Inspection on 25/10/06 for Barnston Court Nursing Home

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 01/12/05

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 25th October 2006 09:45 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.V306998.R01.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. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 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.V306998.R01.S.doc Version 5.2 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. 1st December 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.V306998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted in one day, over a period of six hours, 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. All were found to be extremely well maintained. 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 and found to be in place and up to date. 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.V306998.R01.S.doc Version 5.2 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.V306998.R01.S.doc Version 5.2 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): 1, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment is undertaken on all prospective service users to identify their needs and to ensure that those needs can be met. EVIDENCE: The home has prepared an informative Statement of Purpose and Service User Guide which give full details of the service provided. Copies of these documents are issued to all current and prospective service users and 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. Information is gathered regarding the service users medical, care and social needs and individual preferences are identified. Sufficient information is gathered to ensure that the home can Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 8 meet all of the service users individual needs. The assessment provides sufficient information for a plan of care to be prepared. More detailed information is recorded following admission to the home as the service users’ needs change. Following the assessment, a letter is sent to the service user to confirm that the home can meet their needs and to make arrangements for admission. Prospective service users and/or their representatives are encouraged to visit the home prior to admission to give them the opportunity to view the rooms available and to meet the staff and other service users. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed care plans are prepared for each service user and are reviewed and updated on a regular basis to ensure that service users are provided with the appropriate level of care. EVIDENCE: Care plans are generated from the information gathered at the initial assessment and are reviewed and updated on a daily basis during the first month following admission. Further reviews are made on a monthly basis and whenever the service users’ needs change to ensure that their individual care needs are identified and met. 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. Service users are actively involved with their care planning Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 10 and are given the opportunity to make suggestions and discuss their care with staff prior to implementation. Evidence of the individual care given to service users is recorded in the daily report completed by staff. New service users and/or their representatives are requested to complete a food questionnaire to identify their individual preferences and dietary requirements to ensure that their needs and dietary wishes can be met. This information is held by the chef who prepares meals in line with service users preferences. Records are held of visits made to service users by GP’s, Physiotherapists, Chiropodists, Dentists and Opticians. The advice of the Tissue Viability Nurse Specialist and Continence Advisor are sought as and when necessary. The home has comprehensive and detailed policies and procedures for the administration of medications. Medications were found to be dealt with by the staff in accordance with the home’s policy and procedure. All records relating to medications were completed accurately and storage areas were clean and organised. None of the service users currently administer their own medications, although this is permitted subject to risk assessment. A new lockable refrigerator has been purchased for the storage of medications which are required to be held at low temperatures. 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.V306998.R01.S.doc Version 5.2 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A high number of activities are available to service users to provide them with social stimulation. EVIDENCE: Service users spoken to during the inspection confirmed that their lifestyle was flexible and that staff respected all their wishes. They also 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. The home employs an activities co-ordinator who works with the service users during the afternoon and at weekends. A high number of activities take place within the home and care staff were observed to be spending time with service users on a one to one basis to provide stimulation and to play games. On the day of the inspection, a clothes party had been planned to give service users the opportunity to choose and purchase clothing from a local supplier. Service users spoken to during the inspection said that the staff played cards, dominoes and board games with them and that entertainers visited on a Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 12 regular basis. One service user informed the inspector that the activities coordinator played the guitar and often entertained people during the afternoon, which she really enjoyed. She also said that there was no pressure put on anyone to participate and that some service users didn’t join in, but seemed happy to watch others. Other activities that take place within the home include reminiscence, flower arranging, care making, games, jigsaws, music, singing, videos, snooker and darts. The manager conducts regular surveys of service users to obtain their views and to establish that the home is meeting their individual needs and preferences. Service users and relatives meetings are held regularly and the manager speaks with service users, their relatives and other visitors to the home, on a one to one basis each day or as often as 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. Service users spoken to after lunch said that the meal was delicious, as usual. The chef uses fresh fruit and vegetables as much as possible and ensures that the quality of the food purchased is of high quality. The kitchen was extremely clean and organised and records are held of all fridge, freezer and food temperatures. The dining area was bright and tables were attractively set. A selection of appropriate condiments is placed on tables at mealtimes for service users to choose from. A list is held for staff of individual service users’ requirements and preferences including whether they take sugar in their drinks and the specific amount preferred. Some service users require assistance with meals and staff were observed to attend to this discretely and attended to service users with dignity. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Training on the Protection of Vulnerable Adults has been given to all staff to ensure the protection of the Service Users. EVIDENCE: The home has a comprehensive complaints procedure and information regarding this, and how to make a complaint, is displayed in the hallway of the home and also detailed in the Statement of Purpose. Service uses spoken to confirmed that they knew who to speak to if they had any concerns and felt confident that appropriate action would be taken. None of the service users spoken to said that they had any problem with the home, the staff or the service. The records held in the home provide evidence that a recent complaint was fully investigated by the manager. The investigation findings show that the allegations were not substantiated. The home has a policy and procedure and procedure to be followed 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 been given training on the Protection of Vulnerable Adults and the different types of abuse. Information on the action to be taken is held in the office. A copy of Wirral Borough Council Adult Protection book is held in the office on the ground floor. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 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, 23, 24, 25, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is decorated, furnished and maintained to a high standard to provide service users with a pleasant environment in which to live. 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. Improvements to the home continue to be made. Since the last inspection, four bedrooms have been fitted with new carpets and the manager stated that she is looking to replace the ground floor corridor carpet in the spring of 2007. The redecoration of bedrooms continues as part of the rolling programme of Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 15 improvements and a number of bedrooms have been redecorated since the last inspection. All beds have now been provided with new mattresses. New blinds have been fitted in the conservatory to provide greater privacy for the service users and to provide a more homely environment. The work to provide a new walk-in shower is complete and provides an additional facility for the service users. 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. Service users are encouraged to personalise their rooms and it is evident that relatives and the home’s staff have worked together to achieve this. The majority of rooms were seen to have pictures, photographs and items of memorabilia to reflect the lifestyle, history and tastes of the individual service users. All furnishings and décor within the home is of a high quality and is in good condition. The home was clean throughout and all areas smelled fresh. The home has an infection control policy and appropriate arrangements are in place for the disposal of general and clinical waste. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are protected be a well-trained and committed staff team. EVIDENCE: The home employs and deploys staff in sufficient numbers to meet the needs of the service users. The staff turnover remains extremely low. 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 monitor the service provided. Additional care staff hours are provided as necessary to meet the needs of service users on a group or individual basis. The home has a robust recruitment policy and procedure and the staff records provide evidence that the 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. Gaps in employment history are checked and all prospective staff are required to provide evidence of training and qualifications prior to being offered work at the home. Considerable training is given to all staff and a comprehensive training file is held in the home. The manager has recently completed the NVQ Assessor training course and the deputy has almost completed the NVQ Internal Verifier training course. Recent training includes Medications, Infection Control, Nutrition and Healthy Eating and the Protection of Vulnerable Adults. The Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 17 Registered Nurses are undertaking updated training, specific to service users needs, and includes Catheter Care, Wound Management, Palliative Care and Health and Safety. The domestic staff have all completed NVQ training in housekeeping to further their knowledge and understanding. Records are held of all training undertaken by the staff. Regular supervision is given to all staff and annual appraisals are undertaken. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to ensure the protection of service users. EVIDENCE: The registered manager is a registered nurse and holds an NVQ level 4 in management and is an NVQ assessor. The manager continues to develop her professional knowledge and evidence of this is held in the home. The home holds an ISO 9001 accreditation and also has it’s own quality monitoring system in place. Six monthly questionnaires are sent to service users to obtain information and personal views of the home. One to one discussions are held with service users to gather additional information. Barnston Court Nursing Home DS0000020942.V306998.R01.S.doc Version 5.2 Page 19 The home is accredited to train overseas nurses through Derby University and student nurses though Chester University. 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. 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.V306998.R01.S.doc Version 5.2 Page 20 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 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 3 4 3 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.V306998.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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.V306998.R01.S.doc Version 5.2 Page 22 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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