Inspection on 21/02/06 for Byars Care Home

This inspection was carried out on 21st February 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 11/07/06

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 21st February 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.V277648.R01.S.doc Version 5.1 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.V277648.R01.S.doc Version 5.1 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.V277648.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18/08/05 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. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in five hours and was performed by one inspector. The main method of inspection was case tracking, this is a method of sampling the records of three service users residing at the home 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 users. Three service users and two relatives were spoken with so as to give the inspector an insight into the conditions and standards within the home. Those spoken with were extremely happy with the staff, care received and the standards within the home. The registered manager assisted in the inspection process and four members of staff was spoken with who were able to demonstrate a good understanding of service users needs and the core values and principles in relation to their job role. What the service does well: What has improved since the last inspection? The manger continues to research up to date practices and adapts these into the policies and procedures employed within the home, ensuring service users care needs are fully met. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 6 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.V277648.R01.S.doc Version 5.1 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.V277648.R01.S.doc Version 5.1 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): EVIDENCE: Not assessed during this inspection. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 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): 7,9 The service users health, personal and social care needs are set out in an individual plan of care. Service users are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: A new preadmission assessment has been devised so that further information can be gained and relatives and service users have further input into this process. There was evidence to demonstrate that service users undergo thorough assessments such as the activities of daily living, nutrition, pressure area care, social life, mental health and cognition and manual handling, information gained forms the basis of the plan of care. Care plans in place were extremely in-depth, covered required needs, were personalised and reflected choices and preferences. The manager has also researched the recent paper prepared by the Department of Health with regards to independence, wellbeing and choice and there was evidence that this was being utilised within plans of care and that the whole person approach was in use. There was evidence that service users, as able, and relatives had been involved in the negotiation of care plans due to the in-depth history and extensive information Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 10 available. Various risk assessment tools were used to assess risk and relevant risk assessments were in place with regards to this, these include the risk of falls, developing pressure sores and the use of bedrails. Care plans are comprehensive especially with regards to complex needs and mental health needs. There was evidence of specialist involvement and advice followed. Daily running records are maintained to accurately reflect service users care and current conditions. During supervision sessions the manager discussed service users plans of care and presents scenarios so as to ensure care staff are aware of service users needs and care is delivered in accordance with the plan of care. Service users spoken with stated that their needs are met and they were happy with life within the home. The two relatives spoken with stated that they are kept informed of events occurring within the home and they felt supported by the manager and staff, they stated that they felt their relatives care needs were met. Staff spoken with were able to discuss service users needs and the core values and principles in relation to care delivered. Relevant policies and procedures are in place with regards to medication. Medicines checked corresponded with the prescription. Trained staff audit medicines on a four weekly basis. The manager is currently researching disposal for unused medication in line with the new legislation. Currently there is no one who self medicates in the home. Where homely remedies are used permission has been authorised by the GP and an agreement with service users is in place. Photographs are on prescription charts to enable identification of service users. Fridge temperatures are recorded. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 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): 12,15 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 receive a wholesome appealing balanced diet in pleasing surrounding. EVIDENCE: Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 12 An activities co-ordinator is employed within the home, she was able to demonstrate an excellent insight into service users needs and activities she undertakes and the benefits they bring to service users. She is very enthusiastic and has attended courses specific to her job role. In depth social assessments take place and she also converses with relatives and requests further information so that in-depth information is available and activities can be personalised and specific to individuals. Care files examined demonstrate full assessments with regards to activities and social life; they hold records of individual participation in one to ones, groups and social activities such as the reminiscence group. The activities coordinator concentrates on significant times of the year and a variety of activities are available in house, entertainers also visit and service users go out on trips. Church services are held at the home and service users are facilitated to practice their religion should they wish. A newsletter is prepared by the activities coordiantor, which details forthcoming community 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 is stated to be flexible and service users may choose when they rise and retire and how and where they spend their day. Service users spoken with were able to substantiate this. Although a specific private area is not available there are several quieter areas and service users rooms, which may be used if privacy is required. Service users spoken with stated they enjoyed activities on offer and one was looking forward to the trip to the theatre that evening. There was a coffee afternoon held on the day of the inspection which was well attended by relatives, who stated they are welcomed into the home at all times. There was evidence of an excellent and varied menu, which offered a wellbalanced nutritional diet. Drinks and snacks are also offered throughout the day. Service users are presented with a questionnaire so that their needs, choices and preferences are taken into account; there was evidence of these within plans of care. Meal choices are documented. The cook works closely with the service users to ensure that she meets their expectations. Relevant documentation was in place to demonstrate compliance and the kitchen was well organised, clean and tidy. Service users spoken with stated food was at a good standard and was plentiful. One relative spoken with stated that she has a meal at the home on a weekly basis, which is very enjoyable. Staff were able to discuss specialist diets required. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 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): EVIDENCE: Not assessed during this inspection. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 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 Service users live in a safe, well-maintained environment. EVIDENCE: A maintenance man is employed who carries out maintenance on a regular basis. There are also polices and procedures in place with regards to the maintenance of the home. The home is suitably decorated with domestic style furniture. The exterior of the home is well maintained with small but attractive gardens. There is car parking at the front of the building and there is a ramped entrance and other adaptations throughout the building to ensure safe and easy access. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 15 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): 28,29 Service users are in safe hands at all times. Service users are supported and protected by the homes recruitment policies and practices. EVIDENCE: The providers remain strongly committed to vocational qualifications and the majority of staff have now attained or are waiting to enrol upon the national vocation qualification level two, a number of staff have also achieved level three. The registered nurses who have attained the assessors award support staff in attaining these qualification. There is a thorough policy in place with regards to the recruitment and selection of staff, which was observed to be followed in documentation examined. Staff files observed held the required documentation to meet this standard. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 16 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): 31,36,37,38 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 her responsibilities fully. Staff are appropriately supervised. The homes record keeping policies and procedures safeguards service users rights and best interest. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 17 The Registered Manager is a first level registered nurse; she is due to graduate in July of this year as she has completed a degree in professional studies focused 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. She is dedicated towards improving herself and remaining up to date with working with the service user group the home caters for and is able to evidence this. Staff spoken with spoke highly of the manager and stated she was supportive and approachable. Service users and the relatives spoken with also expressed the home was well run and managed. Supervision sessions take place every two months and during this time both positive and negative issues are discussed and areas upon which there may be improvement. Group sessions also take place where specific subjects are discussed ensuring staff are aware of plans of care and current best practice. On speaking with staff they confirmed that these were taking place and were beneficial. Records were available to substantiate these were taking place. Records are up to date and maintained in accordance with the Data Protection Act. All required certificates and maintenance checks were available for inspection. The home has received visits from other professional organisations such as the environmental health department and this reports was satisfactory. In depth policies and procedures are in place and a number of risks identified have management plans in place, the manager is now aiming to condense these policies to provide clear risk assessments, which are easily accessible. The fire risk assessment is in depth. Staff training is at a good level. Appropriate fire tests, drills and emergency light testing are carried out according to requirements. Accident records are maintained appropriately. Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 4 29 4 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X X 4 4 4 Byars Care Home DS0000024633.V277648.R01.S.doc Version 5.1 Page 19 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.V277648.R01.S.doc Version 5.1 Page 20 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.V277648.R01.S.doc Version 5.1 Page 21 - 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!