Inspection on 11/12/06 for Quay Court Care Centre

This inspection was carried out on 11th December 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

Quay Court Care Centre 17/12/08

Quay Court Care Centre 15/02/06

Quay Court Care Centre 24/08/05

Quay Court Care Centre 06/01/05

Quay Court Care Centre 24/08/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Quay Court Care Centre Squares Quay Kingsbridge Devon TQ7 1HN Lead Inspector Margaret Crowley Key Unannounced Inspection 11th December 2006 11:00 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 Quay Court Care Centre DS0000003784.V314702.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. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quay Court Care Centre Address Squares Quay Kingsbridge Devon TQ7 1HN 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) 01548 852540 01548 852540 Quay Court Care Centre Limited Mrs Susan Jane Shute Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: The Quay Court Centre is part of a group of homes known informally as The Court Group. It is registered to care for thirty older people who may also have a mental disorder, dementia, and /or a physical disability. Accommodation is provided in en suite rooms. There are spacious communal areas and a garden and patio area. There is a passenger lift and stair lifts. Aids and adaptations are provided to meet service users needs. The premises are situated adjacent to the quay in Kingsbridge and have pleasant views and access to local amenities. Fees currently range from £370-£460 per week. Written information regarding the home and the services provided is on display and is given to prospective and new residents. A copy of the most recent CSCI Inspection report is available. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place took place over 6 hours on 11th December 2006. Mrs Sue Shute, the registered manager, was on duty throughout the inspection. Mrs Sally Brazier, the responsible individual, was present during part of the inspection. A tour of the premises was made. Many of the 22 residents in the home on that day were spoken to, including 5 in more depth, regarding the lifestyle in the home and the care services they receive. Five staff on duty were observed and spoken to in the course of their daily duties. In addition, 2 relatives were spoken to during the inspection and two via the telephone. Records were inspected including care and staff records. Comment cards were received from the community nursing service, social services and general practitioners. Feedback questionnaires were received from 10 residents and two relatives. Feedback questionnaires were also received from 10 staff. What the service does well: What has improved since the last inspection? New stair lifts have been installed to ensure the safety of residents. Temperature control devices have been fitted to all hot water taps to prevent the risk of scalds. Residents’ views are actively sought regarding the choice of activities and these are displayed in residents’ rooms. Quay Court Care Centre DS0000003784.V314702.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. The summary of this inspection report can be made available in other formats on request. Quay Court Care Centre DS0000003784.V314702.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 Quay Court Care Centre DS0000003784.V314702.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives receive good information to assist them in making a decision to live at the Quay Court Care Centre. Admission procedures ensure that residents’ needs are assessed and known prior to their admission. EVIDENCE: Residents who had been admitted recently said that staff had been welcoming and kind when they had arrived and had helped them to settle in. This was seen demonstrated when a new resident arrived on the day of the inspection. A service user guide is provided in a resident’s room on admission. The service user guide and statement of purpose are reviewed regularly. A sample of service users’ records was examined and evidence was seen of informative pre- admission assessments undertaken with residents. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 9 Information from other agencies was also available, including Social Services care plans for temporary residents receiving respite care. Discussions with the management demonstrated that they continue to be mindful regarding the kind of prospective residents’ needs that they are able to meet. For example, because of the layout and location of the home, which is close to a busy car park, the premises are not suitable for those residents with dementia who have high levels of needs, and who are known to wander. A written contract is provided for each resident and examples were seen of contracts signed by the resident or their representative. The home does not provide intermediate care. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards7, 8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal care needs are met with respect and privacy. Systems are in place to ensure that residents’ health needs are clearly identified and met in a prompt and timely manner. EVIDENCE: All of the residents who responded to the questionnaire said that they always receive the care and support they needed. Those spoken with commented that staff “ always come if I need to call them”, and “will ask me if I want a hot drink if I can’t sleep”. The home employs both male and female care staff. Residents said that they are given the choice of whether they wished male or female care staff to assist them with their personal care. Staff were described as polite and were observed to be respectful towards residents and to knock on bedroom doors before entering. Feedback from the community nursing service and general practitioners was positive regarding the health care provided. Health professionals said that their Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 11 assistance was sought appropriately, and that staff were always quickly available when they visited. Residents said that their health needs were well met. A complaint was received prior to the inspection from a former resident’s relative regarding the healthcare provided. However, health and social services professionals had no concerns regarding the manner in which the resident’s health needs had been addressed and the complaint was not substantiated. A sample of residents’ records was inspected and contained a Care Plan, Risk Assessment, Doctors/ Nurses notes and Daily Records. Records were clear and concise. Care plans and risk assessments are reviewed monthly. However, there was little evidence of residents or relatives involvement following the initial care plan. Residents and relatives sign to say whether or not they wish to be consulted in the monthly reviews, but their view should be recorded at times of major changes in the care plan. The inspector was shown a proposed new care plan and recording system. This is more person centred and comprehensive than the one currently in use. There are clear systems for the storage and administration of medicines. Risk assessments were in place for residents who wish to self-administer medicines. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents are enabled to live a flexible lifestyle with activities available to provide interest for them. Residents are provided with a nutritious and well-balanced diet. EVIDENCE: Residents said that they can choose how they spend their time and that they are consulted regarding the choice of activities. Evidence of the activities provided is displayed in residents’ rooms and residents are encouraged to make suggestions. During the inspection one relative offered to organise a flower arranging session. Residents are involved with the local community. The home is located in a central position in Kingsbridge, which provides good access for visitors. Visitors said they are made welcome and residents confirmed that visitors can join them for a meal in the dining room. Some residents choose to spend time in their own room and enjoy informal time spent individually with staff, for example in having their nails manicured, Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 13 or in participating in reminiscence sessions. Residents can take their meals in their rooms, but are encouraged to take the main meal of the day in the dining room to avoid become isolated from other residents. Most residents spoken with praised the quality and quantity of the meals and said their likes and dislikes are catered for. A minority of residents wanted more choice at teatime, and fish on the menu more often. Special diets are provided for and there is a varied rotating menu. The midday meal seen during the inspection was of a good standard. Residents’ meetings are held regularly and the minutes displayed on the notice board. Residents have the opportunity to make their needs and choices known in these meetings and via the quality survey. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents can feel confident that there are systems in place to manage issues of concern, complaints or allegations of abuse. EVIDENCE: There is a clear complaints procedure. Three complaints have been received by the home since the last inspection and were recorded in the complaints book, with action taken. Residents said they would speak to the senior care assistant or the manager if they had a complaint, or would tell their relative who would deal with it on their behalf. The Commission has received one complaint since the last inspection, referred to earlier in this report. In discussion with the manager and responsible individual following this complaint, it was suggested that the manager and staff attempt to pre-empt complaints from being referred after the event, by giving more encouragement to residents and relatives to raise any concerns at the time, so they can be addressed. There is an adult protection policy and procedure which is accessible to staff. All staff receive in-house training in adult protection. The manager has attended the multi agency adult protection training, but not senior staff. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,22,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in accommodation that is safe, attractive, clean and comfortable. EVIDENCE: Quay Court is well maintained and furnished to a high standard. A tour of the premises took place and all residents’ rooms were seen. The home was clean, hygienic and free from unpleasant odours, other than in one room where the resident has an incontinence problem, which is addressed. New stair lifts have been installed to ensure the safety of residents. Temperature control devices have now been fitted to all hot water outlets accessible to residents, to prevent the risk of scalds. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 16 Although some improvements have been made in signage within the building, residents’ doors on the lower ground floor do not have a room number. No residents’ rooms have their name on them to assist new residents and those with memory loss. The lower ground floor bathroom and toilet do not have signs. The fastening on the first floor bathroom door was broken and the toilet adjacent to the lounge would not lock, to ensure privacy. Discussions took place with the registered manager and the responsible individual regarding the difficulties in accommodating service users in the three smaller rooms who require to be lifted with a hoist. This issue has arisen with residents whose needs have increased. The responsible individual said that an appropriate hoist will be purchased for use in these rooms. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Sufficient staff are employed to meet the care needs of the current residents. Staff are provided with training opportunities to enable them to develop their knowledge and skills in caring for residents. EVIDENCE: The responsible individual and the registered manager said that there are sufficient staff employed to meet service users needs by day and by night. Staff rotas were inspected and the registered manager and responsible individual confirmed that staffing levels are kept under review dependent on the needs of the service users. At the time of the inspection there were 22 residents in the home. There was one waking night staff and one who sleeps on the premises, on call. This is changed to two night staff who are awake, when the number of residents increases. Residents spoken to said that staff were accessible and available without undue delays if they needed to call for assistance. Communication seen between staff and residents was friendly and positive. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 18 There is a range of experience within the staff group and 50 of the staff currently hold National Vocational Training certificates at level two or above. Two staff are currently completing the qualification. There is a staff training plan and staff have attended a range of in-house courses in the past year, which includes mandatory training in fire and health and safety matters. Discussions with the responsible individual and the registered manager highlighted the need for further staff training in caring for people with dementia and mental illness, categories for which the home is registered. Records were inspected of staff recently employed and provided satisfactory evidence of the recruitment and the induction processes. Criminal Record Bureau disclosures and Protection of Vulnerable Adults Checks were not available for inspection as these are processed centrally and the manager informed when enquiries are complete. The responsible individual agreed to send information to the inspector. Ten staff surveyed all responded positively to questionnaires and confirmed that they received regular supervision, an annual appraisal and regular training. They said they were well supported by the manager and work together as a team for the benefit of the residents. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Quay Court Care Centre is well managed with clear efficient systems in place. Residents live in a home where attention is given to their health, welfare and safety. EVIDENCE: Susan Shute, the registered manager, holds the Registered Managers Award and NVQ 4 in Care. She has many years experience in working in the care of older people including several as the manager. The home is managed efficiently and she works with the staff team to create a homely environment. Residents’ financial records were examined and were in order. There are clear systems in place to ensure that residents’ finances are appropriately maintained, to safeguard residents’ interests. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 20 There are monthly quality audits and an annual quality assurance survey to gain the views of service users, relatives and staff. The results made available to residents and included the service user guide. An annual development plan published. Regular meetings are held for residents and staff. Routine health and safety issues are managed well and records inspected were maintained up to date and accurate. Fire and accident records were in order. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 21 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X 2 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 3 X 3 X X 3 Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP30 OP19 OP22 Good Practice Recommendations The resident and or his or her representative should be involved in the review of the care plan particularly when the residents needs change. Staff should receive further training in caring for residents with dementia and mental disorders. Locks on bathroom and toilet doors should be maintained in good working order to ensure residents’ privacy. Although some improvements have been made in signage within the building, some residents’ doors do not have a room number. Residents’ rooms and a bathroom and a toilet do not have names or symbols to assist new residents and those with memory loss. Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 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 © 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 Quay Court Care Centre DS0000003784.V314702.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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