Inspection on 07/11/05 for Queen`s Court

This inspection was carried out on 7th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Queen`s Court 01/05/07

Queen`s Court 03/05/06

Queen`s Court 14/06/05

Queen`s Court 12/11/04

Queen`s Court 25/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Queen`s Court 2 Downing Close Bottisham Cambridgeshire CB5 9DD Lead Inspector Alison Hilton Unannounced Inspection 7th November 2005 08:10 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 Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 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. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Queen`s Court Address 2 Downing Close Bottisham Cambridgeshire CB5 9DD 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) 01223 811905 01223 812517 home.bot@mha.org.uk Methodist Homes for the Aged Mrs Rosalind May Wright Care Home 35 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (35) of places Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: Queens Court is in the centre of the village of Bottisham, near the city of Cambridge. Queens Court is a two storey, purpose built home, offering long term and respite accommodation to 35 residents some of whom can have a diagnosis of dementia. The home has five self-contained flats, each with its own kitchenette, dining /sitting room and number of bedrooms. The home also has a day centre operating from the premises, which can be used by residents in the home as well as providing a community facility for older people in the area. Main meals for residents and those attending the day centre are provided from the homes main kitchen and taken to the flats in heated trolleys. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on Monday 7th November 2005 between the hours of 08:10 and 13:30. The senior carer on duty was in charge of the home as the manager was unwell. The inspector spoke to residents and staff and inspected records and staff and resident files. There were 31 residents in the home and no residents in hospital on the day of inspection. What the service does well: What has improved since the last inspection? What they could do better: All care staff must have enhanced criminal record certificates (CRB’s) on file before they can commence work at the home. Staff files should have all the necessary information including interview notes, terms and conditions, start date enclosed. Daily records for residents must be completed, must be legible and factual. These are legal documents. Accident forms must be completed where an unexplained event has occurred such as someone being found on the floor. Food and fluid intake charts must be filled in every day to ensure an accurate record is kept. Staff must have training in relation to equipment and where it should be stored. The district nurse had found the blood sugar monitoring machine in the fridge. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 6 Staff training files must be kept up to date to ensure all statutory training is regularly completed. 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. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 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 Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 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): 3 The homes pre-admission assessments from other professionals and the homes own ensure that residents are only admitted if their needs can be met. EVIDENCE: There was evidence in the files seen during the inspection that pre-admission assessments had been completed. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans, daily records and food and fluid intake charts are not completed adequately and this has the potential of placing residents at risk. EVIDENCE: On the day of inspection the district nurse and a GP visited the home. There was also reference in resident files to other health professional input. Plans of care were not detailed enough in certain areas to ensure the needs of the resident could be met. There was no detail on one file of a pressure area or that the district nurse was dealing with it. Daily records for residents must be completed (this was in relation to one unit where there were no entries during the day on 6/11/05), must be legible (this was in relation to entries by one person in one unit on 5/11/05) and factual (this was in relation to entries such as “keep naughty fingers away” and “friends ah”. These are legal documents. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 10 Where fluid and food intake charts have been introduced for a resident, they must be completed. One resident’s food and fluid intake chart had not been completed for two consecutive days (5 & 6 November 2005), which may have put that resident at further risk. Residents spoken to during the inspection said they felt safe and well cared for in the home and the staff were very caring. The senior on duty said that discussions with residents and their families as well as the staff and other professionals views dictated whether a person kept their medication themselves. There should be evidence on file to illustrate those discussions and/or a risk assessment in relation to self-medication. On the files seen there did not appear to be evidence of discussion or risk assessment. There are currently no residents in the home who self-medicate. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 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): 14,15 Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: Residents commented that the home did offer various activities but they chose not to be involved. They also said that they chose when to go to bed and when to get up. There was a list of activities for November including making Christmas tags, singing songs, playing games, children in need raffle and coffee morning and bingo. The food provided on the day of inspection looked wholesome. One resident said, “The food’s very good and I don’t leave anything.” The menus appeared varied and main meals were things like shepherds pie, stew and dumplings, pork steaks, smoked haddock, liver and bacon and roast beef. All came with vegetables and potatoes. Other residents spoken to said the food was good and they enjoyed it. The meals are cooked in the homes central kitchen and taken to the units in hot trolleys. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Although the home has policies and procedures in relation to whistle blowing and abuse, staff must understand these and have the necessary training to ensure the safety of all residents and their protection from abuse. EVIDENCE: The senior on duty said the home has a complaints procedure, but this was not inspected. There were no complaints logged in the home. The compliments file had many cards and letters showing the appreciation of families for the care their relative had received at Queens Court. Residents said they felt safe in the home and with the carers. Most of the staff spoken to had completed an adult abuse course and were aware of what they must do if they witnessed abuse in the home. However the records of staff training indicated that many staff have not completed training on abuse and this must be rectified as soon as possible. Other staff that come into contact with residents such as domiciliary staff should also undertake the training. Some staff did not understand the term ‘whistle blowing’ although it was evident they knew what to do in the event of witnessing poor care practices by other staff. Financial records were seen and the senior stated that the home does not hold large amounts of cash for individual residents. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23, 24, 26 Residents have comfortable bedrooms containing many personal items providing a homely environment. EVIDENCE: On the day of inspection the home did not have its full compliment of domiciliary staff as one person was on leave and one had gone sick. On a tour of the building it was found to be clean and generally hygienic although there were two rooms in one flat that had unpleasant odours. The cleaner was still cleaning the unit and things had improved later in the day. Bedrooms contained lots of personal items such as photo’s, small items of furniture and TV’s or radios, and any necessary specialist equipment. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 The homes procedures for the recruitment of staff are not robust and do not offer protection for the residents. From the homes records the staff are not receiving the necessary training to ensure they are trained and competent to do their jobs. EVIDENCE: Three staff files were inspected and two had no POVA First or current Criminal Record Certificates (CRB’s). An immediate requirement notice was left in relation to this. There was no evidence on the two files of the most recently appointed staff that notes had been made during the interview to provide evidence of the areas discussed. There were no Terms and Conditions, no job description and no start dates. The staff rota was seen and showed the home has six staff on in the morning, 5 on in the afternoon and two waking nights. It was discussed with the senior about how the dementia unit is covered at night and she said there were hourly checks. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 15 Staff spoken to all said they had received the statutory training such as first aid, moving and handling, food hygiene, fire safety and health and safety. However some carers said they had not completed any abuse training. Some domiciliary staff said they had not completed abuse training or infection control. Some carers had completed other specialist courses such as Huntingtons Disease, deaf awareness and dementia. Staff must have training in relation to equipment and where it should be stored. The district nurse had found the blood sugar monitoring machine in the fridge. The staff training file did not appear to be up to date or if it was then staff training is out of date and requires immediate action to ensure all staff have up to date statutory courses as well as training in abuse and any other area to ensure they are competent to do their jobs. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 16 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): 35,36,37 Some practices in the home are not being adhered to to promote the safety and welfare of residents in the home. EVIDENCE: The senior on duty said that the home does not hold large amounts of cash for individual residents. The home keeps individual records of income and expenditure with receipts. There was evidence that senior staff check the accounts regularly and ensure the balance is correct. Staff spoken to during the inspection said they received regular supervision that was written up and signed by the supervisor and supervisee. There were details of an incident where a resident was found on the floor by night staff (6/11/05), but there was no corresponding incident/accident form completed. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 17 Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 18 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 2 x Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP7 Regulation 15 Requirement Timescale for action 31/12/05 2 OP8 Schedule 3 17 (1) (a) 3 OP18 13 (6) 4 OP29 19 The registered person must prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. (This is in relation to the detail provided in some of the care plans in the units.) The registered person must 07/11/05 maintain in respect of each resident a record, which includes the information, and other records specified in Schedule 3. (This relates to the food and fluid charts in relation to one resident.) Staff should be made aware of this requirement immediately. 31/12/05 The registered person must make arrangements, by training staff or by other measures to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. (This is in relation to staff training in abuse and ensuring staff understand the homes whistle blowing procedure.) The registered person must not 07/11/05 employ a person to work at the DS0000015097.V254215.R01.S.doc Version 5.0 Queen`s Court Page 20 5 OP30 6 OP37 care home unless he has obtained the documents specified in Schedule 2 of the Care `Standards Act 2000. (This is in relation to the Criminal record Certificates for two new members of staff.) An immediate requirement notice was left in relation to this issue. 18 The registered person must 31/12/05 ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. (This is in relation to domiciliary staff receiving abuse and infection control training, care staff receiving abuse and other statutory training and the recording of training completed.) Regulation The registered person must 31/12/05 17 (2) ensure that all incidents are recorded. This is in relation to one entry on 6/11/05 when a resident was found on the floor, but there was no corresponding accident/incident form. 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 OP9 OP29 Good Practice Recommendations The registered person should ensure there is evidence of discussion and decisions made about residents selfmedicating. The registered person should ensure that the homes recruitment procedure is followed and that interview notes, and evidence of terms and conditions and job descriptions are on staff files. Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Queen`s Court DS0000015097.V254215.R01.S.doc Version 5.0 Page 22 - 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. 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