CARE HOMES FOR OLDER PEOPLE
Byron Court Gower Street Bootle Liverpool Merseyside L20 4PY Lead Inspector
Mrs Joanne Revie Key Unannounced Inspection 29th January 2008 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 Byron Court DS0000017267.V358489.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. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Byron Court Address Gower Street Bootle Liverpool Merseyside L20 4PY 0151 922 0398 0151 933 5687 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) Mary George Ltd Karon Elizabeth Wilcox- George Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Sensory impairment (1) of places Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. Service Users to Include up to 52 (OP) and up to 1 (SI) Service user category SI - Sensory Impairment relates to one service user only, should this service user leave, the category SI would be removed. One named female out of category service user receiving non-nursing care, should this service user leave then the condition will cease to apply. The Service may provide nursing care to one named female service user out of category as under pensionable age. Should this service user leave this condition will cease. To include one named male out of category service user under pensionable age on a temporary basis (3 months) Date of last inspection Brief Description of the Service: Byron Court is a purpose built care home registered for the care of a maximum of 52 Residents. The Home provides care to older persons, male and female, over retirement age that require nursing care. The home provides short term and long-term care. Byron Court is owned by a private organisation. Accommodation is situated over three floors and there are three lounges and one dining room. An enclosed lounge is available for those people who wish to smoke. There are landscaped gardens to the front of the establishment that are easily accessed. There are 47 bedrooms comprising of 42 single rooms and 5 double rooms. None of the rooms have en-suite facilities. Byron Court is situated off a main road in the Bootle area, opposite some small local shops. Public transport is easily accessible. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes.
Prior to the site visit taking place the manager was asked to complete a document called an AQAA. This is a document, which gives information about the services strengths and weakness, and future plans for the service to develop further. During the site visit, discussions were held with people who live at the home, and their visitors and some members of staff. Their views have been included within the report. The site visit was unannounced .The manager was in charge at the home so discussions were also held with her. A variety of records were viewed which refer to the health and welfare and care received by the people who live at the home. This review also included viewing staff records. Observations were carried out to assess how well staff interact with the people who live at the home and how staff deliver care. Examples of care and support were observed which showed that the manager and the staff team have good understanding of how to treat people as individuals and how to meet their diverse needs. The cost of living at the home ranges from £347.25 to £586.25 per week. What the service does well:
Each person receives a thorough assessment before admission takes place (except in the case of emergency admissions), which is carried out by a qualified nurse. This gives the person the opportunity to decide whether they want to move into the home and also gives staff the opportunity to decide whether they can meet the person’s needs and plan their care. The staff have very good relationships with the people who live in the home and close bonds have formed in some cases. An overseas member of staff has the opportunity to speak her native language with one person who learnt the language before they moved into the home. The people who live at the home like the staff and believe that they are well cared for and were alos complimentary about the food that is served at the home. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 6 Comments included ”” great food, Great staff- I’ve no complaints” and” Yes, I like the staff they’re a good bunch- they look after me well. The food is excellent- If I don’t fancy something they get me something else- They try very hard”. Staff are good at monitoring peoples health care needs and are quick to take action if deterioration in health occurs. One person who was receiving short term care stated” I’m much better since I came here- I wasn’t well one day and they got the doctor straight away- no questions asked- They’re marvellous”. The manager carries out audits on key areas of care. This means that regular checks are undertaken to ensure that things are how they should be. People feel confident that the manager will take action if they are unhappy and this was proved to be true. The manager and the staff team alos have the skills and the knowledge to protect people form abuse. This means that the rights of the people who live at the home are upheld and respected. The home is welcoming and presents as clean, tidy, comfortable and warm. A visitor commented” Its always clean, the staff are friendly, and there’s always someone to talk to me about “ persons name”. . Over 70 percent of the care staff have achieved an NVQ qualification. This is greater than the national minimum standard of 50 . This means that the staff team lead by the nurse’s have the skills to care for the people who live at the home The manager is a qualified nurse who is experienced in management of care homes and holds the registered managers award. This means that she has the skills and the experience to manage the home well. The people who live at the home are consulted about the homes development and their opinion is also sought about the service provided. This shows a willingness to listen and develop the service according to their wishes. What has improved since the last inspection?
There have been a number of significant improvements in the home, which has caused the quality rating, mentioned at the beginning of this report to rise from adequate to good. Assessment records have been developed further so that a full pen picture of the persons needs likes and dislikes is available when they are admitted to the home. Information has been developed and distributed to each of the people who live at the home informing them of their rights and what they can expect of the service.
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 7 Care plans are much more personal to the individual which gives the reader a real insight into their needs, wishes, likes and dislikes. The quality of care is improved so that people’s privacy and right to dignity is respected and upheld. Staff are managing medications more safely and ensuring that people receive their medication as prescribed. Activities have been greatly developed so that people no have the opportunity to spend their time usefully onside the home and go outside for personal shopping trips or group trips to the theatre etc. The building itself has been improved so that people can now access a large spacious enclosed lounge and those who smoke have a separate comfortable smoking lounge. The dining room has been refurbished so that it is a pleasant place to eat meals and the addition of menus and flowers to each of the tables provides a nice touch. Many of the areas have been redecorated which gives the impression that the home is cared for. Record keeping and storage in general is much more organised so that records can be accessed quickly and easily. In particular staff files are much more organised and all necessary checks have been carried out to ensure that staff are suitable to work with vulnerable adults. There has been a significant improvement in aspects of maintenance, which could affect the health and safety of people who live at the home making the home a safer place to live. What they could do better:
Staff should consider revisiting the assessment tool after admission takes place so that the information recorded is updated and therefore not misleading. This could cause confusion to a staff member who is not that familiar with the persons needs. Staff should ensure that all care plan documentation is reviewed monthly and that any evidence, which shows consultation with people about the care that they receive, is recorded. This will help to show that people are involved in the care that they receive. People who live at the home believe there are enough staff to meet their needs however staff at the home do not agree with this view. Staffing levels are based on the number of people living at the home. It would be better if a resident dependency tool was introduced to show that the home is staffed according to peoples needs rather than the number of people living at the home.
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 8 A staff training plan detailing specialist training according to peoples needs should be introduced as well as ensuring that staff inductions are in line with current best practice. This will ensure that staff have the necessary skills to care for the indivual needs of each person. The manager should carry through her intention to use wound mapping tools and photographs of any wounds so that accurate records exist to show whether wounds are improving or deteriorating. Daily temperature checks of the medication storage room should be undertaken to ensure that medications that require storage at room temperature are not being stored at greater than 25 degrees C Plans have been developed to refurbish some of the bathrooms at the home and some parts of the upstairs lounges. These plans should be carried through to show commitment to the continuous improvement of the home. Two signatures must be recorded on all financial transactions that relate to peoples personal allowances. This will help to ensure that people’s monies are safeguarded. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 9 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 Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive written information, which enables them to choose whether the home is the right place for them and have their needs assessed by nursing staff ant key times so that the care and support is planned according to their individual needs. EVIDENCE: The home provides long term care as well as short term care and different assessment processes exist to support this. For example when someone is admitted for short term care (this is often the result of emergency intervention) nursing staff do not visit the person before admission takes place so that the admission is not delayed. However staff at the home ensure that they receive a copy of the persons care plan before admission takes place.
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 11 A full assessment of need takes place for people who have made the decision that they wish to reside in the home long-term. The documentation used to carry out this process has been improved so that a full picture of the persons needs, wishes, likes and dislikes is available so that staff can plan their care before admission takes place. Following admission to the home the nursing staff carry out a second assessment. At times this information was found to be misleading as staff had not revisited and updated the record since the assessment on admission had taken place. This gave the impression that the persons needs where more complex than they actually were. Staff at the home should consider carrying out a further assessment at a later date to review this record to avoid confusion. Since the last visit the service has developed a clear statement of purpose (this document sets out the aims of the home and tells people in details what they can expect) and from this the service has produced a document called a “service users guide”. This document gives the person an overview of what they can expect from the service. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There have been significant improvements to the quality of care and support offered which has resulted in the people who live at the home receiving good quality care and their medications as prescribed. EVIDENCE: Care plan documentation has greatly improved since the last visit. Efforts have been made to include the person’s personal prefences such as preferred bed and rising times. The instructions in the care plans are written in a more personal way, which gives the reader an overview of the person’s personality as well as the care, and support they need. Some care plans contained records, which showed that the person or their relative had been consulted about how the care should be delivered however one plan was lacking this documentation. Some care plans had been reviewed
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 13 monthly to show that staff were checking that the information within them was still up to date however one plan had not. Records viewed also showed that the manager audits the care plan documentation by viewing a sample of plans each month. Any shortfalls are identified during the audit and action is taken to rectify them. All the plans viewed contained information, which showed that staff had assessed the risk of the person’s health deteriorating in some way. Where necessary (i.e. medium to high risk) appropriate action had been taken by staff to reduce the risk and promote the persons health. Records showed that when the need arises other specialists such as G.P.s dieticians district nurses are consulted about the right course of action to take. Staff are keeping accurate records of any wound care that is given. Theses showed that staff were being consistent in their approach and had the skills and knowledge to promote healing. The manager has recently purchased wound mapping charts so that an accurate record can be kept of whether a wound is healing or deteriorating. Staff ensure that specialist equipment is available for those people who need it to promote their health. E.g. pressure relieving mattresses to reduce the risk of pressure sores occurring. Records showed that people are being weighed regularly and that appropriate action is taken if their weight changes. Everyone spoken with agreed that they were well looked after and that they believed that they received a good standard of care. Medication storage systems were viewed. The home has a locked treatment room, which contains suitable storage for different types of medications. Staff are keeping clear records of what was given when, which is an improvement since the last visit. These records help to show that people are receiving their medication as it is prescribed which helps to promote their health and wellbeing. Staff record the temperature of the medications fridge on a daily basis to ensure that the medicines within it are being stored at the correct temperature. However this good practise could be developed further by monitoring the temperature of the treatment room also to ensure that medicines, which require storage outside the fridge, are being stored at room temperature (25 degrees C). Systems are in place to record all medication, which arrives and is disposed of at the home. This means that a clear audit trail exists for all medication for each person. The manager carries out monthly medication audits to ensure that staff are following procedures so that people do receive their medication as prescribed. During the visit staff were observed interacting well with the people who live at the home. It was evident that in some cases trusting relationships had been formed. Staff were observed knocking on bedroom doors before entering and
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 14 although they could be heard laughing and joking with people they were still respectful in their attitude towards them. In general the people who live at the home appeared well cared for and attention had been given to their personal hygiene and their manner of dress. This is an improvement since the last visit. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant improvements have been made in this area, which has resulted in people being offered a range of activities, which they enjoy. A choice of home cooked food is offered which people also enjoy EVIDENCE: Care plans have been developed to include people’s personal preferences and how they would prefer to spend their time. An activities coordinator has been employed since the last visit. Records were viewed which this person had completed which showed that a variety of activities were being offered on a daily basis weekly activities rota is displayed in the home so that people know what’s happening when. Trips now occur outside the home such as going shopping in the local community or joining in group outings. A recent trip to see the show “ Blood Brothers” was particularly enjoyed. The manager explained that there is a strong focus on trying to get the local community mores involved in the home. An example of this was a recent fundraising community bingo night. Key calendar events are celebrated by
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 16 having family style parties. For example at Halloween, the home was decorated and grandchildren/ younger relatives of the people who live there were invited to a party. This also included children of staff members. The manager also explained that from April 2008 the home will be provided with a budget for the provision of activities. Links have been developed with local clergy who visit the home to offer religious support to those people who wish it. The manager proved knowledgeable in how to support people with diverse needs due to cultural /religious beliefs but no evidence of this was available as no one who lived in the home was requiring such support. The dining room has been refurbished since the last visit. This presented as a pleasant place to spend time with pleasant table settings complete with flowers and a daily menu displayed on each table. Discussions with the chef revealed that he is knowledgeable about the importance of providing a variety of fruit and vegetables on the menu. These are supplied fresh and frozen to the home on a weekly basis. Menus showed that a variety of home cooked traditional meals are available with the main meals being served at lunchtime. Staff consult with the people who live at the home on a daily baisi and then inform the chef of what they would like to eat. Records are kept showing which meals were available each day. People who live at the home confirmed that if they feel like eating something different other then the main meal, staff will try very hard to accommodate their wishes. Everyone spoken with was positive about the food offered at the home. The kitchen is furnished with industrial style equipment and adequate stock levels of both fresh and frozen food were available. Records were viewed that showed that the fridge and freezer temperatures were monitored daily and that the kitchen is deep cleaned monthly. The home also employs a weekend chef. This means that a chef is available seven days per week. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 17 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and believe their concerns will be listened to and acted on. Staff have the skills to protect people from abuse EVIDENCE: The people spoken with agreed that if they were not happy with any aspect of the home they would speak with the manager and she would address their concerns. A visitor confirmed that they had no concerns about the home but if they had they felt confident that it would be addressed. Complaints records were viewed, which showed that the manager deals with concerns and complaints appropriately within the services own timescales. A Complaints procedure was displayed in communal areas of the home. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 18 Viewing staff files showed that staff had undertaken training in protection of vulnerable adults in April 07. The files also showed that Adult protection officer from the local council has also delivered this training in the past. Discussions with two members of staff revealed that they understood what abuse was and knew what to do if they suspected it had occurred. One allegation of potential abuse has been made to social services who take the lead role in such matters since the last visit but this was unfounded. Never the less the manager acted appropriately showing that she understands how to protect people’s rights. No complaints have been made to CSCI about the service since the last key inspection. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Improvements have been made so that key areas of the home are more suitable to peoples needs. The home presents as clean, warm and comfortable which each bedroom being decorated and personalised according to each persons taste and wishes. EVIDENCE: Major alterations have been made to the reception and open plan lounge. This has resulted in a spacious enclosed lounge, which was being used throughout the day by the people who live at the home and their visitors. The division of space has a meant that separate enclosed smoking lounge is also available plus a reception desk which gives visitors a clear indicator of where to go when they need to speak to someone.
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 20 Improvements have been made to some of the bathrooms at the home to make them more accessible for people to use. Further plans have been developed for the remaining bathrooms but theses will not be occurring until after April 08.Viewing these rooms showed that these improvements are necessary. Plans have alos been developed to refurbish two of the remaining lounges on the upper floors. All areas viewed presented as nicely decorated with good quality furnishings Viewing the staff rota showed that the home employs a regular team of domestic staff on a daily basis, to ensure that the environment is clean at all times. However on some days only one domestic staff is available which could be a struggle for a home of this size. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 26,27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at the home receive care and support from staff that they like who have the basic skills to care for them properly EVIDENCE: Discussions with the people who lived at the home revealed that they thought there were enough staff to meet their needs and that they never had to wait too long to have their call bells answered. However discussions with five members of staff revealed that they did not agree with this opinion and felt that the people who lived at the home would benefit from more staff on duty to meet their needs. Viewing off duties revealed that the service is staffed consistently on a weekly baisi however staffing levels change according to occupancy levels. No formal process based on peoples dependency levels is in place to show that the home is staffed according to peoples needs and this should b addressed. Only five of the staff team have not achieved an NVQ qualification in care. This means that 12 of the 17 care staff have achieved the qualification. Three are
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 22 undertaking this award with plans for the remaining two to start in the near future. Improvements have been made to the staff files so that the information is organised and easy to find. All recruitment checks have been completed on all staff, which means that staff have had necessary checks undertaken to make sure that they are suitable to work with vulnerable people. Staff are receiving inductions and plans have been made to ensure that these are in line with current good practise. Viewing a training plan ands a selection of staff files showed that all staff have undertaken mandatory training to enable them to keep the people who live at the home safe. This coupled with the knowledge of the staff who achieved NVQs and the skills of the nursing staff at the home means that staff are able to deliver a good standard of care. However staff training should be developed to ensure staff receive training, which meets peoples individual needs that live at the home. Nursing staff have taken some extra training which is appropriate to their role and to the needs of people who live at the home but this has not been extended to the care staff. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 23 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a safe place for people to live and people’s opinion is sought about how the home is run. The manager ensures that the home is operated within current legislation and has the skills to manage the home effectively. EVIDENCE: The home is managed by a qualified nurse who has achieved the registered managers award, is an experienced manager and is registered with CSCI to manage the home. This means that necessary checks have been undertaken to ensure that she is suitable to manage the service. Improvements have been identified throughout the report that shows that the management team have developed the home and have plans for its expansion.
Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 24 People and staff are regularly asked to express their opinion of the home either through surveys or meetings. This happens from management within the home but also from an outside company who has recently awarded the home with “four stars” due to the improvements that have been made. Records of personal allowances showed that monies are managed safely however this process must be developed to include two signatures for all transactions that have taken place. Information was available during this visit which showed that any monies held on behalf of people are held in a separate account to safeguard them and the manager now receives a weekly break down of who has what so that she can ensure that their interests are being protected. A variety of certificates, contracts and records were viewed which showed that the home complies with Health and Safety legislation by ensuring that the home is a safe place for people to live. This is an improvement on previous visits. The home is fully equipped to fight fire should one occur and staff receive regular update training on how to do this. . Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 25 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP35 Regulation 17(1)(a) Requirement Two signatures are required on all records of personal allowances to demonstrate that financial transactions have occurred. Timescale for action 01/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations Staff should consider revisiting the assessment tool after admission takes place so that the information recorded is updated and therefore not misleading. Staff should ensure that all care plan documentation is reviewed monthly and that any evidence, which shows consultation with people about the care that they receive, is recorded. The manager should carry through her intention to use wound mapping tools and photographs of any wounds so that accurate records exist to show whether wound are improving or deteriorating. Daily temperature checks of the medication storage room should be undertaken to ensure that medications that
DS0000017267.V358489.R01.S.doc Version 5.2 Page 27 3 OP8 4 OP9 Byron Court 5 OP19 6 7 8 OP26 OP27 OP29 require storage at room temperature are not being stored at greater than 25 degrees C. The plans to refurbish the bathrooms and the upper lounges should be carried through to present a homely comfortable environment for the people who live at the home. Domestic staff cover should be explored to ensure that it is adequate for a home of this size A dependency level tool should be introduced which shows that the home is staffed according to people’s needs rather than the number of people living at the home. A training plan detailing specialist training according to peoples needs should be introduced as well as ensuring that staff inductions are in line with current best practice. Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Byron Court DS0000017267.V358489.R01.S.doc Version 5.2 Page 29 - 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!
