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Inspection on 09/03/10 for Red Court Nursing Home

Also see our care home review for Red Court Nursing Home for more information

This is the latest available inspection report for this service, carried out on 9th March 2010.

CQC found this care home to be providing an Excellent 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

This home provides a safe clean and well maintained environment for the people who live there. It is very well presented in a "hotel style" and the atmosphere is always very warm and welcoming. People that we spoke with told us that it is "comfortable" and "a really nice place to live". They told us that they particularly enjoy the lovely gardens. They told us that staff "are very kind" " they are very caring" and one said "they look after us very well". Everyone looked happy, and people that were in bed, because they were unwell, looked comfortable. On the day that we visited, some ladies were enjoying an exercise session and a dedicated activities organiser ensures that there is a range of activities arranged for those people who want to join in. Residents told us that the food that is served is good. The chef meets with them every day to see what they would like and there are always choices available. Drinks and snacks are also available throughout the day if anyone would like them. Several people also commented on the laundry service, telling us that their clothes were always nicely washed and ironed for them.

What has improved since the last inspection?

Since we last visited a new manager and deputy manager have been employed. We are waiting for an application to register the manager with The Commission. Unfortunately neither of them were available on the day that we inspected the home. There has been a succession of temporary managers in the home but staff told us that they felt very positive about the future now. Training was being arranged for them and they have been able to resume working to gain accreditation with The Gold Standard Framework. This helps them to provide expert care for residents who are nearing the end of their lives and their families. we were able to meet the hospice liaison nurse who is working with them to achieve this.

What the care home could do better:

The home is clean and well maintained but several of the comment cards that we received suggested that it would benefit from redecoration in places. One resident also pointed out that a shower rather than the bath, in their en-suite facility, would be more accessible and useful to them. On the day that we visited we considered that the staffing arrangements in the absence of the manager and her deputy were insufficient. They were improved, following a conversation with one of the company`s operations managers, but we have recommended that some thought should be given to how similar situations will be organised in the future.

Key inspection report Care homes for older people Name: Address: Red Court Nursing Home 27 Stanhope Road Croydon Surrey CR0 5NS     The quality rating for this care home is:   three star excellent 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: Alison Ford     Date: 0 9 0 3 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Red Court Nursing Home 27 Stanhope Road Croydon Surrey CR0 5NS 02086812359 02086803938 chiverop@bupa.com www.bupa.com BUPA Care Homes (BNH) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category of service only: Care home with nursing (CRH - 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 Date of last inspection Brief description of the care home Red Court is a care home owned by BUPA and registered to provide nursing care for up to thirty-five older people. The home is situated near to the centre of Croydon and is an extended house, which provides accommodation over three floors. Two lifts ensure accessibility throughout the home. All the bedrooms are single occupancy and have been fitted with hand basins and almost half of them have en-suite facilities. There are two dining rooms, a main lounge, two smaller seating areas and an activities room. Care Homes for Older People Page 4 of 26 Over 65 35 0 Brief description of the care home The home is surrounded by exceptionally well-maintained gardens in the front and an orchard to the rear of the property. It is attractive and well presented and maintained and there are off street parking facilities to the front of the building. At the time of this latest inspection fees were from £900 per week and would be agreed prior to admission. Different rates apply to those whose placement is funded by the local authority. 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: This report follows an unannounced visit to the service as part of our planned inspection programme. However, in writing the report we have also given consideration to other information that we have received since we last inspected the service in 2007. This includes information that we have about how the service has managed any complaints and also what the service has told us about things that have happened there, notifications. We have listened to what other people have told us about the service and we sent out survey forms to some residents and members of staff. In addition the home sent us their Annual Quality Assurance Assessment, ( AQAA) when we asked for it. This is a self assessment which tells us how well they believe that they are meeting their aims and objectives and about their plans for the future. Care Homes for Older People Page 6 of 26 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 Care Homes for Older People Page 7 of 26 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 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 9 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. No one is admitted into the home without having a pre-admission assessment undertaken to ensure that their needs will be met and the placement will be suitable for them. Evidence: As part of the admission process for new residents they would be visited, either in hospital or their own homes, and an assessment undertaken to ensure that the home would be able to meet their needs. Anyone admitted through care management arrangements would also have an assessment from their care manager. We spoke with a resident who had been admitted recently and who was able to explain how this process had worked. They had been in hospital at the time and told us that they had been very impressed by the way the assessment had been conducted. They said it had been very thorough and lots of questions were asked about the support that they would need. They had been given a brochure about the Care Homes for Older People Page 10 of 26 Evidence: home and the procedure had made them feel quite positive about the move. Written information about the home is also available in the form of a Service User Guide which explains all about the home. The home does not provide intermediate care therefore this standard does not apply. Care Homes for Older People Page 11 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. Residents are very happy with the way that health care is delivered and medication procedures are all in order. Work is being undertaken to improve the quality of care for people who are nearing the end of their lives. Evidence: In order to help us assess this outcome group we looked at a sample of care plans, choosing those of the people that we had spoken with during our visit. We found that they were reflective of the support and care that was needed and reviewed regularly in order to identify any changes. All aspects of residents health care needs are addressed and include risk assessments, moving and handling assessments and review of factors which might lead to the development of pressure sores. Each resident is allocated a named nurse who takes responsibility for planning their care and also a key worker who liaises with them and their families on a more practical level. This would include delivering personal care such as nail care and also identifying when items such as toiletries are needed. Residents told us that they were very happy with the way that care was delivered in the home.They agreed that staff Care Homes for Older People Page 12 of 26 Evidence: were very kind and caring and did things how they liked them. We looked at medication records and saw that they were all in good order. and included care plans for use of any medication prescribed on a when required basis. Currently all medication is administered by trained nurses other than some eye drops which residents manage themselves. We saw that people who were being nursed in bed because they were unwell looked clean and comfortable and that appropriate pressure relieving equipment was in place. The home is currently implementing The Gold Standard Framework. This provides best possible care for those people who are nearing the end of their lives and their relatives. Staff are being helped to work towards accreditation by a liaison nurse from the local hospice, St Christopers. She is helping them both with the documentation which underpins the framework and also with practical help including how to deliver personal care to people who are terminally ill. She is also able to advise staff about how they can communicate with relatives at this time. From the information that we have from residents and our own observations we have judged that this outcome group should be judged as excellent. Care Homes for Older People Page 13 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. Daily life in the home suits the people who live there. They are able to choose how they spend their days and their families and friends are always welcomed. Mealtimes in the home are an an enjoyable experience. Evidence: People are able to choose how they spend their days. A dedicated activities organiser arranges various sessions for those who wish to participate, including craft sessions, card games and bingo. Many of the residents are able to go out of the home with their families and friends. Some residents told us that they enjoyed having something organised for them although others said that they liked to sit and watch television. On the day we visited a group of ladies were enjoying a regular excesise session. Visitors are always welcome in the home and one resident told us that they regularly have friends who come in to play bridge with them. The lunchtime meal was served during our visit and it seemed to be an enjoyable experience. Most residents sit in one of the two dining rooms and there is help Care Homes for Older People Page 14 of 26 Evidence: available for those who need it. Tables are nicely laid, drinks are available and tea and coffee is served afterwards. There is a choice of meal available and residents told us that the chef comes round every day to ask what they would like too eat. Snacks and drinks are also available to them throughout the day. From the information available to us from residents we have judged this outcome group as being excellent. Care Homes for Older People Page 15 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. The BUPA company policy for handling complaints is followed and residents are given information to explain this process. Evidence: BUPA as an organisation has a robust complaints policy which is used in all of its homes. Details are available in the Service User Guide given to all of the residents and is displayed in the entrance hall. Complaints are always viewed in a positive way, to improve the service, and any concerns are addressed promptly. Any issues that cannot be resolved by the home would be referred to the regional team. The home tells us that they have addressed two complaints during the last year, none have been received by The Commission. Those people that we spoke with told us that, should there be a need to complain, they were confident that the manager would deal with any issues promptly. As the manager was not in the home on the day of our inspection it was not possible for us to see the files of any staff members however, those we spoke with were able to confirm that they had not been able to work there without having been cleared by The Criminal Records Bureau. They were also able to demonstrate an understanding of the procedures to be followed should they suspect that any of the residents were the subject of abuse or neglect. Care Homes for Older People Page 16 of 26 Evidence: Two of the senior staff in the home are currently undertaking specialised training with regard to the protection of vulnerable adults 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home provides an exceptionally well presented and maintained environment which meets the needs of the people who live there. Evidence: The home is situated in South Croydon and is very well maintained both internally and externally. It is surrounded by attractive gardens which are enjoyed by residents in the warmer weather and there is a car park. Residents bedrooms are arranged on the lower ground and upper floors and there is a passenger lift. All are for single occupancy and many have en-suite facilities. There are also bathrooms, toilets and showers on each floor with adaptations to help those with limited mobility. We did note comments from one resident who told us that their room had a bathroom, with bath, but it would not accomodate a hoist. They were a little dissapointed to be paying for en-suite facilities that they could not use and suggested that a shower would have been better thatn the bath. There are lounges and dining rooms which offer residents a choice of where they would like to sit and privacy for their visitors should they want it. Residents bedrooms are well appointed and decorated and people have been able to bring in their own possessions to make them more homely. The home has an ongoing redecoration and refurbishment programme in place Care Homes for Older People Page 18 of 26 Evidence: although we did receive some comments about the need to redecorate some areas. It is always very clean and free from malodour. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that there will generally be enough staff on duty to meet their needs and that they will be well trained. Robust recruitment procedures help to ensure the safety of the people in the home. Evidence: On the day that we visited the home both the manager and her deputy were on holiday. We did raise some concerns about the arrangements in place during this time as there was only one trained nurse in the home. The expectation was for her to mange the home as well as undertaking the role of the nurse on duty and we did consider that this was not sufficient. After contacting the area manager this situation was addressed and another nurse arrived to help. We have recommended that some thought should be given to how rotas will be managed in future in order to ensure that there is enough cover when the manager is away. Other than this, staffing rotas we looked at were satisfactory. The majority of the staff work both day and night shifts helping to provide continuity of care for residents, all of whom told us that staff were very kind and caring. Each resident is allocated a named nurse and a key worker, both of whom assume a special responsibility for their resident and liaising with their relatives. BUPA consider staff training to be very important and the majority of care staff have Care Homes for Older People Page 20 of 26 Evidence: achieved an NVQ to at least level 2. We were told that the manager is currently arranging the training schedule for this year however, staff were able to tell us about sessions they had attended. One staff member was currently undertaking their induction programme and was able to explain what they were learning. This process can take them up to twelve weeks. The home is able to access the companys HR department and robust recruitment procedures are in place. As the manager was away we were not able to look at any personnel files however, staff were able to tell us about the checks that had been made before they were employed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people who live there and allows them the opprtuinity to influence the service they receive. Evidence: Since we last visited the service a new manager, who is still awaiting registration, and deputy have been appointed to the home. Surveys that we sent to staff, prior to the inspection, pointed out that, prior to their appointment , there had been a series of people managing the home whio had not stayed for very long and that this had been very unsettling for the home. The management team are supported by a comprehensive range of corporate policies and procedures which are reviewed and updated on a regular basis. The size of the company ensures that there is always access to expert advice and guidance. There are effective quality assurance systems in place to ensure that residents views are sought and able to influence the service. These include regular residents meetings and also quality surveys. The home is subject to regular audits from the quality Care Homes for Older People Page 22 of 26 Evidence: consultants within the company and staff participate in the Personal Best initiative which concentrates on providing a customer focused approach. The home does not deal with any of the residents financial affairs, all of them have relatives or representatives to do this for them. The information that we have been given tells us that equipment is all properly maintained and the building complies with fire safety and environmental health regulations. 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 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 27 It is reccommended that consideration should be given as to how management responsibilities and staffing levels will be maintained when the manager is not in the home. Care Homes for Older People Page 25 of 26 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. 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. 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