Inspection on 03/10/06 for Premier Court Nursing & Residential Home

This inspection was carried out on 3rd October 2006.

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

Premier Court Nursing &... 25/06/09

Premier Court Nursing &... 02/07/07

Premier Court Nursing &... 25/10/05

Premier Court Nursing &... 17/05/05

Premier Court Nursing &... 16/11/04

Premier Court Nursing &... 05/08/04

Premier Court Nursing &... 27/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Premier Court Nursing & Residential Home Thorley Lane East Thorley Bishops Stortford Hertfordshire CM23 4BH Lead Inspector Jeffrey Orange Key Unannounced Inspection 3rd October 2006 09:05 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 Premier Court Nursing & Residential Home DS0000019499.V314574.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. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Premier Court Nursing & Residential Home Address Thorley Lane East Thorley Bishops Stortford Hertfordshire CM23 4BH 01279 758585 01279 758586 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) www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Patricia Margaret Vincent Care Home 60 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (60), Terminally ill (5), Terminally ill over 65 years of age (60) Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 2 Service Users under the age of 55 years must not be admitted under the category TI This home may accommodate 1 named female service user in category MD(E) (The Commission must be informed if the named service user leaves the home permanently for any reason.) Date of last inspection 25th October 2005 Brief Description of the Service: Premier Court is a purpose-built care home providing nursing and personal care and accommodation for 59 persons for reason of old age. It is owned and operated by BUPA Care Homes Limited and is situated on the outskirts of Bishops Stortford in a pleasant semi-rural setting. The home is on one floor and is built around a courtyard garden to which a number of bedrooms have direct access. All rooms are for single occupancy and have en-suite toilets and wash hand basins. There is a large dining room and lounge with a number of smaller lounges positioned around the home. The home also has a hairdressing salon, kitchen and laundry that, together with aids such as assisted bathing and toilet facilities, ramps and wide corridors, provide well for the needs of older people. There are several small garden areas around the outside of the building, including a newly developed sensory garden. The home also provides ample parking provision. The home has a range of documents providing details of its terms and conditions including a comprehensive service user’s guide and statement of purpose. The report on the last inspection by the Commission for Social Care Inspection (CSCI) is also available. Weekly fees range from £800-£875 for nursing care and £700-£750 for residential care. Personal toiletries, newspapers, hairdressing, optician, chiropody and dentistry are subject to additional charges. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been compiled following a visit to the home, which provided an opportunity to speak to residents, the manager and her staff and to inspect the home’s environment and a sample of records including those for medication and staff recruitment. The report is also informed by any information received about Premier Court since the last inspection in October 2005. A number of surveys have been sent out to relatives of residents. Any issues raised from these will be discussed with the manager and will be included in the next inspection report. What the service does well: What has improved since the last inspection? Action has been taken to address the requirements and recommendations made following the inspection in October 2005. The sensory garden that has been developed with help from several individuals and organisations has further enhanced the experience of living in the home for those residents able to take advantage of it. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 6 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. Premier Court Nursing & Residential Home DS0000019499.V314574.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 Premier Court Nursing & Residential Home DS0000019499.V314574.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 5 (Standard 6 does not apply to Premier Court) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive information is available to prospective service users and their relatives so that they can make a well-informed decision about the home and whether it can meet their needs. There is a robust assessment process in place that should ensure that only those people whose needs can be fully met are admitted into the home. EVIDENCE: The home has a comprehensive set of documents available, including a Statement of Purpose and Service User’s Guide together with BUPA details of the terms and conditions that apply. It has previously been established that pre-admission visits to the home are encouraged and facilitated. The care plans seen, including those for recently admitted service users, contained evidence that a pre-admission assessment of needs had been carried out. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 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 the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall standard of care experienced by service users is good. Care plans contain the required information that staff need in order to appropriately meet the health needs of service users. The social care needs are less well documented. The basic medication practice in the home is satisfactory and provides for the safe administration of medication for service users. However gaps in medication records must be addressed at the earliest possible opportunity and medication must be stored at appropriate temperatures to prevent possible deterioration. EVIDENCE: Care plans were examined and a copy of the proposed new “Quest” format was provided to the inspector following the inspection visit. This is a much clearer format and should enhance the transfer and updating of information. However, attention needs to be paid to the capture and recording of social care Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 10 information in a similarly clear and accessible way, so that staff can fully meet social care needs in an appropriate way. Medication records were checked and with the exception of some inconsistent practice with medication administered on an as required basis, and a very few omissions in recording, the standard was good. In order to ensure that the medication is being appropriately stored records of the temperature of the medication storage must be taken and noted, and action taken if they exceed recommended levels. It is acknowledged that the home has recently changed their pharmacy and that several changes are being put in place that should address these concerns satisfactorily. “I am very well looked after” was one typical comment from a service user spoken to during this inspection visit. Observation of the way that care was provided by staff throughout this inspection visit was very positive and fully supported the views expressed by service users. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 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 the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can influence the way their care is provided and exercise choice over day-to-day decisions concerning them. Visitors are welcome and service users are enabled to access the community including trips organised under the homes activities programme. EVIDENCE: “I am very outspoken and often speak to the Chef….they don’t mind and always offer an alternative” This comment by one service user confirms what service users said in general, that there are a range of activities they can take part in if they choose, that the food is generally very good and provides them with choices and alternatives. The home has won an award under the “Heartbeat” scheme run by Hertfordshire County Council in respect of nutritional content. The activities organiser gave more details of current activities and past or future events inside and outside of the home. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 12 The spring/summer edition of the new “Premier Court Clarion” was seen and indicates that a continuing process of resident/relatives meetings are to take place in the near future. The dining room is pleasantly laid out and the lunch observed appeared to be a social occasion for the service users. It was confirmed that service users are able to have meals in their rooms if they choose. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A robust complaints procedure is in place that provides service users and those responsible for them the opportunity to make a complaint about the service with confidence that it will be dealt with appropriately. Staff now receive appropriate training in what constitutes abuse and how to respond if it is seen or suspected and this should give further confidence to service users that they will be adequately protected from any form of abuse. EVIDENCE: Those members of staff spoken to were aware of what constitutes abuse and were very clear about what action to take if they suspected it. There is a comprehensive and well-publicised complaints policy and procedure in place. The CSCI have not received any complaints about this service since the previous inspection in October 2005. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19 20 24 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home and its environment provide service users with a pleasant, comfortable and safe environment that enhances their lives and provides them with the physical support and assistance they need. EVIDENCE: The home was found to be very clean and there was no noticeable problem with unpleasant smells throughout this inspection visit. One service user noted “It is always lovely and clean, which is very important” The premises were well maintained and the sitting areas were pleasant and varied in size and location, offering a good choice to service users. The new sensory garden is an added facility for those service users able to access it and several service users mentioned the recent opening ceremony. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 15 Those rooms seen, with the permission of the service users, were well furnished and personalised and reflected the service user’s individual taste and interests. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by adequate numbers of care and nursing staff, with the skills, training and support that they require to adequately meet their needs. EVIDENCE: Service users spoken with were very positive about the quality of care that they receive and throughout this inspection visit this view was supported by what was seen and heard. Staff spoken with were impressively positive about working in the home and with the support and training they receive. “We are a good team” was one of the positive comments made. NVQ training is supported and encouraged, at least to level 2, it would be a positive step in the future if consideration could be given to the support available to those wishing to develop their skills beyond this level. The recruitment files for some recently employed members of staff were seen and were satisfactory, providing evidence that the necessary steps to protect service users are in place. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well managed home which provides a high level of care to its service users and supports its staff team to help them meet the needs of service users and to develop their own skills. EVIDENCE: Service users and staff were all positive in their comments about the manager and the way that she manages the home. The manager will shortly complete her Registered Managers’ Award. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 18 The standard of record keeping within the home has been maintained at the previously determined good level, and this can give confidence to service users and those responsible for them that their best interests are being safeguarded. Staff supervision is in place and documentary evidence to support this was provided. However, some staff spoken to appear to be unclear about the frequency of formal supervision, this could be addressed if both parties signed off their one-to-one supervision sessions once they are completed. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 19 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 20 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. 1 Standard OP9 Regulation 13(2) Requirement The storage temperature of medication must be monitored and recorded to ensure that it remains within the approved limit in each case. Appropriate action must be taken if the temperature consistently falls outside of the approved limit. A consistent practice in respect of the recording of PRN medication must be followed. Any gaps in the medication administration records must be identified and acted upon at the earliest opportunity. Timescale for action 03/10/06 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 OP7 Good Practice Recommendations The Manager should monitor the new care plan and DS0000019499.V314574.R01.S.doc Version 5.2 Page 21 Premier Court Nursing & Residential Home 2 3 4 OP9 OP30 OP36 assessment format to ensure that sufficiently full and comprehensive information is obtained, reviewed and updated on the social care needs of service users and that this information is equally accessible to staff as that relating to the health needs of service users. When determining a consistent approach to the recording of PRN medication, the manager should consider obtaining the advice of the CSCI’s Pharmacy Inspector. Consideration should be given in due course to the support of staff in training at NVQ level 3 as part of their personal development programme. Consideration should be given to the signing off of all one to one supervision sessions by both parties to ensure that they are clear that they have taken place. Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Premier Court Nursing & Residential Home DS0000019499.V314574.R01.S.doc Version 5.2 Page 23 - 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. 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