Inspection on 17/12/08 for Quay Court Care Centre

This inspection was carried out on 17th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Quay Court Care Centre 11/12/06

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 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Quay Court Care Centre Squares Quay Kingsbridge Devon TQ7 1HN     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: Judy Hill     Date: 1 7 1 2 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 26 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 26 Information about the care home Name of care home: Address: Quay Court Care Centre Squares Quay Kingsbridge Devon TQ7 1HN 01548852540 01548852540 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Quay Court Care Centre Limited Name of registered manager (if applicable) Mrs Janet Reeve Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who may be accommodated is 38. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Physical disability aged 65 years and over on admission (Code DE(E)) Dementia aged 65 years and over on admission (Code DE(E)) Mental disorder aged 65 years and over on admission (Code MD(E)) Date of last inspection 0 0 0 0 Over 65 38 38 38 38 care home 38 Care Homes for Older People Page 4 of 26 Brief description of the care home 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 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 £380 to £520 per week and are based on the quality of the room. Care Homes for Older People Page 5 of 26 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 inspection included an unannounced site visit that was carried out on 17th December 2008. During the site visit we spoke with several residents as well as management and senior staff, care workers and visitors to the home. We carried out an inspection of the premises and looked at some of the homes records, including samples of residents needs assessments and plans of care, staff recruitment and training records, medication records, menus and staff rotas. Additional information was gathered prior to the site visit from a Annual Quality Assurance Assessment completed by management and surveys completed and Care Homes for Older People Page 6 of 26 returned to the Commission by some of the residents and staff. We also looked at the previous inspection report and notifications and correspondence between the Commission and the home since the last inspection. 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. Care Homes for Older People Page 8 of 26 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 9 of 26 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 10 of 26 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. The people who use the service or their representatives have the information needed to make an informed decision about the ability of the home to meet their needs. Evidence: A folder is kept in the main entrance hall of home, which contains a copy of the homes Statement of Purpose, a brochure that includes the aims and objectives of the Court Group and the latest inspection report. We asked if each of the residents were given a copy of a Service Users Guide and were told that they were not, although they do have contracts for the provision of services from the registered providers. The pre and post admission needs assessments of the two most recently admitted residents were inspected and found to be detailed and well presented. Care Homes for Older People Page 11 of 26 Evidence: The residents spoken with during the inspection and those that returned completed questionnaires to the Commission before the inspection told us that either they or their families had received the information they needed to make an informed decision the suitability of the home before they moved in. Care Homes for Older People Page 12 of 26 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. The health and personal care that people receive is based on their assessed needs. Evidence: The care plans seen were well detailed and clearly presented. Some risk assessments and management plans had been included to provide guidance for the care staff. The residents told us that the care staff kind and that they are meeting their care needs. Quay Court does not provide nursing care. Visits by doctors and district nurses are recorded and these tell us that timely referrals are being made as and when necessary. Prescribed medication is kept in locked cabinets. At the time of the inspection these were cabinets were being kept in the dining room but we were told that this was a temporary arrangement and that they are usually stored in a locked cupboard. The home has suitable storage facilities for controlled medicines and medicines that require refrigeration. Care Homes for Older People Page 13 of 26 Evidence: One resident handles her own medicines. We were told that each of the residents was asked if they would like the staff to handle their medicine for them and that risk assessments would be carried out if a resident said that they would like to manage their own medicines. The staff who assist the residents with their medicines receive training to ensure that they do so safely. Paracetamol are kept for general use and we were told that checks are made to ensure that this is compatible with prescribed medicines before it is given to a resident. Each of the residents has their own private bedroom that they can lock from the inside to ensure that their privacy is maintained when they receive private or professional visitors. The residents are not able to lock their bedrooms from the outside because they are not given keys to do so and because the same key operates all of the locks. The residents told us that a telephone is available if they wish to make or receive calls. Care Homes for Older People Page 14 of 26 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. The people who use the service are encouraged to continue to make choices in their daily lives and routines. Evidence: On the day of the site visit a Christmas concert performed by children from a local primary school was taking place. We were told that this is a annual event. Most of the residents attended the concert but some residents choose to remain in their bedrooms and their wishes were respected. Regular in house activities are arranged and details of these are posted on a notice board in the home. The staff told us that occasional group outings are arranged for the residents. Each of the residents has a key worker and two key workers told us that part of their role as key workers is to do personal shopping for residents. Both said that they enjoyed taking the residents out to do their own shopping. The Statement of Purpose tells is that visitors are welcome at any time and that Care Homes for Older People Page 15 of 26 Evidence: arrangements can be made for them to be served a meal. Some of the residents who completed and returned surveys and all of the residents we spoke with during the inspection said that they had maintained close ties with the families. The rights of the residents to make choices in relation to their daily routines are respected. The residents who need help to handle their finances are encouraged to seek help from their families or a legal representative but the home will keep small amounts of personal spending money in the safe for residents if they wish. Clear records were seen of personal money held for individual residents. The daily menu is written on a board in the dining room. This shows that residents are offered a choice of two different meals. However, this information is not accessible to residents who have poor eyesight and one of the people spoken with said that she was unaware that she did have a choice of meals. Several of the people who completed and returned surveys to the Commission said that the meals were not always well prepared but we were told on the day of the site visit that two new cooks had been appointed and that the quality of the meals had improved. The home currently caters for a vegetarian and people who are diabetic. Care Homes for Older People Page 16 of 26 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. The people who use the service are able to voice their complaints and concerns. Policies and procedures are in place to protect the residents from the threat of abuse. Evidence: Information about how to make a complaint is available to residents and visitors to the home. We asked to see the record of complaints and none had been recorded. No complaints have been made to the Commission in the last year. The residents we spoke to and residents who completed and returned surveys to the Commission told us that they would know how to make a complaint or raise concerns if they needed to. The Annual Quality Assurance Assessments tells us that policies and procedures are in place to safeguard the residents from the threat of abuse and that new staff receive in house training to enable them to recognise the signs of abuse and to how to report any concerns they may have. Care Homes for Older People Page 17 of 26 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. Residents live in accommodation that is safe, attractive, clean and comfortable. Evidence: Quay Court is beside the quay in Kingsbridge. A good range of shops and other facilities are close by. It is accessed through a public car park, but ample private car parking space is provided for visitors. At the time of the site visit work on a new extension to the home was nearing completion. This extension will provide additional bedrooms and communal space. There is a large lounge, although this was out of use at the time of the site visit because it was being refurbished. The residents also have a smaller lounge, a large entrance hall with seating and a dining room. The bedrooms are on the ground floor and the first floor and a passenger lift is provided for people who find it difficult to use the stairs. All of the bedrooms have numbers and different animal motifs on the doors to help people who may be a little confused to locate their rooms. All of the bedrooms are single rooms with en-suite facilities. The bedrooms seen were Care Homes for Older People Page 18 of 26 Evidence: clean, well decorated and comfortably furnished. The residents are encouraged to bring personal items into the home with them to give their rooms a homely feel. Some of the residents had brought their own furniture in with them, although the amount of furniture that some of the residents were able to bring into the home with them is very restricted in some of the smaller rooms. All of the residents can lock their bedroom doors from the inside, but we were told that the residents could not lock their bedroom door from the outside because they were not given keys. We were told that this was because the residents might loose them and because the same key would open all of the bedroom doors. Most of the communal toilets, bathrooms and shower rooms were lockable from the inside to ensure that the people using them could maintain their privacy and dignity. One wet room with a toilet in it was not lockable. The provision of wet rooms and bathrooms with hoisting facilities enables the residents to bathe and shower safely. The laundry facilities and the kitchen were seen to be clean and adequate for the needs of the home. Care Homes for Older People Page 19 of 26 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. Staff at the home are trained and are employed in sufficient numbers to support the people who use the service. Evidence: Staff recruitment records were checked during the site visit and safe practices are being used to recruit new staff. The staff rota was seen and this showed that there are usually four care staff on duty in the mornings and three in the afternoon. Two waking night care staff are employed from 8pm to 8am. A cook is employed for six hours a day, seven days a week and a domestic for four to five hours a day, five days a week. A key worker system is in place and feedback from the care staff and some of the residents indicated that this works well. The Company have a training officer and he provides most of the staff training. Records are kept of the training courses that each member of staff has attended and any gaps in their training provision. Feedback from the staff about their training was mixed, some of the people who completed surveys for us or spoke with us during the inspection felt that their training needs were being met, others said that they would Care Homes for Older People Page 20 of 26 Evidence: like more training. The Annual Quality Assurance Assessment tells us that only seven of the eighteen permanent care staff employed have completed a National Vocational Qualification in Care at level 2 or above. We were, however, told during the inspection that a further eight have started or are about to start working towards gaining an NVQ. Positive feedback was received from the residents about the competence and friendliness of the staff. Care Homes for Older People Page 21 of 26 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. Although there is currently no registered manager in post, the home does appear to be well managed and to be providing a safe and comfortable home for the residents to live in and the staff to work in. Evidence: There is currently no registered manager, although a prospective manager has been appointed and has applied to be registered with the Commission. Quality assurance programmes are in place and records were seen of feedback from staff and residents surveys. The recorded outcomes clearly highlighted areas where the feedback was good, and areas where improvements could be made. The service providers do not generally get involved in the residents personal financial affaires but small amounts of personal spending money will be kept in the safe for individual residents if this is requested. Records are kept of any money stored for Care Homes for Older People Page 22 of 26 Evidence: safekeeping. The Annual Quality Assurance Assessment tells us that all of the required and recommended written policies and procedures are in place and that they are kept up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 1 5 Each of the residents must be given a copy of a Service Users Guide. To ensure they have easy access to information about the service provided. 18/02/2009 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 15 To ensure that all of the residents know that they have choices and alternatives the catering or care staff could discuss the menus with each of the residents on a daily basis so that they can choose the meal that would like or ask for an alternative if they do not want either of the set meals. Suitable locks should be fitted to all bedroom doors and each of the residents should be given a key to enable them to lock their bedroom doors from the outside as well as from the inside if they choose to do so. 2 24 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!