Care Home: Bybuckle Court

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What the care home does well All residents spoken with during the inspection visit were very happy with the home and the care they received. There was evidence observed that residents are treated with respect and talked to in a respectful manner. The home now has a registered manager in post who has the skills to provide the necessary leadership and focus on resident outcomes. One resident commented on an improvement in the home recently, and a multi-disciplinary approach to care is being established with improved individual recreational activity. The new registered manager has already established improvements in the handling of medicines, and the recruitment practice followed, she is keen to change the home`s environment and is working with the owners to progress planned improvements to the toilet and bathing facilities, as a priority. What the care home could do better: Although the registered manager had trained all staff involved in medicine administration with regard to the new medicine system in the home, the official training from the supplying pharmacist is not planned until next week. In addition there is currently no medicine procedure that accurately records the current practice or promotes best practice. This matter was discussed with the registered manager who acknowledged this shortfall, and the need for improvement with some of the records to ensure all are full. She advised that she would be working with the new Pharmacist to ensure a suitable fullprocedure, that covers all areas. Although the home was found to have a good standard of cleanliness it was clear that the fabric and furniture of the home needs to be improved. The need for a full audit of the home that includes the equipment, furniture, fabric and standard of decoration was discussed with the registered manager, who agreed to progress this with written timescales for improvements. The recruitment practice still needs further improvement to ensure all records are retained and a clear audit trail for the recruitment process is available. The registered manager demonstrated that she had promoted a much improved process since her appointment, and confirmed an understanding of what was required. It was however noted that despite guidance from an employment advisory service, a recruitment procedure to promote a clear robust recruitment process, is not in place. Random inspection report Care homes for older people Name: Address: Bybuckle Court Marine Parade Seaford East Sussex BN25 2PZ two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Melanie Freeman Date: 1 9 0 8 2 0 1 0 Information about the care home Name of care home: Address: Bybuckle Court Marine Parade Seaford East Sussex BN25 2PZ 01323898094 01323898094 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Katey Welsh Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr James Lord,Mrs Sylvia Lord care home 17 Number of places (if applicable): Under 65 Over 65 17 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 17. The registered person may provide the following category/ies of service only: Care home only - (PC) 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 (OP) Date of last inspection Brief description of the care home 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. Residents accommodation comprises fifteen single rooms and one double room, Care Homes for Older People Page 2 of 10 Brief description of the care home situated on two floors. The majority of the rooms have en-suite facilities, including a toilet and washbasin and all are fitted with a call bell system. On the ground floor there is a large, light and spacious lounge and dining area. A shaft lift provides access to the first floor. Information about the service, including the Statement of Purpose, Service Users Guide and Care Quality Commission reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees from April 2010 is £365 - £495. Additional charges, not included in the fees, include hairdressing, chiropody, toiletries and newspapers. Care Homes for Older People Page 3 of 10 What we found: This random inspection was undertaken on Wednesday the 18 August 2010 and included an unannounced visit to the home completed by Melanie Freeman, compliance inspector and Lesley Meech, compliance inspector. The visit lasted approximately four hours, and a follow up visit lasting a further two hours was completed by Melanie Freeman the next day. This was arranged by appointment and assured access to recruitment files. Both inspection visits were facilitated by Katey Welsh who completed the process for registration as the homes manager with Care Quality Commission on the 17 August 2010. Although she was not officially working when the inspectors first arrived she made herself available. Although Katey Welsh has been working in the home for eight weeks she only took over the managers appointment two weeks ago, when the then appointed manager left the home. For the purpose of this report Katey Welsh will be referred to as the registered manager. The random inspection was completed in response to information received that resulted in two safeguarding alerts being raised about the home in August 2010. The concerns raised which are being investigated by Social Services, brought into question the adequacy of the management arrangements, and therefore the safety and welfare of residents living in the home. Key areas of concern were related to the safe management of medicines, safe and robust recruitment practice, and the provision of a suitable clean environment. The Care Quality Commission needed to satisfy its self that suitable management arrangements had been put in place, bearing in mind the home had been without a registered manager since October 2009, and the key areas of concern identified above. At the time of the visit there were 15 residents living in the home and the inspection focused on the following areas; How medicines were being handled. What recruitment practice was being followed. What management arrangements, and structure has been established for the home and how these impacted on outcomes for residents. During the inspection visit the registered manager demonstrated her management skills and a commitment to ensuring good outcomes for residents and improving the homes fabric. She responded in a very positive way when one resident said that he was left without his bell for half an hour. She validated his concern and discussed positive options with him. She also demonstrated that she had a good understanding of what needed to be improved in the home and had recognised that the home had been through a difficult time recently, which could be related to the lack of a registered manager. She was fully aware that the home can only care for residents whose mobility is suitable for the home, and was able to refer to specific actions she had taken to ensure residents in the home have the appropriate care, and support relevant for their changing needs. In August 2010 a new system for the supply and handling of medicines was introduced. Records relating to five residents were reviewed as part of the inspection. These were found to be accurate and cross referenced fully with the medicines held in the home. Evidence seen confirmed that residents were receiving their prescribed medicines in a timely fashion. Training records recorded that all staff involved in medicine administration Care Homes for Older People Page 4 of 10 have been trained by the previous supplying Pharmacist. New medicine storage facilities are in place and the home is working closely with the Pharmacist to ensure safe practice. It was however noted that records relating to a prescribed topical cream needed to be clearer. Individual guidelines for those medicines administered as required needed to be established along with additional supporting records to confirm when they are provided. Areas of the home seen during the inspection visit that included all communal areas and six bedrooms, were found to have a good standard of cleanliness. Areas that needed additional attention were known to the registered manager and an industrial carpet cleaner was being used to address such areas. A fan was identified as very dusty during the inspection, and the registered manager had ensured that this was cleaned by the second visit completed by Melanie Freeman. It was noted that one toilet was in the process of being upgraded to provide improved facilities and the registered manager confirmed the planned improvement to the two bathing areas. This included the replacement of one bath, with a disabled access shower. The five most recently recruited staff members staff files were reviewed. This review verified that suitable references are now being sourced, and that appropriate Criminal Records Bureau and Protection of Vulnerable Adults checks are completed and responded to. Some shortfalls however remain in some of the files and included; health checks, staff photographs, job descriptions and terms and conditions of employment. What the care home does well: What they could do better: Although the registered manager had trained all staff involved in medicine administration with regard to the new medicine system in the home, the official training from the supplying pharmacist is not planned until next week. In addition there is currently no medicine procedure that accurately records the current practice or promotes best practice. This matter was discussed with the registered manager who acknowledged this shortfall, and the need for improvement with some of the records to ensure all are full. She advised that she would be working with the new Pharmacist to ensure a suitable full Care Homes for Older People Page 5 of 10 procedure, that covers all areas. Although the home was found to have a good standard of cleanliness it was clear that the fabric and furniture of the home needs to be improved. The need for a full audit of the home that includes the equipment, furniture, fabric and standard of decoration was discussed with the registered manager, who agreed to progress this with written timescales for improvements. The recruitment practice still needs further improvement to ensure all records are retained and a clear audit trail for the recruitment process is available. The registered manager demonstrated that she had promoted a much improved process since her appointment, and confirmed an understanding of what was required. It was however noted that despite guidance from an employment advisory service, a recruitment procedure to promote a clear robust recruitment process, is not in place. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 9 13 A suitable medicine policy 06/09/2010 and procedure is established for staff to adhere to that covers the receipt,recording,storage, handling, administration and disposal of medicines. This will ensure staff are provided with clear guidelines to follow to ensure the safe handling of all medicines in the home. 2 19 12 That the home is subject to a 13/09/2010 full audit to identified works, maintenance programme and fabric renewal needed, with identified timescales for completion. This will ensure that the home is suitable for its stated purpose and provides proper provision for the health and welfare of residents. 3 29 19 A suitable recruitment policy 13/09/2010 and procedure is established and adhered to, based on Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 equal opportunities and ensuring the protection of residents. This will ensure that a thorough recruitment process is always followed and only those people fit to work in a care home are employed. 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 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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