Inspection on 06/10/08 for Providence Court

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good 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

Providence Court 22/11/06

Providence Court 16/01/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Providence Court Providence Way Baldock Hertfordshire SG7 6TT     The quality rating for this care home is:   two star good 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: Bijayraj Ramkhelawon     Date: 0 6 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. that people have said are important to them: They reflect the things 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 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 23 Information about the care home Name of care home: Address: Providence Court Providence Way Baldock Hertfordshire SG7 6TT 01462490870 01462499067 providence@quantumcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Quantum Care Limited Name of registered manager (if applicable) Mrs Jackie Beaumont Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The home was first registered under the Registered Homes Act 1984 with Hertfordshire County Council on 9th May 1995. 0 0 0 Over 65 61 61 61 care home 61 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 Care Homes for Older People Page 4 of 23 Brief description of the care home reception lobby, sun lounge, the administrators office, the managers 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. The fees for the service range from £420.00- £590 per week (as 06/10/08). A copy of the Statement of Purpose, Service users guide and the last inspection report is available from the care home on request. Care Homes for Older People Page 5 of 23 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: two star good 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 unannounced key inspection took place on 6th October 2008. It included talking to residents, staff and visitors, examining a sample of care plans, staff training records and their files, records relating to the management of medicines, Fire and Health and Safety records, maintenance records, all other relevant records and documents and a tour of the premises. Observation was made of staffs interaction with the residents at lunch time and other activities. The registered manager has completed an Annual Quality Assurance Assessment (AQAA). This is a self assessment document that looks at how the service is meeting the needs of residents and also provides us with some numerical information. Information from this assessment has benn reflected in the report. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 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 23 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 23 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. People deciding to use the service can be assured that their needs would be assessed and met by the home. Evidence: Information about the home was available to current and prospective residents including the Statement of Purpose and Service Users Guide. These documents should help prospective residents and their families in deciding whether to use this service or not. Care plans examined and information gained from people using the service and members of staff indicated that individuals are admitted to the home after a comprehensive assessment of needs has been carried out. This assessment should help staff at the care home to decide whether they would be able to meet the identified needs of the resident and whether additional support or equipment is Care Homes for Older People Page 10 of 23 Evidence: required. Care Homes for Older People Page 11 of 23 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. People using the service can be assured that their health and personal care needs would be planned in accordance with their needs and wishes and delivered in a manner that respects their privacy and dignity. Evidence: Residents spoken to said that they were being well looked after and that their identified needs were being met and were complimentary of the staff and the care they received. 6 Care plans were examined and these included residents details on admission, their history and life, plans of care as per identified needs, risk assessment in relation to manual handling and falls, Waterlow charts for pressure sore risk assessment, nutritional assessments, activity plans, daily progress report, care plan monthly reviews, weight charts and other health care observations (assessment of needs were kept separately in the main office. However, care plans were devised as per identified needs). Where individuals Waterlow pressure sore assessment charts have been scored as very high risk a specific plan of care should be devised to indicate how these risks could be minimised and managed so as to prevent the Care Homes for Older People Page 12 of 23 Evidence: residents from developing pressure sores. There are policies and procedures for the management and administration of medicines that show that medicines were being handled and administered safely. However, there were medicines stored in the medicine room on open shelves that were exposed to direct sunlight and a record of the temperature of this room has not been kept nor a room thermometer provided. Thus, the home is unable to assess whether medicines are being stored within the manufacturers recommended temperature. It was also noted that medicines returned to the pharmacy for disposal have not been signed by the pharmacist to acknowledge or to indicate that these medicines were taken away and are no longer in the care home. Staff spoken to said that they were aware of the rights of residents to make choices about their lives and the need to ensure their privacy and dignity is respected. They also commented that the home does well because the staff worked as a team and are very caring. Care Homes for Older People Page 13 of 23 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. People living in the home benefit from the variety of activities provided that are appropriate to their needs and from the support they receive by a team of experienced and qualified staff team. Evidence: A variety of activities are provided for residents who said that they are able to choose which ones to take part in. Some residents said they preferred to stay in their room and do their own things but they also said that they do join in selected activities. Where possible some residents are facilitated to access local community facilities and amenities e.g shopping to the local supermarket and shops. Residents were complimentary of the food offered and alternatives were also provided. Staff were observed to be assisting residents with their meals in a discreet and sensitive manner. There was a weekly menu that offered choice of meals and residents spoken to said that they were happy with the food provided. Care Homes for Older People Page 14 of 23 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. People using the service can be assured that their concerns and complaints would be listened to and acted upon and that they would be safeguarded from abuse, neglect and harm. Evidence: The home has a complaints procedure and information on complaints is also included in the Service Users Guide and the Statement of Purpose. Residents spoken to said they are aware of how to go about making a complaint and expressed confidence that their concerns and complaints will be listened to and acted upon. The home maintains a record of complaints and two were received since the last inspection and 26 compliments were received during the same period. The home has a copy of the Hertfordshire County Council procedures on Safeguarding Adults. Staff spoken to confirmed that they are familiar with these procedures and staff records showed that they have received this training . An element of adult protection is also covered in the induction programme for all new staff members and those people undertaking the NVQ assessment. Care Homes for Older People Page 15 of 23 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. People using the service are cared for in an environment that is homely, comfortable and safe. Evidence: The home was kept clean and reasonably well-maintained. However, there were lots of debris behind the washing machines in the laundry room that had gathered a thick layer of dust. These should be removed and kept clean so that the health of staff and residents using this room are protected. Residents spoken to said that the home was comfortable and homely. They also said that they were happy with their bedrooms and they were able to bring their personal possessions and belongings. Staff spoken to confirmed that they had undertaken training in infection control. protective clothing and gloves and hand washing facilities were provided. Staff said that they adhered to the policies and procedures so as to control the spread of infection. As stated in the AQAA, the manager will within the next twelve months continue with their programme of redecoration and will continue to listen to the residents and their visitors on their views on how to improve the environment. Care Homes for Older People Page 16 of 23 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. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policy and practices Evidence: Adequate levels of staff are rostered on duty to support the number of residents in the care home. 6 staff files were examined and these were found to have all the necessary documents including two written references for each staff and Criminal Records Bureau (CRB) checks were carried out before employment so that residents would be safe and protected. New staff undergo a programme of induction and all staff are provided with training relevant to their work so that they are well equipped to perform their tasks in supporting the residents. Staff spoken to confirmed that they received one to one formal supervision on a regular basis. They also said that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the people using the service. Staff were very knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, there are 40 care staff employed of whom 75 have completed the NVQ Level 2, thus indicating that the majority of staff are qualified in supporting to meet the needs of the residents. Care Homes for Older People Page 17 of 23 Care Homes for Older People Page 18 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health, safety and welfare are protected by the systems and practices in place and the support they receive from an open and transparent management team. Evidence: People using the service have commented positively on the good practices and quality of care and support they received. Staff spoken to said that the management team was approachable and supportive. The views of residents and staff are sought in order to improve the quality of care provided. However, it was noted that risk assessments were not carried out for people using the electric reclining chairs. This should be undertaken with a support plan in order to ensure that the identified risks are managed appropriately so that residents are not put at risk. Fire Safety Regulations were maintained and regular testing of fire alarm systems and fire drills were carried out. This practice should ensure that staff are kept up to date with these regulations and are confident of applying safe practices should an incident occur. All statutory Care Homes for Older People Page 19 of 23 Evidence: records were available for inspection and maintained in accordance with legislation to ensure that the safety of people in the home is promoted. Records inspected were up to date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. A valid insurance certificate was displayed in the notice board and this offered cover of no less than Five million. This certificate expires on 01/07/2009. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 8 Where individuals Waterlow pressure sore assessment charts have been scored as very high risk a specific plan of care should be devised to indicate how these risks could be minimised and managed so as to prevent the residents from developing pressure sores. The temperature of the room where medicines are stored should be recorded and monitored so that it does not exceed the manufacturers recommended level. Medicines returned for disposal should be signed by the pharmacist to indicate that these medicines have been taken away and are no longer in the care home. The debris behind the washing machines that are layered with dust should be removed so that people working in this environment are protected. A risk assessment should be carried out for the use of electric reclining chairs including a action plan of how to minimise and manage the identified risks so that residents are not put at risk. 2 9 3 26 4 38 Care Homes for Older People Page 22 of 23 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 © (2009) 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 23 of 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. 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!