Inspection on 29/10/09 for Lancaster Court

This is the latest available inspection report for this service, carried out on 29th October 2009.

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.

Similar services:

Claremont House

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Sun Court Nursing Home

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Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: Lancaster Court 108 High Road Leavesden Green Watford Herts WD25 7AJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Patricia House     Date: 2 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Lancaster Court 108 High Road Leavesden Green Watford Herts WD25 7AJ 01923689348 01923682175 lancaster.court@runwoodhomes.co.uk www.runwoodhomecare.com Runwood Homes Plc Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ann Hill Type of registration: Number of places registered: care home 65 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accomodated is: 65 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 Dementia-code DE Date of last inspection Brief description of the care home Lancaster Court is a newly built residential home providing accommodation for 65 people. It is one of the Runwood Plc group of homes. Residents may require nursing Care Homes for Older People Page 4 of 24 Over 65 0 65 65 0 Brief description of the care home services or have a dementia and all bedrooms are for single occupancy. Some bedrooms have en-suite showers and all have en-suite wash hand basins and toilets. The home is situated in a residential area near to the town of Watford with its extensive amenities and transport networks. There is a garden around the building and large car parking area at the front. The homes Statement of Purpose and Service Users Guide are displayed in the entrance hall and copies are available from the office. Fees for the home currently range from £600 to £725 per week according to need. Care Homes for Older People Page 5 of 24 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: two star good 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: This home was registered with the Commission on 3rd June this year and this was the first key inspection of the service. The information in this report is based on an unannounced inspection of the home, which took place over one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The registered manager was on duty throughout the day and we spoke with staff, residents and visitors. We visited all parts of the home and checked a variety of records. Before the inspection the manager had completed and returned to the Commission an annual self-assessment quality review, the Annual Quality Assurance Assessment, (the Care Homes for Older People Page 6 of 24 AQAA).This document included statistical information about the home and confirmation of policy reviews and equipment checks. We have also reviewed any other information we have received about this service since its registration. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 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 9 of 24 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. Prospective residents are provided with detailed information so that they can make an informed choice about moving in to the home. People who use the service have their needs fully assessed and documented to ensure that all individual and specialist needs will be met. Evidence: We saw copies of the homes Statement of Purpose, Service Users Guide and Complaints policy displayed in the homes entrance hall. Some of the visitors we spoke with confirmed that they had been given this information before their relative entered the home. We checked a selection of care records and in all cases full needs assessments had been completed before the person concerned entered the home. Care summaries from referring agencies were also on the files. from this information initial care plans had been completed so that all staff could be clear about peoples individual needs and Care Homes for Older People Page 10 of 24 Evidence: how best to meet them. We saw evidence that staff have all received training in dementia care and demonstrated an understanding of the specialist needs of current residents. There were appropriate pictures and signage around the dementia unit to enable the more confused residents to remain as independent as possible. The manager confirmed that more equipment and provision for the dementia unit has been planned and that this specialist area is still a work in progress. Care Homes for Older People Page 11 of 24 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 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 have their health needs met in appropriate and timely ways and procedures followed by staff for the administration of medication ensure that residents are protected from the risk of harm. Evidence: We spoke with residents and some visitors and then tracked a selection of the corresponding care plans. In all cases the planning accurately reflected the health needs of the people concerned and showed evidence of how these needs were being met. Appropriate risk assessments had been completed and reviews had been detailed. We saw details of two residents who had been admitted to the home with pressure sores and saw the equipment provided and noted the progress made in dealing with the sores. People had also been provided with equipment to help them transfer and we saw some good practice used by some of the care staff when people were helped to move from chairs to wheel chairs and vice versa. Bed rails were in place in some rooms and we saw written risk assessments and signed permission for their use in care plans. We saw that people who were in their bedrooms had call alarms positioned near them and when one person activated their alarm during the Care Homes for Older People Page 12 of 24 Evidence: visit we saw staff respond very promptly. The residents we asked confirmed that this was always the case. One resident with higher needs has their own electric wheel chair and some residents use the homes wheel chairs for occasional use. One nurse confirmed that people with diabetes all have their own blood testing equipment to ensure good infection control is maintained. All care plans had been signed by either the resident concerned or their relative and visitors we spoke with said they had been involved in the care planning. The visitors also said they were aware of their relatives key worker and clear about this role. We also saw details of the choices made for end of life care recorded on care plans. Care staff told us that they have received bereavement training and have been provided with a bereavement training pack to ensure appropriate procedures are followed at such times. We saw evidence that residents were referred to other health agencies at appropriate times and attended health appointments. Two residents had had treatment from physiotherapists. Some visitors we spoke with confirmed that their relatives health needs were attended to promptly and that they were kept fully informed of the situation. All new residents have a nutritional chart completed for the first 28 days they are in the home. From this monitoring the staff can be clear about individual nutritional needs and choices and can ensure peoples good health is promoted. The residents we spoke with, and their relatives, said that staff in the home always respected their privacy and promoted peoples dignity and independence at all times. We observed a medication round during the inspection and also checked medication records and storage in the home. Most drugs are administered from blistered packs and those administered from packets had dates of opening noted so that audits could easily take place. One nurse confirmed that controlled drugs were audited and checked at every staff shift handover. There are behaviour charts in place to record the details when medication is administered to assist any challenging behaviour. These records demonstrate that medication is appropriately given at all times. The homes medication policy is comprehensive and provides staff with clear information about their roles and responsibilities. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures followed in the home ensure that the social needs of residents are continually reviewed and met and that the meals provided are appropriate and enjoyed by all the people using the service. Evidence: Currently there is one activity co-ordinator employed at the home and they provide most of the activities for the residents, although care staff also assist with events and we saw staff providing various activities during this inspection. however we felt that in a home where there are a wide range of different needs, for people who are confused, very ill as well as some in need of minimum support, more staff activity hours are needed to fulfill all their social needs. The manager is aware of this and the activity provision in the home is under review. There are activities provided on most days which include music events and trips out. A local pastor visits the home weekly and friends and families are invited to the reflexology sessions which take place in the home. One resident has a computer and one has their own budgerigar in their bedroom. The activity co-ordinator records the daily events which people take part in and has produced a pictorial activity sheet so that the more confused residents can understand what is taking place. The co-ordinator is given details of residents life histories and has completed individual assessments of peoples personal interests. The Care Homes for Older People Page 14 of 24 Evidence: co-ordinator has clearly worked hard to implement varied events which are relevant to the residents in the home. However, some residents and visitors did comment that they would like more activities especially at weekends. As already stated, the manager is reviewing the staff hours allocated to this service. The residents we spoke with confirmed that care staff support them to make their own choices about their daily lives. One resident had made a choice to move to another vacant bedroom and this move had taken place. The visitors we asked said that people could get up and go to bed when they wanted to. We saw the days food menu displayed in the home during the inspection and care staff said that changes were being made to the meals provided as a result of feed back from the residents. People now have a choice of meals and we saw a choice of drinks offered when the mid day meal was served. The chef confirmed that he speaks with residents personally to check their preferences and has changed some of the corporate menus as a result. There is a 4 weekly rolling menu plan in place and a variety of new snack meals, fresh fruit and finger food is also available between the main meals. Care staff give the chef a shopping list of snacks they want each day and these are prepared and provided for the various units in the home. Currently the chef caters for the food choices of one Jewish resident and also provides special meals for people who are vegetarian and diabetic. Pictorial menus are also being completed so that the more confused residents are enabled to make informed choices about the next meal. We saw care workers probe the food served at mid day and record the food temperatures to ensure it was safe to eat. We saw the residents enjoying their meal and this was appropriately served with quiet music on in the background adding to the relaxed atmosphere. Since its opening, an Environmental Health inspection has resulted in the home being awarded the maximum 5 Stars for hygiene standards. Care Homes for Older People Page 15 of 24 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 can be sure that any concerns they might have will be listened to and that procedures followed in the home will help to protect them from the risk of harm. Evidence: The home has written policies covering Adult Safeguarding, Complaints and Whistle Blowing. The staff we spoke with said they were aware of these policies and their implications. The residents we asked said they would not hesitate to make a complaint if they had any concerns and visitors said they were aware of how to make a complaint. We checked the homes complaints records and saw that issues had been recorded and investigated appropriately and in a timely manner. The staff we spoke with confirmed they had received training in safeguarding procedures and the manager demonstrated a clear knowledge of procedures followed in Hertfordshire. The manager has made one referral to the Local Authority under Hertfordshire County Council joint agency safeguarding procedures. Care Homes for Older People Page 16 of 24 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. People who use the service benefit from living in a home which is well maintained and where procedures followed ensure that all areas are kept clean and hygienic. Evidence: We visited all areas of the home and all rooms were well decorated and furnished. All bedrooms are ready for occupancy except one where the decor is nearing completion. All bedrooms and communal lounges are equipped with flat screen televisions for the benefit of the residents. We visited one bedroom where the resident has their own fridge and all occupied rooms have been personalised by the residents concerned. The garden looked very attractive but is not yet completely secure so that residents are not left alone when outside at this time. There is a quiet relaxing lounge for residents and their families to use if they want. All areas were clean and hygienic and there were paper towels and liquid soap in place in all communal bathrooms and toilets as recommended in guidelines for good infection control. Call alarms are available in all bathrooms and toilets for the safety of residents. Care Homes for Older People Page 17 of 24 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 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 supported by a well trained work force and procedures followed in the home for staff recruitment, help to protect them from the risk of harm. Evidence: The residents and visitors we asked said that there were usually enough staff on duty to meet peoples needs and that the staff were supportive and caring and well trained. The manager said that two more domestic staff had been recruited and would start when all employment checks had been made. During the inspection more care staff were also interviewed for more staff posts. The care staff we spoke with confirmed they had received extensive training and we saw evidence of all the completed courses on staff training records. Training had included Safeguarding, Dementia Awareness and Mental Capacity courses. One of the care workers who had worked at the home since it was opened said they, and other new staff, had received six or seven weeks training before any residents entered the home, which had been of great benefit. The staff member said that the induction training had been very thorough and all members of staff signed that they had fully understood the content. They also said that very few agency staff ever worked at the home. Some of the care staff confirmed they had started doing NVQ training and that they Care Homes for Older People Page 18 of 24 Evidence: were all encouraged to start this training and so ensure people were supported by a professional and competent workforce. We checked the recruitment records of a selection of staff. In all cases, all appropriate recruitment checks had been in place before the employee started work at the home. Care Homes for Older People Page 19 of 24 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 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 benefit from living in a home which is well run and where their views are always listened to. Procedures followed by staff in the home ensure that the welfare of both residents and staff is promoted at all times. Evidence: The manager of the home is registered with the Commision and during the inspection demonstrated a clear understanding of the policies and procedures necessary for managing a well run service. The manager is currently completing a management training course and the residents, staff and visitors we spoke with said the manager was approachable, supportive and very competent. The manager completes monthly audits and analyses of a variety of records in the home, such as falls records, risk assessments ands complaints. From this information the manager makes decisions about the running of the home. There is already a thorough quality assurance system in operation and there had been a recent residents and relatives meeting where fifteen people had attended and Care Homes for Older People Page 20 of 24 Evidence: voiced their views. Staff and unit meetings take place monthly and care staff said that their views were always listened to. The manager is also planning to set up a Friends of Lancaster Court visitors group and has already asked for volunteers. In addition there is a company quality assurance programme in operation at the home and regular quality surveys will be sent out to stakeholders. The manager has started a staff supervision programme and said that eventually the registered nurses will supervise the care staff in the home. We checked the system for handling residents personal allowances. The system used is thorough and checks are made to ensure amounts held and issued are always documented and accurate. Most residents have families who handle their finances and some residents go out to their banks themselves. Only small amounts of money are held at the home for residents. We checked the fire safety records and saw evidence of the drills which take place and the safety checks. Future fire drill records will show the names of participants and the manager will then ensure that all staff take part in a drill. Generic risk assessments have been completed for a variety of areas in the home and the manager said she will now complete a first aid training risk assessment for staff. We just recommended that copies of the risk assessments for kitchen equipment are also kept in the kitchen, not just in the office, for the safety of kitchen staff. Care Homes for Older People Page 21 of 24 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 22 of 24 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 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 23 of 24 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. 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