Inspection on 15/08/07 for Barrock Court Nursing Home

This inspection was carried out on 15th August 2007.

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

Barrock Court Nursing Home 27/01/09

Barrock Court Nursing Home 17/09/08

Barrock Court Nursing Home 04/07/06

Barrock Court Nursing Home 11/01/06

Barrock Court Nursing Home 16/06/05

Barrock Court Nursing Home 25/02/05

Barrock Court Nursing Home 23/08/04

Barrock Court Nursing Home 26/02/04

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 Barrock Court Nursing Home Barrock Park Low Hesket Carlisle Cumbria CA4 0JS Lead Inspector Jenny Donnelly Unannounced Inspection 15th August 2007 10:45 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 Barrock Court Nursing Home DS0000038773.V344081.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. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrock Court Nursing Home Address Barrock Park Low Hesket Carlisle Cumbria CA4 0JS 016974 73765 016974 73865 manager.barrockcourt@aermid.com 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) Aermid Health Care (UK) Ltd Mrs Roseanne Fearon Care Home 28 Category(ies) of Dementia (1), Mental disorder, excluding registration, with number learning disability or dementia (2), Old age, not of places falling within any other category (28), Physical disability (5) Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 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) 1 named service user in the category of DE (Dementia under 65 years of age) may be accommodated within the overall number of registered places. 2 named service users in the category of MD (Mental disorder) may be accommodated within the overall number of registered places. Date of last inspection 4th July 2006 Brief Description of the Service: Barrock Court nursing home is purpose built and is situated near Low Heskett at the end of a long driveway with fields and trees surrounding it. The home has its own internal courtyard that people are able to enjoy in warmer weather. The building is on one level, divided into three units. These units accommodate people of varying levels of dependency and each unit has its own lounge and bathing facilities. Ancyra, the company that owned Barrock Court, was sold in December 2006 to Aermid Health Care (UK) Ltd, who now operates the home. There was no change in the management structure or service delivery when this change took place. At the time of this key inspection, the weekly fees ranged from £483.00 to £567.00 according to the residents dependency. Information for prospective residents and relatives was available in the form of a service users guide. The homes’ latest inspection report was also available in the home. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.45 and 16.15 hours on 15th August 2007. The registered manager was on leave at the time, so a further planned visit was made on 28th August to speak with the manager and to access certain files. In the months before the inspection, the manager had completed a quality audit document for the inspector and submitted various data about Barrock Court. CSCI also sent out satisfaction surveys to 12 people who live in the home, their relatives, and the 3 GP surgeries who attend the care home. Information received from these surveys is included in this report. During my visit to Barrock Court I spoke with people who live in the home, and with visitors and staff. I toured the building and looked at care, medication, maintenance and staffing records. Further to the last full inspection of 4th July 2006, a “random” inspection took place in November 2006 to follow up on requirements made in July. The report from that visit can either be obtained from the care home, or by request from the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? Since the last inspection refurbishment work has continued with new floor coverings laid in the dining rooms, lounges and bathrooms. A new walk in shower has been created and there has been some general redecoration. The quality of record keeping has improved in relation to care planning, admission assessments and staff training. Staff have received training in safeguarding people. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 6 Meal times have been altered in accordance with people’s wishes, and additional art and craft equipment has been purchased for activities. 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. The summary of this inspection report can be made available in other formats on request. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 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.V344081.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Barrock Court operates sound admission procedures which ensure people are well informed about the services offered and can feel confident that staff will be able to meet their needs. EVIDENCE: The home had a Statement of Purpose that detailed the services offered, and this had been updated to show the contact details of the new company. There was a detailed pre-admission document, which had been completed prior to people being offered a place in the care home. This ensured the home could meet peoples’ needs before they were offered a place. This assessment was done in conjunction with assessments by the persons’ social worker or hospital if relevant and served to build a good picture of the person and their care needs. The admission process had improved since the last inspection. A Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 9 number of the visitors I spoke to said they had viewed several care homes, and made a positive choice to bring their relative to Barrock Court. Another person felt they had no choice of care home, as they wanted to stay in the local area. People said, • “ We looked at seven homes and chose this one” • “ We looked at several homes and thought this was the best” • “ I had to come here so I can be close to my friends and family” People living in the home had a contract of residency, either directly with Barrock Court or through their funding agency. The home does not provide intermediate care. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were benefiting from receiving good quality personal and health care in accordance with their wishes. EVIDENCE: Each person had a named nurse who was responsible for planning and overseeing their care. Everyone had a written plan of care that was individual to them and described in detail the level of support required from staff. The standard of care planning had generally improved from the last inspection. There was evidence that plans were kept up to date and included peoples personal wishes and choices. Health needs were promptly attended to and there was evidence that staff sought external advice from specialists in continence, wound care, mental health and dietary needs. People had good access to their doctor and staff followed any medical instructions given. There were some inappropriate comments seen written in one persons care plan, and this was brought to the attention of the manager. Apart from this instance, Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 11 staff were seen to treat people with respect and provide personal care in a sensitive and dignified way. People said they felt well cared for saying, “I am very happy here, I get my shower every day”. And “I am very happy and content at Barrock Court”. Relatives commented that: • “ Mum is very well cared for, nothing is any trouble” • “ Mum is always dressed clean and tidy when we visit” • “ Everything is excellent, I would complain otherwise” • “ It can take time for instructions to filter to all care staff which is frustrating” One visitor did not feel their relative got the attention required, although care records demonstrated this person did receive individual attention. The management of medicines was sound, with staff having a good understanding of the medicines system and peoples’ individual requirements. The medicine records and stock were examined and found to be correct and kept properly secured and tidy. The manager undertakes periodic audits of the medicines to ensure that all is in order, and staff had been trained in the medicines system. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to maintain links with the local community, and can join in with group activities or pursue individual hobbies and interests as they wish. People enjoyed the meals served. EVIDENCE: The activity organiser continues to work individually with people as well as organising group activities, which are planned daily in accordance with people’s wishes. New art and craft materials have been purchased and more effort is being made to access external events although transport arrangements remain difficult. There are plans to introduce a newsletter, which hopes to include contributions from residents. People were content with the level of activities on offer and visitors also felt supported by staff. • “ Staff pick me up and drop me off at bus stop or I wouldn’t be able to come” • “ I have made friends with another resident, and we spend a lot of time together” Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 13 • • • “ The home enables …… to take up many hobbies and skills to provide interest and activities at her own level and choice” “ Mum watches TV but can’t read or do puzzles since her stroke, she used to read the Bible but now sees the vicar for regular services. Mum used to be a cook and enjoys the meals here. She has the hairdresser weekly and saw the chiropodist today” “ There is life in the place”. Since the last inspection meal times had been altered so that cooked breakfasts finish at 10.30am, so as not to put people off eating lunch. The teatime meal has moved from 4.30 to 6pm, to lesson the overnight gap. People were happy with this, saying it suited them much better. Lunch was meatballs with rice or mashed potatoes and vegetables. People said they enjoyed the meals and today was a favourite. There was no second choice of main course, but alternatives were available and the cook was aware of people’s preferences, saying “one person does not like chicken so I always do him a bit of corned beef which I know he loves”. The desert was hot chocolate sponge suitable for diabetics or there was fruit and cream. Staff liaised with the speech and language therapist over peoples’ swallowing needs, and she was present at lunch assessing people. People generally said the food was very good although one person wanted chips more often. Visitors commented that, • “ We are pleased with the new tea time of 6pm” • “ The food is good” • “ The meals always look nice”. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People knew how to complain about the service and felt they would be listened to. Staff were aware of safeguarding procedures and people living in the home felt protected. EVIDENCE: There was a complaints procedure on display in the home, and people spoken to and surveyed confirmed they knew how to raise concerns, saying, • “ The information on how to complain is displayed” • “ Normally immediate action (is taken) to meet any special needs” • “ We would certainly complain if needed, but don’t believe it would ever be necessary”. Since the last inspection, the inspector received one complaint about the quality of a persons respite care. This was looked into by the person’s social worker and a subsequent respite had been successful. The inspector had also received two anonymous phone calls about shortfalls in staffing on a particular day, which the company had already reported and were dealing with. The manager had not received any other complaints. Since the last inspection the manager had completed a trainers course in safeguarding adults and had since been running training sessions on this for staff. Staff were aware of the company whistle blowing policy and people living in the home said they felt safe and protected. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment at Barrock Court is being continually improved and provides a safe and pleasant place for people to live in. EVIDENCE: Barrock Court is a purpose built care home, all on one level. There is good wheelchair access throughout the home, with external ramps where necessary. The building is divided into three units, with each having its’ own lounge and bathrooms. There are two dining rooms. There is a designated smoking room. As well as ground to the front of the home, which overlooks the surrounding countryside, there is an enclosed courtyard where people can sit out. All bedrooms are single with an en-suite toilet and basin. At the last inspection the home was undergoing a programme of refurbishment. Although this was interrupted by the change of ownership, the Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 16 refurbishment has re-commenced. Both dining rooms and two lounges had been redecorated and new flooring laid. Bathrooms had also been redecorated and had new flooring, and a new walk in shower room had been created. There were plans to create another shower room, and decorate the remaining lounge and bedrooms. There are also long term plans for some landscaping to improve the grounds. Comments received included: • “ We would like to see more refurbishments as some rooms are dreary and need decoration” • “ Mum’s bedroom is lovely” • “ It’s always nice and clean” There were some minor points in need of attention, such as one toilet being crowded with bins and another having no sign on the door to help people locate it. The home was clean and fresh throughout. The laundry was in operation throughout the day, and domestic staff were going about their duties keeping the home clean and fresh. People said the laundry service was very good. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Despite some problems with maintaining staffing levels, people felt they were cared for by caring and properly vetted staff who had received training on how to support them. EVIDENCE: The manager has experienced some difficulties maintaining staffing levels this year, particularly over the summer period when staff were taking holidays. The company were unable to provide a registered nurse for a night shift in June, and had to provide additional care staff and make on-call arrangements. Since then two new nurses have been recruited with two others in the process of being recruited. There was just one carer vacancy, which was being covered by casual staff. On the day of this inspection there were two nurses on duty (one of whom was on induction) and five care staff. As one person had a one to one individual carer, there should have been six care staff on duty. The rota showed future shifts to be adequately covered, and the manager needs to maintain this. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 18 People living in the home and visitors were complimentary about the staff team, saying: • “ Staff are kind, friendly and caring” • “ The supervision obviously encourages staff to provide high quality service from effective training” • “The staff and manager are excellent” • “ Nothing is too much trouble for the staff” One person said “ I have issues with some staff members”. Inspection of staff files showed that there was a standard set of company documentation in use to assist with sound recruitment procedures. Staff had completed application forms, attended for interview, references and criminal records bureau checks had been obtained. The provision of staff training had improved since last year, and the manager now had better systems of keeping track of training. Nine care staff had completed an NVQ (National Vocational Qualification) in care, representing 41 , and a further 5 were working towards an NVQ, which when completed will be 63 of the staff group. Training sessions had included mandatory health and safety topics as well as specific health conditions relevant to the client group. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from consistent management, and are consulted about their veiws and wishes. EVIDENCE: The registered manager has been in post at Barrock Court for three years, and is suitably qualified for the post. The manager receives regular support in her role from the company who own the home. Quality assurance checks are in place and comprise of satisfaction surveys and the managers’ own quality audits. The satisfaction surveys covered different topics including the environment, the admission procedures, catering and daily Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 20 life in the home. The latest survey, conducted in March of this year, showed a majority of excellent and good responses to the questions asked. The managers’ quality audits included regular checks on care plans and medication records. The audit tool showed that any shortfalls found were followed up and corrected. People commented that; • “ The manager is our best source of information and appears to have personal interest in (my relatives) care and needs” • “ The manager is excellent” The manager operated a system of regular supervision sessions for staff as well as an annual appraisal, to monitor performance and identify new training needs. Policies and procedures were in place to guide staff, and the company updated these as necessary. The manager and administrator generally did not get involved with peoples’ personal finances. There were systems in place to promote and protect the health, safety and welfare of people living in the home, visitors and staff. This was demonstrated through the regular fire safety checks, and health and safety training. The inspector saw a list of last inspection dates for services and equipment within the home, such as water temperatures and electrical testing. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 21 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 3 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 22 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. 1. Refer to Standard OP27 Good Practice Recommendations The manager should have contingency plans in place to maintain adequate staffing levels during periods of staff absence. Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Barrock Court Nursing Home DS0000038773.V344081.R01.S.doc Version 5.2 Page 24 - 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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