section, one floor was cold for a time due to the number of windows being opened by staff. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30 Although sufficient numbers of staff are deployed some did not hold appropriate qualifications to meet the needs of the service users they were caring for. The majority of care was good but some staff were not following service users care plans and acting in ways that were contrary to their training. Better supervision of staff is required to ensure service users are cared for correctly and kept safe. EVIDENCE: In spite of earlier conversations with the manager, during which inspectors had been assured that only suitably trained staff would be deployed, some shifts on the first floor were in the charge of nurses who had no qualifications in mental health. An immediate requirement notice was issued in relation to this and the home has taken appropriate action and agency cover is being provided when necessary. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 18 Some service user’s relatives have the impression that the home is short of staff, although they were complimentary about the staff’s attitude and relationships with service users. In most of the home the staff work as a team and do seem to support each other. On the first floor there were fewer staff available at lunchtime and the qualified staff were not evident at this time, in contrast to the other floors. Also on this floor, a lot of relatives feed service users but, as observed in an earlier section, some service users missed their meal or had to wait an unreasonable time for it to be served. At other times service users were managed in a way that was contrary to care plans and provoked rather than avoided challenging behaviour. If this floor is correctly staffed then it is certainly not well enough managed to meet these service user’s needs. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 38. The manager gave inspectors inaccurate information during the inspection and some aspects of staff performance needs to be better monitored. This gives an indication of some areas in which the manager’s performance needs to be improved to ensure the home will be well run. Most practices are good but in some areas practice is not always carried out in the service user’s best interests. Although most aspects of the homes operations are safe, some health and safety issues are not being addressed, therefore service user’s safety may be compromised. EVIDENCE: Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 20 The manager of the home is relatively new to her post. She has experience of running care homes but has not yet completed her registration as manager. Inspectors were disappointed to be given inaccurate information about qualification of staff employed in the home. The service users and their relatives confirm that the manager and staff are approachable and that they would be happy to raise concerns with them. Although staff are trained and supervision does take place some aspects of the homes management raised questions about the way staff’s performance was monitored in terms of daily practice. For example, although staff members confirmed that they received fire training one escape route, on a stairway, was partially blocked by stored furniture. This was placed directly under a notice saying the area should not be used for storage and should remain clear. Similarly the door to the “games” room on the ground floor binds on the carpet and will not self-close in the event of a fire. This is particularly hazardous in that this is an area were smoking is permitted. Although the majority of care practices were carried out in the service users interests there were some exceptions. Some of the care practice on the first floor, such as placing service users at the dining table long before they were due to eat, was not well thought out. Other aspects of care were not linked to service user’s assessed needs. Some of the care practice on the first floor did not prevent episodes of challenging behaviour and may even have provoked such episodes. Some of the design faults in the home provoke wheelchairbound service user’s to use unsafe manoeuvres, such as kicking doors open, to gain access to rooms. Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 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 x 2 x 3 2 4 3 5 3 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 2 3 2 2 3 3 3 Score Standard No 7 8 9 10 11 Score 2 2 3 2 x Standard No 27 28 29 30 2 2 x 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 2 33 2 34 x 35 x 36 x 37 x 38 2 Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? 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 3, 7, 8. Regulation 13 (4) 14 (1)(2) (b) 15 12(4)(a) Requirement Timescale for action 30/06/05 2. 10 3. 14, 20, 22, 23 4. 5. 6. 15 18, 38 19, 38 7. 27, 28, 30 8. 31, 32, 38 Service users should have an appropriate plan of care and staff should put this into practice. Forms of address and environmental factorss (such as viewing panels) must be reviewed in relation to the dignity of service users 13, 16, 23 The building design and equipment must allow service users control over their environment and meet their assessed needs. 16 All service users should be adequately supported to ensure they their meals 13 Service users should be adequately protected from abuse or neglect. 13, 23 Fire precautions must be observed and breaches of these and defective equipment must be rectified promptly. 18, 19 Staff should be adequately trained and hold an appropriate qualification. Care practice must be based on this training and appropriate qualifications. 9, 10,13 The manager must ensure that B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc 30 / 06 / 05 30/09/05 30/06/05 30 / 06 / 05 30/06/05 30/06/05 30/06/05 Page 23 Barnes Court Version 1.30 inspecotrs are given accurate information and that staff are adequately monitored, to ensure health and safety is maintained and that care practice is appropriate. 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 Good Practice Recommendations Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT 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 Barnes Court B52-B02 S18188 Barnes Court V217691 100505 Stage 4.doc Version 1.30 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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