Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 15/07/08 for Baytrees Nursing Home

Also see our care home review for Baytrees Nursing Home for more information

This inspection was carried out on 15th July 2008.

CSCI found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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 last inspection highlighted that people living in the home were satisfied with the overall service provided. They said that members of staff were kind and respectful, they enjoyed the activities, particularly the outings, and they liked the food provided.

What has improved since the last inspection?

The Inspector was able to see improvements in they way in which residents` personal allowances were managed and accounted for. Care plans now record social interests and how staff should offer support to individuals to ensure that these needs are met. The Kitchen was seen to be clean and hygienic. The walls and ceiling in the food store had been re-plastered and new flooring fitted. The food store is now easily cleanable. The Complaints policy and procedure has been updated and now includes the required information and contact details of the Commission. It was seen on the notice board in the entrance hall and at a lower level so accessible to people using a wheelchair. Steps have been taken to ensure that people living in the home and their relatives are fully aware of what a person is expected to pay for out of their own funds and what the service is responsible for providing.It has been made clear that the service is responsible for the provision of nursing equipment and consumables. The requirements made at the last inspection by the Fire officer have been complied with and the Fire Officer is satisfied with the overall management of fire prevention in the home. The Registered Manager has taken action to improve end of life planning for people living in the home to ensure their wishes are known and respected.

What the care home could do better:

There has been no change to the laundry since the last inspection. The walls are not easily cleanable, the floor is not impermeable and is uneven and there is no hand washing facility. This poses a health & safety risk to members of staff and a risk to the health and well being of people living in the home due to poor infection control in this area. A statement of purpose and service user guide were not available at the last inspection and again not available at this inspection. This means that prospective service users and their relatives do not have up to date written information about the service. The service does not have a safeguarding adult policy and reporting procedure specific to the service. This means that members of staff do not have clear guidance about what procedures the service expects them to follow in the event of allegations of abuse. Safeguarding matters have not been reported through the correct procedures and puts people living in the home at risk of abuse. The Complaints record does not respect confidentiality of information. The fire risk assessment for the home has not been reviewed since 2004. There is no emergency plan for the home in the event of a fire. Medication that requires storing in a fridge must be stored in a fridge that can be locked or in a room that can be locked at all times. The pre-admission assessments are not dated and do not indicate where the assessment took place and do not include a question about the specific needs or requirements in respect of a person`s religion, sexuality or culture. There is no indication of how a person or their relative/representative have been involved in the compilation of their care plan. The garden/decking area requires improvement to make it a pleasant and attractive place for people living in the home to spend time.There is no place in the home defined as a dining area. Evidence of the last gas safety inspection and the electricity certificate were not available for inspection so it is unclear as to when this was last undertaken.

CARE HOME ADULTS 18-65 Baytrees Nursing Home 1 Highfield Road Worthing West Sussex BN13 1PX Lead Inspector Jan Aston Unannounced Inspection 15th July 2008 09:50 Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 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 Baytrees Nursing Home DS0000024113.V366949.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 Adults 18-65. 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. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Baytrees Nursing Home Address 1 Highfield Road Worthing West Sussex BN13 1PX 01903 693833 01903 693822 baytreeshomes@aol.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) Bay Trees Homes Limited Mrs Denise McWilton Care Home 30 Category(ies) of Physical disability (30) registration, with number of places Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only service users in the category Physical Disability (PD) 18-65 years may be admitted. Rooms 21 and 27 can only be used for service users who are not independently mobile through the use of a wheelchair. 21st January 2008 Date of last inspection Brief Description of the Service: Baytrees is a care home proving nursing care and accommodation for 30 younger adults with physical disabilities. Baytrees Homes Limited owns the service and the Responsible Individual on behalf of the company is Mr T Francis. The Registered Manager responsible for the day to day running of the service is Mrs Denise McWilton. The home is located in Worthing and is close to shops, pubs and other amenities. The main house consists of a three-storey building, which has been extended and adapted. In 2004 a new extension for 10 service users was added to the premises this increased the registration to 30 service users. All rooms in the new extension and a small number of rooms in the main house have en-suite facilities. All rooms are accessible by a passenger lift. Service users have level access to two lounges/dining rooms, a conservatory, a smoking room and a large decked area to the rear of the property. The fees charged are £500-£900 Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means that people who use this service experience adequate quality outcomes. The outcome of the last key inspection undertaken in January 2008 was a 0 star poor rating for the service. This inspection has focused on ensuring that the requirements made for improving the service have been complied with. A visit to the home was made on Tuesday 15th July 2008. Five hours were spent in the home. The Inspector looked around the home, examined a sample of records in relation to care plans, residents’ financial records, recruitment records for new staff, complaints and safety inspections for equipment and utilities. Information was also used from the Annual Quality Assurance Assessment form (AQAA) that had been completed and sent to the Commission prior to the inspection. What the service does well: What has improved since the last inspection? The Inspector was able to see improvements in they way in which residents’ personal allowances were managed and accounted for. Care plans now record social interests and how staff should offer support to individuals to ensure that these needs are met. The Kitchen was seen to be clean and hygienic. The walls and ceiling in the food store had been re-plastered and new flooring fitted. The food store is now easily cleanable. The Complaints policy and procedure has been updated and now includes the required information and contact details of the Commission. It was seen on the notice board in the entrance hall and at a lower level so accessible to people using a wheelchair. Steps have been taken to ensure that people living in the home and their relatives are fully aware of what a person is expected to pay for out of their own funds and what the service is responsible for providing. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 6 It has been made clear that the service is responsible for the provision of nursing equipment and consumables. The requirements made at the last inspection by the Fire officer have been complied with and the Fire Officer is satisfied with the overall management of fire prevention in the home. The Registered Manager has taken action to improve end of life planning for people living in the home to ensure their wishes are known and respected. What they could do better: There has been no change to the laundry since the last inspection. The walls are not easily cleanable, the floor is not impermeable and is uneven and there is no hand washing facility. This poses a health & safety risk to members of staff and a risk to the health and well being of people living in the home due to poor infection control in this area. A statement of purpose and service user guide were not available at the last inspection and again not available at this inspection. This means that prospective service users and their relatives do not have up to date written information about the service. The service does not have a safeguarding adult policy and reporting procedure specific to the service. This means that members of staff do not have clear guidance about what procedures the service expects them to follow in the event of allegations of abuse. Safeguarding matters have not been reported through the correct procedures and puts people living in the home at risk of abuse. The Complaints record does not respect confidentiality of information. The fire risk assessment for the home has not been reviewed since 2004. There is no emergency plan for the home in the event of a fire. Medication that requires storing in a fridge must be stored in a fridge that can be locked or in a room that can be locked at all times. The pre-admission assessments are not dated and do not indicate where the assessment took place and do not include a question about the specific needs or requirements in respect of a person’s religion, sexuality or culture. There is no indication of how a person or their relative/representative have been involved in the compilation of their care plan. The garden/decking area requires improvement to make it a pleasant and attractive place for people living in the home to spend time. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 7 There is no place in the home defined as a dining area. Evidence of the last gas safety inspection and the electricity certificate were not available for inspection so it is unclear as to when this was last undertaken. 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. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People thinking about moving into the home do not have sufficient written information about the service that will help them make an informed choice about living in the home. Prospective service users would be more confident that their needs could be met if they were consulted about their religious, cultural or sexual needs prior to admission. People living in the home are aware of the terms and conditions of service and have an individual contract. EVIDENCE: The Statement of Purpose and Service user guide that are required under regulation 4 and 5 were not available at the last inspection in January 2008. They were not available at this inspection. The service has breached regulation 4 and 5 and a requirement has been made for the Provider to compile both documents and send a copy to the Commission. Pre-admission assessments were examined for two people recently admitted to the home. Pre-admission assessments covered all aspects of needs and support required. Information from previous placement and hospital setting for each person had been obtained. They did not enquire or record information about a person’s needs or requirements around their religious, cultural or sexual needs. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 10 It is a requirement that a service registered to provide nursing care provides nursing equipment and supplies. It was found at the last inspection in January 2008 that some residents had bought their own specialist beds and pressure relieving equipment. There was no written agreement or information as to why this had been necessary and this had not been made explicit in the contract/terms and conditions agreed with each person before or on admission to the home. Through this inspection it was confirmed that nursing equipment is provided as part of the fee for the service and it had been the choice of individuals or their relatives to purchase specialist equipment not a requirement. A revised residency agreement has been issued to all people living in the home or their relatives. The agreement states what a person living in the home is required to fund from his/her own resources and what the fees paid to the Provider cover. It states clearly that nursing equipment and consumables are provided within the fees. People living in the home are free to purchase equipment if they so choose but this is not a requirement. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of people living in the home are met and they are supported to have choice and can take risks in daily life. People living in the home would benefit from a more person centred approach in planning their care and the care plans were produced in a suitable format for their communication needs. EVIDENCE: At the last inspection in January 2008 it was found that all residents had a plan of care based on an assessment of need. The plans inspected gave clear information on meeting physical need, such as hygiene, continence and pressure care and managing risk but little information on social need. How much the residents and/or their representative is involved in drawing up the plan was unclear. Two care plans were examined at this visit to the home. Both care plans included information about a person’s social interests and needs and how staff should support individuals to meet this need. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 12 Care plans are written using a standard format and are not available to people who use the service, as accessible versions (for example, easy read). As the AQAA records that eight people living in the home have a dementia and three have specialist communication needs this needs to be considered. Care plans were seen to record problems not needs and there was no evidence that people living in the home are consulted about any specific needs or requirements around their race, age, gender, sexual orientation, religion or beliefs. How much a person or their representative is involved in drawing up the plan was still unclear. This was discussed with the Registered Manager who confirmed that the care plan format and documentation is currently being reviewed and how people living in the home can be involved and included in their care planning will be part of this review. Standards 7 and 9 were assessed at the last inspection and were met as residents spoken to say, that all needs are met to their liking and they have choice in daily life. People who use this service experience good outcomes area because assessed care needs are met and residents have choice and can take risks in daily life. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 were assessed at the last inspection and were met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good outcomes area because there are appropriate and varied leisure and dietary provision. Rights are respected and responsibilities recognised in their daily lives. EVIDENCE: Standards 12, 13, 15, 16 and 17 were assessed at the inspection in January 2008 and were met and people living in the home experience good outcomes in this area. At the last inspection residents said that they are happy with the recreational activities available in the home. The home has its own transport and the residents enjoy frequent trips out. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 14 One survey received stated that the trips are very good; another said the home provided good activities in a friendly atmosphere. Upcoming events are displayed on the notice board. Family and friends are welcome in the home. Members of staff were observed talking to residents in a respectful manner and were seen to knock before entering residents’ rooms Residents are offered a nutritious and varied menu. There is choice at each meal. . Residents spoken to stated that they enjoyed the meals. The Commission has not received any information to indicate that these standards are not being met therefore these standards were not assessed again at this inspection. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 were assessed at the last inspection and were met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service experience good outcomes in this area because they receive personal support in the way they prefer and can retain their own medication if they choose. Physical and emotional health needs are met. Residents can retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Standards 18, 19 and 20 were assessed at the last inspection and were met. At the last inspection residents confirmed they receive support as indicated on the care plans and as they wish. Members of staff spoken with said that the home is run in the home is run in the best interests of the residents. The deputy manager stated that risk assessments are in place to enable residents to self-administer if they wish. Medicines were stored and administered appropriately. Medicine administration charts inspected were up to date. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 16 The Commission has not received any information to indicate that these standards are not being met and therefore these standards have not been assessed at this inspection. One matter regarding the storage of medication was observed during this visit to the home. Medication was being stored on a temporary basis in a fridge that could not be locked in an area accessible to people living in the home, visitors and all members of staff. The Inspector was informed that this was due to the medication fridge being defrosted. It was seen that the medication had been moved to the appropriate medication fridge but the lock on this fridge was broken. The room in which the fridge was kept was not locked. The Registered Manager took immediate action to lock this room and inform staff that the room should remain locked until the fridge had been repaired. The Registered Manager was required to confirm in writing to the Commission that action had been taken to either repair the lock on the fridge or to replace the fridge. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are not safeguarded through the complaints procedure, as confidentiality of their information is not protected. People living in the home are not protected, as matters raised by them in respect of poor practice have not been reported through safeguarding adult procedures. People living in the home would benefit from the home having a range of formats about the complaints procedure. EVIDENCE: It was found at the last inspection in January 2008 that the complaints procedure for the service provided out of date information about which authority could also be contacted in respect of a complaint. The procedure on display was not displayed at a height that was accessible to people living in the home who use wheelchairs. Since the last inspection the complaints procedure has been updated and provides relevant information about the process and contact details of other authorities. It was observed that the procedure had been displayed at a more suitable height so that it was accessible to those in a wheelchair. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 18 The Annual Quality Assurance Assessment Form completed by the Provider stated that there are eight people with a dementia living in the home and three with specialist communication needs. The Inspector was informed that the complaints policy and procedure is explained to all people living in the home and a copy given to their relatives. It is appropriate however for the Provider to consider making the complaints procedure available in a format that is more suitable for their communication needs. The Inspector examined the complaints record. It was noted that a complaint had been received from a person living in the home about the actions of a member of staff and a complaint from a member of staff about another member of staff. Names and all details of the complaint and action taken were recorded. The details of the complaint are accessible to all members of staff and therefore a person’s right to confidentiality is not respected. The last inspection identified that the service had the West Sussex Multidisciplinary safeguarding adult policy and procedures in place and that all staff had received training in awareness of abuse in October 2007. The home did not have a policy or procedures of their own to assist staff in responding to suspicion of abuse or evidence. The Registered Manager confirmed at this inspection that she and a Senior Care Assistant had attended training in the new safeguarding adult procedures. It was seen that information about the new procedures had been obtained and would be cascaded to all members of staff. However the service still has not developed and put in place their own policy and procedure in respect of responding to safeguarding adult allegations. A complaint made since the last inspection by a person living in the home about the way in which a member of staff spoke to them and being handled roughly had not been reported under safeguarding adult procedures. The last inspection highlighted that the residents’ personal allowances were poorly managed and the recording sheets did not match the amount in the pooled tin. At this inspection the Inspector was informed that the service does not act on behalf of people living in the home in respect of their financial affairs. A family member or representative who has Power of Attorney supports those who are unable to manage their own financial affairs. The service only support people where required with personal allowances and small amounts of money provided by family for individual personal expenses. The system used to manage the personal allowances was examined. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 19 Records demonstrated that for each individual any expenditure is recorded, receipts obtained, any money received recorded and a running balance kept. The records relating to the personal allowance for four individuals were examined. This showed itemized expenditure and receipts and the balance of money was correct. From this record it was seen that the balance and records are checked weekly. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a homely and comfortable environment. Shortfalls in hygiene standards in the laundry do not provide safe working conditions for staff or safeguard people living in the home of potential risks of infection. The quality of daily living for people living in the home could be improved by providing a defined dining area and making the outside decking area a more attractive place to spend time. EVIDENCE: On the day of the visit to the home the communal areas, bedrooms and bathrooms looked generally well maintained and clean and hygienic. At the last inspection in January 2008 a requirement was made in respect of keeping the kitchen clean and hygienic and adhering to Environmental Health legislation in respect of food safety standards. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 21 After the inspection the Commission contacted the Environmental Health Officer from Worthing Borough Council who made a visit to the home on the 7th February. A report was sent to the Commission of their findings. This inspection and report found that previous requirements made had been attended to, the Safer Food Better Business Pack was being implemented and arrangements had already been made to undertake a deep cleaning to the extraction unit, oven and tops of the wall tiles. However they required that “The external store must be maintained in a sound clean condition, the floor finish should be sealed to facilitate cleaning”. It was observed at this inspection that the flooring in the food store area has been replaced and is now easy to keep clean, the walls and ceiling have been re-plastered. The leaking roof over the external store has been repaired and the ceiling is waiting to be re-plastered. There was no evidence of damp or mould. The kitchen looked clean and hygienic. The requirement made has been met. At the last inspection in 2008 and at the previous inspection a requirement was made in respect of the laundry area to ensure that surfaces were easily cleaned and a separate hand washing facility be provided to prevent the spread of infection. The Environmental Health Officer also inspected the laundry area on the 7th February 2008. Although this was an area for the Health & Safety executive the Environmental Health Officer was concerned about the poor working conditions they informed the Provider that they should give consideration to upgrading the laundry facility. The Environmental Health Officer gave the Provider three months to address this matter. At this inspection the Provider confirmed that apart from the leaking roof in the external store adjacent to the laundry room being repaired no other work has been undertaken in the laundry room. The floors are not impermeable or easily cleanable. The floor is uneven. There is no separate hand washing facility. This poses a health & safety risk to members of staff and a risk to the health and well being of people living in the home due to poor infection control in this area. This requirement has not been met. The Provider must now consult with the Health & Safety Executive to ensure that the legislation in respect of laundry facilities in care homes is clarified and understood and complied with. A requirement was made at the last inspection in respect of ensuring people living in the home are not at risk of receiving burns from radiators. It was seen at this inspection that radiator covers had been purchased for all radiators and the majority of radiators have now been covered. This requirement has been met. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 22 The fire officer was undertaking an inspection on the day of the visit to the home to follow up on the requirements and recommendations made at their last inspection in November 2007. He reported that he was satisfied with the overall management of fire prevention in the home. However he confirmed that the fire risk assessment that had been completed in March 2004 should be updated and the emergency plan should be completed and both documents should be reviewed at least every six months. There is a large decking area accessible through the lounge/conservatory. It was observed that although this area could be a pleasant place for people living in the home to spend time there were only a few chairs and a table that had blown over and the space looked generally uncared for. It was observed that most people living in the home stayed in the smaller lounge throughout the morning and also during lunchtime. People living in the home ate their lunch in their chairs with a small table in front of them or with assistance from members of staff. The larger lounge/conservatory area was generally unused. Storage of equipment is a difficulty in the home and it was observed that a large amount of equipment was being stored in an empty double room that was being prepared for any future prospective service user. It was also observed that screens and a laundry trolley were being stored in the small room used as a private meeting room for visitors or professionals. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 34. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service experience good outcomes in this area because they are supported by a competent and caring staff and recruitment procedures are robust. EVIDENCE: The last inspection in January 2008 assessed standards 32, 34 and 35 and found them to be met. These standards were not fully assessed again but the recruitment records for two new members of staff were examined. This demonstrated that good recruitment procedures had been followed and a POVA first and references were in place before people started working in the home. Criminal record checks had also been obtained. Where they had not come through before the person started work POVA first checks and references were in place and the Provider confirmed they were supervised. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using this service experience adequate outcomes in this area because there are shortfalls in the health & safety practices in the home, people living in the home are not safeguarded by the policies and procedures in respect of safeguarding allegations. The Statement of Purpose and Service User Guide that are fundamental documents for the service and for prospective service users are not in place. EVIDENCE: This outcome area was rated as poor at the inspection in January 2008. This was due to the findings at that inspection that the management of residents finances was poor, the Statement of Purpose, Service User Guide were unavailable for inspection, the complaints procedure was out of date and not accessible and there was evidence that people living in the home had purchased their own nursing equipment. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 25 There was also a shortfall in the hygiene standards in the kitchen and laundry that meant means the health, safety and welfare of residents are not promoted. There was a risk to people living in the home from receiving burns from radiators. At this inspection it was found that measures are now in place to ensure the correct and efficient management of people’s finances. Hygiene standards had improved in the kitchen and food store and action taken to repair the leaking roof. The complaints procedure had been updated and was more accessible to people living in the home. Action had been taken to review the residency agreement and to confirm to people living in the home and their relatives that it is the responsibility of the Provider to provide nursing equipment. Radiator covers had been purchased for all radiators and the majority had been covered. The Provider must undertake monthly visits to the home and to produce a report of the findings of that visit to be kept in the home under Regulation 26. It was noted that the inspections had been undertaken and a report compiled and kept in the home up until May 2008. People living in the home are consulted about the service through residents meetings. At the last inspection people living in the home said that they are happy with the day-to-day running of the home and that they are listened to. They also said they enjoyed good relationships with the manager and staff who are friendly and helpful. However the Statement of Purpose and Service User Guide were not available for inspection. This is a requirement under Regulation 4 and 5 of the regulations. The requirement in respect of the laundry has not been complied with. A complaint about poor practice was not reported through safeguarding procedures. The service does not have a specific safeguarding adult policy and procedure. The gas and electricity safety inspection certificates were not available for inspection so it was unclear as to when the last safety inspection was undertaken. The fire risk assessment had not been reviewed since 2004 and the emergency plan had not been completed. Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 1 2 3 3 2 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 X 2 2 X 2 X Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 27 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 YA30 Regulation 16 (2) (j) Requirement Timescale for action 20/10/08 2 YA1 4, 5, and 6 The Registered Person must consult with the Health & Safety Executive in respect of the requirements of the quality of laundry facilities and they must seek to adhere to this legislation. The Registered Person shall 20/10/08 compile in relation to the care home a written Statement of purpose and Service User Guide. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Baytrees Nursing Home DS0000024113.V366949.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!