Inspection on 11/07/06 for Byars Care Home

This inspection was carried out on 11th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Byars Care Home 21/02/06

Byars Care Home 18/08/05

Byars Care Home 07/03/05

Byars Care Home 10/09/04

Byars Care Home 30/01/04

Similar services:

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Annesley Lodge Care Home

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

CARE HOMES FOR OLDER PEOPLE Byars Care Home Caythorpe Near Lowdham Nottinghamshire NG14 7EB Lead Inspector Karmon Hawley Unannounced Inspection 11th July 2006 10:00 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 Byars Care Home DS0000024633.V302758.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. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Byars Care Home Address Caythorpe Near Lowdham Nottinghamshire NG14 7EB 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) 01159 663981 01159 663529 Beckedge Limited Verity Gay Hallam Care Home 27 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (27), Terminally ill (2) of places Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: The Byars is a two-storey building, in a rural setting offering care to 27 service users with nursing needs. There are twenty-one bedrooms; fifteen single and six double, with ample bathroom and toilet facilities. A lift and stair lift facilitates access to the first floor. There is a large open plan lounge; sun lounge and dining area with outlook onto the small but well maintained gardens. There is a small parking area to the front of the building, however car parking is available at the village hall across the road. A fully trained team of nursing and care staff are employed and ensure that all aspects of service users health and social care needs are addressed. There are no restrictions on visiting and the home is well supported by both the local community and service users (past and present) families. The current weekly fees, which are made available on the point of enquiry, are as follows: general accommodation and nursing care £343. Nursing contribution as assessed and paid by primary care trust £83 or £133. Room supplements payable on some rooms only, all rooms are individually priced. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit an analysis of the performance of the home over the previous year took place in line with the key national minimum standards. The evidence gained was assessed and thus the site visit planned in accordance with further evidence required to demonstrate compliance with the national minimum standards. The unannounced site visit took place in four and a half hours and was performed by one inspector. The main method of gaining evidence during the site visit was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Six service users were spoken with so as to give the inspector an insight into the conditions and standards within the home. Those spoken with were happy with the staff, care received and the standards within the home. The proprietors assisted in the inspection process and two members of staff were spoken with. Staff were able to demonstrate an understanding of service users needs and the core values and principles in relation to their job role. What the service does well: A kind and caring ethos is prevalent throughout the home. Staff were observed to interact in a meaningful manner with service users and good rapport was evident. Service users spoken with spoke highly of the staff and care received. Assessments and care plans are extremely in depth and personalised according to service users needs. The manager continues to research up to date practices and adapts these in to the methods employed within the home. The activities coordinator is extremely enthusiastic with regards to her role, which is evident with regards to activities that take place. Staff training is at a high standard and staff spoken with were knowledgeable. Equality and diversity of service users is fully acknowledged and enhanced. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the home. Service users may be assured their needs will be assessed and met prior to moving into the home. EVIDENCE: Pre admission assessments are carried out in the community prior to service users being admitted to the home. Assessments remain in depth; cover the requirements of the standard and present detailed information, which assists in the initiation of the plan of care. Service users and relatives may also visit the home prior to admission if required. One service user spoken with stated that their relative dealt with the admission into the home, however they received all required information. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. Service users 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 are protected by the homes medication policies and procedures. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Service users undergo various assessments such as the activities of daily living, manual handling, pressure area care, social life, mental health needs and cognition, information gained underpins the plan of care. Care plans in place remain extremely in-depth were based upon current research and best practice and were personalised according to service users individual needs. There was evidence to demonstrate that personal choices and preferences had been fully considered to ensure equality and diversity of individuals is fully recognised. The research the manager had undertaken in regards to the Department of Health paper on independence, wellbeing and choice has been Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 10 fully utilised ensuring a whole person approach is in use. There was evidence available to demonstrate that service users as able and relatives had been involved in the negotiation of care plans and information obtained due to the in depth history and extensiveness of information available. Relevant risk assessments were in place for highlighted needs. There was evidence of specialist involvement and advice followed as required. Daily running records are maintained to accurately reflect service users care and current conditions, as are monthly reviews. Service users needs are discussed during supervision sessions and staff spoken with stated that had access to plans of care and were able to discuss service users needs to a good standard. Service users spoken with stated that their needs were met and care received was at a good standard. There was evidence to demonstrate that health care needs are assessed and the relevant specialist services are liaised with to ensure needs are met. There was evidence of specialist equipment available within the home. One service user spoken with stated that they were able to see the doctor as they wished. Relevant policies and procedures are in place with regards to medication. Medication issues were discussed within the plan of care. Service users undergo regular consultations and reviews with the general practitioner. Those service users case tracked medication was checked against the prescription these corresponded. Fridge and room temperatures are recorded appropriately. Relevant documentation was available. Policies and procedures are in place to ensure service users are treated with respect and their right to privacy is upheld. Care plans reflect that this is considered. Service users spoken with stated that staff were kind and caring, listened to their needs and were respectful they also stated that privacy is maintained as required. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality rating for this outcome rating is excellent this judgement was made using evidence available including a visit to the service. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their needs. Service users are enable to maintained contact with relevant others. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing diet in pleasing surroundings. EVIDENCE: An activities coordinator is employed who offers a wide range of activities on an individual and group level. There was evidence available to substantiate this and service users spoken with discussed the recent trips out and events within the home. There was in depth information in regards to service users social life and needs within the plan of care. Reminiscence therapy is also offered. Church services are held in the home and service users are facilitated to practice their religion should they wish. A newsletter is prepared by the activities coordinator, which details forthcoming events, social outings, entertainment and religious services. An invitation is extended to relatives and friends to join in the activities of the home. The routine of the home was stated to be flexible and service users may choose how they spend the day, service users spoken with were able to substantiate this. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 12 There are no restrictions imposed upon visiting and visitors may be received in private should this be required. The main door is kept locked but relatives are issued with the security code so they may enter at any time. Service users are able to choose whom they wish to see and staff prepare for visits with service users if required. Links with the local community are maintained and residents of the village are regular visitors along with family and friends. One service user spoken with discussed the recent trip taken outside the home. Service users are enabled to exercise choice and control over their lives as able. It was evident that equality and diversity of service users is an important issue in respect of the ethos of the home. Staff spoken with were able to discuss how this is maintained and there was evidence that this had been fully recognised and considered within plans of care. In the main due to complex needs relatives are responsible for service users finances. Advocacy services are accessed as required. There was evidence of an excellent and varied menu on offer, which offers a well balanced diet. A variety of drinks and snacks are also available throughout the day. Specialist diets are catered for and there was evidence that needs had been assessed on an individual basis within plans of care. Appropriate documentation and records were in place. Service users spoken with stated that food was at a good standard and choices were offered. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users and relevant others may be assured their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: An in depth complaints policy and procedure is in place and all concerns or complaint if received are taken seriously. Staff were able to discuss the action they would take should a complaint be received. There have been no complaints or concerns received since the last inspection. Service users spoken with expressed no complaints with care received or life within the home. Relevant policies and procedures are in place. All staff have received training in adult protection. All staff have current criminal record bureau checks in place. Staff spoken with were able to discuss relevant issues. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users live in a safe well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: A maintenance man is employed who carries out maintenance on a regular basis. The home is suitable decorated with domestic style furniture. Service users are able to bring in personal possessions should they wish, one service user spoken with substantiated this. The exterior of the home is well maintained with small but attractive gardens; several service users were sitting outside during the visit. There is car parking at the front of the building and a ramped entrance and other adaptation throughout the building. Domestic staff are employed in sufficient numbers to keep the home clean, tidy and hygienic. Infection control procedures are in place and staff spoken Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 15 with were able to discuss these. All areas of the home were clean and tidy on the day of the visit. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. The number and skill mix of staff meets service users needs. Service users are in safe hands at all times. Service users are supported and protected by the homes recruitment policies and practices. Staff are trained and competent to do their jobs. EVIDENCE: The duty rotas were observed and demonstrated that sufficient staff are employed to meet service users needs. Service users and staff spoken with substantiated this. Extra staff are allocated should the need arise, for instance if escort duty is required or a new admission into the home is planned. 98 of staff are trained to the National Vocational Qualification level two or above. A further seven staff are due to start level three and one is due to start level two. The induction programme remains thorough and meets the requirements of this standard. Four staff files were examined and contained all the require documentation. The level of staff training remains at a high standard, evidence was available to substantiate this. Staff spoken with were knowledgeable when spoken with. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 17 Service users spoken with spoke highly of staff and care received. Staff were observed to interact with service users in a meaningful manner and were kind and considerate when attending to needs. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. 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 her responsibilities. The home is run in the best interests of service users. Service users financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The registered manager is a first level nurse; she has now finished her degree in Professional Studies focussed on Care of the Elderly with Physical and Mental Health Needs. She has also completed the Registered Managers Award and many other courses relevant to her job role. Staff spoken with spoke highly of the management of the home and stated that they are supported in their job Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 19 role. Service users spoken with also expressed they were satisfied with the way in which the home was run. A thorough quality assurance programme is in place, which covers all aspect of the home such as care, activities, facilities and the environment. Audits are carried out weekly and service users are supported in completing these. If an individual is unable relatives are approached. Results are collated and discussed at meetings and any action taken as required. Results observed were of a positive nature. There are no service users finances kept on the premises. The fees paid by service users covers numerous items however should an additional cost be incurred relatives are invoiced accordingly. All required certificates and maintenance checks were available for inspection. In depth policies and procedures are in place and good working practise were observed. Appropriate risk assessments were in place for individual service users and for the environment. Fire alarm systems are tested and maintained as required. Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 20 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 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Byars Care Home DS0000024633.V302758.R01.S.doc Version 5.2 Page 23 - 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!