Inspection on 25/10/05 for Bay Tree Court

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bay Tree Court 17/07/06

Bay Tree Court 06/02/06

Bay Tree Court 02/11/04

Bay Tree Court 08/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bay Tree Court High Street Prestbury Cheltenham Glos, GL52 3AU Lead Inspector Janice Patrick Unannounced 25 October 2005 th 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. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bay Tree Court Address High Street Prestbury Cheltenham Glos GL52 3AU 01242 236000 01242 244576 ` European Healthcare Group plc 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) To be appointed Care Home with Nursing 59 Category(ies) of Old Age not falling within any other category registration, with number (59) of places Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9 March 2005 Brief Description of the Service: Baytree Court is a purpose built care home situated in the heart of Prestbury Village which is on the outskirts of Cheltenham Town. It is convenient for local shops, post office and public house. It has its own designated parking within well kept grounds. The Home offers both personal care and nursing care to those over 65 years of age. Spread out over two floors, those requiring nursing care are predominantly cared for on the first floor. This area has a key pad entry. The ground floor is mainly designated to those that require personal care. Both areas offer well appointed, single accommodation all with ensuite facilities. There are ample communal facilities. The Home and its grounds are wheelchair friendly. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out this inspection between the hours of 11am and 2.15pm. The acting Manager was not at work, but the Operations Manager for the Company was on site and one of the Home’s Registered Nurses was in charge. This inspection was carried out on the nursing floor, but it has taken into account several areas that incorporate the Home in its entirety. Several residents were spoken to including one relative. Care staff were spoken to, in relation to care issues and some care documentation was inspected. Staff rota was inspected. One complaint received by the Home was discussed. A tour of the nursing floor was carried out and one domestic member of staff spoken to. What the service does well: What has improved since the last inspection? The standard of food and nutrition has improved. This is at present being organised by contracted caterers who work within the Homes kitchens. The Home’s Policies and Procedures have been reviewed and many rewritten. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 6 Many working systems within the Home have been completely reviewed, but not all of these have been mentioned within this report. 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. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 standard(s) None Inspected. N/A EVIDENCE: N/A Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 standard(s) 7, 8 & 10 Although a care planning system is in place, it is not user friendly and at times the paperwork is disorganised. It therefore does not offer a clear system for care staff to get guidance from regarding a residents care needs. Residents health care needs are met with the help of external health care professionals where required and is delivered in such a way that upholds the residents’ privacy and dignity. EVIDENCE: Four sets of care notes were read, two of which were inspected in some detail and cross-referenced with additional care records held. In several areas, review dates were overdue, although the basic care planning appeared to match the needs of the resident. In one case however, bedrails were in place, but there was no working risk assessment. In another, a care plan relating to a residents communication problems lacked substance and enough guidance for staff to make a difference for this resident. The registered nurse on duty explained that due to staffing problems, which she anticipated to be nearly resolved, the paperwork has not been a priority. She also explained that within a week of this inspection a date was already set to change the care planning system and update all reviews. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 10 One resident was very aware of her problems relating to her diabetes and was able to show the Inspector a chart for recording her blood sugar levels, but was unaware of any care planning process. There was a care plan relating to her diabetes in her care documentation, but she was clearly unaware of it. Both relatives spoken to were also unable to confirm that they had been involved in any care planning process, but both visited on a regular basis and were aware of their relatives needs and some of the care they get. The care documentation demonstrated that residents were getting access to outside care professionals on a regular basis, such as the Chiropodist, GP and attending hospital appointments. On the day of this inspection, an optical service was reviewing all residents that wished to be reviewed or who were due. At all times staff and external health care practitioners were seen to be treating residents with respect and all care was being carried out in private. Two residents spoken to were able to confirm that staff always spoke to them appropriately and kindly and that they were never made to feel embarrassed. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 standard(s) 12 & 13 The Home tries to fit around the residents’ choices and preferences as much as is practicable and encourages contact with relatives, friends and the community. EVIDENCE: Residents said that they liked the food they were given and that staff were kind and often found an alternative if they did not like what was on their plate. Those who could remember confirmed that they choose what they want to eat the day before. One lady said she likes ‘her usual’ for breakfast but that this was very late on the day of the inspection. The registered nurse acknowledged that this was correct and due to one member of staff going off sick and the optical service requiring the help of other staff on duty. Another resident was about to go downstairs with her relative, as they prefer to frequent the ground floor lounge. This relative visits every day and confirmed they were free to do as they choose, bearing in mind his relatives heath care needs. Another relative takes it in turn with other members of her family to visit each day. Clearly this is unrestricted and varies in times. She confirmed that she is able to take her relative out when she wishes. A comment was made by a relative about the length of time it sometimes takes for staff to respond to her relatives call bell, when she wished to use the toilet. This has been subsequently discussed with the acting Manager. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 12 Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 standard(s) 16 & 18 The Home’s policy and procedures relating to complaints are adhered to and the responses that follow are timely, indicating that the Home takes these seriously. The Home’s Policy and Procedures for Adult Protection are comprehensive, but through staff ignorance of the contents or by just not following the procedures, vulnerable residents are not being protected as well as they could be. EVIDENCE: A complaint made recently by a relative has been responded to initially by the Operation Manager and will be investigated by the acting Manager on her return to work. The contents of this complaint were discussed during this inspection and relate to ongoing problems the Home was aware it had. It would appear that several of the issues raised have already been dealt with. The complaints log was not seen on this occasion, but has always shown in the past this Home to be quick in response to any complaint made. A recent incident, which required the Home’s Adult Protection Policy and Procedures to be evoked showed that staff are either not aware of the contents of the policy or did not follow it. This incident was discussed with the Inspector and eventually appropriate action was taken. Staff have received training in Adult Protection but clearly need to be more aware of the Homes policy, with particular regard to its sections on ‘Handling Disclosures’ and ‘Reporting Procedure’. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 14 Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 26 Residents live in comfortable surroundings that are clean and able to be personalised. This gives a sense of private and familiar space for the resident. EVIDENCE: All bedrooms are well appointed and many have been furnished with the resident’s own furniture and personal items. One resident enjoyed sitting in one particular area of her room, which enabled her to look out of the windows. Her family had placed familiar objects and pictures in positions where she could see them. She said that having these items around each day gave her much pleasure. One of the cleaning staff described her routine for each bedroom. The nursing wing was extremely clean on the day of this inspection. One bedroom had a strong odour despite being cleaned each day. Another form of floor covering may need to be considered. This member of the cleaning staff had a good working knowledge of general health and safety issues. She also said that she enjoyed talking to residents each day, ‘you become fond of them’ she said. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 16 Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 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, 28 & 30 Despite recent staff shortages the Home has been staffed to ensure residents’ needs are met. Staff are trained and experienced enough to carry out their jobs competently. EVIDENCE: A recent loss of staff for differing reasons has caused some problems, but staffing has been maintained at an adequate level to ensure the residents’ daily needs are met. Some paperwork and staff supervision has been a casualty of this and will require getting in order. The Home is currently advertising for a deputy Manager but a new registered nurse has just employed. The registered nurse on duty and subsequently the acting Manager, have both confirmed there are enough staff on duty at any given time. This was questioned in relation to the comments made by a relative about how long it took staff to answer her relatives call bell. It has also been discussed in previous inspections, the need for a trained nurse to take the lead in some of the care on the lower floor, where residents health needs have increased. This was achieved earlier this year but that nurse has since left. Care staff are actively encouraged to study for a NVQ Award in Care and at present, there are four staff undertaking this training via external assessors. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 18 A more experienced member of staff was mentoring one new carer at the time of this inspection as is required as part of any induction training. The Inspector was unable to inspect any induction documentation during this visit. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 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, 32 & 36 The acting Manager has a clear vision for the Home and communicates this effectively to her staff. Staff are not at present supervised adequately. This process enables staff to look at their practice and other issues and ultimately provide a better standard of care to the resident. EVIDENCE: The acting Manager has been a Registered Manager with the CSCI in relation to another Home within the same company. An application will need to be submitted to the CSCI in order to register her as Manager of Baytree Court. In her time at Baytree Court she has effectively introduced several systems and restructured how the care teams work within the Home. She is a strong communicator and has used staff meetings and one to one sessions with some staff, to get her plans and visions across. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 20 On the day of this inspection staff were seen to be working as a team, although one carer was from an agency, he was well known to the core staff. Care staff were seen to be carrying out care tasks as planned and recording these as required. They have regular staff meetings, with the last trained staff meeting being in August. This was poorly attended, but as explained by the registered nurse there has only been herself and the acting Manager on day duty. Due to this, she admitted that a structured staff supervision system has not been a priority. The Inspector did however, witness a more senior member of care staff give guidance to another member of staff on two separate occasions. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION x x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 3 x x x 1 x x Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 22 No 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 7 Regulation 15 Requirement Care planning and associated care records must be maintained in an organised fashion and reviewed in a timely fashion or as required. The Registered Person must ensure that all staff have knowledge of the Homes Adult Protection Policy and understand the importance of adhering to this. An application must be forwarded to the CSCI in respect of a Registered Manager for Baytree Court. A structured supervision system must be recommenced for all staff. Timescale for action 31st December 2005 19th December 2005 2. 18 13 (6) 3. 31 8 (1)(a)(b) 18 (2) 19th December 2005 19th December 2005 4. 36 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 7 Good Practice Recommendations The Home should demonstrate that residents/representatives are being included in their care planning. D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 23 Bay Tree Court 2. 36 That at least 6 supervision sessions for each member of staff should be recorded and kept within their staff file. Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Bay Tree Court D51_D03_S16383_Bay Tree Court_V254823_080805_Stage 4.doc Version 1.40 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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