Inspection on 15/04/08 for Bosworth Court Nursing Home

This inspection was carried out on 15th April 2008.

CSCI found this care home to be providing an Good 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

Bosworth Court Nursing Home 13/03/09

Bosworth Court Nursing Home 04/11/08

Bosworth Court Nursing Home 23/05/07

Bosworth Court Nursing Home 13/06/06

Bosworth Court Nursing Home 14/11/05

Bosworth Court Nursing Home 16/06/05

Bosworth Court Nursing Home 22/12/04

Bosworth Court Nursing Home 21/06/04

Bosworth Court Nursing Home 13/01/04

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

CARE HOMES FOR OLDER PEOPLE Bosworth Court Nursing Home Station Road Market Bosworth Nuneaton Warwickshire CV13 0JP Lead Inspector Debbie Williams Unannounced Inspection 15th April 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bosworth Court Nursing Home DS0000001891.V363216.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. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bosworth Court Nursing Home Address Station Road Market Bosworth Nuneaton Warwickshire CV13 0JP 01455 290867 01455 292455 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) www.givecare.hotmail.com Dr Kumar Tripurari Prasad Mr Anthony C Marson Mr Stuart Smithers Care Home 47 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (47), Physical disability (5), Physical disability over 65 years of age (24) Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person under 55 years falling within category PD may be admitted to the Home Service User Numbers No person falling within categories MD(E) or DE(E) may be admitted to the home when 5 persons in total in these categories/combined categories are already accommodated within the home. No person falling within category PD(E) may be admitted to the Home when 24 persons of that category are already accommodated within the Home No person falling within category PD may be admitted to the Home when 5 persons who fall within that category are already accommodated within the Home 23rd May 2007 3. 4. Date of last inspection Brief Description of the Service: Bosworth Court is a care home registered to provide care and accommodation for up to forty-seven people, both men and women. The home is registered to provide care for people who have needs relating to mental health, becoming older, physical disability and dementia. The home is situated in the historic town of Market Bosworth in Leicestershire. It is situated on two floors, and there are stairs and a passenger lift to enable access. The home has two large lounges and each lounge has an adjoining dining area. On the ground floor, there is also a large conservatory. Outside the home there is an enclosed garden patio area for residents’ use. The home is staffed twenty-four hours per day by trained nursing and care staff. The home is situated on the main road close to attractions such as Bosworth Field and Country Park, and also to shops and restaurants. At the time of this inspection the weekly fees ranged form £450 to £850 per week. A copy of the last inspection report was available at the home. Bosworth Court Nursing Home DS0000001891.V363216.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 2 star. This means the people who use this service experience good quality outcomes. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. The four people who were case tracked had some difficulties with communication and therefore discussion with them about the care they received was limited. Four relatives were spoken with and all were positive about the service provided. Evidence from the providers Annual Quality Assurance assessment was also used. This inspection was unannounced and took place over five and half hours. The Registered Manager and other members of the management team facilitated the inspection. All staff spoken with during this inspection were extremely professional and helpful. Since the last key inspection in May 2007 concerns were raised on two occasions regarding care practices and documentation at the home. These concerns were investigated by social services. The provider has responded to these concerns in a positive and professional manner and worked with social services towards a resolution. Two complaints were also received regarding care practices and health and safety, both of which were referred to the provider to investigate. The provider investigated these using their complaints procedure and found them to be unsubstantiated. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the providers have met the recommendation made at the last key inspection. We recommended that two signatures be obtained for all transactions involving residents personal money, this is to protect people who live in the home from financial abuse. At the time of this inspection staff were working towards improving the risk assessment and documentation process. New documentation had been introduced regarding fall risk and a body-mapping chart was also being used. This ensures that staff record any injury or wound and take appropriate action to protect people form any further injury. Policy and procedure has been updated to ensure that people are more regularly re assessed and monitored in the event of any accident or injury. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bosworth Court Nursing Home DS0000001891.V363216.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 Bosworth Court Nursing Home DS0000001891.V363216.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 1 and 3. (Standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed choice before moving into the home. A needs assessment is carried out prior to moving in and this ensures that these needs can be met. EVIDENCE: Prospective residents are able to view the home at any time. Information about the Home is provided through brochures, a Statement of purpose and a Service User Guide. One relative spoken with confirmed that they had been provided with the information they required to make an informed choice about moving into the home and that the manager had carried out a full needs assessment prior to Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 10 the admission-taking place. A contract setting out the provider’s terms and conditions had been provided. A qualified nurse carries out needs assessments. We looked at the assessment records of four residents. Assessments are carried out prior to and on admission to the home and this information is used to develop and inform the plan of care. Where applicable social services assessments were also in place. Risk assessments were also in place. New documentation had recently been introduced and this included a more comprehensive risk assessment for managing the risk of falls and of recording any injuries sustained, wounds or pressure sores. This ensures that any risks are managed and communicated to care staff and people who live in the home receive the appropriate treatment and protection. The individual social, cultural and psychological needs and preferences of people moving into the home are also assessed and recorded, for example supporting people to continue to practice their religion if they choose. Bosworth Court Nursing Home DS0000001891.V363216.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is responsive to individual needs and preferences. People who live in the home have access to healthcare services. EVIDENCE: We looked at four care plans; care plans were detailed and included the diverse individual needs and preferences of residents. At the time of this inspection staff were working hard to improve their care planning and documentation systems and had made considerable improvements in this area. However, there were some shortfalls identified in the care planning and documentation process and within the communication of residents needs to all care staff that still required improvement. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 12 Four relatives were spoken with and all felt that staff treated residents with respect, maintained privacy and dignity and were caring. Interactions observed between staff and residents on the day of this inspection appeared positive and respectful. Care records seen confirmed that the advice of healthcare professionals outside of the home was sought as required. Relatives spoken with felt that staff did request a GP visit as required and kept them well informed of any changes. One relative said that staff attend to any problems straight away. Risk assessments were in place for the management of pressure sores, nutritional risk and fall risk and the appropriate action was taken. Medication management records were checked and found to be accurate. Staff were trained and aware of the correct medication policies and procedures and therefore people who live in the home are protected. A staff-training programme was ongoing and this included induction and National Vocational Qualification training. The manager said that staff training in dementia care was the target training area for all staff. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home have their lifestyle needs and preferences met. EVIDENCE: Relatives spoken with said that there were no restrictions on visiting and they were made to feel welcome by staff. Activities of daily living such as getting up, going to bed and meal times are made flexible in order to meet individual needs. Individual needs and preferences are documented within care records and this included any cultural and religious needs. Relatives spoken with praised the quality of meals provided and confirmed there was always a choice. The lunchtime meal was observed during this inspection, the meal served appeared nutritious and well presented. There was a choice of meal available. Staff were organised and ready to assist residents with their meals and did so in a sensitive manner. The dining room appeared congenial. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 14 The cook has been in post for 15 years and is also the basic food hygiene trainer. The cook has developed an information pack for staff with details of resident’s preferences, likes and dislikes and suggestions of how to assist with feeding. The cook was knowledgeable about special dietary requirements and the importance of food presentation. Planned activities were being provided and these included arts and crafts, the activities organiser said that when the weather gets warmer, more activities outside of the home will be provided. The forthcoming dementia care training should assist staff further in providing meaningful activities for people with dementia. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well protected by procedures and good staff awareness regarding complaints and safeguarding residents from harm. EVIDENCE: There is a complaints procedure in the home. The manager has dealt with complaints raised with him and two complaints referred to him by CSCI, and we saw from records that these were looked into and appropriate action taken. Relatives spoken with told us that they felt able to raise any concerns with the manager or with staff and that their concerns would be taken seriously. Staff had received safeguarding adults training and were able to demonstrate their knowledge and awareness in this area. Since the last inspection, transaction records for resident’s personal money have been improved and this provides better protection for people who live in the home. The home has an open culture, which encourages people to express their views and concerns. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 16 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 19,22 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home live in a safe and comfortable environment. The physical environment is appropriate to the specific needs of people living at the home. EVIDENCE: During the visit, we looked around at some parts of the home. We looked at a sample of bedrooms, bathrooms and toilets, and lounges/dining rooms. Two of the bathrooms had recently been refurbished and disabled showers provided. The garden area was accessible to people living in the home and provided an attractive and secure outside area. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 17 Specialist disability equipment such as hoists and specialist beds were provided as required. All areas of the home were accessible to residents. Resident’s rooms were personalised with their own possessions. Relatives spoken with said the home was usually clean and fresh. Fire safety and environmental health regulations were followed and regular checks and routine maintenance minimised risk and kept people safe. Staff had received training in infection control, all areas of the home seen appeared clean and hygienic and mostly well maintained. Some attention to the décor was required in the upstairs corridor as some of the paintwork and wallpaper was scratched and peeling but the environment was mostly homely and comfortable. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home benefit from a competent staff team and are protected by the home’s recruitment procedures. EVIDENCE: Staffing levels on the day of this inspection appeared to be meeting the needs of people living in the home. Relatives and staff spoken with said that at times staff were very busy. The manager had provided extra staff at peak times such as breakfast and lunchtime in order to prevent these meals being rushed. It was evident during the lunchtime meal that this strategy was very successful as staff appeared very organised and ready to assist residents with their meals. Two relatives spoken with felt that staff would benefit from more training regarding caring for residents with dementia, the manager said that this had been incorporated into the staff training plan and he was aware of the need for this. A qualified registered mental nurse had recently been employed and would be part of this staff-training programme. A separate staff member was employed to provide training for staff. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 19 Training records seen were seen and it was evident that staff received the mandatory training required to do their jobs. A programme of National Vocational Qualification staff training in Care was in place Recruitment procedures were robust and protected residents from harm. All relevant checks and references were obtained for each staff member. However, references for one staff member could not be found during this inspection and a requirement was made regarding this. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 20 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 31,32,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and is run in the best interests of people living in the home. EVIDENCE: The registered manager was appropriately trained and experienced and competent to run the home. Relatives spoken with felt the manager and staff team were very approachable and dealt with any problems promptly and appropriately. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 21 Two relatives said they would like a relatives meeting, the manager said he was in the process of arranging a residents meeting. The manager completed an annual quality assurance assessment and this provided clear and relevant information. Information supplied within the providers annual quality assurance assessment and records checked during this inspection confirmed that residents were protected by health and safety risk assessment and routine maintenance work. Health and safety was also addressed within the staff training and induction programmes. Risk assessment policy and procedures regarding accident and injuries had recently been updated and improved. Customer satisfaction questionnaires had recently been sent out to relatives. This enables the providers to base any development plans on the needs and preferences of people living in the home. Resident’s financial interests are protected by good procedures in place for handling resident’s personal money. Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 19(b) Requirement A copy of the references obtained for each staff member must be available for inspection. Timescale for action 30/04/08 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 OP7 Good Practice Recommendations Care records should provide more detail and include all the assessed needs of people living in the home and this should include the actions staff must take to meet the needs. Documentation should provide a clear account of progress or otherwise and the actions staff have taken. This will ensure that care provided to people who live in the home is meeting their needs. All staff should receive training in caring for people with dementia and this should include providing meaningful activities foe people who live in the home. This will ensure that the specialist needs of people with dementia are met and their lifestyles are enhanced. Some attention is required to the décor in the corridors on the first floor. This is to ensure that people who live in the home live in a comfortable and pleasant environment. DS0000001891.V363216.R01.S.doc Version 5.2 Page 24 2. OP30 3. OP19 Bosworth Court Nursing Home Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Bosworth Court Nursing Home DS0000001891.V363216.R01.S.doc Version 5.2 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. 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