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Inspection on 17/03/09 for Barnes Court Nursing Home

Also see our care home review for Barnes Court Nursing Home for more information

This inspection was carried out on 17th March 2009.

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

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.

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

Inspecting for better lives Thematic inspection report Care homes for older people Name: Address: Barnes Court Nursing Home Wycliffe Road High Barnes Sunderland SR4 7QG two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a thematic inspection of this care home. A thematic inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Clifford Renwick Date: 1 7 0 3 2 0 0 9 Information about the care home Name of care home: Address: Barnes Court Nursing Home Wycliffe Road High Barnes Sunderland SR4 7QG 01915202000 01915202622 barnes.court@ashbourne-homes.co.uk 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) : Ashbourne Homes Ltd care home 89 Number of places (if applicable): Under 65 Over 65 20 20 41 1 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 3 0 0 15 The DE category of registration refers to 3 current service users only The service may from time-to-time admit persons under the age of 65 within the OP category Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 2 of 12 Brief description of the care home 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. Care Homes for Older People Page 3 of 12 What we found: One person was due to move into the home on the day of our visit and had undergone a trial visit where they had visited the home previously for 2 hours. The manager confirmed that the home had completed an in depth assessment for this person though this was not available during our visit and could not be located. Other assessment information was available that had been completed by other professionals for example the occupational therapist and also the Primary Care Trust assessment. From the information that was available there was sufficient for staff to develop a care plan in readiness for the person moving into the home. In looking at assessment information for other people who had been admitted to the home there were some gaps in the pre admission assessment documents and also the ongoing assessment documents. With some not being fully completed, signed or dated. As part of this visit we looked at the care files for 3 people and we call this process case tracking. This enables us to look at all records of care to establish how staff are supporting people. The care plans that we looked at were not up to date and in some cases did not contain sufficient detail to demonstrate how staff were supporting people with their assessed needs. For example one persons assessment identified three areas of care in which support was needed but the care plan only showed one area that staff were offering support with. Another person had needs related to continence management but this was not addressed in the care plans. In looking at the records that were being used to support the care plans such as the manual handling assessment and other standardised assessment documents. These were not always fully completed. The daily progress sheets confirmed that peoples needs are being met but these needs have not been fully identified in the care plans. The home have a range of standardised documents that they use to assist with people care but like the care plans these are not always fully completed with gaps in some areas and others not being signed or dated. Care Homes for Older People Page 4 of 12 The malnutrition screening tool that is used for monitoring peoples weights had a gap for one month for one person with no recorded weight or any recorded reason as to why this had not been followed up by staff. For those residents files that we looked at there was no photograph of the resident kept on the file. In one of the assessment documents that looks at medication staff were using abbreviated terminology about the frequency of dosage, this potentially could lead to errors. For another person the body mapping tool that is used to record accidents/injuries had been completed incorrectly. And the chart did not match with the written description. Records are in place to demonstrate that people are able to access G.P.s when necessary and also other health services provided by the NHS. Good systems are in place for the management of prescribed medicines however the administration sheets vary in how they are maintained. Some have a photograph of the resident and also a list of any allergies and some do not. The purpose of having a photograph rules out the chance of any drug errors occurring and a list of any allergies ensures that staff are up to date with individual residents needs. Menus are in place that demonstrated a good range of meals are provided and these take into account individual preferences as well as any special dietary needs. The home have been without an activities coordinator for some time but have recently been successful in appointing a new person. This person will be commencing work in the home soon and will be working 35 hours per week. Once they have commenced work they will be looking at developing a range of activities suitable for everyone currently living in the home. At present there is no program of regular planned activities. There are no restrictions on visiting the service and a number of residents relatives were present during our visit. It was good to see relatives getting involved with small tasks particularly during the lunchtime while at the home and this is encouraged by staff. Relatives were complimentary about the service and said that they were satisfied with the home. Discussion with the manager confirmed that residents are supported and encouraged Care Homes for Older People Page 5 of 12 to make choices about how they spend their day and this was evident on the unit that caters for younger physically disabled people. The home have a complaints procedure that is on display in the home and a copy of this has been issued to all residents and their relatives. There has been one complaint made within the last 12 months and this was dealt with by the home to the satisfaction of the complainant. The manager holds a weekly evening surgery whereby she ensures that she is available on Thursday evening to talk with any resident or their family should they have any concerns or matters that they wish to discuss. In addition to this the manager is always available during the working day if people need to speak with her. Policies and procedures are in place that deal with safeguarding adults and staff have received appropriate training in this to ensure that residents are protected from the potential of abuse occurring. The home have their own maintenance person who deals with day to day repairs to ensure that building is kept in good order. All of the bedrooms have been refurbished and extra lounge space has been created on the ground floor through change of use of some bedrooms. In discussion with the manager it was confirmed that there is a constant/rolling programme of decoration for the bedrooms. All bedrooms are now used for single occupancy only and the home can accommodate a maximum of 72 people though the home is registered for 89 persons. The home can no longer accommodate 89 people unless it reverts back to using shared rooms. During our visit we looked at a number of areas of the home including bedrooms and communal areas and this confirmed that the building was being maintained to a good standard. At the time of our visit sufficient staff were on duty on each of the units to ensure the care needs of the residents could be met. The staff team consists of a mixture of qualified nurses and care staff. It was good to see that there are photographs of each staff member on display on each unit as this informs families of who is working on the unit. A number of new staff have commenced work in the home since the last inspection and robust recruitment procedures are in place to ensure only suitable people are employed. Care Homes for Older People Page 6 of 12 The person currently managing the service has worked in the home for 13 years. During this time they have held a variety of posts which have included unit manager, deputy manager and acting manager. They were appointed in the post of manager at the end of 2008 and are now in the process of applying to the commission to be the registered manager. The manager is a qualified nurse and is also in receipt of a Diploma in Care of the Elderly. They have completed the Registered Managers Award and have ensured that they have kept their training up to date having recently completed a course on the Mental Capacity Act and the deprivation of liberty. Records that relate to health and safety are in good order and the manager has ensured that the home operates in the best interests of the residents. What the care home does well: What they could do better: The standardised documents that are used by the home as part of the assessment and care planning process should be completed in more detail. Care plans should be set out in a way that demonstrates how staff are supporting people with their assessed needs. In addition to this steps should be taken to ensure that the care plans are kept up to date and when they are evaluated they should be signed and dated by staff. Staff should not use any abbreviated terminology when recording the frequency of prescribed medicines and there should be no unrecorded gaps on medicines administration sheets. Care Homes for Older People Page 7 of 12 The staff who are responsible for administering prescribed medicines should undergo updated training in the safe handling of medicines as this will keep them up to date with best practice. The registered provider should submit an application to the commission for a change in the registered numbers. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 12 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 The assessment documents that are in use must be fully completed for all residents. This will ensure that residents needs are fully assessed and will assist staff in developing individual plans of care. 31/05/2009 2 3 14 All areas of the assessment documents need to be fully completed when assessing individual peoples needs. This will ensure that all aspects of health, personal and social care are covered. And will assist staff in developing the individual plan of care. 31/05/2009 3 7 15 Individual care plans must 31/05/2009 include more detail as to how people are being supported by staff. This will ensure that staff are following consistent practices. Care Homes for Older People Page 10 of 12 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 9 Medicines administration records should be revised to include a photograph of the resident. And there should be no unexplained gaps on administration records when medicines have not been administered. Staff should not use an abbreviations or terminology All staff who are responsible for administering prescribed medicines should receive updated training in the safe handling of medicines. The person currently responsible for managing the service should submit an application for registration to the commission. And an application should be submitted to the commission to reflect the numbers of people who can be accommodated in the home. 2 9 3 38 Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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