Inspection on 14/10/08 for De Baliol Nursing and Residential Care Home

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: De Baliol Nursing and Residential Care Home Woodhorn Road Newbiggin By The Sea Northumberland NE64 6HN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Thompson     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: De Baliol Nursing and Residential Care Home Woodhorn Road Newbiggin By The Sea Northumberland NE64 6HN 01670852017 01670857650 debaliol@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Louise Veronica Spoors Type of registration: Number of places registered: Southern Cross OPCO Ltd care home 59 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 59 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 59 Physical Disability - Code PD, maximum number of places 1 Date of last inspection Brief description of the care home DeBalliol accomondates frail elderly people, some of who require nursing care. Accomodation is over two floors. There is a passenger lift to the first floor and level access throughout the ground floor. Sitting and dining areas are on both floors. The home is situated in the centre of Newbiggin. Local shops and transport facilities are close by. There are attractive, well maintained gardens and sitting areas at the home Care Homes for Older People Page 4 of 26 Over 65 59 0 0 1 Brief description of the care home for residents to use. Fees for the home vary and are available from the manager on request. Further information about the home can be found in the service users guide which is kept in the main entrance foyer. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use the service experience excellent quality outcomes. This was an unannounced inspection. The manager was present at the inspection. Before the visit we looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is Care Homes for Older People Page 6 of 26 usually given to us in the form of questionnaires. At the time of writing this report we had received two responses from questionnaires. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. Feedback was given to the manager and operations manager at the end of the visit. What the care home does well: What has improved since the last inspection? What they could do better: The home is very short on storage space. Some external storage is about to be provided. We said that we would be happy for one unused bathroom to be designated as a storage area. There are not enough assisted bathing facilities. Some of the bathrooms are not used Care Homes for Older People Page 8 of 26 because residents would have to climb in the baths, which they are unable to do. We recommended that a walk in shower room is provided. This would provide residents with more bathing choice. Not all of the toilets were fitted with grab rails for residents to use for balance. Some of the pedal bins used were not foot operated. This is essential for limiting the spread of any infections. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessments. We spoke to residents about the admissions procedure but they could not remember the details. One resident could remember coming from hospital into the home then deciding she wanted to stay. Prospective residents and their families are welcome to look around the home at any time. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Five care plans were examined and three were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Care plans had been evaluated regularly and updated as needed. Residents looked clean and well cared for. Residents told us that they could see their Doctor when they needed to. They said that staff were very attentive when they were ill or if they required help with personal care. One resident said that some days she Care Homes for Older People Page 13 of 26 Evidence: needed more help than others and staff where happy to accommodate this. Plans relating to tissue viability showed that risks are regularly assessed. Where residents have wounds these were accurately described and measured. Residents said they were well looked after. They said that staff attempted to protect their privacy when giving personal care. Residents needing medical attention receive this in the privacy of their own bedrooms. Residents said the nurses in the home were excellent and the care was second to none. One resident described his relief as he no longer had to struggle at home to dress and feed himself. He described the home as a haven. Medication ordering, administration, storage and disposal were examined. All medicines are audited monthly. All medicines were accounted for and all those administered were signed for. Three amounts of controlled drug were checked and were correct. Staff were seen to treat residents politely and respectfully. Staff spoken to were knowledgeable about the care needs of residents. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: An activities co-coordinator, referred to by the organisation as the diversional therapist, is employed at the home for 30 hours per week. She supports residents to use a range of services within the local community. Residents are encouraged to be in control of their own lives and enjoy their own interests and hobbies. The services of Mind Active are used and they were in the home to entertain some residents on the inspection day. The home has its own minibus. The manager reported that this is very well used and residents were able to go on many outings. Each resident has a social assessment carried out. This describes each individuals likes, dislikes and fears, religion and beliefs, leisure, sport, hobbies and preferred relaxation. Residents said there was enough to do at the home. They told us that they did not have to join in but could watch or stay in their rooms. Residents also said that staff Care Homes for Older People Page 15 of 26 Evidence: popped in to chat with them whenever they could. A lot of residents had their own telephone to keep in touch with families. Residents told us that visitors were welcome at all times of day. One resident had recently had a birthday party in the home attended by all of her family and friends. The cook was busy making a birthday cake for another resident. Residents also said they liked the food. We ate the food at the home. It was steak pie with mashed potatoe, carrots and cauliflower. This was followed by rhubarb crumble and custard. It was excellent. The food was hot enough and very tasty. The standard of the cooking was very good. The home has taken on a new nutritional system. This is an independent nutritional tool that devises balanced menus and promotes healthy living. The cook home bakes all of her own cakes, biscuits and scones. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date on these subjects with information and training. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. There were no recorded complaints for 2008. There have not been any issues requiring the intervention of the vulnerable adults team in 2008. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean and free from odours. The furniture and general décor provides residents with a comfortable homely environment. They said the home was warm enough and was always clean. Residents bedrooms were well personalised. Many had brought items such as chairs and furniture from home. The provider organisation has just purchased seven profiling beds. These enable staff to position the bed for the best comfort of residents. The general appearance of the home was welcoming and comfortable. The dining rooms were nicely set and looked pleasant. None of the dining chairs had skids fitted. These enable easier movement of chairs for residents with physical difficulties. There are not enough assisted bathing facilities. Some of the bathrooms are used as storage areas because residents cannot access the baths. We said that we were happy for a bathroom to be adapted for use as a permanent storage area if other assisted facilities, such as a wet room, were provided. Care Homes for Older People Page 18 of 26 Evidence: Some toilets did not have fixed guardrails. Some of the bins in the home do not have lids that are operated by foot. This is essential to limit contamination and the spread of infection. There were no obvious trip hazards in the home. External grounds were tidy and well maintained. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. Evidence: Records showed that there were enough staff on duty. The current staffing levels are: Daytime. 8am-8pm. Four care staff upstairs, five care staff downstairs and two qualified nurses. Night time. Four care staff and one qualified nurse. There were also two laundry assistants and three domestics on duty. A handyman is employed for 40 hours per week and an activities person for 30 hours per week. Training records showed and staff confirmed that over 50 of staff had achieved NVQ level 2. Nine staff have NVQ level 3. Other essential training was up to date. This included moving and handling, food hygiene and protection of vulnerable adults. There is a training plan which is updated monthly. The manager is able to see at a glance where training is needed. Each staff member also has a personal development file. The training records were comprehensive and demonstrated a good commitment to staff education. Care Homes for Older People Page 20 of 26 Evidence: Four staff recruitment files were examined. These were for one nurse and three carers. All contained good information. Thorough background checks had been carried out before employment. Residents were protected through checking of criminal records information for all employees. Interviews were conducted against a person specification list to ensure fair and equal employment. An equality and diversity monitoring form is also used to demonstrate fairness in employment. All residents spoken to praised the attitude and abilities of the staff. Residents described staff as kind and caring. They said staff were competent and efficient. One resident said the staff were what made the place so good. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are protected through reflective management taking account of the diverse needs of the service. Evidence: The home has an experienced registered manager. She has been assessed as having the competency and skills to run the home. The residents told us that the manager ran the home well. We saw several residents addressing the manager by name, she has a high profile in the home and is well liked. Staff told us that the manager is approachable, reasonable and fair. The fact that the home runs well demonstrates that the manager expects staff to give high standards of care. The home does operate a quality assurance system. Residents, their relatives and professionals are consulted about the service provided. Residents, relatives and staff meetings are held. The minutes of these showed that people have an opportunity to comment on the running of the home. Staff have an opportunity to share information Care Homes for Older People Page 22 of 26 Evidence: and discuss care practices. The organisation encourages self monitoring in the home through the use of a wide range of audit tools. Servicing and maintenance agreements are in place for facilities and equipment. These were up to date. Risks in the environment and tasks, including safe working practices are assessed and reviewed. Internal health and safety checks were up to date. These included checks on hot water, nurse call systems, window restrictors and beds. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Residents personal monies were well accounted for. Records were examined and showed that two signatures were obtained for all transactions. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 13 Waste bins must be foot operated. This means contamination is contained and the risk of infection spread reduced. 01/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 22 Provide a walk in shower room or other assissted bathing facilities. Ensure that all toilets are fitted with grab rails. Provide dining chairs with skids. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!