Inspection on 09/01/06 for Barons Park Nursing Home

This inspection was carried out on 9th January 2006.

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

Barons Park Nursing Home 25/01/10

Barons Park Nursing Home 17/02/09

Barons Park Nursing Home 09/01/07

Barons Park Nursing Home 11/10/05

Barons Park Nursing Home 10/01/05

Barons Park Nursing Home 14/07/04

Barons Park Nursing Home 24/01/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOMES FOR OLDER PEOPLE Barons Park Nursing Home Desford Lane Kirby Muxloe Leicestershire LE9 2BE Lead Inspector Mrs Gillian Adkin Unannounced Inspection Monday, 6th January 2006 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 Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barons Park Nursing Home Address Desford Lane Kirby Muxloe Leicestershire LE9 2BE 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) 0116 2387337 0116 2387976 info@baronspark.co.uk www.baronspark.co.uk Mr Les Warren Mrs Lesley Warren Mrs Janet Thevamanohary Stanley Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (33) Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To be able to admit the person of category DE (55 ) named in variation application dated 16th July 2002. 11th October 2005 Date of last inspection Brief Description of the Service: Barons Park is a nursing home registered for thirty-three service users of both sexes over sixty-five years of age. Its registration categories include Mental Health and Dementia. The home has established links with the Alzheimers society and is staffed by registered mental health nurses and care staff. Situated in a rural area close to the village of Kirby Muxloe Leicestershire it is within a short distance of Junction 22 on the M1 The home is owned by Mr and Mrs L Warren. The property has been developed and offers accommodation on two floors, which are served by a passenger lift. The home has large mature gardens and a patio area and has pleasant views of the countryside. It has three comfortable lounges and the main lounge has a dining area. The home has twenty-one single bedrooms and six double bedrooms of which two are ensuite. Adequate parking facilities are available and the home is situated on a main road. The home has a website at www.baronspark.co.uk Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4.5 hours and was facilitated by the home’s general manager. The inspector selected three residents and tracked the care they receive through review of their records, discussion with them (where possible), the care staff and observation of care practices. The inspector also spoke with staff members regarding service users tracked and with three visitors to the home. This was a very positive inspection and was facilitated by the general manager, registered manager and staff in a helpful, friendly and professional manner. No new comment cards had been received by the Commission for Social Care Inspection since the last inspection. Comments made by residents and relatives included – ‘ “I was able to make my decision about the home after reading the last inspection report” “ The staff are very patient and kind” “ I have been made very welcome in the home” “The staffing levels in the home are very good, they have time for individual interaction” “ I have no complaints about the home it is well run and the managers/owners are actively involved” “Staff, visitor, family relationships are excellent and the food is very good” “My mother is well cared for and the home always has a pleasant atmosphere”. “The home is very clean and hygienic” Core standards not inspected at the previous inspection were inspected on this occasion. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 6 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. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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 Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4.5 Core Standard 6 does not apply. A thorough and informative range of information is readily available for all persons to access about the service offered by the home. This ensures that service users’ and their relatives have an informed choice about the homes ability to meet their needs. EVIDENCE: Good evidence was found to demonstrate that service users and their representative are confident in the homes ability to meet their needs. This was evidenced by discussion with three relatives who stated that they had received information prior to the admission of their relative and had been able to access the previous inspection report in advance. Other relatives stated that the management at the home showed an active interest in their relatives individual needs before being shown around the home. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 9 Relatives stated they had been issued with a Statement of Purpose and service user guide after admission. The Statement of Purpose is due to be updated in February with the new manager details. All relatives commented on the registered manager and staffs willingness to provide information and support them. The home does not provide intermediate care facilities. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9. Comprehensive care plans and associated risk assessments, which include the input of relevant professionals, are in place, this ensures that staff are fully aware of residents needs and are able to provide a measurable standard of care. EVIDENCE: All of the three-service users case tracked and care plans in place, which were based on the initial assessment. Care plans were comprehensive and included all relevant risk assessments and monitoring records.A scare plan is in place specific to night care routine. It was recommended that oral hygiene independently of the personal care plan. care plans be documented Continence and nutritional assessments had been undertaken for all service users tracked. Nutritional assessments had been reviewed along with weight monitoring. One service user tracked who on admission was assessed as Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 11 nutritionally at risk had increased significantly in weight. Relatives spoken with praised the home for this improvement. It was identified on assessment that the service user in question did not like eating meals alone and staff were observed sitting with the person throughout the midday meal. One out of the three care plans had been routinely reviewed (monthly) and evidence was found to demonstrate relatives’ input. Discussion took place with the registered manager about the care plan format and she indicated that she was in the process of reviewing this. Recommendations were made and agreed regarding the inclusion of overnight checks in night care plans. None of the service users’ tracked were able to self medicate. Medication systems inspected overall were well managed however an error was found in the recording of two medications. It was recommended that a medication profile / care plan is completed when service users’ are admitted and particularly where there are identified medication compliance issues which require significant input /changes. Discussion with two relatives indicated that their relatives had pressure sores on admission these were now fully healed, relatives stated that service users were regularly moved and personal hygiene was exceptional. Evidence found in training records demonstrated that staff have attended continence care and infection control training. Evidence of pressure relieving equipment was seen during this inspection. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Care delivered in the home is person centred this promotes and encourages choice and control for service users wherever practicable. EVIDENCE: Discussion with management and relatives demonstrated that the home have no involvement with personal or legal affairs. The general manager stated that a number of people accommodated have legal representatives including relatives. Those relatives spoken with during inspection confirmed this. The home support service users and their families with advocacy services, which are provided by the Alzheimer’s Society, leaflets were on display for relatives to take home. One out of three service users tracked were able to make informed choices and express views. Discussion with relatives and observation of staff at work demonstrated that every opportunity was given to individuals in helping them make choices. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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. 17 Service user rights are protected by robust policies and procedures and appropriate representation. EVIDENCE: No complaints were recorded on file at this inspection. Although service users tracked were unable to confirm there understanding of the complaints procedure relatives spoken with stated they had never had reason to complain but would speak to the general manager or registered manager if they were concerned. One relative spoken with stated that the registered manager had asked her “never to leave the home unhappy” The home has a complaints procedure prominently displayed in the entrance hall. Relatives all indicated they had read this document. It was confirmed during discussion with staff and relatives that service users legal rights are protected and where identified legal representatives or advocates are used to protect rights. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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): 22.23 Service users live in safe, comfortable and homely surroundings with their possessions around them, this ensures that the accommodation meets their individual needs. EVIDENCE: During this inspection a tour of the accommodation of those service users’ tracked and communal areas took place. Evidence was seen of appropriate specialist equipment in use such as hoists, nursing beds, pressure mats, hip protectors, and specialist chairs and ramps etc. The home has a passenger lift and the exterior of the home is accessible to those wishing to go outside. One of the service users’ tracked required specialist equipment and adequate evidence was found in care records to indicate that other professionals had been involved in this. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 15 Discussion with the registered manager and staff indicated that all were aware of the needs / reasons related to the equipment used. Training records inspected indicated that all staff were up to date with moving and handling training. Bedrooms and associated rooms of those tracked were inspected and were found to be of a size, which met their needs, all rooms seen were very well decorated, homely and well maintained. Those rooms, which were, shared rooms were screened to protect privacy and dignity. Rooms were sufficiently large enough to accommodate specialist equipment such as chairs and hoists etc and contained evidence of personal belongings. Pictures of families and relatives were displayed in service user’s rooms. Two relatives spoken with stated they had chosen the home for its homely feel and considered individual rooms felt like home, this was considered important in the settling in process for those concerned. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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): 27.29 The needs of residents are safely met by thorough a robust recruitment and selection process and adequate numbers of suitably skilled and trained staff. EVIDENCE: During this inspection staff rosters were inspected and it was noted that adequate numbers of staff were rostered on duty and were sufficient to meet the high dependency needs of those accommodated. Staff were observed attending to service users’ at regular intervals and when required. Discussion with relatives in the home indicated that there was always adequate staff on duty and that service users’ were well cared for. The inspector noted that staff were able to spend I-I time with a service user (tracked) at lunchtime whilst eating lunch. It was indicated that having someone with the person encouraged her to eat. This was confirmed with the relative who visited later. The registered manager has recently been appointed into the role and discussion with her and the general manager indicated that a deputy manager would be put in place following a period of adjustment back into her role. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 17 Discussion with the registered manager demonstrated that service users and staff benefit from a diverse skill mix. Nursing staff consists of both registered general nurses and registered mental health nurses who provide training and support to others. Three staff files were inspected and contained evidence of all documentation as required in Schedule 3 of the Regulations. POVA 1st and CRB disclosures were in place. The registered manager stated she is involved in the recruitment of staff along with the general manager. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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): 33.35.36. Regular supervision of staff and their non-involvement in financial matters ensures that the best interests of service users are protected. EVIDENCE: The home has a variety of methods of reviewing their service provision. Ample evidence was found to demonstrate that relatives and service users are regularly consulted with over changes in the home. The general manager stated that the annual satisfaction survey was due to be undertaken in February2006. Service users and representatives are invited to attend a relative’s forum, which is held Bi-monthly, and a newsletter is provided bi-monthly. During discussion several examples were given in relation to multi-agency working, these included involvement with three specialist Dementia care Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 19 agencies who have assisted the home in providing training and specialist advice and resources. Relatives spoken with praised the management for their input into service users care provision. The home are not responsible for the financial arrangements of any service users. Relatives and the general manager confirmed this. It was indicated that a number of service users have legal representation. Service users tracked were unable to confirm their financial arrangements with the inspector. Adequate evidence was found through discussion to demonstrate that staff are well supported and that supervision takes place, Currently supervision is of a group nature and I-1 sessions were well evidenced for new staff on induction. It was recommended that other staff should be given the opportunity to have a I-1 session periodically or as need arises. It was indicated by the registered manager that clinical supervision of staff takes place through discussion and monthly meetings. A more formalised approach to supervision would ensure practise issues are identified and acted upon in a sensitive manner with staff involved and give the opportunity for confidential discussion to take place. Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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 X X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X 3 X 3 X 3 3 X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 3 X 3 X X Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 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. 1 Standard OP9 Regulation 13 Requirement Timescale for action The registered provider must 31/01/06 make arrangements to ensure that medication records are appropriately signed to avoid errors occurring. 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 OP9 Good Practice Recommendations It is recommended that the home put in place a medication profile / care plan where there are polypharmacy issues and /or medications change on a regular basis. It is recommended that a more formal approach to supervision is considered and implemented. Supervision of individuals on a 1-1 basis may ensure staff are confidant in raising issues directly with management. 2 OP36 Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. Extracts may not be used or reproduced without the express permission of CSCI Barons Park Nursing Home DS0000001887.V275607.R01.S.doc Version 5.1 Page 23 - 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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