Inspection on 23/10/08 for Ebury Court

This inspection was carried out on 23rd October 2008.

CSCI 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.

Other inspections for this house

Ebury Court 01/11/06

Ebury Court 27/02/06

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ebury Court 438 Rush Green Road Romford Essex RM7 0LX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Legg     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ebury Court 438 Rush Green Road Romford Essex RM7 0LX 01708728734 01708728797 beverley.manzar@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Beverley Anne Manzar Type of registration: Number of places registered: Ebury Court Residential Home Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No person with Dementia will share a room. In the event that Ebury Court has a referral of exceptional circumstances of two persons - relatives or a particular close friendship - wishing to share a room, and taking into acount the Mental Capacity Act 2005, the Registered Person will have to apply to the Commission for a specific Minor Variation. Date of last inspection Brief description of the care home Ebury Court is a private care home that can accommodate up to 39 older people. It is set well back from Rush Green Road, which connects the main town centres of Romford and Dagenham. There are 37 bedrooms with en-suite toilets All are used as singles, but the two largest can be used as doubles by couples. On the ground floor there are communal lounges and a conservatory. Three of the bedrooms are on the ground floor and the remaining bedrooms are on the first and second floor. There is a Care Homes for Older People Page 4 of 26 39 0 Over 65 0 39 Brief description of the care home good-sized forecourt, additional rear car park, and a well maintained large secluded garden. The fees for the home are £560 a week but there will be additional charges for hairdesser and other sundries. This information was given by the manager on the day of the visit. 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 was an unannounced inspection that took place over seven hours. The inspection was undertaken by Julie Legg the lead inspector. The manager was present for the duration of the inspection and was available for feedback at the end of the inspection. Discussions took place with the registered provider, the manager, care staff, the cook and ancillary staff. We also spoke to a number of residents and relatives.Care staff were asked about the care residents receive and were also observed carrying out their duties. The cook was asked about meals she provided to the residents and their likes and dislikes. Staff were also asked about their recruitment, induction programme and their ongoing training. Residents and relatives were asked about the care they or their relative received and professionals who were visiting the home on the day of the Care Homes for Older People Page 6 of 26 inspection were also asked for their views of Ebury Court. A tour of the home was undertaken and this included some of the bedrooms, bathrooms, the laundry and kitchen. Residents files were examined and case tracked; including risk assessments and care plans together with the examination of staff files and other home records. these records included medical charts, financial transactions and staff rotas. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment (AQAA), Regulation 37 notifications and Regulation 26 reports. The manager had previously told us that the people living in the home preferred to be called residents and this is reflected accordingly throughout this report. we would like to thank the residents, relatives and staff for their contribution to this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. Prospective residents and their relatives have detailed information on the home, which assists them to decide whether the home is right for them. A detailed pre-admission assessment is undertaken on all prospective residents and they have the opportunity to visit the home prior to them moving in, this will ensure that the home can meet the residents needs. The home does not provide intermediate care. Evidence: We wanted to know about peoples decisions to choose this care home and what it is like for people if they decide to move into the care home. We spoke to three residents, the manager and three care workers. We also looked at the information that the home gives to people and how they assess whether they can meet peoples needs. All of the residents we spoke to told us that they had clear information from the home Care Homes for Older People Page 10 of 26 Evidence: which gave them a picture of what the home would be like. We also looked at the information, which is called a Service User Guide and found that it was informative and written in a way that people could understand. The manager is in the process of producing the brochure in talking book format. This means that people are give accessible information in a user friendly format, which will assist them on deciding whether the home is right for them. The manager or deputy manager arrange for people to visit the home, this will help people decide whether they want to move into the home. During this visit people would be asked questions about their needs, what they enjoyed doing and what they want from the care home. Residents that were spoken to said they felt that they were involved in the decision as to whether they moved into the home. One resident said I visited the home before I moved in and met some of the other residents and staff. This made it easier for me to move in, as I felt that I already knew some of the people and I knew what my room looked like. We looked at the assessments that had been completed on the residents and these covered aspects of peoples health and social care needs and were person centred. Residents confirmed that they had been involved with the completion of the assessments. Staff members that were spoken to also had a very good understanding of the residents needs. This means that residents can be confident that the home will meet their needs before they move in. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, social and personal needs of each resident are set out in comprehensive and person centred care plans. This ensures that residents receive the appropriate care to meet their needs. There are medication policies and procedures for staff to follow, this ensures that residents are not put at risk regarding the administration of their medication. Residents are treated with respect and dignity and the arrangements for their personal care ensure that their right to privacy is upheld. Residents can be assured that at the time of their death, staff will treat them and their family with care sensitivity and respect. Evidence: Care plans that were seen were comprehensive and covered health, social and personal care needs. There was evidence that these care plans are being reviewed and Care Homes for Older People Page 12 of 26 Evidence: updated on a regular basis. Written daily logs are a reflection of the care the residents are receiving. Equality and diversity issues are identified and addressed by staff, and there was evidence of equality and diversity needs in individual care plans. For example, specific religious needs and preferences are clearly recorded and residents are enabled to participate in religious activities as desired, both inside the home and in the community. Specific cultural dietary needs are clearly recorded and residents confirmed that they are able to have food of their choice. It was evident from the care plans seen and through discussion with residents and staff that their health care needs were being understood and met on a daily basis. Some of the residents are able to access health professionals in the community and others access them by domiciliary visits to the home. From observations, and discussions with staff, residents and relatives, it was evident that the privacy and dignity of residents was respected. Discussions with the staff, the manager and the Pharmacist and the review of medication records show that care staff are following policies and procedures, this ensures that residents are safeguarded with regard to medication. From discussions with staff and from letters/ cards received by the home, it was evident that residents are assured that at the time of their death, both they and their families would be treated with care, sensitivity and respect. The home routinely sends sympathy cards and floral tributes to families where appropriate, and staff are supported to attend residents funerals. One family had written thank you for all you did to make Mums last days as comfortable as possible. We were so pleased that she was able to die at home with the people who knew her. Another relative wrote The staff were wonderful in the way they cared for Mum right to the end. Our heartfelt thanks to you all. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle within the home meets the needs and choices of the residents. Residents are enabled to exercise choice and control over their lives, which enables them to retain as much autonomy as possible. Residents receive nutritional meals and snacks in conducive surroundings. Evidence: There is a planned general programme of activities for all of the residents as well as visits by professional entertainers and visits to place of interests. Some of the residents are enabled to attend religious services within the community and also within the home. One resident told us I really enjoy going to the church service at St Augustine and afterwards we have tea and biscuits. The annual summer fete and Christmas Bazaar and the celebration of residents birthdays are just some of the special events that are held within the home. Relatives are actively encouraged to attend all of these events and there is a quarterly newsletter advising everyone of forthcoming events. Residents are fully involved with the planning of activities both in the home and in the community. Care Homes for Older People Page 14 of 26 Evidence: Staff that were spoken to were very aware of residents individual needs and to allow them time to express their wishes. Also to support residents to make choices in their everyday lives e.g. activities, menu planning, where they chose to spend their leisure time, what clothes they wore and what time they got up and went to bed. They spoke of Ebury Court as being the residents home and that they were committed to make their lives as pleasant as possible. One resident told us I like to spend time in my room but I also go down to the lounge especially if we have entertainers, another resident said I spend most of my time in my bedroom, I like my own company and I can watch television or listen to my radio. Visiting times are flexible within the home and this was confirmed by visitors at the time of the visit. One relative said I visit at all different times and I am always made to feel welcome and get offered a cup of tea. The dining room is bright and spacious with residents sitting at tables for four people and each table had a tablecloth and a vase of fresh flowers. There was evidence that residents have a choice at all mealtimes and that all dietary needs are met. Residents were seen enjoying their meal in a relaxed atmosphere and throughout the lunchtime meal staff were seen to offer assistance and encouragement where necessary and this was done discreetly and individually. All of the meals looked appetising and those that had been pureed were kept individually portioned. One resident told us: I really enjoy the meals and the cook will always cook something different for you if you dont like what is on the menu, another resident said I only like small meals and they make sure that they dont overload my plate. The cook had a good knowledge and understanding of the importance of well balanced and well presented meals. She was very aware of residents dietary needs and their likes and dislikes. There has been an increase in the amount of organic produce, only free range eggs are used and fresh fruit is provided on a daily basis. 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. Residents and their relatives have the information to know how to make a complaint and can be assured that any of their concerns will be looked into and acted upon. There are robust procedures in place and all of the staff have received training in safeguarding vulnerable adults, this will ensure that there is an appropriate response to any suspicion or allegation of abuse. Evidence: The home has a written policy and procedure for dealing with complaints. Copies of the complaints procedure and details of an advocacy service are readily available. Staff that were spoken to were aware of the complaint procedure and how to deal with complaints or concerns made to them. Most of the residents have relatives/friends who visit them, for residents that do not receive visitors the manager has arranged a befriender. Residents and relatives that were spoken to were all aware of how to complain if they wished to do so. One resident said I do not have any complaints but if I did Iwould speak to Beverley (manager) as she would sort it out. A relative stated I had a very minor issue and Beverley dealt with it straight away. The home has policies and procedures for the safeguarding of residents monies and there was evidence that all financial transactions are robust. Care Homes for Older People Page 16 of 26 Evidence: There are all of the appropriate policies and procedures for dealing with safeguarding vulnerable adults; these include whistleblowing and the local authorities protocols on dealing with safeguarding vulnerable adults. These policies and procedures are available to staff, who comfirmed that they had read them as part of their induction. All staff including anciliary staff have undertaken appropriate training and were aware of the actions to be taken if they had any concerns regarding the health and wealth of the residents. The Commission has not received any concerns regarding safeguarding vulnerable adults in the last twelve months. 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 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 homely and provides the residents with a clean, safe and comfortable environment that meets their individual needs. Residents bedrooms are decorated and furnished in a way that suits them. Evidence: The home is decorated and furnished in a homely fashion and to a good standard. There is a continuous programme of redecoration and the main lounge is to be redecorated within the next three months. There are various lounges, a dining room and a conservatory where residents can meet their relatives/friends or alternatively they can meet in their bedrooms. Bedrooms have been individually decorated and furnished and residents are encouraged to bring some of their own possessions to reflect their interests, culture and religion. There are sufficient toilets and bathrooms, however the home is looking to install a hydrotherapy bath in the next twelve months. The kitchen and laundry are both well equipped and maintained. The home has the necessary equipment and adaptations to meet the needs of the residents and there is good infection control which reduces the risk of infection. Care Homes for Older People Page 18 of 26 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. Staffing levels are good and there are sufficient staff on duty who have the appropriate skills and knowledge to meet the needs of the residents. The recruitment and selection procedure of the home is robust and this ensures the safety and protection of the residents. Evidence: The staffing levels have been increased during the day to ensure that the diverse and changing needs of the residents are fully met. Staff are effectively deployed so as to ensure that residents choosing, or needing to remain in their bedrooms are cared for appropriately. All of the staff were seen to interact and communicate well with all of the residents. Staff that were spoken to were clear about their roles and their responsibilities and demonstrated a strong commitment to provide good quality care to all people living in the home. There is a fairly stable team of staff which mean that residents receive consistent care from staff they know well. The home was able to demonstrate that they operate a robust recruitment and selection process in accordance with the requirements of legislation, equal opportunities and anti discriminatory practice. Care Homes for Older People Page 20 of 26 Evidence: Staff training is seen as a high priority and the manager ensures that the training will enhance the knowledge and skills of the staff. This will ensure that residents receive the appropriate support from competent and skilled staff. Many of the staff are from diverse cultures and backgrounds, some of which are different from the people living in the home. Staff have undertaken training in equality & diversity, this will ensure that the needs of the residents are understood by staff and appropriately met. All staff receive induction training which covers all essential essential areas and other appropriate training as identified during staff supervision. All of the staff have recently received training in the Mental Capacity Act 2005 and some of the staff are soon to commence training in end of life care. Residents and relatives were complimentary of the care received at Ebury Court. One resident said The girls are really good, nothing is too much trouble for them, another resident said I would rather be living in my own home but that isnt possible. This is the next best place, they look after me so well. One relative told us My Mum is looked after really well and that puts my mind at rest. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a qualified and experienced manager and is run in the best interest of the residents. Residents can be confident that their views underpin the self-monitoring, review and development of the service. Evidence: The registered manager is very experienced and well qualified. She holds a social work qualification with over twenty years experience of managing social care services. She is a Train the Trainer and has completed her practice supervisor course and her Registered Managers Award. She undertakes regular training and understands and values the opportunities for continuing her professional development. All of the staff spoke very highly of the manager; that she is very supportive and is very much a team player. One member of staff said Beverley is very supportive and Care Homes for Older People Page 22 of 26 Evidence: approachable and is often walking about the home, she has a visible presence which is good for us and the residents, another member of staff commented We have a good management team, they will often compliment us, which makes us feel valued. Residents and relatives also spoke positively about the manager; that she is very approachable and she is often seen talking to residents and staff. one resident said, She is very caring, if you ask for anything she sees to it straight away. The manager is very resident focused, she has a strong and supportive staff team, and works in partnership with the families of residents and professionals involved in their care. There is strong evidence that the ethos of the home is open and transparent. The views of both the residents and the staff are listened to, and valued. The Annual Quality Assurance assessment (AQAA) contained very comprehensive information that was fully supported by evidence. There is a clear understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to residents. She has a clear understanding of what further improvements are needed and areas which need development. The home has a comprehensive range of policies and procedures. There are clear written records of all safety checks and accidents/ incidents. Such records were found to be maintained in good order. The registered individual monitors the quality of the service being provided in the home through monthly Regulation 26 monitoring visits and the manager undertakes out of hours spot checks on the service. Quality assurance is also undertaken by annual quality questionnaires to residents, relatives and other stakeholders. the manager has also implemented a listening form for residents to complete on a regular basis and from the feedback individual action plans and targets are set. Residents are supported to manage their own finances where possible or by their relatives/ representatives. The manager does not have responsibility for any of the residents finances. there are secure facilities for the safekeeping of any sums of money that residents bring in on admission. These monies are held in the safe until the next of kin or the Receivers office are able to take it. Records are maintained to document this process. 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 Care Homes for Older People Page 25 of 26 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!