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Inspection on 18/07/07 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 18th July 2007.

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.

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

What the care home does well

A variety of activities are enjoyed by the service users inside and outside the home. The service users can make excursions outside the home and staff support this. Care staff are strongly committed to providing good care and relatives and service users spoke well of staff`s attitude and enthusiasm. Examples of good and thoughtful care practice were seen in the home. Service users commented on the good relationship they had with staff. The kitchen staff are equally enthusiastic and "home cooking" features strongly on the menu. The cook is well informed about nutritional needs of the elderly. The quality and timing of meals is good for the majority of service users. The majority of rooms are spacious and well decorated. The furnishings in bedrooms reflect the service users own tastes and interests, particularly on the ground floor. New staff receive a good induction and are well supported by the company during this time.

What has improved since the last inspection?

The layout of the ground floor has improved to provide better access and accommodation for service users. The home has a social programme that is overseen by an activities coordinator. The garden area is better planted and containers are placed on the pathway into it.

What the care home could do better:

The home should ensure that if any door is held open, it should be done with a device that closes in the event of a fire alarm.

CARE HOMES FOR OLDER PEOPLE Barnes Court Nursing Home Wycliffe Road High Barnes Sunderland SR4 7QG Lead Inspector Tom Moody Key Unannounced Inspection 18th July 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnes Court Nursing Home Address Wycliffe Road High Barnes Sunderland SR4 7QG 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) 0191 520 2000 0191 520 2622 barnes.court@ashbourne-homes.co.uk Ashbourne Homes Limited Pauline Waite Care Home 89 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (20), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (20), Old age, not falling within any other category (41), Physical disability (15), Physical disability over 65 years of age (1) Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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 13th July 2006 Date of last inspection 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 Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this inspection took place over one day on 2 July 2007. One inspector carried out the inspection. The providers self-assessment was not available before the site visit took place. The Acting Manager of the service was present during the site visit. The views of people living at the home were gathered during the site visit, by talking to them and to their visitors. Care plans, medication records, staff records and other documents were examined during the site visit. Care practice was observed at various times throughout the visit. Positive feedback was received from the great majority of those whom the inspector spoke to. The Acting Manager was interviewed, several members of staff were spoken to and a tour of the home took place. A mealtime was observed but the inspector did not sample the food at this inspection. What the service does well: A variety of activities are enjoyed by the service users inside and outside the home. The service users can make excursions outside the home and staff support this. Care staff are strongly committed to providing good care and relatives and service users spoke well of staff’s attitude and enthusiasm. Examples of good and thoughtful care practice were seen in the home. Service users commented on the good relationship they had with staff. The kitchen staff are equally enthusiastic and “home cooking” features strongly on the menu. The cook is well informed about nutritional needs of the elderly. The quality and timing of meals is good for the majority of service users. The majority of rooms are spacious and well decorated. The furnishings in bedrooms reflect the service users own tastes and interests, particularly on the ground floor. New staff receive a good induction and are well supported by the company during this time. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All service users entering the home have their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this. Most service users and their family have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances. This allows them to make an informed choice about staying in the home. EVIDENCE: The last inspection report concluded that service users and their relatives received appropriate information, that they were able to visit the home in advance and that they had their needs properly assessed. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 9 The Acting Manager has good policy towards giving information to service users and reltives. She states that relatives and can visit as often as they wish before deciding if they want to be placed in the home. The service users guide has now changed to the new company a copy was seen, This is comprehensive and contains all relevant information. The home has also started a newsletter to better inform relatives of what is going on in the home. This is a good source of information and will be mailed out to relatives. The care plans seen were completed well and the assessment of service users needs was good. Service users have commented that their relatives were able to visit the home and make the decision for them to be placed there. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users health care needs met. Service users have access to all healthcare services that they need. The home has appropriate policies and procedures to ensure service users receive their medication in a safe way. EVIDENCE: The Acting Manager has good awareness of service users social recreational and clinical needs. Visiting professionals did visit the home at the time of the site visit. Medication is stored safely. A monitored dosage system is in use and recording is good. Controlled drugs are safely stored and stock balances are correctly kept. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 11 Care plans are comprehensive and well written. The format of these has change in line with Southern Cross policy. The new format is well laid out and the examples seen were completed to a good standard. Pressure damage risk was approriately assessed and all risk assessments being reviewed monthly. Service user’s care plans contain much useful clinical information. Some of the life histories were well recorded and detailed. Reviews are recorded and relatives views on the care are contained in these. All of these comments were positive about their relatives care experience. The home has appropriate equipment and suitable adaptions to meet service user,s needs although more “door guards” are required to ensure service user’s bedrooms remain safely accessible. Discussions with staff revealled that they have a high commitment to the service user’s several spoke of coming in on rest days to support them in going to social events. Staff who spoke to me impressed with the depth of knowledge they had about individuals and their preferred patterns of care. The atmosphere on the Mental Health unit is much improved and it is very calm. The Acting Manager atributes much of this to the increased level of activites and social interaction on this floor. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home endeavours to provide a lifestyle that matches service users needs and preferences. Meals are of good quality and the timing and choice can be varied to meet service users needs. EVIDENCE: The floor caring for dementia has been refurbished to provide corridors the have sensory input based on differing themes. The care workers now have responsibilities for some social programmes and activities although there is a very pro-active activities co-ordinator. Interest groups have been set up and at the time of the site visit the “Gentlemans Group” was enthusiastically engaged in a hard fought game of dominoes. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 13 Staff were interacting with service users and were leading small scale actiivities such as dried flower arranging. One service user was enjoying their own choice of music in their room and singing along to it. Staff deal with relatives, in person, and in telephone enquiries, appropriately. The cook makes regular contact with SU to monitor satisfaction with the meals. Menus are satisfactory. Service users are aware of alternative choices. The kitchen is clean and and well organised. it is well equiped. The quality and presentation of food was good. Most service users were having fish chips and peas. Staff have list of service users choices. Service users on all floors spoke favourably about the quality of food. Service users were supported by staff,during their meal, in a suitable manner. Staff addressed service users appropriately. Visiting is unrestricted and visitors were seen coming and going throughout the day. Service users spoke of going on excursions that enabled them to keep contacts with the family and the wider community. They spoke of visits to the theatre and the acting manager confirmed that the home can use a an adapted bus for transport to facilities such as shops and entertainment. Service users spoke of using the garden if the weather was suitable. All of the service users who were spoken to expressed positive views on the way they were looked after. One said, I went out to the Park yesterday, another said, The activities are very good now. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The homes policy on adult protection reflects the multi-agency approach to adult protection, and local procedures and staff know how to use it. This should ensure the protection of service users. Service users and relatives are confident that the process and the staff will act in the service user’s best interests. EVIDENCE: The homes management has dealt with the issues of adult protection issues appropriately. Complaints are recorded well. The Acting Manager spoke of relative support groups meetings, and meetings with relatives and service users, about the running of the home. The Acting Manager stated she had an open door policy and she is aware of service user’s legal rights. All of the relatives that were spoken to confirmed that they found the staff helpful and felt that the Acting Manager was approachable. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 15 Service users and relative expressed confidence that staff would deal with any problems they had. One said, “Tracey (the Acting Manager) and Clare are very approachable”. A relative said they were “Happy to contact staff if there are problems” Another relative confirmed they had raised the issue of staffing with the acting manager. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The environment is well maintained and safe. The home has most of the equipment it needs to meet service users needs. Rooms are comfortable, furnished to service users tastes, and the home is kept clean. EVIDENCE: The ground floor of the home has been refurbished and the layout altered to provide better access. The garden is secure and was open to be used throughout the day. The planting in this area has improved and is being continually reviewed. A sensory area is planned. The first floor is decorated providing touchable wall hangings and the lounge has movie theme pictures. Some areas have been decorated to represent Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 17 outside streets and shop facades. The home shows some signs of wear and maintenance is ongoing. Bedroom doors have pictures of service users on them including images of themselves when they were younger. Staff confirm that this helps service users relate to their own room and it reminds staff that service users have unique histories. Toilets have large images to represent their use and one service user was abserved finding their way unaided to one of these rooms. Bedooms are peronalised and contain items such as videos, tapes televisions etc. Some rooms are obviously decorated to the service user’s requirements, such as with Sunderland FC wallpaper. One room door was wedged open and the acting manager was advised of this. More door Guards should be obtained if this is necessary. The home is well lit, warm and well ventilated. Bathrooms have suitable aids and adaptations to enable them to be used by all service users. There was no unpleasant odour in any area of the home. All areas of the home are clean and tidy. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager ensures that the home operates safely and sufficient numbers of staff, who are appropriately trained, are available to meet service users needs. EVIDENCE: Staff confirmed that good level of induction take place and that their practice is supervised until they achieve a good level of competency.Training records indicated this was the case and one staff member spoke of having “lots of training.” Duty rotas indicated an appropriate level of staff. The call system was answered promptly. Some concerns were expressed by relatives about about the staffing levels in the home, especially at night, although they stressed they “Could not find fault with the staff” and felt they worked hard. The Acting Manager acknowledged there had been some recent problems due to sicknesss and short notice of this. She had addressed some these issues and felt that shortages had now been rectified. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 19 The home has enthusiastic. appointed an activities co-ordinator who is extremely Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager is professional in her approach and has a positive vision of how the home should be run. Service users and staff benefit from the way she carries out her duties. EVIDENCE: At the moment the Deputy Manager is acting up as the registered manager is on long-term absence. She is fulfilling her new role very well and has introduced some positive changes, such as the Barnes Court Times newsletter. She is an experienced nurse and the staff are responding well to her leadership style. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 21 The manager confirmed that they operate the Southern Cross Quality assurance system and that customer satisfaction surveys are carried out. The results are fed back to each home. The manager is aware of her statutory responsibilities, including health and safety, and record keeping is good. She stated that supervision takes place and staff confirm they have regular supervision sessions. Discussions with staff indicate the moral in the home is good and staff feel motivated and enthusiastic. They confirm the Acting Manager is approachable and they have confidence in her. Service users and relatives say that the manager is approachable. The Acting Manager confirmed she felt well supported in her role by the senior management team. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations Further door guards should be provided for any service user who needs to have their door propped open. Barnes Court Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 Nursing Home DS0000018188.V340515.R02.S.doc Version 5.2 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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