Inspection on 15/02/06 for Quay Court Care Centre

This inspection was carried out on 15th February 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

Quay Court Care Centre 17/12/08

Quay Court Care Centre 11/12/06

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 Annie Foot Unannounced Inspection 15th February 2006 09:35 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.V262498.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. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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.V262498.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 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 chair 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. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was the second inspection of the year. It was conducted over the morning of 15 February 2006. The purpose of the inspection was to follow up on requirements and recommendations made at the last inspection and review progress made in other areas. The registered manager Sue Shute was on duty and present throughout the inspection. 24 residents are currently living at the home, the majority of whom have some form of dementia. Several residents were met during the morning and 9 were spoken with. In addition to the manager, 4 care staff were on duty, also a cook and the housekeeper. All the staff were spoken with. Discussions took place with 3 visitors. Medication, care records and risk assessments were examined. A tour of the premises was undertaken. The manager has an open door policy. With the office being centrally sited adjacent to the dining area, she is easily accessible. What the service does well: What has improved since the last inspection? Signs have been put up around the home to assist residents and visitors in finding their way around the home. Contrasting plain carpet has been fitted on sloping room divides between the communal areas to assist residents mobility around the home. Radiators are now fitted with protective covers. Fail-safe devices have been fitted to most of the taps in bathrooms and residents rooms. Quay Court Care Centre DS0000003784.V262498.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. Quay Court Care Centre DS0000003784.V262498.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 Quay Court Care Centre DS0000003784.V262498.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): Standards in this section were all inspected and fully met at the last inspection. They were not reassessed on this occasion. EVIDENCE: The statement of purpose is clearly on display and available in the reception area. Quay Court Care Centre DS0000003784.V262498.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): 8, 9, 10 Systems in place ensure that resident’s health needs are clearly identified and met in a prompt and timely manner. There is evidence of good multi disciplinary working on a regular basis to meet resident’s health needs. Medication records are well organised and are consistent, in meeting residents needs. EVIDENCE: Residents said that their health needs were well met. A random sample of four residents files were inspected. These contained a Care Plan, Risk Assessment, Doctors/ Nurses notes. Files are well informed and up to date. Care plans and risk assessments are reviewed monthly. Records are clear and concise. The system is well organised. Close working relationships between the home and the local district nursing team assist in addressing health needs without delay. For example the arrangements observed for delivering a pressure-relieving mattress. The district nurse visits the home on most days. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 10 Two residents have said that they would like more regular showers. One said this had been denied another said since raising the matter showers had increased. This was discussed with the manager and had been raised at a residents meeting. Staff confirmed that everyone who administers medication had all received training in the safe handling of medication. 2 residents are able to self medicate. The CD register was checked and tablets counted. This was found to be complete. There is a good storage for medication. A photo of each resident is on display within the medicine cupboard together with a detail of each individual’s medication and how it is administered. This is an example of good practice, to describe exactly who is receive what medicine and how. Staff were observed to be respectful towards residents and to knock on bedroom doors before entering. A member of staff gave an example of respecting a residents view by using a napkin at meals rather than apron, which the resident didn’t like to use. Some residents have their own telephone in their room. A pay phone is also available. Staff said they assist residents with choosing clothes but always left the final decision of what to wear to them. Quay Court Care Centre DS0000003784.V262498.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): 13,14,15 Residents are supported in maintaining contact with family, friends and the local community. Residents exercise choice and control over their daily lives maintaining independence and dignity. The dietary needs of residents are well catered for, although a review of residents likes and dislikes would improve choice. EVIDENCE: Visitors were observed to pop in and out through the morning. Visitors said they were also made welcome and could come at any time. Many of the residents talked about the frequency of visits they received. Visitors are able to join their relative or friend with meals in the dining room. Involvement and contact with the local community is encouraged. One resident was particularly appreciative of the help received by staff in arranging a “bridge four” between her and friends. Residents receive a daily newspaper and magazines of their choice. Residents said that activities are limited. One person said they thought activities were going to start soon. The manager is aware that this is an area that needs more work. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 12 Residents are encouraged to handle their own financial affairs for as long as they have capacity. Families support many of the residents in this respect. The manager has an open door policy and residents may access their records at any time. All the bedrooms seen were individualised. Personal possessions and pieces furniture may be brought into the home. A four-week menu is in place. Alternatives are not routinely displayed on the menu but the cook confirmed that a vegetarian option is always available. She said that she believed menus are discussed at residents meetings. Birthday cakes are made on resident’s birthdays. The manager had provided chocolate hearts on Valentines Day. A lovely touch. Some residents said they liked the food, others said there was a limited choice. One person said that they had never been asked about likes or dislikes. Tea is provided at 5.00p.m and comprises for example, soup, sandwiches jelly and tea. Some residents felt that 5.00 p.m was too early for supper, although drinks and biscuits were available after this time. Lunch on the day of the inspection comprised Roast Pork, roast potatoes, cabbage and carrots. It looked appetising and residents said it was very good. Staff were observed to be on hand to assist. The menu is displayed on the dining room wall. It was not easy to read. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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 Residents can feel confident that there are systems in place to manage issues of concern, complaint or allegations of abuse. EVIDENCE: Four complaints have been received since the last inspection. The complaints book was examined. There is a robust procedure in place. All complaints had been investigated and 3 resolved. The one outstanding complaint was received on 7/2/06 and is in the process of investigation. Action taken is clearly recorded. It is recommended the outcome of each complaint be stated on records to complete closure. Residents are aware of the complaints procedure but some said they would be reluctant to raise issues with busy staff. The manager attended external training in the protection of vulnerable adults in 2003. Senior staff have not yet attended external training, but all staff do receive in house training on abuse. Staff spoken to confirmed they had received training and were able to explain the procedure to follow in suspected cases. There have been no allegations of abuse in the last year. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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): 21,22,24,25,26 Residents live in attractive, well-maintained surroundings, which are clean and hygienic, with their own personal possessions around them. EVIDENCE: The home is well maintained and furnished to a high standard. Several resident bedrooms were seen. Rooms are of varying sizes and layout. All those seen had been individually personalised with items and possessions brought from home. Residents may bring in pieces furniture and these too were seen. Residents rooms are identified by number and by a suite named after a tree e.g. Holly, Rowan, Ash, Acer. Some numbers had either come down or removed from bedroom doors, which is confusing. A fastening device to the upstairs bathroom has been fitted. Radiators are now all covered. However, this appears to restrict the temperature in some of the resident’s rooms. The manager is aware of the problems this has created and residents are able to request a freestanding oil filled radiator where this is a problem. Some residents did say they felt cold at times in their rooms but said they did not want to complain. In one room Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 15 where the temperature appeared chilly, it was noted that the controls on the freestanding radiator could not be reached by the resident; the radiator not on. A member of staff promptly attended to the issue once brought to their attention. Fail-safe devices have been fitted to bathrooms and basins in the home, apart from 2 toilets adjacent to the residents lounge. The manager confirmed these were expected to be fitted the following day. Safety signs are displayed above the basin in these toilets warning users of unregulated temperatures. The temperature in both toilets was tested and in one, found to be in excess of 50oC. In discussion with the manager it was agreed that where residents are confused or had memory loss their remains a potential risk of scalding until the work is completed. The housekeeper was observed in her cleaning duties. The home is thoroughly cleaned daily and is hygienic. Plain strips of carpets have been inserted to break up the patterned carpet between rooms, making it easier for residents to manoeuvre safely. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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 Service users benefit from experienced skilled staff. Sufficient numbers of staff on duty ensure resident’s needs are promptly addressed. EVIDENCE: All of the staff were spoken to during the inspection. One staff member said staff “work as one big family”, supporting and assisting each other. Other staff said that the home was a lovely place to work. All confirmed that they received regular training and felt well equipped to perform their duties. Staff spoke warmly about their relationships with residents. Interaction between staff and residents was positive Residents said that most of the staff are very helpful and caring. Although one or two residents felt that some staff could be “rather abrupt “. One resident complimented the night staff in particular, saying nothing was ever too much trouble for them. There is a key working system in place. The manager said this was not working as well as she would like. The system is being reviewed to ensure that individual contact with residents is improved. Regular staff meetings are held which are valued by staff. Staff confirmed that they received regular supervision and an annual appraisal. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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): 32,35 Resident’s benefit from open and approachable management. There are systems in place to ensure that resident’s finances are appropriately maintained, to safeguard resident’s interests. EVIDENCE: The registered manager provides a clear sense of direction and leadership throughout the home. She encourages a happy and relaxed atmosphere within the home. Staff said the manager was very approachable and supportive. She was said to provide lots of encouragement and always has time for the staff. Residents meetings are held at the home. The last meeting was held 12 February 2006, attended by 12 residents. Meetings are recorded and show that a range of issues was raised, discussed and a timescale agreed for action. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 18 Residents are encouraged to mange their own finances for as long they have capacity. Monies are held for twelve of the residents. Families support other residents. All transactions are recorded. Financial records were examined and found to be consistent and up to date. A fire door was seen held open with a stool, during the tour of the building. Fire doors must not be held open at any time. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 2 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x x 3 x x 2 Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 20 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 OP25 Regulation 13 Requirement The registered provider must ensure that all hot water outlets, accessible to service users is regulated to 43o C (Previous timescale of 24/12/05 not met). This relates to the need to resolve the temperature of water in the two downstairs toilets used by residents. Fire doors must not be held open at any time. Timescale for action 31/03/06 2 OP38 23 (4) 15/02/06 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 2 Refer to Standard OP12 OP15 Good Practice Recommendations To develop an activity programme that meets resident’s interests. To consider alternative methods of displaying the daily menu so that residents know what is on offer in advance. To ensure that residents likes and dislikes are discussed and recorded. To clarify recording of the outcome of complaints to DS0000003784.V262498.R01.S.doc Version 5.1 Page 21 3 OP16 Quay Court Care Centre 4. 5 OP18 OP25 complete closure. Senior care staff should attend the multi agency adult protection training. To establish a system for monitoring the temperature of resident rooms during cold weather to ensure residents are comfortable at all times. Quay Court Care Centre DS0000003784.V262498.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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