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Inspection on 18/08/05 for Byars Care Home

Also see our care home review for Byars Care Home for more information

This inspection was carried out on 18th August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The preadmission assessment is extremely in depth and provides a solid benchmark for the plan of care. Care plans are also in depth, personalised and address complex needs, which enhance care delivered. The manager liaises with other health care professionals and societies; carrying out extensive research to ensure up to date and good practice is employed. The recruitment and selection policy and procedure is also of a high standard and ensure service users are protected. Documentation with regards to palliative care is also at a high standard and ensures all needs are identified.

What has improved since the last inspection?

The adult protection policy has been reviewed and updated ensuring service users are further protected. The preadmission assessment introduced enhances the assessment of whole person needs thus enabling service users needs to be fully met.

CARE HOMES FOR OLDER PEOPLE The Byars Nursing Home Caythorpe Nr Lowdham Nottinghamshire NG14 7EB Lead Inspector Karmon Hawley Unannounced 18/8/05 10.00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Byars Nursing Home Address Caythorpe Nr Lowdham Nottinghamshire NG14 7EB 0115 9663981 0115 9663529 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Beckedge Ltd Verity Gay Hallam CRH 27 Category(ies) of OP 27 registration, with number DE 10 of places TI 3 The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 22nd Febuary 2005 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 Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. Three service users case files, three staff personnel files and other related documentation with regards to care and the environment were examined. Two members of staff were spoken with and four service users. Due to the complex needs of service users within the home staff were also observed in practice. What the service does well: What has improved since the last inspection? What they could do better: The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 6 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 Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users can be assured their needs will be fully assessed and met. EVIDENCE: Pre admission assessments are carried out in the community prior to service users being admitted into the home. Assessments are in depth and cover all the requirements of the standard and present detailed information to assist the plan of care. These are not normally done in the home however if a service user was able this would be considered. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10,11 Service users personal and health care needs are set out in an individual plan of care and appropriate services are liaised with ensuring needs are fully met. Service users are treated with respect and their right to privacy is upheld. Service users can be assured that in the event of their death staff will treat them and their family with care, sensitivity and respect. EVIDENCE: Plans of care examined were extremely in depth and personalised. All complex needs were identified and considered. Various assessments with regards to the risk of falls, pressure areas, fractures and nutrition were carried out which underpinned the basis of the care plan, based upon the activities of daily living. With regards to dementia care, plans again were extremely in depth and concentrate on promoting and maximising life potential. Staff spoken with were able to discuss dealing with aggressive behaviour and the methods used within the home. There was evidence to demonstrate that health care needs are assessed and the relevant service, such as the multidisciplinary team is liaised with to ensure needs are met. The National Osteoporosis Society has recognised the work undertaken with regards to falls prevention. A service users spoken with stated his needs are met. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 10 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 and staff spoken with were able to discuss core values and principles. With regards to palliative care an in depth assessment and care plan is available should it be required. The manager stated family members would be liaised with as needed and support offered. The manager stated that all wishes would be respected. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 Service users are enabled to exercise choice and control over their lives and maintain contact with family and friend and participate in the local community as they wish. EVIDENCE: There are no restrictions on visiting, the main door is kept locked but relatives are issued with the security code so they may enter at any time. Service users may use their own room should they require privacy and there are also small areas around the home which may be accessed. 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. A service user spoken with stated that he goes out on trips with the staff of the home. Service users are enabled to exercise choice and control over their lives as able, advocates are accessed as required and the manager has recently registered with the Care Awards Advocacy Service to promote this. Other advocacy sources are also used if needed. In the main due to complex needs relatives are responsible for service users finances. If able service users participate in their plan of care if not reviews are carried out with relatives to ensure care needs are being met. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Service users and relatives can be assured that complaints will be 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. The abuse policy has been reviewed and rewritten; the majority of staff have completed training with regards to adult protection and have satisfactory criminal records checks and protection of vulnerable adult checks in place. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26 Service users live in a clean, pleasant and hygienic environment. EVIDENCE: Domestic staff are employed in sufficient numbers to keep the home clean, tidy and hygienic. Infection control procedures are in place and staff spoken with were able to discuss these. The laundry room on the day of inspection was clean and tidy and appropriate equipment was available. The kitchen has undergone additional work to install an extractor fan following advice of the environmental health department. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Service users needs are met by the number and skill mix of staff and they are supported and protected by the homes recruitment policies and procedures. EVIDENCE: There are adequate staff employed to meet the needs of service users within the home. Skill mix and experience are considered when planning the duty rota. Extra staff are allocated should the need arise, for instance if escort duty is required or a new admission into the home is planned. A service user spoken with stated that staff are nice, they work hard and he is well cared for. The home has a thorough recruitment and selection policy in place and staff files examined contained all required documentation to meet this standard. All staff receive the general social care council code of conduct and other related material. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 The home is run in the best interest of service users. Service users financial interests are safeguarded. EVIDENCE: 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. 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. The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 4 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x x 4 x 3 x x x The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 17 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. Refer to Standard Good Practice Recommendations The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Edgeley House 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 The Byars Nursing Home C03 C53 S24633 Byars V245458 180805 Stage 4.doc Version 1.40 Page 19 - 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!