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Inspection on 15/06/10 for Court House Residential Home

Also see our care home review for Court House Residential Home for more information

This is the latest available inspection report for this service, carried out on 15th June 2010.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We saw that the manager takes time to ensure that they have enough information about people`s care needs before she agrees that the home can meet their needs. She told us that she visits people in hospital or in their own home, which staff confirmed. We saw how she had gathered information from professionals, relatives and from the person themselves, showing a person centred approach and good practice. Seven people told us in their surveys that they had received enough information to help them decide if the home was right for them, and they told us that they had been given written information about the home`s terms and conditions. We spoke to someone who had moved to the home, and they told us they had been too busy to look around but that a relative had done this on their behalf. We saw from care records that staff provided reassurance when people moved into the home. A staff member described the home as one `big family`. The day we visited there was a positive atmosphere with people laughing and joking with staff, who were affectionate and caring in their approach. The home has invested in a new care planning system, and we looked at two people`s care files, to see how their individual needs are described. The home has moved towards person centred planning and there is a good level of detail about people`s individual needs, the things they like and disliked and their preferred daily routine. Records show that people living at the home are encouraged to participate in reviewing their care plan, which is good practice. Staff told us that they were given up to date information about the needs of people and three staff said they were given training that was relevant to their role, helping them understand the care needs of people and keeping them up to date with new ways of working. Staff talked knowledgeable about the needs of the people they looked after and recognised their individuality. We saw how people`s medical needs were met and how the home consulted with healthprofessionals appropriately. The home told us they felt well supported by their health colleagues and we saw a record of visits. Five people told us that the home always made sure they got the medical care they needed, with a sixth person saying this was usually, the case and the seventh person telling us they would get the care if they needed it. From the home`s notifications and from the care records we looked at, we could see that the home has taken appropriate action and liaised with health professionals for advice and support, such as the Speech and Language Team. We saw that the home has now installed an appropriate controlled drugs cupboard, and we saw that the medication cupboard was well organised. On the day of the inspection, people were decorating hats to celebrate Ladies day at Ascot, while others were having their hair done. Some people were sitting observing but seemed content and relaxed. One person told us that people had warned them there would be nothing to do in a care home. They told us this was far from the truth as they were `always busy` and there was plenty to do. People told us about word games they took part in, with words supplied by another person living at the home. We were shown a collage, which incorporated photos of the people living at the home. Other people had chosen to stay in their rooms. One of the care plans we looked at reflected this choice. We saw that the home`s activities co-ordinator keeps up to date records, which they supplement with additional information. Three people told us in their surveys that the home `usually` arranges activities they can take part in, and four people said this was `always` the case. Staff were also positive about the range of activities. People told us in their surveys that they knew who they could speak to informally if they were unhappy, and six out of seven people said they knew how to make a formal complaint. The home has responded in a detailed and professional manner to a recent complaint. There have been no other complaints received either by the home or by CQC. People told us in their surveys that staff listened to them and acted on what they said. The home was well maintained, and people told that us that the home was either `usually` or `always` fresh and clean. We saw from a report written by the owner and from care records how the home managed odour control and infection control issues. We checked the fire escape and saw that it was clear, and the manager told us one section had been replaced. We saw from records and through our discussion with the manager that they have taken steps to make the home more accessible. We discussed the large garden and how to make the most of the space available to benefit everyone living at the home. People told us they enjoyed sitting outside. Staff told us in their surveys that they felt supported by the manager, two felt that this support was offered regularly and another sometimes. One person praised the quality of their training, including additional training to supplement mandatory training, and told us how they had been supported by the manager to undertake a care qualification. Three staff members felt that they were given enough knowledge about health care and medication but a fourth person felt this could be improved. The manager told us how the home offered yearly updates on dementia care practice, which included practical advice for carers. The home`s AQQA states that health and safety checks are up to date. The home notifies us about issues relating to the home, providing us with a good level of detail to help us make a judgment about how they have managed different situations.

What the care home could do better:

There are some minor changes that need to take place to improve medication practice to help ensure that practice is as safe as possible. We spoke to the manager about making the reviewing process more meaningful so that it gave an overview of all aspects of the person`s life, such as social, emotional and physical. We asked questions about how certain decisions had been reached, for example stopping fluid charts and whether a sore area of skin had healed. We were able to find evidence why these decisions had been reached but not a record of the decision, which we suggested could be incorporated into the review to show the home`s good practice.

Random inspection report Care homes for older people Name: Address: Court House Residential Home Court House Station Road Cullompton Devon EX15 1BE 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: Louise Delacroix Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Court House Residential Home Court House Station Road Cullompton Devon EX15 1BE 0188432510 0188432510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dorothy Hender Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Manjula Odedra care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category- Code OP Date of last inspection Brief description of the care home Court House is a large detached house that has been extended and adapted as a care home, providing care and accommodation for up to twenty three people. It is a short distance from the town of Cullompton and has ample parking. The home has twenty Care Homes for Older People Page 2 of 9 Brief description of the care home bedrooms, fifteen of which have some ensuite facilities, over two floors. These floors are linked by stairs and by a small passenger lift. There are aids and adaptations throughout the home but the layout and the number of steps mean that the home may not be suitable for people who use wheelchairs or for people with severe mobility problems. The home has a lounge and a separate dining room and numerous areas outside where people can sit. There is also a small courtyard sensory garden. Further information about this home, including inspection reports, is available direct from the home. The weekly fees range from #314.00 - #525.00. There are additional charges for items such as hairdressing, newspapers, clothing, toiletries and pendant type call bell systems (all detailed in the guide to the home). Care Homes for Older People Page 3 of 9 What we found: The inspection was unannounced and took place over three hours and fifty minutes. The inspection was a routine random inspection, which means that we focus on particular areas of care rather than inspecting all the key national minimal standards. Only key inspections change the homes rating. We met some of the people living at the home and the staff members who were working with them. We looked at records relating to peoples care and medication administration, we looked at how incidents are logged, and observed how well the home is maintained and run. We also reviewed the requirements made at the last key inspection in 2007. Prior to the inspection, we sent out surveys which gave people the opportunity to comment on the service. We received seven from people living at the home which they had completed themselves, and three from staff members. The service also completed an Annual Quality Assurance Assessment for CQC, which provides us with details about the home, including what the home does well and areas for improvement. Since the last key inspection, Dorothy Hender has been registered as the manager. What the care home does well: We saw that the manager takes time to ensure that they have enough information about peoples care needs before she agrees that the home can meet their needs. She told us that she visits people in hospital or in their own home, which staff confirmed. We saw how she had gathered information from professionals, relatives and from the person themselves, showing a person centred approach and good practice. Seven people told us in their surveys that they had received enough information to help them decide if the home was right for them, and they told us that they had been given written information about the homes terms and conditions. We spoke to someone who had moved to the home, and they told us they had been too busy to look around but that a relative had done this on their behalf. We saw from care records that staff provided reassurance when people moved into the home. A staff member described the home as one big family. The day we visited there was a positive atmosphere with people laughing and joking with staff, who were affectionate and caring in their approach. The home has invested in a new care planning system, and we looked at two peoples care files, to see how their individual needs are described. The home has moved towards person centred planning and there is a good level of detail about peoples individual needs, the things they like and disliked and their preferred daily routine. Records show that people living at the home are encouraged to participate in reviewing their care plan, which is good practice. Staff told us that they were given up to date information about the needs of people and three staff said they were given training that was relevant to their role, helping them understand the care needs of people and keeping them up to date with new ways of working. Staff talked knowledgeable about the needs of the people they looked after and recognised their individuality. We saw how peoples medical needs were met and how the home consulted with health Care Homes for Older People Page 4 of 9 professionals appropriately. The home told us they felt well supported by their health colleagues and we saw a record of visits. Five people told us that the home always made sure they got the medical care they needed, with a sixth person saying this was usually, the case and the seventh person telling us they would get the care if they needed it. From the homes notifications and from the care records we looked at, we could see that the home has taken appropriate action and liaised with health professionals for advice and support, such as the Speech and Language Team. We saw that the home has now installed an appropriate controlled drugs cupboard, and we saw that the medication cupboard was well organised. On the day of the inspection, people were decorating hats to celebrate Ladies day at Ascot, while others were having their hair done. Some people were sitting observing but seemed content and relaxed. One person told us that people had warned them there would be nothing to do in a care home. They told us this was far from the truth as they were always busy and there was plenty to do. People told us about word games they took part in, with words supplied by another person living at the home. We were shown a collage, which incorporated photos of the people living at the home. Other people had chosen to stay in their rooms. One of the care plans we looked at reflected this choice. We saw that the homes activities co-ordinator keeps up to date records, which they supplement with additional information. Three people told us in their surveys that the home usually arranges activities they can take part in, and four people said this was always the case. Staff were also positive about the range of activities. People told us in their surveys that they knew who they could speak to informally if they were unhappy, and six out of seven people said they knew how to make a formal complaint. The home has responded in a detailed and professional manner to a recent complaint. There have been no other complaints received either by the home or by CQC. People told us in their surveys that staff listened to them and acted on what they said. The home was well maintained, and people told that us that the home was either usually or always fresh and clean. We saw from a report written by the owner and from care records how the home managed odour control and infection control issues. We checked the fire escape and saw that it was clear, and the manager told us one section had been replaced. We saw from records and through our discussion with the manager that they have taken steps to make the home more accessible. We discussed the large garden and how to make the most of the space available to benefit everyone living at the home. People told us they enjoyed sitting outside. Staff told us in their surveys that they felt supported by the manager, two felt that this support was offered regularly and another sometimes. One person praised the quality of their training, including additional training to supplement mandatory training, and told us how they had been supported by the manager to undertake a care qualification. Three staff members felt that they were given enough knowledge about health care and medication but a fourth person felt this could be improved. The manager told us how the home offered yearly updates on dementia care practice, which included practical advice for carers. The homes AQQA states that health and safety checks are up to date. The home notifies us about issues relating to the home, providing us with a good level of detail to help us make a judgment about how they have managed different situations. Care Homes for Older People Page 5 of 9 What they could do better: 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 9 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 9 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 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 7 The home should ensure that they record clearly when and how they have made care decisions. This will help provide a clearer audit trail and show the homes good practice. Staff should ensure that all handwritten additions to the MAR sheets are checked and signed by two staff. Creams should be dated as soon as they are opened to ensure medication is in date and still effective. Staff giving medication should ensure that MARS sheets are always filled out correctly so that there are no gaps. 2 3 4 9 9 9 Care Homes for Older People Page 8 of 9 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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