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Inspection on 11/01/06 for Barrock Court Nursing Home

Also see our care home review for Barrock Court Nursing Home for more information

This inspection was carried out on 11th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The residents said that they liked living in the home and felt that their care needs were met. The meals continued to be very good and residents` diets are monitored and choices offered. Care plans were up dated, and contained relevant information. Two care plans contained entries by the residents and there was obvious family involvement in the development of these care plans.

What has improved since the last inspection?

The standard of hygiene within the home has improved. The home environment was clean and free from bad odours. Two bedrooms had been redecorated and carpeted and new carpet has been laid in part of the hallway. Medication procedures had been improved and an audit system put in place, for medication received by the home and returned to the pharmacist. Staffing levels have been increased to improve the standard of care the residents receive.

What the care home could do better:

Social activities need to be reviewed but this will hopefully improve with the appointment of an activities co-ordinator. The activities within the home should be provided to suit the interests of a wider group of residents and not just individuals in the home. Multi disciplinary meeting should be encouraged for residents with specialist needs and staff kept up dated to provide appropriate care. The Manager needs to look at more effective ways of deploying staff at breakfast time to enable residents to get the assistance they require to enjoy their meal.

CARE HOMES FOR OLDER PEOPLE Barrock Court Nursing Home Barrock Park Low Hesket Carlisle Cumbria CA4 0JS Lead Inspector Colette Hibbert Unannounced Inspection 11th January 2006 08:30 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 Barrock Court Nursing Home DS0000038773.V276979.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. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barrock Court Nursing Home Address Barrock Park Low Hesket Carlisle Cumbria CA4 0JS 016974 73765 016974 73865 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) Ancyra Health Limited Mrs Roseanne Fearon Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (5) of places Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of OP (Old age, not falling within any other category) up to 5 service users in the category of PD (Physical disability under 65 years of age) 16th June 2005 Date of last inspection Brief Description of the Service: Barrock Court was purpose built and is near Low Heskett at the end of a long driveway with fields and trees surrounding it. The home has its own internal courtyard that service users are able to enjoy in warmer weather. The building is on one level, divided into three units.These units accommodate service users of varying levels of dependency and each unit has its own lounge and dining room. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, starting at 08:30 and finishing at 15:00. The inspection process included at tour of the buildings and grounds, talking with staff, residents, and visitors. The files of newly appointed staff were checked, as were a number of randomly selected residents. Other relevant documents were also read. The Registered Manager and administrator assisted throughout the day. What the service does well: What has improved since the last inspection? The standard of hygiene within the home has improved. The home environment was clean and free from bad odours. Two bedrooms had been redecorated and carpeted and new carpet has been laid in part of the hallway. Medication procedures had been improved and an audit system put in place, for medication received by the home and returned to the pharmacist. Staffing levels have been increased to improve the standard of care the residents receive. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 6 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. Barrock Court Nursing Home DS0000038773.V276979.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 Barrock Court Nursing Home DS0000038773.V276979.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): 1,2,and 4 Residents have access to information required to make informed choices as to whether the home can cater for their individual needs. Residents have individual contracts / statement of terms and conditions they can expect within the home. EVIDENCE: Residents are each given a service user guide prior to admission, this is a robust document, which explains the organisation, and gives contact names and addresses. It gives all information the residents and their families may need to know about the services offered by the home. Each resident has individual contracts with the home stating terms and conditions of the home. These are issued before admission so that the resident can make an informed choice. Residents are able to visit the home prior to admission and stay for a trial period to determine if their needs can be met by the home. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 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): 7,9,and 11 Each resident had a care plan which set out health, personal and social needs. There has been an improvement in procedures for dealing with medication. Residents feel that at time of death the staff will provide appropriate care for them. EVIDENCE: Several care plans were examined and they had been up to date and contained details for staff to determine the care needs of the residents. They had been regularly updated with amendments made to changes in care needs. Moving and Handling assessments had been done and the appropriate equipment was listed for each resident. Care plans were individualised and some contains entries made by the residents and their relatives. A requirement had been made on the last inspection and the manager has worked hard to meet this requirement. The medication procedure had been reviewed since the last report. Medication was given at the times stated on the prescription chart. The manager had introduced an audit system to monitor the medication received by the home and any returns to the pharmacy are recorded and signed, to provide Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 10 continuous supply of medication for the residents, and ensure safe practice. This was a requirement made at the last inspection and has been met. There had been a death in the home last week; on the day of the inspection it was the funeral, which some staff had attended. Residents and staff supported each other well and the residents said they felt comfortable in the knowledge that the staff would take good care of them ‘when the time comes’ The Manager showed a letter from a family who had written to the home recently after the death of their mother. It expressed thanks for the loving care that their mother had received during her time at the home, and how well supported the family had been. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 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 Social aspects of life are difficult to provide due to the isolated position of this home, but staff are working to develop this to improve the quality of life of the residents. EVIDENCE: The local vicar visits every week and several residents said that they liked and looked forward to this visit. There had been outings before Christmas to concerts and for the residents to do their Christmas shopping with the help of the staff. The local school and church choirs had also been in to the home to sing for the residents. Residents said that they would like ‘more activities and outings’ but getting transport was difficult. There was an O.T assistant who provided activities for part of the week and the home was in the process of appointing an activities co-ordinator. On the morning of the inspection the residents had a poetry reading session in one of the lounges and some had discussions about the daily newspaper. This is an area that the Manager hopes to improve in the future, with the appointment of extra staff. A requirement was made at the last inspection about social activities within this home and will be repeated. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 12 When asked the residents said that they would like more activities but did not know what they would like to do, one lady said anything would be better than ‘staring at the walls’ She did say that she was happy living in Barrock Court. Visitors said that they could visit anytime and were always made welcome, one gentlemen came to visit regularly and he took his dog to see the other residents as well. Barrock Court Nursing Home DS0000038773.V276979.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 and 18 Residents and relatives were confident that their complaints would be taken seriously and acted upon. Residents’ legal rights were protected and there was a robust policy and procedure in place to protect the residents from abuse. EVIDENCE: A formal complaints form has been placed within the service user guide and a book has been made available for residents and staff to write any informal complaints, comments or suggestion in. They had not taken advantage of this new system yet but the residents were aware of what to do if they had a complaint. A requirement had been made at the last inspection and this had been met. Residents legal rights were protected, several residents said that they had been to vote and some had postal votes, they also said that they could see a solicitor if they wanted and in private. The home had a policy in place to protect the residents from abuse and the staff where aware of the procedures to take in the event of an incident. Barrock Court Nursing Home DS0000038773.V276979.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): 19,20,21,and 25 The residents live within a clean comfortable, safe environment that meets their individual needs. The home is working its way through the maintenance programme to improve the living conditions within the home and the washing facilities for the residents. EVIDENCE: The home has two full time domestic staff who were both on duty during the inspection. The home was free from bad odeours and was clean. Two bedrooms had been decorated and with new carpet fitted since the last inspection, also a new hallway carpet had been fitted. The maintenance man was working in another bedroom taking up the carpet ready for the new one to be laid next week. COSHH guidelines and safe practices were seen to be in place and being followed to maintain a safe environment for the residents. This was a requirement at the last inspection and had been met. New commodes had been purchased and hoist were well maintained, this was also a requirement made at the last inspection and has been met. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 15 One of the shower rooms had experienced a leak and the home is in the process of major alterations in the provision of washing facilities which should take place within the next two weeks and will be monitored at the next inspection. Residents spoken to say that they could have a bath when they requested one and that they had privacy and were treated with dignity. There are three small lounges within the home and the residents can use which one they wanted. Each was clean and bright and very homely, with a variety of comfortable chairs. There are two dinning rooms’, which are laid out with small tables, each with table clothes and napkins. These rooms were clean with dining chairs and ample room for wheelchairs, the residents were given the choice were they wanted to sit and whom they ate their meals with. Outside there was a courtyard for the residents to sit in. There was an excess of rubbish awaiting disposal at the back of the property, which the manager said, would be removed later in the day, it was visible from one of the residents bedroom and did not make a very pleasant view. Barrock Court Nursing Home DS0000038773.V276979.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): 27,28,and 30 Residents within the home benefit from a stable staff group who are aware of their needs. The home has a robust recruitment policy in place to enable appropriate staff to be employed to keep the residents safe. EVIDENCE: The home has recruited since the last inspection and extra staff have been employed. Criminal Record Bureau Disclosure, Protection of Vulnerable Adults and two references are all obtained prior to employment. The staffing levels have been increased to provide more care for the residents. Breakfast took most of the morning running from 08:00 to 11:30, the manager said that the residents had the choice of what time they got up but was looking at ways to try to improve the efficiency of this part of the service. The residents spoken to said the staff were ‘ wonderful, and nothing was too much trouble’ they said that they never had to wait for help and the staff were very friendly. Staff treated the residents with dignity and respect. The training programme continued within the home with staff undertaking NVQ level 2,3 and 4. Staff had received training for Infection Control, Moving and Handling, and Safe Administration of Medication. Staff said that they enjoyed the courses that they had been on. One of the nurses said she was looking forward to a course on syringe drivers, which she felt would expand her role within the home and help her to deliver adequate pain relief to the residents. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 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, 36and 38 The Manager has clear vision and direction, she is aware of her responsibilities to keep the residents safe. The residents are kept safe by the procedures and policies carried out in the home. Staff do not have formal supervision which would provide ways of communicating any issues and help to maintaining standards of care for the residents. EVIDENCE: The Manager has completed her NVQ Level 4, Registered Managers Award. Staff spoken to said that they where well supported by the Manager and they felt that they could take any problems or concerns to her and that she would act upon them. Residents and visitors said that the Manager was very committed, friendly and approachable. If they had a complaint it would be listened to and acted upon in an appropriate manner. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 18 Health and Safety requirements had been made at the last inspection and all fire exists were clear and free from hazards. Prescribed creams and dressings are now stored in a locked cupboard. This was a requirement made at the last inspection and has been met. Staff spoken to said they did not have supervision 6 times a year, but were able to talk to the manager on an informal basis. The Manager should set up a more formal system for supervision, which will lead to a more effective team. This will highlight any weaknesses and training needs to improve the standard of care for the residents. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 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 3 3 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 X X X 3 X STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP12 Regulation 16.2m Requirement Resident’s social needs must be met. This was a requirement made with timescale of 30/06/05 Bathrooms and shower rooms must be updated as per re fitment programme. Staff must receive formal supervision which is documented within the staff individual personnel file Timescale for action 28/02/06 2 3 OP21 OP36.2 23 (2 (J)) 18.2 28/03/06 28/02/06 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. 2 Refer to Standard OP 4.2 Op27 Good Practice Recommendations All specialist services offered are based on current good practice and reflect relevant specialist and clinical guidance. The working routine at breakfast time needs to be reviewed to enable residents to have more assistance with DS0000038773.V276979.R01.S.doc Version 5.1 Page 21 Barrock Court Nursing Home their meal if they require it. Barrock Court Nursing Home DS0000038773.V276979.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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