Inspection on 07/06/05 for Barnston Court Nursing Home

This inspection was carried out on 7th June 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 01/12/05

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 7 June 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barnston Court Nursing Home Address Barnston Lane Moreton Wirral CH46 7TN 0151 677 5573 0151 604 0012 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cozee Care Homes Ltd Pauline Margaret Westaway CRH N 30 Category(ies) of OP - 30 registration, with number of places Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To accommodate four named service users who are under 65 years old within the overall number of 30. Date of last inspection 26 October 2004 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of five hours. During the inspection, service users, visitors and staff were spoken to in order to gather their views and opinions of the home. No requirements or recommendations are made following this inspection. 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 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 standard(s) 1, 3 The homes Statement of Purpose and Service User Guide are excellent providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to the home. EVIDENCE: The informative Statement of Purpose and Service User Guide give full details of the service provided. Copies are available from the home on request. A comprehensive pre admission assessment is undertaken on all prospective service users. The assessments are undertaken with the service user, their family, the social worker, the long term care team and other multi disciplinary teams as necessary. This enables the home to gather full information regarding the service user’s needs and to establish whether the home can meet those needs. Visits to the home are welcomed and encouraged prior to making a decision regarding long term care. 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, if necessary. Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 8 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 standard(s) 7, 8, 9, 10 Care plans are detailed and comprehensive to enable staff to access full information to ensure that the individual needs and preferences of service users is met. EVIDENCE: The care plans are generated from the initial assessment and are reviewed and amended on a regular basis to ensure that the changing needs of the service users are met. This is usually 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 records held in the home give details of visits to and by GP’s and other health care professionals. This includes Dietician, Physiotherapist, Chiropodist, Dentist and Optician. None of the service users have pressure sores, although the advice of the Tissue Viability Nurse would be sought if necessary. Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 9 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 10 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 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 confirmed that their lifestyle was flexible and that they could go to bed and get up when they wished, could participate in activities or could choose from a selection of meal options at each meal time. A high number of activities take place within the home and a designated activities co-ordinator works with service users each afternoon to provide activities and social stimulation. One service user is very involved in the garden and enjoys pottering about in the greenhouse. Service users have their own vegetable patch which is tended by one service user and those service users spoken to said that they enjoyed watching the progress of the vegetables. A Gazebo has been provided in the garden to enable service users to choose whether they sit in the sun or shade. Activities within the home include flower arranging, crafts, snooker and darts and staff spend time on a one-to-one Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 11 basis during the afternoon in addition to the activities provided by the activities co-ordinator. 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. 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 12 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 standard(s) 16, 18 The home has a robust complaints procedure with evidence that service users views are listened to and acted upon. 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 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 they would 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. Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 26 The standard of the environment in this home is good providing service users with an attractive and homely place 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. The building is on two floors with a passenger lift 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. Service users are encouraged to personalise their rooms and it is evident that the staff work with them to achieve this. Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 14 Since the last inspection, new beds and mattresses have been provided and it is planned that a new walk-in shower will be provided to assist the service users. Furniture throughout the home is of good quality and is in good condition. 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. 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. 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 were inspected and 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, all care staff are being given training on medications and the homes policy and procedures for administration. NVQ training continues. Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 has recently achieved 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 17 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 small 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 F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 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 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 x 3 x 3 x x 3 Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 19 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Barnston Court Nursing Home F52_F02_s20942_Barnston Court_v234321_130605_Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 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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