Inspection on 16/01/06 for Providence Court

This inspection was carried out on 16th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Providence Court 06/10/08

Providence Court 22/11/06

Providence Court 23/11/04

Providence Court 20/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Providence Court Providence Way Baldock Hertfordshire SG7 6TT Lead Inspector Mrs Alison Butler Unannounced Inspection 16th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Providence Court Address Providence Way Baldock Hertfordshire SG7 6TT 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) 01462 490870 01462 499067 www.quantumcare.co.uk Quantum Care Limited Mrs Jackie Beaumont Care Home 61 Category(ies) of Dementia - over 65 years of age (61), Old age, registration, with number not falling within any other category (61), of places Physical disability over 65 years of age (61) Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: `The home was first registered under the Registered Homes Act 1984 with Hertfordshire County Council on 9th May 1995. Providence Court is a purpose built home for the elderly situated in a quiet cul-de-sac in a residential area of Baldock, within walking distance of all amenities. Accommodation is provided in four self contained units, two on each floor and a passenger lift is fitted. Each unit comprises 15 single bedrooms (there is one that is located between two units) with en-suite toilet and wash hand basin facilities, kitchen and dining room, lounge and assisted bathroom. The ground floor also comprises a reception lobby, sun lounge, the administrator’s office, the manager’s office, the main kitchen and the laundry room. There is ample car parking to the front of the home and a very large garden. The aim of the home is to ensure that the residents are given care that respects their privacy, dignity and rights; it also encourages independence depending on the needs of the individuals. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 2 inspectors spent a total of 7 hours in the home carrying out this unannounced inspection. This inspection concentrated on the requirements, recommendations and core standards that were not inspected on the previous occasion. Discussions were held with staff and residents in the home. Care records were examined. Where standards remain the same the information has been brought forward. What the service does well: What has improved since the last inspection? Staff have been made aware of the whistle blowing policy through staff meetings and individual supervision. The home are recording alternatives food choices offered to residents. Staffing levels appear appropriate to meet the personal care needs of the present residents. A deputy has been newly appointed and she appears very committed to ensuring the residents receive the best care. She also supports the manager in the administrative tasks. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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 Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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): Not inspected EVIDENCE: Not inspected on this occasion. See previous report dated 19th June 2005 for comments. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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 Good quality information is recorded. Knowledgeable and experienced staff support the residents. They receive a good quality of care. EVIDENCE: Staff were observed delivering care in a manner that showed respect, privacy, dignity and promoted independence where possible. Information on the care plans remains at a high standard and risk assessments were in place. The manager should look at ensuring the risk assessments are more personal to the individual and not just by using their name but look at other information relating to them. For example a resident who is self medicating should have details recorded and, where they hold that medication, any risk for that individual or others, who is to check etc. Staff need to be reminded that they sign and date any additional information when it is added On examination of the medication again a number of issues were again identified, recording of given as required medication (prn) needs to be improved to allow for reconciliation. For example, a recording method that Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 10 would maintain a running balance. If the medication is given to the family when a resident is leaving the home staff must not sign the MAR sheet, as this would indicate that they have administered it. A risk assessment should be completed and where possible the family should sign and take responsibility for the administration. All medication leaving the home must be recorded in the returns book to allow for a complete audit trial. At present any medication that is returned in the dosetted box is not recorded and therefore cannot be audited. Staff must ensure that residents do not run out of prescribed medication as on one unit two residents had run out of their prescribed creams. Staff should remember that when handwritten instructions are placed on the MAR sheet should be signed by the author. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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 The residents maintain contact with family, friends and the community as chosen. Activity plans are being introduced and encourages integration and further stimulation. EVIDENCE: A member of the care staff has taken on the role of activities co-ordinator and is currently putting together an activity plan that will be in a pictorial format. Residents spoken to have enjoyed the activities on offer especially over the Christmas period, they were able to choose which ones to take part in. Where possible some residents are assisted to visit the local community and do some personal shopping at the local supermarket. Residents were observed reading their newspapers, watching TV and listening to music. Relatives said they were always made to feel welcome and were happy with the care provided at Providence Court. Residents were complimentary about the food offered and alternatives are recorded. Staff were observed encouraging independence and providing appropriate support at lunch time. Some residents had chosen not to eat their meal in the lounge and their own bedrooms and this was taken to them on a tray. On Boxing Day the kitchen had become unoperational due to a major leak and therefore ovens on the units and the day centre had to be brought into use to provide residents with a hot meal. The residents had enjoyed the ham, egg and chips that were provided at short notice. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 Robust procedures are in place to ensure the protection of the residents. EVIDENCE: A complaints procedure is available. Resident were aware of who to speak to if they were unhappy about any aspect of their care and felt confident that it would be dealt with appropriately. Those staff spoken to were aware of the whistle blowing policy and some had receive training in adult protection and abuse. Quantum Care as an organisation keep the Commission For Social Care Inspection informed of all serious complaints and their actions and outcomes. Records are also held within each home appropriately. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 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 the following standard(s): 19 & 26 The home is clean, and reasonably well maintained. Regular checks are carried out on services and equipment. EVIDENCE: The home was well maintained both internally and externally with the exception of the kitchen. There had been a major water leak over the Christmas period in the kitchen this had made it unoperational for a short period. This appeared not to have a detrimental effect on the residents and they still received a hot meal. The manager stated they were waiting for their insurance company to sort out the repair. The laundry facilities are adequate to meet the needs of the residents and they all looked well kempt on the day of the inspection. Policies and procedures are in place for the prevention of infection. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 14 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 Robust recruitment procedures are in place to ensure the residents are protected at all times. The numbers of staff and the deployment appears to meet the needs of the residents. EVIDENCE: Two staff files examined showed that all the relevant checks had been carried out prior to staff commencing employment, which ensure the protection of the residents. There were 9 care staff on shift on the day of the inspection plus the deputy, care team manager and manager and this was felt adequate to meet the personal care needs of the residents in the home at the time of this inspection. One member of the care team now covers care up till 10am and then has taken on the role of daily activities co-ordinator, she is in the process of putting together a plan having talked to the residents about their likes and dislikes. Staff confirmed the units are no longer left unattended. Quantum provide an on-going training programme to ensure staff have regular updates on care practise and ensure they are competent to carry out their role. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 15 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 There is a good management structure in place and an area manager also supports the management in the home. Care staff are supervised in their day to day work and also through formal supervision. The manager ensures the standards are maintained. The welfare health and safety of residents is protected at all times. EVIDENCE: The manager continues to update her own training and that she is conversent with current care practice. All staff spoken to stated they receive regular supervision and regular staff meetings are held. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 16 All statutory records were available and well maintained with the exception of the medication records. Policies and procedures are in place to ensure the welfare, health & safety of all residents, staff and visitors is maintained. A spot check was carried out on residents monies held in the home these were well kept and they had recently had an external auditor in to check records and procedures etc. All accidents and incidents were well documented and the Commission For Social Care Inspection had been informed as appropriate. Regulation 26 reports are carried out although these are not receive by the Commission For Social Care Inspection in a timely manner, the last received was in August 2005. The organisation must ensure that these are received by the Commission For Social Care Inspection on a monthly basis. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X 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 2 X X X X X 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 2 X 3 3 X 2 Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 manager must ensure that medication procedures are followed: *A reconciliation of medication must be able to be carried out at any point in time. *Residents must not run out of prescribed medication especially creams. *All handwritten instructions must be signed by the author. *All medication for disposal must be recorded to allow an audit trail. *Staff must not sign if they do not witness the administration of medication The proprietor must ensure that reports are received by the Commission For Social Care Inspection on a monthly basis Timescale for action 16/01/06 2. OP33 26 16/01/06 Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP7 OP7 Good Practice Recommendations Staff should sign and date additional information that is added to the care plan. Where generic risk assessments have been written these should be individualised for a specific residents and not just by adding their name. Providence Court DS0000019502.V277923.R01.S.doc Version 5.1 Page 20 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. 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