Inspection on 24/01/06 for Queens Court Nursing Home

This inspection was carried out on 24th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Queens Court Nursing Home 06/02/08

Queens Court Nursing Home 15/01/08

Queens Court Nursing Home 23/05/07

Queens Court Nursing Home 05/12/06

Queens Court Nursing Home 26/06/06

Queens Court Nursing Home 17/01/05

Queens Court Nursing Home 28/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall 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 Nursing Home 52 - 74 Lower Queens Road Buckhurst Hill Essex IG9 6DS Lead Inspector Diane Roberts Unannounced Inspection 24th January 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queens Court Nursing Home DS0000015397.V280954.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. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Queens Court Nursing Home Address 52 - 74 Lower Queens Road Buckhurst Hill Essex IG9 6DS 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) 0208 559 0620 0208 559 0315 queenscourt@hotmail.com Ranc Care Homes Limited Mrs Rosemary Mathias Care Home 89 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (21), Physical disability of places over 65 years of age (27) Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 40 years and over, who require nursing care by reason of a physical illness/disability (not to exceed 21 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical illness/disability (not to exceed 27 persons) Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 41 persons) 3rd June 2005 Date of last inspection Brief Description of the Service: Queens Court is a purpose built two-storey care home, with garden to the rear and a patio area to the front. It is near to the local shops and underground railway system. It has a local bus stop nearby and is within easy access of the M25 and M11.The care home provides personal care to people over 65 on the ground floor and nursing care for persons with physical disabilities above the age of 55 on the first floor. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six and a half hours and was carried out as part of the annual inspection programme for this home. The registered manager was present during the inspection. The Inspection focused upon the outstanding standards, not previously covered this year and the homes response to the last agenda for action. A partial tour of the premises was undertaken. Six residents, two relatives and four staff were spoken to during the inspection. Agenda items 1-3 were not covered/reviewed at this inspection and have been carried forward on this agenda. This should not reflect negatively on the home. What the service does well: What has improved since the last inspection? What they could do better: The home needs to address the significant shortfalls noted with regard to the food and activities provided in the home. Residents are dissatisfied with these aspects of the home and improvements made are not sustained. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 6 The home also needs to improve upon its staff-training programme and maintain better records. 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. Queens Court Nursing Home DS0000015397.V280954.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 Queens Court Nursing Home DS0000015397.V280954.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 not assessed at this inspection. EVIDENCE: Queens Court Nursing Home DS0000015397.V280954.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): Standards not assessed at this inspection. EVIDENCE: Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 10 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): 12, 13, 14 and 15. Residents’ lifestyle experiences in the home are limited in some areas. Residents’ maintain contact with family and friends as they wish. Residents’ are helped to exercise choice and control over their lives. The meal provision service at the home is poor. EVIDENCE: Residents spoken to report that they are able to spend their days as they wish within the general routines of the home. Residents reported that the day staff were caring and flexible but some felt that the night staff did not have the same approach. Residents confirmed that they were able to attend church should they so wish, but were generally dissatisfied with the overall activity programme at the home. Residents feel that there is not enough social stimulation and activities within the home and that mental stimulation was poor, especially for those who are able to interact with others. Some residents said that the programme offered did not encourage them to attend and that they relied on visitors for this part of their daily life. Residents also often relied on attending the local church hall for coffee and activities. On inspection of the recent activities offered and discussion with the activities officers, it is apparent that the programme and the staff have lost their way. The staff are not inspired and are unsure about how to encourage residents Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 11 and develop the programme. They often feel disheartened and are focused on residents who refuse rather than why and what they can do about it. The activities programme was seen to lack any substance and activities staff record that giving fruit to residents is an activity for residents. Records show that birthday parties are held and events, such as barbecues are held during the summer months and that Christmas was adequately covered. The activities programme was discussed with the manager on the day of the inspection. Residents and relatives spoken to confirmed that there was an open visiting policy at the home and that this was suitable to their needs. They confirmed that they were able to go out with relatives/friends and that the staff at the home helped with this, when required. Relatives said that they felt welcome at the home. Residents are able to have private phones in their rooms and confirmed that staff help them, if required, with dealing with any post. Residents confirmed that they were able to organise their own affairs if they so wished and that the home’s management team would help with any queries. Information on local advocacy services is available around the home and have been used in the past. Residents are able to bring personal possessions with them when they are admitted to the home, the limit of which is discussed at this time. The meal provision at the home needs urgent attention. This has been an ongoing issue at the home, whereby some improvements are made but not sustained and then both residents and their relatives/representatives are dissatisfied. Whilst the menu looks reasonable, it could be improved upon with more variation, especially with the deserts. Residents spoken to on the day of the inspection, regarding the food, were very dissatisfied with both the quality and variety. Residents and relatives felt that the food provided is poor compared to the weekly fees paid to the home. The home has a resident’s comments book, collated by the Activities staff, for them to comment on the meals. This does not reflect the comments of any of the residents spoken to on the day of the inspection and it therefore requires some review. Residents spoken to felt that the quality of some items brought into the home is poor, such as yoghurts. Other comments included: hard pastry, roast potatoes oily, bacon hard, toast soggy, corn beef brown, no nice biscuits, poor tasting mash potato, salads boring and that the food was generally overcooked Residents felt that the ingredients were generally fine but the food was spoilt in the cooking and presentation, or it was cooked early and then stored making it unpalatable. They commented that the food was often bland with no flavour and the inspecting officer concurred with this, on tasting the lunchtime meal available that day. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 12 The inspecting officer noted overcooking and poor cooking practices when visiting the kitchen early that morning. She observed fresh vegetables cooking at 09.40 a.m and cold par boiled potatoes sitting in cold oil waiting to be cooked later that morning for roast potatoes. Good quality fresh fruit and vegetables were observed in the food store and consisted of cabbages, broccoli, plums, satsumas, grapes etc. Residents mainly reported that the fruit given out tends to be bananas only and they feel fruit is not offered enough during the week. Meat supplied to the home was seen to be of a good quality. Residents report that the temperature of the food is not as it should be if you choose to take your meal in your room, but is fine if you eat in the dining room. Residents confirmed that there was always a choice of meals but there were differing views as to whether you were able to have more food should you so wish. Records show that the residents have choice with the menu and that dietary needs are accommodated. The shortfalls noted at this inspection were discussed with the manager at length. Queens Court Nursing Home DS0000015397.V280954.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 and 18 The home has a complaints procedure, which helps to ensure that complaints will be listened to, but records need to improve. The home has systems in place to help ensure that residents are protected from abuse but it needs to review its staff training programme. EVIDENCE: The home has a complaints procedure in place; this is displayed around the home and within the Service Users Guide. There have been no recent complaints, with the last one logged in November 2005. Records show that this was dealt with appropriately and within set timescales. Some complaints logged did not have all the required documentation available, with the Director of Nursing holding some records. This needs to be addressed and the home needs to consider analysing complaints over a period of time to check for trends etc. The home has policies and procedures in place for the Protection of Vulnerable Adults. These are currently due for review. From discussion and records, the home deals with any POVA incidents appropriately, referring to the responsible agency when required. The home has approximately 50 of its staff trained on POVA in 2005 with the rest having undergone training in 2003/4. The home needs to review its training programme on this subject. Queens Court Nursing Home DS0000015397.V280954.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): Standards not assessed at this inspection. EVIDENCE: Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 15 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 and 29. Resident’s needs are met by the current staffing levels and skill mix in the home. The home has sound recruitment policies and procedures. EVIDENCE: Staff rotas were inspected over a recent 2-week period at random. Staffing levels in the home are appropriate for the resident group at the current time. The home uses minimal agency staff and has a bank of their own staff that they call on to cover shifts. The rota shows that in general the home maintains its staffing levels and it is clear who is in charge of each unit and the home. Residents spoken to on the day of the inspection commented that the staff are generally a caring team. Residents commented that the day staff answer the call bells promptly but the night staff were less prompt at answering call bells. Residents were very complimentary regarding the domestic team in the home and the standards of cleaning. The home has recruitment policies and procedures in place and this includes equal opportunities. Staff files were checked at random and were found to be in good order with the appropriate documentation and checks in place. Records show that staff are issued with the GSCC Code of Conduct. Records also show that staff are issued with terms and conditions of employment. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 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): 33, 35 and 38. The home has a limited quality assurance system in place. Resident’s financial interests are safeguard but this could be improved. The home has shortfalls with regard to health and safety EVIDENCE: The home has a quality assurance system in place. This consists of an internal audit and a resident/relative questionnaire. The internal audit has yet to be completed and results/action plans produced. The last resident/relative questionnaire was sent out in October 2005, achieving only a 20 return rate. 2 questionnaires were inspected and these were both seen to be limited and require further development in consultation with interested parties. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 17 The home has polices and procedures in place for the safe handling of residents finances and property. The home holds small amounts of money on behalf of residents and has the appropriate storage facilities for this. Accounts were checked at random. Some anomalies with the accounts were noted and this related to the account not being maintained up to date. Otherwise the records were in order and receipts available. It is recommended that the home have a system of internal audit for this system. The home has a health and safety policy in place. Safety and maintenance certification was inspected for the fittings and equipment in the home. These were found to be in order with all checks etc. up to date apart from a gas safety certificate. Safe working practice risk assessments have been completed in 2003, which were due for review in 2004. To date these have not been reviewed. Records show that hot water temperatures are checked regularly in the home and adjusted where necessary. Records supplied show that some statutory training has been provided to both care and ancillary staff. These show that compliance levels are poor, compared to the number of staff employed and this requires addressing. The home also needs to review the training records held to ensure that it can evidence a clear picture to the CSCI. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X X 1 Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 15 Requirement The registered person must ensure that residents have a care plan in place for all care needs and that these are reviewed on a regular basis. The registered person must ensure that all health related risk assessments are regularly reviewed and that where, appropriate, advice from healthcare professionals is linked into the care planning process. The registered person must ensure the safe handling and administration of medicines within the home. The registered person must provide, in consultation with residents, a meaningful activity programme and maintain records of such. The registered person must provide wholesome, nutritious and suitable food in adequate quantities and of a good quality. The registered person should ensure that records are maintained of all concerns/complaints investigated DS0000015397.V280954.R01.S.doc Timescale for action 03/06/05 From previous agenda 14/07/05 From Previous agenda 2. OP8 15 3. OP9 13(2) 4 OP12 16 (m,n) 03/06/05 From previous agenda 14/05/06 5 OP15 16 (i) 24/01/06 6. OP16 22 30/04/06 Queens Court Nursing Home Version 5.1 Page 20 7. 8 OP18 OP33 13 (6) 24 9 OP35 17(2) Schedule 4 13 10 OP38 by the home. This is a repeat requirement. The registered person must provide statutory training for staff and keep this up dated. The registered person must establish and maintain a quality system for reviewing and improving services and care offered in the home. The registered person must maintain up to date records for each resident that has deposited money with the home for safekeeping. The registered person must address the shortfalls in relation to health and safety i.e staff training, safe working practice risk assessments and gas safety certificate. 14/05/06 14/05/06 30/04/06 30/04/06 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 OP15 OP38 Good Practice Recommendations The registered person should develop further ways of obtaining feedback from residents on the meal service provided at the home. Repeat recommendation. The registered person should consider employing a training officer for the Ranc group to help fulfil the training requirements of staff. Repeat recommendation. Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Queens Court Nursing Home DS0000015397.V280954.R01.S.doc Version 5.1 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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