Inspection on 01/12/05 for Barnston Court Nursing Home

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Barnston Court Nursing Home 25/10/06

Barnston Court Nursing Home 07/06/05

Barnston Court Nursing Home 26/10/04

Barnston Court Nursing Home 02/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Barnston Court Nursing Home Barnston Lane Moreton Wirral CH46 7TN Lead Inspector Jeanette Fielding Unannounced Inspection 1st December 2005 11:50 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 Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 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. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barnston Court Nursing Home Address Barnston Lane Moreton Wirral CH46 7TN 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) 0151 677 5573 0151 604 0012 Cozee Care Homes Limited Pauline Margaret Westaway Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate four named service users who are under 65 years old within the overall number of 30. 7th June 2005 Date of last inspection Brief Description of the Service: Barnston Court is registered to provide nursing care to service users over the age of 65 years of age. The home is purpose built and comprises of five companion rooms and 20 single bedrooms located on the ground and first floor levels. The kitchen and laundry are located in the basement area. All levels of the home are serviced by a lift. The home has both stairs and ramped access to the front entrance and wheelchair access to the garden at the rear of the home. The home has a lounge/dining room and separate lounge on the ground floor. A conservatory leads off from the lounge/dining room. The garden is accessed via the conservatory patio doors. There is a car park at the rear of the home. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted in one day, during which time, service users, staff and visitors to the home were spoken to in order to gather their views and opinions. Records relating to the care provision were inspected together with records relating to the staff. A tour of the building was undertaken to ensure that all criteria for registration was met. Health and safety certificates were inspected to ensure the protection of service users. What the service does well: 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. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 6 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 Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Comprehensive assessments are undertaken on all prospective service users to ensure that the home can meet their individual care needs. EVIDENCE: The home has prepared an informative Statement of Purpose which gives full details of the service provided. Copies of this and the Service User Guide are available from the home on request. Detailed pre- admission assessments are undertaken on all prospective service users prior to their admission to the home. The assessments are undertaken by the manage or the deputy manager and information is gathered from the service user, their family, the social worker, the long term care team and other multi disciplinary teams as necessary. Full information is gathered to ensure that the home is able to meet the service users individual care needs and for a plan of care to be prepared. Visits to the home are welcomed and encouraged prior to making a decision regarding long term care and to give prospective service users the opportunity to view the room available and to meet with Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 8 other service users and staff. When both the service user and the home have agreed that the admission should take place, a letter of confirmation is sent to the service user and the hospital, as appropriate. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Detailed care plans are prepared and regularly reviewed to ensure that each service user is provided with the appropriate level of care required. EVIDENCE: Care plans are generated from the information received at the initial assessment and are reviewed and updated on a regular basis to ensure that the changing needs of the service users are met. This review is undertaken on a monthly basis or more frequently as required. The care plans also include risk assessments together with risk management plans on how to remove or reduce any identified risks. The information held by the home is detailed and informative. Care staff are encouraged to read the plans to give them full information regarding the care needs of each service user. The care plans also include individual social preferences to enable an appropriate social and activities plan to be prepared. Evidence of the individual care given to service users is recorded in the daily report completed by staff. The records held in the home give details of visits to and by GP’s and other health care professionals. This includes Dietician, Physiotherapist, Chiropodist, Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 10 Dentist and Optician. None of the service users have pressure sores, although the advice of the GP or Tissue Viability Nurse would be sought if necessary. Medications are dealt with in accordance with the homes policy and procedure. The manager regularly audits the medications to ensure that GP’s are contacted for advice and information as necessary. Personal care is given to service users in their bedroom or in the bathroom as necessary and all bathroom and toilet doors are fitted with appropriate locks. Screens are provided in shared rooms to ensure the privacy of service users. Lockable furniture is provided in each bedroom to enable service users to store personal items. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. The systems for service user consultation are good with a variety of evidence that indicates that service users’ views are both sought and acted upon. EVIDENCE: Service users were spoken to during the inspection and confirmed that their lifestyle was flexible and that staff respected all their wishes. They confirmed that they could go to bed or get up at a time of their choosing, could choose from a range of social activities or make a selection from a range of meal options at each meal time. A high number of activities take place within the home. The social plan is designed and implemented by the activities co-ordinator who is supported by care staff as necessary. Some service users have recently enjoyed a trip around the local area to view and admire the Christmas decorations on the outside of house. Those who went on the trip said that they really enjoyed it. Activities that take place within the home include reminiscence, flower arranging, card making, games, jigsaws, music and singing, videos, snooker Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 12 and darts. All service users are encouraged to participate in the activities but their refusal is respected. Staff spend time with service users during the afternoon to provide one to one activities. Some service users have maintained links with the local community by using the local library, pub, social clubs and hairdresser. A hairdresser visits the home twice each week to provide for those service users who are unable to go out or have chosen to use this service. The manager conducts regular surveys of service users to establish that the home is meeting their preferences. Service users and relatives meetings are held on a regular basis and the manager spends time on a one-to-one basis with service users and family members on a daily basis where possible. Surveys on the meals are regularly undertaken and menus are changed according the suggestion of service users and the season. A choice of meals is offered at all mealtimes and service users can choose whether they take their meal in the dining room or in their own bedroom. The menus provide evidence that a varied and balanced diet is offered to service users. Special diets are provided on request or on the advice of the GP or dietician and currently include diabetic, low fat, soft and liquidised diets. The meals served on the day of inspection looked and smelled appetising. The dining area is bright and tables are attractively set. A selection of appropriate condiments is placed on tables at mealtimes for service users to choose from. The kitchen was clean and well organised and contained all the necessary equipment for the chef. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure and information regarding this is displayed in the hallway of the home and is detailed in the Statement of Purpose. No complaints have been received since the last inspection. Service users spoken to said that they knew who to speak to if they had any problems and felt that appropriate action would be taken. Those spoken to said that they had no complaints about the home, the service or the staff, who were all caring and helpful. The home has a policy and procedure to follow in the event of abuse being suspected. The manager was fully aware of the action to be taken and of the appropriate people to contact in the event of abuse being suspected. Staff have full access to all information which is held in the office. Training is given to staff regarding the different types of abuse and of the action to be taken. A copy of Wirral Borough Council Adult Protection book is held in the office on the ground floor. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The décor and furnishings within this home are good and provide a welcome and homely environment for the service users. EVIDENCE: The home is located near to the centre of Moreton, close to shops and other amenities and is accessible by public transport. Many of the service users visit the local shops on a regular basis and some enjoy lunches at the local pub as part of the activities programme. The building is on two floors with a passenger lift and two stairways providing full access to all areas of the home. A rolling programme of redecoration and improvements to the home continues and all areas are bright, clean and welcoming. The home provides one lounge, one lounge/dining room and a conservatory. All rooms are well used by service users who are free to choose where they go and with whom they socialise. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 15 Service users are encouraged to personalise their rooms and it is evident that the staff work with them to achieve this as all bedrooms were seen to contain items of memorabilia and reflected the individual tastes of the service users. Work is currently taking place to provide an additional walk in shower. One new one was provided last year and has been so successful, a further one is being provided. All furnishings and décor within the home is of good quality and in good condition. The small lounge has recently been redecorated together with a number of bedrooms. New mattresses are being provided throughout the home. The office in the basement has been refitted and was found to be organised and effective. The home was clean throughout and everywhere smelled fresh. The home has an infection control policy and appropriate arrangements are made for the disposal of general and clinical waste. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff have a good understanding of the service users’ support needs. This is evident from the positive relationships which have been formed between the staff and service users. EVIDENCE: The home is fully staffed and there has been only a minimal turnover of staff since the last inspection. The manager has 20 supernumerary hours to undertake management tasks but also works with both staff and service users to enable her to evaluate the home and the service provided. Additional care staff are provided to meet the needs of the service users as necessary. Recruitment is based on equal opportunities. A robust recruitment procedure is followed. All prospective staff are required to complete an application form, attend for interview and have references, POVA checks and CRB checks undertaken prior to commencing work at the home. Staff files inspected were found to contain all necessary information. Considerable training continues to be given to staff and a comprehensive training file is held in the home. At present, the manager is undertaking NVQ assessor training and the deputy is training to be an NVQ Internal Verifier. Recent training given to staff includes moving and handling, hoist awareness, stoma care, fire prevention, health and safety, diabetes, infection control and peg feeds. Medication training has been given to care staff. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The management of this home is good and records are well managed. This practice ensures that service users are protected and not placed at any risk. EVIDENCE: The manager of the home is a qualified nurse and provided evidence of ongoing training and development. She also holds an NVQ level 4 in management. Service users, visitors and staff spoken to during the inspection confirmed that the home is run in the best interests of the service users. The home has its own quality monitoring system in place together with holding ISO 9001 quality assurance accreditation. Six monthly questionnaires are sent to service users to obtain information and personal views of the home. The home is accredited to train overseas nurses through Manchester University. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 18 Family members or advocates deal with all service users financial matters. Small amounts of money are held for some service users at their, or their family’s request, to cover the cost of items i.e. hairdressing and chiropody. Other families prefer to be invoiced for expenses. Detailed records are held of all transactions made on service users behalf and includes the retention of receipts. One service user has chosen to attend to their own finances. All health and safety issues are addressed by the owner, manager or handyman, although staff are responsible for identifying and reporting any risk or maintenance matter. Evidence was in place of safety checks made on the home and all safety certificates were up to date and in place. The owner visits the home regularly and prepares a report each month as required. Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X X 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Barnston Court Nursing Home DS0000020942.V272033.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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