CARE HOMES FOR OLDER PEOPLE
Bybuckle Court Marine Parade Seaford East Sussex BN25 2PZ
Lead Inspector Nigel Thompson Unannounced 14 April 2005 12:30 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. Bybuckle Court Version 1.10 Page 3 SERVICE INFORMATION
Name of service Bybuckle Court Address Marine Parade Seaford East Sussex BN25 2PZ 01323 898094 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) Mr James Lord Mrs Sylvia Lord Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places 17 Bybuckle Court Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The maximum number of service users to be accommodated is seventeen (17). 2. Service users are older people aged 65 years or over on admission. Date of last inspection 02.09.2004 Brief Description of the Service: Bybuckle Court is an established home providing residential care for up to seventeen older people. It is a large detached property, overlooking the seafront in Seaford and within easy walking distance of the town centre shops, amenities and railway station. Service users’ accommodation comprises fourteen single rooms and two double rooms, situated on two floors. The majority of the rooms have en-suite facilities and all are fitted with a call bell system. A shaft lift provides access to the first floor. In addition to Bybuckle Court, the proprietors own a second home in Seaford, Hillersdon Court, which also provides residential care for older people. Bybuckle Court Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours in April 2005. It found that many of the National Minimum Standards had been met or partially met and the overall quality of care provided was good. Service users and relatives spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. A tour of the premises took place and documentation, including service user and staff files were inspected. Two of the service users’ relatives, all the staff on duty and five of the eleven residents were spoken to. What the service does well:
The relaxed, homely and welcoming environment has evolved over several years and reflects the positive attitude and general stability within the staff team and the open and inclusive management style. Independence is promoted within the home and service user consultation and involvement in day-to-day decision making is encouraged. Regular residents’ meetings provide opportunity to discuss many aspects of daily life including menu planning, activities and colour schemes for communal areas within he home. The standard of the environment within the home continues to improve and provides service users with a clean, comfortable and pleasant place to live. Staff have a sound understanding of the support needs of the service users. Overall standards of care remain high and individual residents spoken to during the inspection expressed satisfaction with the service provided. Bybuckle Court Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bybuckle Court Version 1.10 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 Bybuckle Court Version 1.10 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) 1 & 3 Very little progress has been made in developing the service users’ guide. Without this information, service users and their relatives are not able to make a fully informed choice about the Home and the services provided. EVIDENCE: The home has produced a comprehensive statement of purpose and an integrated statement of intent. However, as discussed with the deputy manager and despite a previous requirement, at present there is still no separate and specific service user’s guide. Following a referral to the home, the acting manager carries out a full and detailed assessment of all potential service users, prior to admission. As well as the personal and social care needs of the individual, the profile and assessment includes details such as environment, communication and mobility. Bybuckle Court Version 1.10 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 & 9 Service users’ care plans are developed from a comprehensive assessment of an individual’s needs and enable staff to meet such needs in a structured and consistent manner. EVIDENCE: The deputy manager confirmed that, whenever possible, the service user (and/or a relative or representative) is involved in drawing up and reviewing the individual care plans. This was confirmed by a relative, spoken with during the inspection. The format for service users’ care plans has recently been reviewed and amended to include, in detail, the action which needs to be take by staff to ensure that all aspects of the health, personal and social care needs of the individual are met. As required, care plans now show evidence of being clearly linked to assessments. It was however noted that details of service users’ wishes for arrangements after their death have not bee recorded.
Bybuckle Court Version 1.10 Page 10 Each service user’s medication file has a photograph attached. All appropriate documentation, including policies, procedures and medication administration records, was found to be up-to-date and well maintained. Bybuckle Court Version 1.10 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) 12 & 15 Social activities and meals are both well managed, creative and provide daily variety and interest for people living in the home. EVIDENCE: There are a number of activities that service users can be involved in, including board games, gentle exercise, indoor bowls and walks along the seafront. However, attempts by staff to introduce more organised activities have not always been well received. An activities programme, based on individual and collective leisure and recreational interests, has been developed since the last inspection. A record is maintained in service users’ care plans of individual preferences and social and recreational interests. A new cook has been appointed and the improvement in the choice and overall standard of meals was commented on by several service users and relatives. ‘Vegetables are steamed now and have far more taste’. ‘Fresh produce is now used instead of frozen’. ‘You couldn’t wish for better’. Bybuckle Court Version 1.10 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 The open and inclusive atmosphere within the home enables service users, staff and visitors to feel able to express any concerns, confident that they will be listened to. Service users are safeguarded from abuse through robust policies, procedures and relevant staff training. EVIDENCE: Policies and procedures relating to abuse and including whistle blowing are in place and have recently been reviewed and updated. The deputy manager stated that abuse training is provided for all staff and this claim was supported by training records and certificates in staff files and confirmed by members of staff themselves. A clear and accessible complaints procedure has been produced and is in place in the entrance hall. Service users, members of staff and a relative spoken to during the inspection, confirmed that they would have no hesitation speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. Bybuckle Court Version 1.10 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) 19, 25 & 26. Redecoration, refurbishment and general improvements have been made to the physical environment, including service users’ rooms, providing people living in the home with safe, comfortable and pleasant surroundings. EVIDENCE: Since the previous inspection the programme of redecoration and partial refurbishment has continued, with several service users’ rooms and the first floor bathroom having been redecorated. Residents are clearly happy with the home and their rooms. ‘I love my room’. ‘It’s so clean and comfortable here’. It was evident that many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and personal belongings, to reflect individual taste, choice and preference. Paintwork on the first floor landing walls is marked and flaking, however the deputy manager understands that this is soon to be attended to, as part of the ongoing maintenance programme. This programme was not available for inspection on this occasion.
Bybuckle Court Version 1.10 Page 14 Although the majority of radiators have now been fitted with guards, it was noted that in one of the bathrooms, a radiator has not been covered and was excessively hot. This potentially places vulnerable people at risk. Levels of cleanliness and hygiene were found to be high throughout the home. Bybuckle Court Version 1.10 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 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 There are sufficient staff on duty at all times to meet the assessed, low dependency needs of the service users. Thorough recruitment procedures help to ensure the safety and protection of service users. EVIDENCE: A rota is in place, showing which staff are on duty at any time and their designation. Staff, service users and relatives spoken to were satisfied with the number of staff on duty during the day. One relative spoke of the ‘kindness’ of the staff. ‘They are so caring - nothing is too much trouble’. ‘I couldn’t wish for anywhere better for my mother’. The current recruitment procedure is satisfactory. Staff files that were inspected contained the necessary documentation, including two written references and Criminal Records Bureau (CRB) checks. Bybuckle Court Version 1.10 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 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 & 38 Up to date policies and procedures relating to health and safety ensure the health, safety and welfare of all service users and staff. EVIDENCE: Staff spoken to were aware of and adhered to policies and procedures, relating to health and safety. The majority of staff have received relevant training in manual handling, first aid and fire safety. The cook also holds certificates in food hygiene. All training is recorded. Bybuckle Court Version 1.10 Page 17 The acting manager or deputy manager carries out routine environmental risk assessments. COSHH assessments and guidelines are in place. All accidents are recorded. Satisfaction questionnaires were not made available for inspection, however service users and relatives spoken to expressed a high degree of satisfaction with the home and the care services provided. Bybuckle Court Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x 3 2 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 3 x 3 x x 3 x x x x 3 Bybuckle Court Version 1.10 Page 19 Yes 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 1 Regulation 5 (1) & (2) Requirement It is required that a written service users guide be produced and made availble to current and prospective service users. (Timescale of 31.12.2004 not met). It is required that the radiator in the first floor bathroom be fitted with a guard, to ensure the safety of service users. Timescale for action 30.04.2005 2. 25 13 (4) 30.04.2005 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 7 Good Practice Recommendations It is recommended that details of an individuals wishes for arrangements after death are discussed and recorded in their care plan. Bybuckle Court Version 1.10 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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