Inspection on 21/08/07 for Queens Court Care Home

This inspection was carried out on 21st August 2007.

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

Similar services:

Spinney (The)

Queen Elizabeth House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Queens Court Care Home 32-34 Queens Road Wimbledon London SW19 8LR Lead Inspector Emma Dove Unannounced Inspection 21st and 23rd August 2007 2:25 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 Queens Court Care Home DS0000069365.V348477.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. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queens Court Care Home Address 32-34 Queens Road Wimbledon London SW19 8LR 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) 020 8971 5019 020 8871 1536 Barchester Healthcare Homes Ltd Mrs Shaaron Caratella Care Home 43 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Old age, not falling within any other of places category (0) Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Older people aged 55 years and over N/A this is the first inspection of the home since it was registered as a Barchester Healthcare Home. Date of last inspection Brief Description of the Service: Queens Court is a care home which can provide nursing for forty-three people over the age of fifty-five. Forty people are currently living there. The home is owned and managed by Barchester Healthcare Homes Limited, who have similar services in the Merton and Richmond area. Accommodation is provided over three floors. A large restaurant, two lounges and eight single bedrooms are on the ground floor. Sixteen bedrooms a large lounge, shower room, toilets and a hairdressers room are on the first floor. The second floor has the remaining seventeen bedrooms, a small lounge, shower room, bathroom and a staff office. Thirty-eight bedrooms are single, with three double rooms. A lift serves all floors. People who use the service have access to a well-maintained garden to the rear and side of the building. Queens Court is situated in a residential area of Wimbledon, close to shops, public transport systems, churches of a number of denominations, a cinema, theatre and other leisure facilities. Trained nurses and care staff are on duty twenty-four hours a day. Three meals are provided with drinks and snacks available between meals. Information about the CSCI is available in the Statement of Purpose and Service Users Guide. The weekly fees are from £990. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours on the 21st and three and a half hours on the 23rd August 2007. One inspector visited and spoke with people who use the service, visitors, staff and the registered manager. Records were looked at, communal areas and bedrooms were seen. Questionnaires were left for people who use the service and visitors to the home and sent to health professionals. Fifteen questionnaires have been received, comments from these are included in the relevant sections of this report. An Annual Quality Assurance Assessment was returned to the CSCI. Appropriate notifications have been sent to the CSCI by the service. A copy of the monthly visit report by the registered person is sent to the CSCI. What the service does well: What has improved since the last inspection? What they could do better: The manager noted a number of areas that they plan to improve over the next year, including the chef documenting conversations with people who use the service; to put more emphasis on reminiscence in activities provided; to become more involved in events with local schools and churches; for key Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 6 workers to take responsibility for arranging Birthday celebrations and for staff to be offered more mentoring support and attend more training. There were also some areas that the manager felt could be improved, mainly around spending more time with people who use the service to find out more about their background and experiences and recording this information. 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. Queens Court Care Home DS0000069365.V348477.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 Queens Court Care Home DS0000069365.V348477.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): 1, 3, 4 and 5 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. It has developed clear information to help people understand the services the home provides. A Statement of Purpose and Service Users Guide are in place. These documents are given to all people who move into the service. Assessments are completed before admission. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed. These documents contain information about staff, meal times, the fees including what they cover, safety, smoking and complaints procedures, activities, information about local services and the outcome of a service user survey. Eight people noted that they received enough information to decide that the home was right for them. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 9 Two people said that they chose to come to Queens Court. Five questionnaires indicated that people had a contract. One person said ‘two visits were made and every effort to show us the home and the services it could provide’. The manager and senior staff reported that they complete assessments before admissions. Assessments were seen in case files. Queens Court Care Home DS0000069365.V348477.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): 7, 8, 9, 10 and 11 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are developed with people who use the service from assessments and reflect their needs and wishes clearly so they can be met by staff. Risk assessments are in place and updated when required. People’s health care needs are recorded and met by professionals visiting the home and local community services. Medication is well managed with records up to date and in good order. The service works with specialists regarding end of life care. Details are well documented and staff are aware of their responsibility to ensure people who use the service wishes’ are followed in a dignified and respectful manner. EVIDENCE: Care plans are in place, those seen had been reviewed monthly and more often when required. Care plans contain details to ensure staff can meet people’s individual and specific needs and reflect their wishes and choices. People who use the service confirmed that they meet regularly with staff to discuss their Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 11 care needs. Case files contain peoples’ ‘life story’ which includes their family members and important people in their lives, their occupations and any hobbies and interests. One care plan needs updating to reflect a change in bedroom. For one person, new to the home, (one week) a care plan was in place, good health and medical information was recorded and the life story work noted that this will be completed with the relative. Six people said that they ‘always’ and two people said that they ‘usually’ get the care and support they need. One person said ‘I am very happy with the support I receive’. One person stated that ‘there is a good team of nurses’. Four questionnaires said that the home ‘always ‘ and three said the home ‘usually’ meets their relatives needs. Five people indicated that the home ‘always’ and two people that it ‘usually’ gives the care and support expected or agreed. People who use the service are asked by staff how often they wish to receive a bath and this is noted in their care plan. Records indicated that some people have a bath daily or regularly three times a week and that this is flexible to people’s wishes. Case files contain a medical history and details of current medication. Good systems are in place to monitor people’s weight, with clear information about any actions taken when there is a loss of weight. The service uses a nutritional tool in conjunction with dieticians to ensure people who use the service receive appropriate meals and nutrition. Good records are kept of any pressure sores or wounds, including a photograph, details of the size, records of any treatment given and regular reviews of progress. The GP visits weekly and sees people for regular medication reviews and anyone who is unwell. Some people have retained their GP from before they moved into the service. Medication is well managed, clear policies are in place for staff. Staff complete training in medication administration. A full audit of medication is carried out every six months, with the last one completed in October 2006. In addition, a check is completed every week. Medication Administration Records Sheets were up to date and signed. Eight questionnaires indicated that people ‘always’ get the medical support they need. A member of staff is responsible for wound care, end of life care and continence issues. All staff receive regular in-house training from these staff, ensuring that they have access to up to date information and good practice initiatives. Good links are in place with the tissue viability nurse, and a local hospice to support the home in providing these services. The end of life care package is detailed with the individuals needs. Staff demonstrated a good knowledge of their responsibilities and how to work with both people who use the service and their relatives and friends. Queens Court Care Home DS0000069365.V348477.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): 12, 13, 14 and 15 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to enjoy a variety of activities and outings in the home and in the community. Routines are flexible. Visitors are made welcome. Meals are well balanced and meal times are a pleasant experience for people. EVIDENCE: A varied programme of activities is displayed in the entrance and on each floor, for people who use the service and visitors to access. Information was also seen in individuals’ rooms so they can choose the activities they wish to join in. Comments from people who use the service included ‘I consider myself lucky to have the care and entertainment’, ‘the activities programme is excellent’, ‘activities information could be more readily available to people who don’t read’, ‘there’s plenty to do here’ and ‘activities are available although I often choose not to join in’. Five questionnaires indicated that people ‘always’, two ‘usually and one person ‘sometimes’ have activities they can take part in. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 13 The manager reported that they plan to look at the aims of activities and evaluate them and to develop more activities around reminiscence. Five relatives thought that the home ‘always’ and two ‘usually’ supported people to live the life they choose. Visitors are welcome, this was confirmed by people who use the service, visitors and comments in questionnaires. Three relatives said that the home ‘always’ and one relative said the home ‘usually’ help the person keep in touch. The manager said that religious services are available at the home and people who use the service can be escorted to church. This was confirmed by two people who use the service. Meals are served in the restaurant on the ground floor. Some people said they prefer to eat in their rooms and this was seen to happen. Staff are employed specifically to serve meals in the restaurant, they receive training to support them in their job. Food is home cooked from fresh ingredients. Mealtimes were seen to be a pleasant experience for people, with tables laid, wine served if requested and the menu for the day on the table. People said that they choose their meal for the next day, that this is recorded and they can change their mind. Four people said that they ‘always’ and ‘usually’ like the meals. Other comments included ‘some successful innovations with the restaurant’ and ‘the food is to be highly commended’. Queens Court Care Home DS0000069365.V348477.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): 16 and 18 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure which is clear and easy to understand and is accessible to people who use the service. The home has an open culture that allows people who use the service to express their views and concerns. People who use the service and their relatives say that they are happy with the service, feel safe and supported by staff and manager who see safety and protection and a priority. EVIDENCE: The complaints procedure is included in the Statement of Purpose and Service Users Guide. People who use the service and their relatives were generally aware of how to make a complaint and who they should speak to with concerns. Two relatives noted that they did not know how to make a complaint and one noted that they couldn’t remember. Five relatives noted that the home ‘always’ and one person said ‘usually’ responds appropriately to concerns. One complaint had been received at the home, which was being addressed. The CSCI has not received any complaints or concerns about the services provided at Queens Court. Senior staff confirmed that they have completed training in how to deal with complaints and are aware of the procedures to Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 15 follow and how to support people who have raised concerns or made a complaint. Policies and procedures are in place for the protection of vulnerable adults. Staff complete training and demonstrated an understanding of their responsibilities. The organisation has a ‘whistle blowing’ policy which staff are made aware of. Copies of recent safeguarding policies and protocols were seen and the manager said that these are being discussed with staff. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 16 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): 19, 20, 21, 23, 24 and 26 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides an environment which is appropriate for the people using the service. People who use the service are encouraged to see the home as their own. It is a well maintained home with good access to community facilities and services. There is a selection of communal areas inside and outside the home which means people have a choice of where to sit in private and meet with family and friends, as well as where they can join in with others. Bedrooms are personalised to the individuals taste. EVIDENCE: Queens Court has been developed over the years to meet the needs of people using the service. Thirty-eight bedrooms are single with three double rooms which can be used by one person. Currently double rooms are used by couples who choose to be together. Two small lounges are on the ground floor with Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 17 one lounge on the first and second floor. A restaurant is on the ground floor. A number of toilets, bathrooms and shower rooms are available on all floors. Some bedrooms have ensuite toilet and wash hand basin. The gardens are fully accessible and used by people who use the service and their visitors. The manager reported that the home had recently won an award for the garden, which both people who use the service and staff were proud of. Bedrooms were seen to have been personalised to peoples taste with some people bringing items of furniture and others having their belongings such as paintings, pictures and ornaments around them. One person said that they have all they need in their room and two people said ‘what more could I want’. One person said that their room was a little cramped at times when staff were providing support with personal care tasks. Staff confirmed that this was being addressed. All areas of the home were seen to be clean and fresh. Eight questionnaires confirmed that the home is ‘always’ clean. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 18 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): 27, 29, 29 and 30 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has plenty of staff available at all times to provide support and activities to people who use the service. Staff recruitment practice is in line with regulations. The service acknowledges the importance of having the right staff to deliver good quality services and for the protection of individuals. Staff have access to appropriate training. EVIDENCE: The staff rota noted two nurses and six members of staff on duty in the morning and afternoons with two nurses and three members of staff at night. Also the manager, activities staff and hospitality staff are available. Staffing levels were seen to be appropriate to meet people’s needs. Peoples comments about the staff included ‘staff are kind’, ‘staff are caring’, ‘staff respond to the call bell’, ‘staff give me the help I need’, the staff are good’, ‘staff are committed to giving people the best quality of life’. Seven questionnaires said that staff listen and act on what is said. Three people said that staff are ‘always’ and five said staff are ‘usually’ available when needed. Five relatives said that staff ‘always’ and three people said staff ‘usually’ have the skills and experience to look after people. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 19 Good systems are in place for the recruitment of staff. Staff files contained an application form, two written references, a clear enhanced Criminal Records Bureau check, a POVA first check, proof of the individuals identity a copy of their contract of employment and confirmation that their registration as a nurse has been checked. Copies of annual appraisals were seen for two members of staff, other staff confirmed that they had had a recent appraisal. The organisation has a training programme available to all staff. The service also makes good use of training provided by the local authority. Staff have completed training in manual handling, first aid, palliative care, stroke rehabilitation, infection control and the protection of vulnerable adults. Staff confirmed that they attend relevant training courses to help them do their job. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 35, 36 and 38 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the required skills and experience to run the home and demonstrated a commitment to improving the services provided with the involvement of people who use the service, their relatives and staff. Systems are in place within the organisation to monitor the quality of service provided. Health and safety checks are completed at the required intervals. EVIDENCE: The manager has many years experience working with older people and has completed an MSc in Health Sciences and a BS in Nursing Studies, incorporating management studies and other relevant training to keep up to date with good practice initiatives. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 21 The manager is available to people who use the service, visitors and staff. Regular meetings are held with people who use the service and their relatives. Minutes of these meetings were available and demonstrated a number of changes to the environment have been from ideas and suggestions raised at these meetings. The organisation has systems in place to monitor quality with monthly visits by a representative from the organisation and internal monthly audits. The manager reported that a new job has been created within the organisation to monitor compliance with the National Minimum Standards and Care Homes Regulations. Appropriate policies, procedures and records are in place and up to date to ensure people who use the service, staff and visitors health and safety is maintained. A representative from the organisation visits the home regularly to see that all health and safety checks have been completed. Records indicated these checks have been done. Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 22 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 X 3 3 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 X 4 4 X 3 STAFFING Standard No Score 27 4 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Queens Court Care Home DS0000069365.V348477.R01.S.doc Version 5.2 Page 25 - 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. 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