Inspection on 18/04/07 for Rush Court

This is the latest available inspection report for this service, carried out on 18th April 2007.

CSCI 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.

Other inspections for this house

Rush Court 28/07/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Hillyfield Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rush Court Shillingford Road Wallingford Oxfordshire OX10 8LL Lead Inspector Annette Miller Unannounced Inspection 18th April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rush Court Address Shillingford Road Wallingford Oxfordshire OX10 8LL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01491 837233 01491 826723 enquiries.rushcourt@elizabethfinn.org.uk Elizabeth Finn Homes Ltd Mrs Pierrette A F Gifford Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (3) of places Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of persons with nursing needs must not exceed 35. The PD category is for service users aged 50-65 years only. The total number of service users must not exceed 50 aged 50 years and above on admission. 12th January 2006 Date of last inspection Brief Description of the Service: Rush Court is registered to provide nursing and personal care for up to 50 male and female service users. The maximum number of service users with nursing needs must not exceed 35. Registered nurses are on duty 24 hours a day and are assisted by care assistants. Accommodation is provided in single bedrooms and most have en-suite facilities consisting of toilets and washbasins. There are also six assisted bathrooms, a physiotherapy room, hairdressing salon, library (which is also used as a chapel) and an activities room. The public rooms are spacious and extremely well decorated and furnished. There is a wide range of activities available and service users are actively encouraged to maintain their independence for as long as possible. The home has large, wellmaintained gardens and is near to the market town of Wallingford. The fees for this home range from £550.00 to £1,040.00 per week. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted over 5½ hours starting at 10 am. The inspector looked at how well the home was meeting the national minimum standards set by the government and has in this report made judgements about the standard of service provided. The Residential Care Manager was the person in charge of the home on the day of inspection and was present throughout the inspection. The home’s Registered Manager and also the Clinical Care Manager (Nursing) were attending training arranged by the organisation. The inspector toured the building and spoke to residents to find out what life in the home was like. Three residents were case-tracked. This means their care records were looked at in detail and the arrangements around their care observed. Each resident agreed to talk to the inspector in private to give a view of their care. The Commission for Social Care Inspection (CSCI) received a good response to the ‘Have your Say’ questionnaires it sent out prior to the inspection. 13 residents, 5 relatives and 1 GP responded. What the service does well: The majority of comments made by residents during the inspection and on CSCI questionnaires indicated a high level of satisfaction with the home and the care provided. Comments included: “It’s a brilliant place – like a five star hotel.” “The care both medical and pastoral at Rush Court is of the highest quality. There is good communication between staff and families and a very welcome and inclusive atmosphere.” “I think the care we receive here is phenomenally good.” The organisation provides good opportunities for staff to attend training to ensure they have the skills and knowledge to do their job well. The standard of accommodation is exceptionally high and provides people with safe, comfortable and clean surroundings in which to live. There is a good range of social and recreational activities for residents to choose from. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Intermediate Care (Standard 6) is not provided. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move into the home. EVIDENCE: Admissions are not made to the home until a full needs assessment has been undertaken. The manager carries out these assessments in the person’s own home, or in hospital if that is their current situation. This ensures care needs are fully assessed before admission enabling the manager to determine whether or not the home is able to provide the care the person needs. A resident commented on a CSCI questionnaire that the manager had travelled some distance to see her in her home: “Not just to assess me but to tell me about the home and answer my questions”. This indicates the importance Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 9 placed on giving people the information and help they need to make informed decisions about their future care. The organisation has a good track record for providing regular training for its staff to ensure they have the skills and experience to deliver the services people need. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health needs of residents are well met. Personal support is offered in such a way that promotes and protects residents’ privacy, dignity and independence. EVIDENCE: The majority of comments made by residents on CSCI questionnaires, as well as verbally during the inspection, indicated a high level of satisfaction with the heath and personal care they receive. Comments included: “It’s a brilliant place – like a five star hotel.” “The care both medical and pastoral at Rush Court is of the highest quality. There is good communication between staff and families and a very welcome and inclusive atmosphere.” “I think the care we receive here is phenomenally good.” Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 11 The three residents case tracked had care plans showing in detail their care needs and what action staff needed to take to help them. There was evidence of regular care plan reviews ensuring people’s changing needs were taken account of in a timely way. Care plans are drawn up in consultation with the resident or their representative. Residents are assessed for any potential risks. For example, all residents are assessed for risk of trips and falls and staff discuss with appropriate health care professionals appropriate action to reduce risk. All residents have a physiotherapy assessment on admission to determine their level of mobility and to determine if physiotherapy is needed. The initial assessment is funded by the organisation. The health care needs of residents unable to leave the home are managed by visits from local healthcare services. Some of the residents on the residential wing prefer to visit their doctor’s surgery and staff encourage this to help the person remain independent for as long as possible. Residents can either arrange private transport for this, or book the home’s mini-bus. The home has a good range of aids and equipment that are well maintained to ensure people’s safety. For example, all residents are assessed on admission to find out if they are at risk of developing pressure sores. Pressure relieving mattresses and cushions to reduce this risk are provided when needed. The home has an efficient medication policy supported by procedures and practice guidance. The inspector looked at the medication record charts of the three residents case tracked and found they were complete with the required entries and were signed by appropriate staff. Regular management checks are carried out to monitor compliance. Residents who wish to manage their medication are supported in doing this. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: The home employs an activity organiser who is responsible for planning and arranging activities. She visits new residents to find out what they like doing and if they have particular hobbies they wish to pursue. The activity programme is regularly reviewed to ensure it meets the needs of the people living in the home. The majority of residents spoken to and who completed CSCI questionnaires said they though there was a good range of activities to choose from. Several commented on the musical events that took place, saying how much they enjoyed them. A resident said: “The place, staff, food, care etc and inmates are all wonderful”. Another said: “I am pretty active, able to enjoy my hobbies. It is hard to believe that anywhere could be as good as Rush Court”. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 13 The majority of residents spoken to thought the food was good and liked the daily choices offered. Menus were inspected and found to be balanced and interesting and mealtime arrangements are also flexible enough to accommodate individual preferences. A resident indicated dissatisfaction with the allocation of seating at mealtimes and this was brought to the attention of the person in charge. The inspector was confident that this would be dealt with sensitively. Residents confirmed they could have visitors whenever they wished and that there was good provision for seeing people in their rooms in private, or in one of the many quiet areas situated within the home’s communal areas. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints system with evidence that residents feel their views are listened to and acted upon. The vulnerable adults procedure ensures a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints procedure is included in the home’s Statement of Purpose, as well as being displayed in the home. There is a well established procedure for dealing with any complaints received. The manager has dealt with two since the last inspection and one was upheld. No complainant has contacted the Commission with information concerning a complaint since the last inspection. Everyone who returned CSCI questionnaires felt safe, listened to and able to speak to the staff and manager if they were not happy about anything to do with their care. A resident said: “Care and consideration is given by all members of the staff in their individual responsibilities. There is always a feeling of security and care, and all comments are listened to with patience and consideration. We who are here as residents are very fortunate knowing we have security and care at all times.” New employees receive adult protection training to ensure they know how to respond to any suspicion of abuse. Training updates are regularly provided. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of accommodation is exceptionally high and provides people with safe, comfortable and clean surroundings in which to live. EVIDENCE: Residents and relatives who completed CSCI questionnaires consider the accommodation to be ‘second to none’. The home is situated in lovely grounds with most rooms overlooking the gardens, or small courtyards, planted with an abundance of shrubs and herbaceous plants. The grounds are very well maintained. Cleanliness throughout was particularly good and the domestic team are commended for this. A resident said her room was thoroughly cleaned each day, with further checks made during the day on her en-suite facilities and Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 16 waste paper baskets to see if anything else needed to be done. Several residents praised the domestic team for keeping the home ‘looking good’ at all times. The Fire Service and Environmental Health routinely inspect the premises to ensure good standards are maintained in these areas of the service. Plans are in place to refurbish parts of the kitchen during 2007 to ensure kitchen facilities continue to comply with best standards. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to safeguard the welfare of residents living in the home. EVIDENCE: The majority of residents consider there are usually enough staff to provide the assistance they need. Comments included, “The staff are wonderful”, “Most of the staff are very friendly and caring”, “My mother is looked after extremely well in every way”. However, the inspector also received a small number of comments about staff not remembering to introduce themselves when entering rooms of partially sighted residents and not always leaving items within reach before leaving rooms. One resident said: “The staff always seem too busy to help me with tasks that are very important to me”. A relative said: “Carers bundle clothes into my mother’s wardrobe and always seem in a hurry”. Three people mentioned they would like to go into the garden more often for fresh air, but said staff seemed too busy to take them. The staffing level was good on the day of inspection. The nursing wing had two registered nurses and 4 carers on duty. One carer was off sick and cover from the home’s ‘staff bank’ was obtained for part of the morning. The Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 18 Residential Care Manager and two carers were on duty in the residential wing. The home also employs a large team of support staff to assist in the day-today running of the home. The organisation is committed to NVQ training and 21 out of 31 carers have obtained at least NVQ level 2 in care, some have achieved level 3. The Clinical Care Manager (Nursing) and Residential Care Manager have the NVQ level 4 in management and this ensures these key members of staff have a good level of management knowledge and expertise. The Clinical Care Manager is a registered nurse and the Residential Care Manager has the NVQ level 4 in care. Recruitment procedures are generally good ensuring staff members are appropriately vetted prior to appointment. The only shortfall is that a fullemployment history is not routinely obtained and there was also no evidence to show that gaps in employment had been checked. This information is needed. At present the home’s application form asks for a 10-year employment history and this needs to be amended to ask for a full employment history in order to meet current requirements. Induction training is well developed and provides new staff with the knowledge and supervision they need to be confident in carrying out their duties. For the first two weeks of employment new staff are not included in staffing numbers and work alongside experienced staff to gain an understanding of their role. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of the residents. EVIDENCE: The registered manager has a wide range of experience in managing care homes for older people. She is a registered nurse and is currently studying for the Certificate in Management Studies. This is equivalent to the Registered Manager’s Award, a qualification that registered managers are required to have for Standard 31 to be fully-met. The manager said she expects to complete this training in July 2007. There are good quality assurance systems in place to enable the organisation to find out what residents think of the services provided. This assists the Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 20 organisation to identify where improvements are needed ensuring the present high standards are maintained. The home has efficient systems to ensure effective safeguarding and management of individual’s money including record keeping. The pocket money accounts of three residents were checked and the balance of money held matched the records. The organisation takes seriously its responsibility to ensure the safety of people living in the home, as well as staff and visitors. The home employs maintenance staff to carry out the required safety checks and day-to-day repairs. External contractors are brought in to check specialist equipment on a regular basis. All staff are required to attend mandatory health and safety training with records being kept. Previously arranged training was taking place for a number of staff on the day of the inspection. The external trainer said he was impressed with the organisation’s commitment to providing training and also with staff attendance, which he said was always good. Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP15 OP27 Good Practice Recommendations Review the seating arrangements at mealtimes to ensure these meet individual preferences. Review the allocation of staff during each period of duty to ensure they have sufficient time to take residents into the garden when residents request this. Through training and supervision ensure staff understand the importance of completing tasks that are important to individual residents. A full employment history needs to be obtained from all new staff with gaps in employment checked to ensure residents are safeguarded. OP27 OP29 Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rush Court DS0000065412.V333934.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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