Inspection on 01/08/05 for Court Regis

This inspection was carried out on 1st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Court Regis 30/01/07

Court Regis 19/04/05

Court Regis 09/12/04

Court Regis 21/04/04

Court Regis 09/09/03

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Court Regis Middletune Avenue Sitingbourne Kent ME10 2HT Lead Inspector Sue McGrath Announced 1 August 2005 10:00 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 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. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Court Regis Address Middletune Avenue Sittingbourne Kent ME10 2HT 01795 423485 01795 471348 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kent Community Housing Trust Mrs Pauline Lilian Florence Wise Care Home 54 Category(ies) of PD Physical Disability (1) registration, with number OP Old Age (35) of places DE(E) Dementia - over 65 (18) Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Care for one person with a physical disability is limited to 1 person with a date of birth of 19/09/1942. Date of last inspection 20 April 2005 Brief Description of the Service: The home occupies detached premises, which was custom built initially for the local authority, and offers accommodation on the ground floor only, although there are staff facilities on the first floor. There are 32 single rooms and 11 shared rooms, all of which have call bell and television points. It is located on the edge of a large residential estate and adjacent to a junior school, to the north of Milton Regis. It is close to a bus route and about a mile from the main line railway station of Sittingbourne. Local shops are within a short walking distance.The staff compliment numbers 46 carers, 13 domestic staff, who attend to catering and cleaning, including one who works exclusively in the laundry, a technician/handyman and an administrator. The registered manager, who has worked in the home for more that 27 years, has acquired comprehensive experience in the provision of care. She has attained qualifications in management and care and overseas a skilled and competent team who are trained in working with older people and those suffering from dementia. The duty rota includes 3 cares on waking night duty, with a senior member of staff on-call for emergencies. There is also a full time activities coordinator.The unit within the home that offers care for those people suffering from dementia is self-contained, but shares the catering and domestic services within the main building. It has access to a large secure garden. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was announced inspection and took place on the 1st August 2005. The Commission was represented by Sue McGrath, the home by Pauline Wise, the Registered Manager. The main focus of the inspection was on the general environment, activity and staffing levels and the well being of the residents. During the inspection documentation and records were read, including care plans. A tour of the building was undertaken and many of the residents and some visiting family members/friends were spoken to. Time was also spent talking to staff and members of the management team. Following comments received from families prior to the inspection, the inspector spent a lot of time on the dementia unit observing practises and staffing levels. What the service does well: The residents confirmed that they felt comfortable and relaxed in the home and that they felt well cared for. The home is friendly and homely. Health needs are well managed and a good relationship is enjoyed with the local District Nurse team. Residents are encouraged to maintain contact with their loved ones and visitors are made very welcomed. All resident said that the food was good and that there was always ample to eat. Staff training is well organised and provides staff with the competences to fulfil their roles at the home. The residents enjoy a good level of activities within the home. All of the staff contribute to the well running of the home and the friendly and warm environment. Staff on the dementia unit were seen to be working to a high standard and a good level of care was offered. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4,5 A written statement of terms and conditions protects Resident’s legal rights to occupancy. Residents’ benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: Standards 1 and 3 were assessed at the last inspection and scored 3. Standard 6 is not applicable. Samples of the current contract/terms and conditions were viewed. They contained information regarding room number, costs, notice times and other appropriate information. Discussion took place regarding guidance from the Office of Fair Trading and information was left with the manager for future reference. The contract was standard for all KCHT establishments. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 9 The home had a specialist unit for residents with dementia and all staff had received training in the care of dementia and had the relevant experience to deliver this level of care. Staff on the residential unit also had the skills and experience necessary. The manager explained the process of admission which was thorough and consisted of a home visit where possible and a phased admission to the home. One resident spoken to confirmed that she had visited the home prior to her admission and that she had been able to bring in a few personal items with her. The manager confirmed that sometimes it was possible for personal items to be brought in prior to the resident arriving, so that they feel more at home straight away. The home also uses a buddy system were existing residents help a new arrival to settle in. All resident had a full review after four weeks to ensure his or her needs continue to be met, this can be extended if required. The home tried to avoid emergency admission, but when these do occur a lot of time is spent with the new resident explaining routines etc and within 5 days a full assessment would have been completed. Evidence in resident’s files confirmed this does happen. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 10,11 Residents feel they are treated with respect and their right to privacy is upheld. The Residents benefit from having the issue of aging and illness handled sensitively. EVIDENCE: Standard 7 and 8 scored 3 at the last inspection. Standard 9 scored 2. Several resident were spoken to and all were highly complementary about the way staff spoke to them and how the care was actually delivered. All felt at ease with the staff and enjoyed the homely atmosphere. Some spoke of how they enjoyed jokes and general banter with the staff. During the inspection it was noticed how well staff interacted with the residents. The homes had 11 double rooms and all had privacy curtains. The manager confirmed that medical visits were mainly conducted in the privacy of the residents’ bedrooms; sometimes the medical room was used. The manager confirmed that if a resident arrived without sufficient clothing and none was available from home, then KCHT had access to their own charity and Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 11 they could apply for funds to cover such eventualities. The home did not have a supply of spare clothing as recommended by good practise. Residents preferred names were used and these were highlighted on care plans. The home had a comprehensive policy on illness and palliative care which as far as medically possible enabled residents to remain in the home for as long as possible. Support would be sought from the local District Nurse team and in the past a good relationship had been developed. Relatives would be encouraged to stay with their loved ones and overnight accommodation could be provided if require. Some staff were in the process of receiving training in palliative care and this would then be cascaded down to all staff. Spiritual needs were also addressed at this time. Notes seen on care plans indicated that families had been involved with the necessary arrangements after the death of a resident. It was clear that this had been handled with dignity and respect. The manager was also aware that staff might need extra support at these times. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 Residents’ social and recreational interest and needs are well provided for with a wide range of activities organised. Where possible residents are able to exercise choice and control over their lives. EVIDENCE: Standards 13 and 15 were assessed at the last inspection and both scored 3. Although there was a need for certain routines such as meal times, the residents said that life was very relaxed and that they could get up and go to bed when they wanted to. Breakfast was time was very flexible. Residents could have their meals in their own room if they wished, although they were encouraged to come to the dining room to ensure they enjoyed the company of the other residents. Several notices were seen around the home informing the residents of future activities and entertainments. Four of the residents were encouraged to handle their own monies, with one resident being taken to the bank, so that he could manage his own financial affairs. Again several of the residents had their own mobile phones, other had access to the phone within the home. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 13 The manager explained how the residents could access their own personal files and discussion took place regarding family access to those records. The home was following good practise with these matters. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home has a clear complaints procedure and service user and relatives are aware of how to complain. Service users’ legal rights are protected and service users themselves are protected from abuse by the home’s Adult Protection Policy and procedures. EVIDENCE: The home had a clear complaints procedure that complied with all the requirements of the regulations. One visitor was aware of the procedures and was confident that any issues she raised would be dealt with effectively. Although she had never made a formal complaint she was happy that issues she had raised informally had been dealt with very quickly. Discussion with several staff members indicated that they had an awareness of Adult Abuse and had received appropriate training in this subject. There had been no complaints recently, but the home had received a number of letters of compliments from family members. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21,24,25,26 The home needs to be refurbished for the benefit of service users. Service users have access to safe and comfortable indoor and outdoor communal areas. Service users are encouraged to maximise their independence by having access to the range of specialist equipment supplied by the home. Whilst service users’ rooms are homely and comfortable not all service users benefit from living in rooms that meet the requirements for space. The service users benefit from living in a clean, pleasant and hygienic home. EVIDENCE: Standards 19,20,23,26 were assessed at the last inspection and scored 3’s,standard 22 scored 2. Some of the toilets in the home were situated in block and were in need of refurbishment, however staff said that these were the toilets most of the residents choose to use most of the time. There were other toilets situated throughout the building. All were clean and tidy but again very tired looking. The home had one very old sluice situated in the laundry that again it was in Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 16 need of replacement. Urgent consideration must be given to refurbishment if the proposed new build is not confirmed in the immediate future. All of the double room had screening. It was evident that some residents had been able to bring in some of their own personal items to their rooms. Some of the furniture supplied by the home was looking tired and well worn. This must be addressed in the coming months. All of the rooms were centrally heated and felt comfortable on the day of the inspection. The lighting generally was adequate and the home had emergency lighting throughout. Evidence was seen that the homes water supply system had been tested clear for Legionella bacteria. The certificate was seen on the day of the inspection. Some concern was raised over the sluicing facilities and the manager was advised to seek advise from the Infection Control Nurse to ensure correct procedures were being followed. The overall impression of the environment was that the home urgently needs a refurbishment or a rebuild. It is recognised that KCHT are hoping to develop a new build but this remains in the planning stage only. Should these plans not come to fruition then urgent consideration must be given to completing a full refurbishment programme. It will be a requirement that an action plan is drawn up, with realistic timescales included, for the future of Court Regis. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 The service users benefit from staff who enjoy good morale and are trained and competent to do their jobs. EVIDENCE: Standard 30 was assessed at the last inspection and scored 3. Following some comments received from relatives in the comment cards distributed for the Commission, the inspector spent a lot of time in the dementia unit, alone, to observe practises and staffing levels. On the day of the inspection three staff were working in the unit. Although the unit was busy, it was not out of control. The residents were seen to be encouraged to sit and eat in the dining room and some excellent care practises were observed. Several residents did get up and wandered around, but this was considered normal practise and staff coped well with the situation. The atmosphere was calm. Three residents were assisted to eat and again very good practise was observed. One resident was given excellent encouragement to mange her own meal, as opposed to being fed. This resident finished all of her meal, albeit slowly, mainly on her own. The issue of understaffing on the dementia unit was discussed with the manager afterwards and it was agreed that lunchtimes was generally more relaxed than tea times, when possibly some of the residents were tired. The manager agreed to monitor the mealtime activity and if necessary adjustments in staffing levels would be arranged. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 18 Out of the 42 members of staff 31 had already completed or were currently working towards their NVQ level 2. This was a very high percentage and exceeds the expected 50 . KCHT has recently appointed a new Training Manager and currently a training matrix was being developed. Training needs were identified during supervision sessions and in observing working practises. All new staff completed a TOPPS based induction programme. The home had robust recruitment procedures in place. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,37,38 The residents’ benefit from having a manager who is well supported by the senior staff in providing leadership throughout the home and from staff who demonstrate an awareness of their roles and responsibilities. Residents’ also benefit from a service which is safe and well managed. EVIDENCE: Standard 31 and 32 scores 4 at the last inspection, standard 33 and 36 scored 3 at the last inspection. The home’s financial procedures were examined and found to be sound with records kept of all financial transactions. Insurance cover was in place which reflected a suitable level of cover. Financial and business plans were made available to the inspector. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 20 Some of the residents managed their own finances but for those who did not there were systems in place to safeguard and protect their interests. Written records were well maintained and accurate. Resident’s monies were all kept separate with all appropriate records kept. The home had secure facilities for the safe storage of personal items, although encouragement was given to families to remove valuable personal items. Individual records and home records were secure, up to date and in good order. The home’s records regarding health and safety checks were viewed and were found to be in good order with all the relevant checks taking place and records kept. Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION x x 2 x x 2 3 x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x 3 3 x 3 3 Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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. 1. Standard 26 Regulation 12(e) Requirement Advise must be sought from the Infection Control Nurse with regard to the procedures used in the laundry and the sluicing facilities Timescales for the new development to be produced with realistic timescales and probable outcomes included Timescale for action Action plan by 2nd September 2005 Action plan by 2nd September 2005 2. 19 23(2) 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. Refer to Standard 26 Good Practice Recommendations t is recommended that carpets in the dementia wing be cleaned on a regular basis Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. ME16 9NT National Enquiry Line: 0845 015 0120 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 Court Regis H56-H06 S23918 Court Regis V232892 010805 Stage 4.doc Version 1.40 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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