Inspection on 16/06/08 for Bierley Court

This inspection was carried out on 16th June 2008.

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

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

Bierley Court 10/07/07

Bierley Court 15/08/06

Bierley Court 28/10/05

Bierley Court 06/05/05

Bierley Court 03/11/04

Bierley Court 03/06/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Bierley Court 49 Bierley Lane Dudley Hill Bradford BD4 6AD Lead Inspector Caroline Long Key Unannounced Inspection 16th June 2008 09:00 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 DS0000034010.V366662.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. DS0000034010.V366662.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bierley Court Address 49 Bierley Lane Dudley Hill Bradford BD4 6AD 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) 01274 680300 01274 680303 bierleycourt@schealthcare.co.uk Southern Cross Healthcare (Kent) Ltd Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (5), of places Physical disability over 65 years of age (25) DS0000034010.V366662.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2007 Brief Description of the Service: Bierley Court is a purpose built care home. It is owned and run by Southern Cross Health Care Ltd. It is a care home, which does not provide nursing care and has room to care for up to forty older people. Within the total of forty, the home is registered to look after twenty five people who have a physical disability and ten who may have dementia or other memory loss disorder. The home has forty single bedrooms which all have an en-suite. There are communal areas, which are comfortable and provide a venue for social activities to take place and for people to meet. There is a passenger lift to the first floor. Smoking is allowed in a designated lounge. There are safe and accessible garden areas with seating and there is ample car parking for staff and visitors. Access for the disabled is good. The home is in a residential area in the Bierley district of Bradford. There is a good bus route nearby which runs into Bradford town centre. The bus stop is immediately outside the home On the 16th June 2008 the fee charged was between £377 and £441 per week, this can be increased when more care is needed. People are charged extra for hairdressing, newspapers, private chiropody treatments and some toiletries. The Commission for Social Care reports are on display in reception DS0000034010.V366662.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 the people who use this service experience adequate quality outcomes. Bierley Court has had two changes of manager in the last year; this has resulted in a lack of leadership and a decline in the service provided. The operational manager is aware of this and following two complaints she is reviewing the service the home provides for those who are in need of most help and making improvements to the quality of the care provided. When we visited we could see some systems had been introduced which would lead to a better quality of life for people. This is what we used to write this report: • • • We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We sent surveys to people living in the home and to their relatives and health professionals. Ten surveys from people living in the home, two from relatives and one from a member of staff were returned following our visit to the home. One inspector visited the home unannounced. This visit lasted over six hours and included talking to the staff and the manager and the operational manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time talking with people who live in the home and two relatives who were visiting. We looked at three people’s care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. • • • DS0000034010.V366662.R01.S.doc Version 5.2 Page 6 • We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. An expert by experience was asked to accompany the inspector during the visit to the home. An ‘expert by experience’ is a person who because of their shared experience of using services and /or ways of communicating visits a service with an inspector to help them get a picture of what it is like to live in or use the service. During this visit they were asked to look at peoples daily life, social activities, and the environment their observations have been used in this report. • What the service does well: What has improved since the last inspection? What they could do better: To make sure people remain healthy staff must follow the advice of health professionals. People who live at the home should be given the opportunity to take part in meaningful daily activities of their own choice and according to their individual interests and capability. This improves the quality of their lifestyle and can help reduce isolation. Food should be considered to be highly important and meal times considered a social occasion. It should look appealing and the home manager should monitor the quality of the food given to people. There must be enough staff to make sure people are safe and can take part in activities both during the day and in the evening. To keep people safe staff must be trained to use the hoists correctly. DS0000034010.V366662.R01.S.doc Version 5.2 Page 7 Good practice recommendations have been made about the information provided to people, the number, supervision and training of staff and the use of reclining chairs. 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. DS0000034010.V366662.R01.S.doc Version 5.2 Page 8 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 DS0000034010.V366662.R01.S.doc Version 5.2 Page 9 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): Standards 2 and 3 (Standard 6 - N/A, the home does not provide intermediate care) People who use the service experience good quality outcomes in this area Peoples’ needs are properly assessed prior to admission, which means that people know the home can meet their needs before they move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager said they always visit the person before they move in to carry out a comprehensive assessment of their needs, following this they will encourage people to look around the home and stay for a meal. This helps the home to make sure it has the staff skills and equipment necessary to care for people properly and gives the person the opportunity to meet everyone and get a ‘feel’ for the home. We looked at three peoples records that had moved into the home recently. Two contained detailed assessments of people’s needs, and one had information from social services. The other did not have an assessment of DS0000034010.V366662.R01.S.doc Version 5.2 Page 10 needs but information from when they had previously stayed temporarily in the home. This information would have enabled the staff to make a decision about whether they could meet people’s needs when they move in. A draft plan of care is written using the information from the assessment, this is to make sure all the staff are fully informed of a persons needs. The staff records showed and staff confirmed they had the necessary training to enable them to look after people properly. Most staff had also recently completed a training course on dementia care. One relative said staff had been welcoming when a person moved in. A member of staff said how they would prepare a room for when people move in. The operational manager explained they generally redecorated rooms before people moved in. There was information about the home on display in the reception area. Nine people who returned their surveys stated they have not received a contract, one said they had. People must be provided and made aware of a statement of their terms and condition when they move into the home. This helps people know their rights and what service they can have. When we asked did you receive enough information about this home before moving in so you could decide if it was the right place for? Four said they had and five said they had not. The home does not provide intermediate care. DS0000034010.V366662.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 & 10. People who use the service experience adequate quality outcomes in this area. People do not always receive the personal and health care they need which has been recognised by the managers who are now working towards making sure that everyone receives a good standard of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager and the operational manager explained following a recent complaint they had started to look very carefully at how and if they are meeting peoples health and personal care needs. As a result of this they have reviewed their care plans and risk assessments and have introduced new charts to record what people are eating and whether they had a bath or wash etc daily. The manger explained this would help him to make sure people were receiving the care they needed. We looked at three people’s care records to check that a plan had been formulated, which would help staff provide support to people according to their DS0000034010.V366662.R01.S.doc Version 5.2 Page 12 needs and wishes. We found two had been reviewed and the third was due for review, all contained care plans and risk assessments, which had been regularly reviewed and changed, as people’s needs had changed. The care plans contained some people’s personal preferences and good descriptions of how to interpret peoples body language when they had difficulty in communicating verbally. However the papers were mixed up making them difficult to follow. Although relatives had not signed them the personal preferences showed people had been involved and a relative did say they had seen a care plan. We looked at one person’s records in detail who needed a lot of help with their personal care, we found they had been washed and dressed and sat in the lounge area from six am, however it was difficult to assess whether this was their preferred time of getting up. A complaint also showed that another person had been washed and dressed for the day at just after six am. The expert by experience observed that some people had dirty fingernails and one man was unshaven. For three people the records and the complaints show they were sleeping overnight in reclining chairs, two of these people records showed they had pressure sores, the manager and staff explained they were sleeping in chairs because they were restless and at risk of falling or they preferred it. If reclining chairs are used for people to sleep in the reasons for this should be in their care plans and their consent obtained. We saw staff providing care in a kind and helpful manner, although during lunch one carer did shout across the room that a person wanted the toilet, which they may have found very embarrassing. People who were quite independent were making their needs known and seemed happy with the care provided. Seven people who returned their surveys stated they always received the care they needed, two stated usually and one said sometimes. One comment made by a person who lives in the home is: ‘Some staff don’t behave as they should do I am a poorly person and i don’t receive enough care as I would like.’ Comments made by three relatives were:‘They look after my relative very well they keep them nice and clean and they care. Also the home always smells lovely no urine smells or anything.’ ‘Ensures that the residents and relatives feel at home in the care home a friendly and helpful approach is always evident.’ DS0000034010.V366662.R01.S.doc Version 5.2 Page 13 ‘The level of care a person receives is dependant on which staff are on duty. ‘ The home keeps good daily records which provided a picture of the daily lives people and had the essential information to track any changes the people may experience, with ill health or involvement in social activities for instance. The records showed people were accessing health care professionals, such as general practitioners, chiropodists, and district nurses. However a health professional gave examples of when their advice was not followed, of how incontinence pads were not being used correctly and how people were not always being moved correctly. Also where a physiotherapist advised a person needed to be helped to walk twice a day, this was not part of their care plan. The home has established an efficient medication policy and practices. There is a medication procedure to guide staff’s practice and training is provided on safe storage, administration and disposal of medicines. A monitored dosage system is used and the staff were able to explain the system for administering the medication fully. A sample of medication was checked and found to be correct. There were weekly fridge temperatures taken to make sure the medication was kept at a safe temperature. We have received a complaint about a person not receiving the medication they needed however this was responded to by the home and staff have been provided with training. DS0000034010.V366662.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14, and 15. People who use the service experience adequate quality outcomes in this area. People have access to limited activities, which are not offered with individual interests in mind. People experience at mealtimes needs to be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The atmosphere was calm and friendly and people were seen moving around the home as they choose. One person said they were going to the shops after breakfast; people who smoked were able to go to the smoking lounge as they choose and were content to sit and chat. The manager explained some people do have keys to their rooms and staff told us people can go to bed and get up when they choose. However during the morning there were no organized activities and people appeared to doze in front of the TV, two people remained sleeping in the same posture most of the morning, when one woke they said that they were not watching it. There were no daily newspapers or magazines in the lounges, or card tables or evidence of board games, dominoes or craftwork. We didnt see a desk in any of the rooms where a person might write a letter, card or just DS0000034010.V366662.R01.S.doc Version 5.2 Page 15 doodle. We talked to the activities organiser, who has not been in post long, she told us that in the mornings she often takes people out individually for walks or to the shop. Sometimes she helps the ladies with their nails when they ask her to do so. In the afternoon we saw her encourage four people to play Connect Four a large version of the childrens game. It was difficult for them all, people were sitting in armchairs, and the activities organiser was on her knees. They would have found this easier to take part if they had been sitting round a table sitting on upright chairs. There is a garden for people to use and the activities organiser had helped people to plant hanging baskets. However despite the good weather we did not see anyone in the garden and a relative explained the home did not have any patio umbrellas for people to sit under. The sample of care plans we looked at did not contain a lot information about people’s preferred social interests and a relative told us that there were not many activities in the home, and they often had to suggest putting on appropriate music or a video. People who live in the home when asked if activities were available five said they were never available, two said sometimes, one said usually and one said always. Comments made by people were:‘More options want to go out a bit more.’ ‘I’d like to get out of my room do things like a normal person would living by themselves in there own home I feel like a prisoner in this home.’ ‘I would like to ride an exercise bike in my room go out for walks, always stuck in this home.’ ‘Bingo not all the time have a new activities lady but we need more like our old one we never get out only if my family takes me.’ ‘Only a few residents have activities I would like to do some.’ ‘Not always would like more activities my last home had them every day.’ We saw two people being helped and encouraged to eat in a very quiet, kind and considerate way. When we visited people were offered fish cakes or corn beef hash with vegetables for lunch followed by apple sponge pudding, we were offered a meal and tried the corn beef hash but found the gravy had lumps and a strong flavor, however the peas and new potatoes were good and the pudding was homemade. Many people did not eat this meal and one person was provided with a soft diet where everything had been liquidized together, it looked unappealing. People were shown the meals so they could make their choice, this is good practice as some people are unable to remember what they have previously DS0000034010.V366662.R01.S.doc Version 5.2 Page 16 ordered, however the calling loudly to people to make their choices detracted from this good practice. When we visited the kitchen it appeared disorganized, and not clean, there also was a shortage of dinner plates during the meal and staff were heard suggesting using the bathroom to wash some of the plates. A member of staff also commented that the home was sometimes short of plates. Relatives also said the quality of the food was not good, one commented negatively on the presentation of the sandwiches and lack of cakes at tea time, Ten surveys were returned by people who live in the home five said they always, two said sometimes, two said usually, and one said they never like the meals. Comments made were: ‘Not up to the standard I expect for what I pay variety is good but standard of food isnt food is either rock hard burnt or not cooked.’ ‘Like stews, meats always hard here never cooked.’ ‘Some very good some not worth eating.’ ‘A long-time for meals to arrive becomes frustrated and says other residents also do also.’ ‘Very nice loads of choice.’ One person who has experience of another home, told us that the lack of a strict routine, especially meals not being on time was very upsetting to them. DS0000034010.V366662.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18. People who use the service experience adequate quality outcomes in this area. People have access to a complaints procedure and are protected from abuse. However management need to be aware of the local procedures for reporting any suspected abuse and need to respond to all complaints. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy was displayed in reception. A record of complaints is kept and is well organised and met with data protection guidelines. This showed when people had raised concerns these had been responded to and recorded correctly. The manager told us there have been seven complaints in the last year. The manager also explained that one of these had not been responded to in the necessary timescales but the operational manager was now responding to this. She explained following this complaint and others she was taking action and reviewing the service offered to people who needed more care. DS0000034010.V366662.R01.S.doc Version 5.2 Page 18 We have received two complaints since the last inspection one about the standard of health care and one about medication both were passed to the provider to investigate. From the ten surveys returned six knew how to complain four said they didn’t. Also two negative comments were made about whether the manager would respond to their complaints. For instance:‘Yes but when making a complaint nothing is every followed up by boss.’ Staff said they had attended training on the protection of vulnerable adults and were aware of whom to alert if they suspected abuse. However although the manager was aware of what constituted abuse and would have contacted the operational manager for advice, he lacked knowledge on what local services and procedures he has to follow if he suspects abuse. Staff who are left in charge of the home must attend training on the local procedure for reporting abuse. DS0000034010.V366662.R01.S.doc Version 5.2 Page 19 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): Standards 19 and 26 only. People who use the service experience good quality outcomes in this area. People live in a clean and comfortable home, but this would benefit from a ‘homely’ touch. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bierley Court is on two floors access between both the floors is by a lift. Both floors have communal lounges and a dining room. There are additional sitting areas around the home where people can get away from others without having to go to their bedrooms. There is also a smoking room. All the bedrooms are single and en suite. We found Bierley Court to be clean and fresh, and people said this was always the case. We were taken for a tour of the premises and found there was very little in the way of, landmarks such as pictures on the walls or variety of colours to differentiate the corridors from one another. DS0000034010.V366662.R01.S.doc Version 5.2 Page 20 Most of the chairs were upholstered in a chintz fabric, some worn threadbare on the arms and marked. We did not see any loose cushions for the comfort of people who sat for long periods who had nothing to support their heads and necks. The manager said they had recently ordered replacements for the chairs and he had plans to make the home more ‘homely’. People are encouraged to bring their own pieces of furniture and personal possessions for their bedrooms. There was some confusion as to whether a hoist was working correctly, staff believed it was not working but the manager looked at it and confirmed it was working but the staff were unaware of what the buttons were for. To keep people safe staff must be trained to use the hoists correctly. The home employs a handyman who is responsible for some maintenance and the monitoring of some health and safety aspects of the premises. The operational manager explained they are carrying out a programme of refurbishment of the bedrooms. The lift had been broken since Friday 13th June and people on the 1st floor told us they were very concerned and restricted and were unable to carry out their normal daily routines. Staff were also having to run up and down the stairs with the food. The manager explained they had called the engineers and were expecting them in the evening. There is a policy on the prevention of infection and the management of infection control. The guidance is followed and systems are in place to prevent the spread of infection. Gloves and aprons were available throughout the home. However the records show only seven members of staff have received infection control training. DS0000034010.V366662.R01.S.doc Version 5.2 Page 21 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): Standards 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. People generally receive the care they need from an experienced and skilled workforce. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments made by the residents and relatives about the staff at Bierley Court for instance: • ‘Very good staff everyone of them.’ • ‘I’ ve been very comfortable and happy while living here just got to take the good with the bad dont agree with staff being treated like servants running about always short staffed the girls are very good to me.’ • ‘No staff has done any harm to me, all very kind can have a banta with them.’ • One relative explained how their family was treated exceptionally well by a member of staff and how grateful they were to her. On the day we visited there were two senior care workers, and four care workers, domestic, cooking and maintenance staff supported these. Staff told us this was generally enough staff to meet people’s needs. DS0000034010.V366662.R01.S.doc Version 5.2 Page 22 However there was a mixed response when asked as part of the survey whether there was enough staff five people said always, two said usually, two sometimes and one said never. Comments made were: • ‘Need more staff the staff are good but there isnt enough of them around.’ • ‘Need more staff always short staff, would like more baths.’ • ‘Always about seeing if everybody is ok. There always a buzzer to press if no one is about and someone always comes to answer it.’ • ‘Sometimes the staff appear to be stretched. Perhaps a review of numbers of staff working at any one time is required that said this is the exception rather than the rule.’ We also saw people in the downstairs lounge were left unattended in the lounge area for long periods and were not engaged in any meaningful activities or talking to staff. The home has a training matrix that enables the manager to identify when staffs are in need of updating their training. The home manager does a monthly audit of training, and an action plan, which is sent to his operations manager. Staff confirmed they have received induction training and where they had worked at the home for a number of years their training had been up dated. Examples of training staff had taken were the safe handling of medication, dementia care, nutrition, and moving and handling. Both manager and a senior carer are an YTT (yesterday, today and tomorrow) facilitators, the Alzheimer’s Society accredited course for all staff. There are two moving & handling facilitators within the home. However during our visit their was evidence to show that staff were not fully aware of how to use a hoist. To keep people safe staff must be trained to use the hoists correctly. Most staff have successfully completed their national vocational qualification in care level two or above. Four staff files were examined; all contained an application form, two written references, and a completed criminal record bureau checks and protection of vulnerable adult check. A member of staff confirmed the home had followed a recruitment procedure. This all makes sure the staff have the necessary skills and attitude to work at the home. DS0000034010.V366662.R01.S.doc Version 5.2 Page 23 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): Standards 31, 33, 35, 36 and 38. People who use the service experience good quality outcomes in this area. The effects of the changes in management have been recognised by the providers, who are providing staff support and reviewing systems to make sure the home is again run in the best interests of the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is owned by Southern Cross Healthcare (Kent) Ltd, who are a large organisation and own many homes. This means there is plenty of support for the home manager if it is needed. This helps to make sure the home is managed in the best interests of those who live there. Over the last year the home has had a change of home manager, the present one has only recently been appointed and is still receiving support from the DS0000034010.V366662.R01.S.doc Version 5.2 Page 24 operational manager. The new manager is working towards their national vocational qualification level four in care and the Registered Managers Award. The manager is planning to register with us. This is to make sure they are the right person to manage the home and are suitable to work with vulnerable people. Bierley Court has had two changes of manager in the last year; this has resulted in a lack of leadership and a decline in the service provided. The operational manager is aware of this and following two complaints she is reviewing the service the home provides for those who are in need of most help and making improvements to improve the quality of the care provided. Two staff told us they did not feel supported by the manager and felt they were unapproachable. Staff also told us they had not received regular supervision. A representative of the organisation visits the home every month to monitor the quality of the service and provide support to the manager. The reports from these visits provide a clear audit trail to show how areas for improvement are identified, the actions taken, or an evaluation of the effectiveness of any actions taken. The administrator carries out the administration of people personal moneys she explained the safeguards are in place for the correct management of people’s money. In the annual quality assessment questionnaire the manager has written that that the annual checks for health and safety are in place, and regular health and safety committee meetings are held within the home. The maintenance man is responsible for the checking of all health and safety documents. DS0000034010.V366662.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 1 X 3 DS0000034010.V366662.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 12 (1) (a) Requirement Staff must follow the district nurses advice when offered. In areas such as mobility assistance, incontinence and application of creams. This is to make sure people receive the proper health and personal care Everyone living in the home must be offered the opportunity to engage in appropriate recreational activities. The numbers of staff should be reviewed to make sure there are enough to meet people needs. To keep people safe staff must be trained to use the hoists correctly. Timescale for action 01/07/08 2 OP12 16 2 (m) & (n) 18 18 1 (c ) 01/08/08 3 3 OP27 OP30 01/08/08 01/08/08 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 OP2 Good Practice Recommendations People should be provided and made aware of a statement DS0000034010.V366662.R01.S.doc Version 5.2 Page 27 2 3 OP8 OP15 4 OP18 of their terms and condition when they move into the home. This helps people know their rights and what service they can have. When people sleep in a reclining chair the reasons this is occurring should be part of their care plan and their consent should be gained. When people receive soft diets different foods should be liquidised separately to make it more appealing and the home manager should make sure there enough crockery is available. To make sure the appropriate actions are taken if staff suspects abuse. Staff who are left in charge of the home should attend training on the local procedure for reporting abuse. Staff should be provided with regular supervision, this helps to make sure they are well trained. 5 OP36 DS0000034010.V366662.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000034010.V366662.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!