Inspection on 19/04/05 for Court Regis

This inspection was carried out on 19th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 01/08/05

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 Sittingbourne Kent ME10 2HT Lead Inspector Sue McGrath Unannounced 19 April 2005 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 V221822 190405 Stage 4.doc Version 1.20 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 Physical Disability 1 registration, with number Old Age 35 of places Dementia 18 Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 9 December 2004 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 V221822 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over 4 hours on the 19th April 2005. The inspector spoke to 14 service users, several family members and six members of staff plus the management team. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with service user and families. A tour of the premises was undertaken which included several resident’s rooms. Some records were viewed including care plans and staff files. The requirements made at the lat inspection had been complied with. What the service does well: What has improved since the last inspection? Staff are now regularly supervised by a senior member of staff. The supply of the medication has improved since the last inspection, with only a few minor shortfalls in the system seen. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full 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 V221822 190405 Stage 4.doc Version 1.20 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 V221822 190405 Stage 4.doc Version 1.20 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) 1,3,6 The homes Statement of Purpose and Service User Guide are comprehensive and provide prospective service users with the information they need to make an informed choice about moving into the home. Service users benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. EVIDENCE: The Statement of Purpose and Service Users Guide were seen and both these documents contained all the information required under the regulations and were presented in a clear format. One service user spoken to confirmed that she had recently completed her trial period and was happy to remain at Court Regis. The manager confirmed that full assessments do take place and examples of such assessments were seen and were comprehensive and detailed. Care Managers also provide the home with information regarding the needs of the service users. These assessments were seen in the care plans Intermediate care is not provided at Court Regis. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 9 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) 7,8,9 Service users have clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users have full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Four care plans were viewed and these contained clear and directive information about the amount of support the individual needed. Monthly reviews were recorded and changes highlighted for staff. Risk assessments were in place for identified risks. Records of visits by G.Ps. District Nurses, Chiropodists and other health care professionals were seen. Outcomes were also recorded. The Manager confirmed that the home received good support from the District Nurses team. Some of the service users were seen to be in need of dental treatment and the manager was endeavouring to find a dentist who will visit the home. Several Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 10 service users stated they did not want to see a dentist and that they were not in any pain. The medication was generally administered in accordance with guidelines from the Royal Pharmaceutical Society of Great Britain, with only a few minor issues. A few gaps were noticed in the Mar sheets but when checked the medication balanced. The manager agreed to remind staff to ensure they sign for medication when it is administered. The assistant manager described the system used for recording dose changes for Warfarin, which was in line with current guidelines. The sharps container was found to contain items other than sharps and this was highlighted to the manager. Staff were trained in house to administer medication and discussion with the manager confirmed that the home was waiting for accredited training to be arranged. All staff that administers medication would complete the course. There were no service users with pressure sores in the home and the staff described a range of preventative equipment for use in the home should it be required. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 11 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) 13,15 Service users are supported to maintain contact with family and friends which ensures they continue to receive stimulation and emotional support. The service users benefit from the appetising meals and balanced diet offered by the home and those service users requiring specialist diets are well catered for. EVIDENCE: Visitors to the home said that they were always made very welcomed and were offered refreshments as needed. One visitor stated that she was always kept informed of all the changes in her husbands care and was involved with the care planning documents. The visitor also stated that the atmosphere in the home was very friendly and that she was sure her husband was well cared for. All service uses spoken to said the food was always very good and that there was plenty of it. The manager confirmed that specialist diets, such as diabetic diets, were catered for. One service user spoke of how pleased she was when staffed baked her a birthday cake. Spot the difference posters and various other posters and displays indicated that service user enjoyed activities during the day. The home employs an activities organiser. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 12 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 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. The manager was able to produce the voting cards for the service user for the General Election in a couple of weeks. She stated that if service user wished to vote she would make arrangements for them to be taken to the polling station. 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 V221822 190405 Stage 4.doc Version 1.20 Page 13 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) 19,20,21,22,23,26 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: The home has 32 single rooms and eleven double rooms, some of which are quite small and do not meet the requirements for room space. This has been discussed with manager in the past and plans are underway for a new build to start soon that will address all of the environmental issues. Although the home has plenty of toilets there is a shortfall in the number of bathrooms, however this will be addressed in the new build. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 14 Most service user spoken to, said their rooms were nice, some used the expression of cosy and comfortable. Evidence seen indicated that although the environment was slightly worn, the level of care was high. The home was warm and lighting was appropriate throughout. The service users meet in the large dining room for meals, which was clean and airy. Bedrooms seen were personalised and the lounges had a selection of ornaments etc to ensure a homely feel. The homes kitchen remains in need of refurbishment and consideration must be given to ensure it remains suitable for use even though a new build is planned. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 15 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) 30 The service users benefit from staff that are trained and competent to do their jobs and who enjoy good morale. EVIDENCE: The manager explained that she had reorganised staff files to enable evidence of training and supervision to be clearly identified. A training analysis was seen in staff files, which was comprehensive. Visitors spoken to state that they thought the staff were knowledgeable and competent and cared for their family members well. Staff spoken to all stated that they enjoyed working at the home and staff turnover was low. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 16 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) 31,32,33,36 The service users benefit from living in a home where the manager is competent, enthusiastic and very experienced with the care of older people and has a clear vision for the home. Service users benefit from staff who are appropriately supervised by senior members of staff. EVIDENCE: The manger has worked for many years at this home and has very clear ideas and values that benefit all service users and staff. Staff spoken to, held the manager in high regard, as did visitors spoken to on the day. Discussion with the manager was lively and she could demonstrate a clear understanding of the needs of the service users in the home. The manager oversees the supervision of care staff, which is mainly completed by Team Leaders. Discussion with one Team Leader indicated that although it Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 17 was difficult sometimes to fit all the supervision session, in they were working hard to keep up to date and that staff were beginning to see the value of the sessions. Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x 2 3 x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 4 4 3 x x 3 x x Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 19 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 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. Refer to Standard Good Practice Recommendations Court Regis H56-H06 S23918 Court Regis V221822 190405 Stage 4.doc Version 1.20 Page 20 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. 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