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Inspection on 25/04/06 for Queensway House Residential Care Home

Also see our care home review for Queensway House Residential Care Home for more information

This inspection was carried out on 25th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Queensway House is well managed. Support and care is provided to residents by an experienced team of staff who are familiar with their needs. Residents said `it`s good here` and the `staff are very good`. They confirmed there was plenty to do and staff had time to spend talking with them. There is an excellent programme of activities in place, which provides a stimulating environment for residents. A visitor said the home was `brilliant` and residents always seem to be `doing things`. The quality assurance system offers genuine opportunities for residents and their relatives to be involved in decisions affecting the running of the home and contribute their own experiences of Queensway House.

What has improved since the last inspection?

The focus of the manager and staff has been on the development of a separate living area for residents with dementia. This has provided residents with familiar surroundings, a consistent staff team and resources such as activities specifically designed for residents with higher level of confusion.

What the care home could do better:

Some recommendations have been made with regard to information provided to residents on admission and procedures within the home.

CARE HOMES FOR OLDER PEOPLE Queensway House Residential Home Jupiter Drive Hemel Hempstead Hertfordshire HP2 5NP Lead Inspector Mrs Sheila Knopp Unannounced Inspection 25th April 2006 09:35 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queensway House Residential Home DS0000063303.V290642.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. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Queensway House Residential Home Address Jupiter Drive Hemel Hempstead Hertfordshire HP2 5NP 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) 01442 266088 01442 261818 Queensway@goldcarehomes.com GCH (Queensway) Limited Mrs Marie Shouler Care Home 60 Category(ies) of Past or present alcohol dependence (1), registration, with number Dementia - over 65 years of age (60), Mental of places disorder, excluding learning disability or dementia (1), Old age, not falling within any other category (60), Physical disability over 65 years of age (60) Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category MD will be conditional on the continued occupation of a (named) service user. 15th February 2006 Date of last inspection Brief Description of the Service: Queensway House is a sixty-bedded care home for older people, who may also have a physical disability or dementia. The home does not provide nursing services. The building is on two floors and has a passenger lift. There is an eleven-bedded dementia unit on the first floor of the home. This unit has its own dining and lounge areas. A dedicated staff group provides care for individuals whose levels of confusion are more advanced. All bedrooms in the home are single occupancy and have en-suite facilities. The main dining room and kitchen are on the ground floor. There is a large, secure garden to the rear of the home and a parking area at the front. The home is situated in a residential area, near to the town of Hemel Hempstead, which has extensive shopping areas, leisure facilities and good transport links. Detailed information about the services offered including the latest report by the Commission for Social Care Inspection can be obtained from the home on request and is displayed in the reception area. The fees, which range from £525 - £600 per week, are based on an assessment of individual needs and type of room required. Additional charges are made for newspapers, toiletries, hairdressing and chiropody. (This information was correct at 25.4.06). Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced visit to the home by two inspectors who spent a total of 10 hours 50 minutes hours in the home. The report includes information provided by residents (6), visitors (2), community nursing staff (2) and staff (7). Five care plans were reviewed following discussions with the residents and staff. Information received about the home since the last inspection in February 2006 has also been reviewed and included in this report. This was a positive inspection. Residents expressed a high level of satisfaction with the service provided at Queensway House. No concerns have been brought to the attention of the Commission by residents, relatives or health & social care professionals since the last inspection in February 2006. What the service does well: What has improved since the last inspection? The focus of the manager and staff has been on the development of a separate living area for residents with dementia. This has provided residents with familiar surroundings, a consistent staff team and resources such as activities specifically designed for residents with higher level of confusion. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Queensway House Residential Home DS0000063303.V290642.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 Queensway House Residential Home DS0000063303.V290642.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): 3 - standard 6 does not apply to this service. Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Residents are assessed before admission to Queensway House to confirm that their needs can be met. Contracts are issued to residents by the home or responsible local authority. Details of the terms and conditions of residence had not been given to residents whose funding is the responsibility of the local authority. EVIDENCE: On the morning of inspection the manager was visiting an individual in their own home to carry out an assessment. Residents had been admitted under the home’s registration categories and no issues were identified which would indicate staff were not able to meet the needs of the residents in their care. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 9 The manager agreed to review the records of contracts issued to ensure individuals placed by the local authority are also given a signed copy of the home’s terms and conditions which are not included in the contract between that authority and the provider. Details are included in the Service User Guide available to residents. A review of care records confirmed that information from other health & social care professional sis obtained and considered as part of the assessment process. The care records also indicate that where needs change following admission appropriate referrals are made to specialist services. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Residents were receiving support to enable them to maintain a high level of personal care & hygiene. Residents confirmed that their privacy and dignity was respected. This was also observed by inspectors in the caring and sensitive way staff approached residents. The health and continued well-being of residents as their needs changed was being regularly reviewed by the care staff. Advice and treatment is available from a variety of community health professionals and specialist services in the area. There are safe systems in place for the management of medicines within the home. In discussion with staff residents are able to continue to take responsibility for their own medication if they wish. An oxygen trolley should be provided to prevent tanks from being knocked over when in resident rooms. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 11 EVIDENCE: The care plans provided a good record of the care required by residents to meet their changing needs and reflected what residents and their carers told the inspectors. Very good information involving health care professionals had been put in place in preparation for the return of a resident to the home following admission to an assessment unit. The nutritional needs of residents is regularly reviewed by calculating and assessing the body mass index (BMI) of each person. The records confirmed that residents and / or their representatives are involved in developing and reviewing their plan of care. On the day of inspection community nurses, and community psychiatric nurse and physiotherapist were involved with residents in the home. A district nurse and nursing auxiliary confirmed that staff responded appropriately to the changing health needs of residents. Individual needs were being catered for and specialist equipment such as hand rails, adjustments to walking aids, pressure relieving equipment and height adjustable beds had been requested and provided. The medication records and procedures were reviewed and found to be in order. Risk assessments are in place and reviewed for residents who continue manage their own medication. This includes a resident who gives their own insulin. The manager agreed to look at providing a suitable trolley to stand an oxygen cylinder in when it is in the resident’s room to reduce the risk of it being knocked over and causing an injury. The staff approach to residents supported their privacy and dignity. Residents were addressed as individuals and staff were calm and unhurried in their approach giving each resident time and support to respond. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is assessed as excellent. This judgement has been made using available evidence including a visit to this service. The inspectors were very impressed by the range of activities available to residents and the involvement of residents in planning what they would like to do. The key worker role is very well developed and an interview with a member of staff confirmed their knowledge of the individual and action they were taking to provide activities they would enjoy. The individual rights of residents to make continue to make choices in their every day life is supported. Residents were positive about the choice of meals being provided. EVIDENCE: The social life of resident is well resourced within this home. A full time activities organiser with many years experience provides cover during the week and on alternate weekends. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 13 An activities room provides additional space for residents to meet in private, pick up books, videos and other resources as well as leaving work in progress, such as jigsaws and paintings, to continue when they wish. A visitor said that there always seemed to be something going on. Resident planning meetings are held to decide on activities, social occasions and outings. Leaflets on local attractions were available to residents could make an informed choice of where they would like to go. The home has it’s own minibus which enables impromptu outings to take place. Where possible the plan is for the resident’s key worker to accompany them on trips to develop this relationship further and provide support. From interviews with residents and staff it was confirmed that individual hobbies, interests and contact with the local community are supported. Staff across the home were seen to interact well with residents as they went about their jobs. Detailed records of the formal and informal activities are maintained. There is a social activity plan for each person which the activities organiser reviews with the manager and information is used to update that person’s care plan. Activities include one to one support and formal and informal group activities of varying sizes. Overall residents were very positive about the standard of the meals being served. They have a daily choice and cooked breakfasts are available each day on request. Residents requiring specialist diets and soft or puree diets were being catered for. It was reported that sandwiches as well as biscuits are available with late night drinks. Residents and visitors also have access to a Kitchenette to make their own drinks and were using this facility during the inspection. A resident overheard talking to a member of staff said staff always bring her a ‘lovely cup of coffee at 8 o’clock’. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are provided with information detailing how they can raise any concerns. Opportunities to be involved in the running of the home are available through regular residents and relative meetings. The recruitment, training, reporting and financial procedures in place protect residents. EVIDENCE: A record of compliments and concerns received by the manager is maintained and was examined as part of this inspection. No concerns have been raised directly with the Commission between inspections. Residents know who to go to if they have a problem. Staff confirmed there was an open and supportive atmosphere in which they could raise any concerns. Staff are trained in protection of vulnerable adult and whistle blowing procedures. Copies of the Hertfordshire multi-agency protection of vulnerable adult procedure was available. There are systems in place for enabling residents to have access to personal finances and advice, which do not unduly involve staff. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 15 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): 19 & 26 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a comfortable well-maintained environment to live in. Aids and adaptations are available to promote independence. Residents can bring in personal possessions to make their room feel more home like and reflect their individual preferences. Following the development of a separate dementia care unit it has been recommended that the manager updates the risk assessments to include the use of a key pad door locks to ensure the rights and safety of residents are regularly reviewed. A clean & hygienic environment is provided which reflects current infection control practices. A recommendation to provide laundry staff with a clear working procedures has been made. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 16 EVIDENCE: There is planned programme of refurbishment and renewal in place. A resident who had lived at Queensway for a number of years confirmed their mattress had recently been replaced. Residents have been able to bring in personal possessions and have received support to hang pictures and lay their room out as they wish. Window restrictors on upper floor windows, low surface temperature radiators and regulated hot water supplies protect residents from accidents. Staff are provided with equipment and training to reduce the spread of infection. A contract is in place for the disposal of clinical waste. Laundry staff were able to detail the procedures in place for the management of resident laundry and soiled items but did not have a comprehensive written procedure to refer to. The manager needs to ensure a safe system for cleaning behind the machines is introduced to prevent the build up of dust, which can be hazardous in laundries if allowed to build up. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Residents are supported by an experienced and consistent team of staff who are known to them and familiar with their needs. Policies for staff recruitment and training ensure that residents are protected and supported by competent staff. EVIDENCE: From observation of the staff approach to residents during the inspection and examination of the staff rotas it was confirmed that appropriate numbers of staff are being provided to support residents. It is positive to note that the housekeeping staff as well as care staff have been involved in dementia care training. This was reflected in the positive contact and involvement with residents inspectors observed across all staff groups It was reported that the home is fully staffed and agency staff are not used. The staff interviewed demonstrated a positive and caring approach to encouraging and supporting residents. They also confirmed they are able to contribute their views through regular staff meetings. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 18 The records of staff induction, mandatory and NVQ training were reviewed. The manager has a computerised training plan so that any gaps can be identified and followed up. Standard 28 has not been fully met as the number of care staff with qualifications at NVQ level 2 in care have not yet achieved the required 50 ratio. A requirement has not been made as the manager is progressing towards meeting this target. The recruitment records for 4 new members of staff were reviewed and found to contain the required information including Criminal Record Bureau checks. It has been recommended to the company following a visit to another of their homes that the application form be amended to include a full employment history rather than the last 10 years. Staff confirmed they have formal supervision sessions, which enable them to discuss and review their work. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 19 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): 31, 33, 35 & 38 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Effective management and quality monitoring systems ensure that the interests, rights and safety of residents and staff are protected. EVIDENCE: The registered manager has completed the Registered Managers Award (RMA) and NVQ 5 training. She has introduced and continues to develop robust systems for monitoring the quality of the service provided. The views of residents and relatives are actively encouraged. Details of the meetings are available and these provide confirmation that suggestions and ideas are taken up and acted upon. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 20 The quality monitoring system within the home also includes the view of residents and relatives. The annual cycle is nearing completion and the manager anticipates being able to provide residents and the Commission with a report on the outcome of the quality review within 3 months. There is a good system in place, which enables residents or their relatives to deposit money and valuables for safekeeping. The records and amounts deposited are also audited by the company finance officer. There are systems in place for reviewing health & safety matters and ensuring that regular servicing and checks are carried out on systems and equipment. The service and fire safety records were reviewed. The Commission is informed of significant accidents and the manager has a system for monitoring the frequency, timing and place accidents are occurring within the home to identify any trends. Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 21 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 22 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. 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. 1. 2. 3. Refer to Standard OP3 OP9 OP19 Good Practice Recommendations The manager agreed to ensure all residents are provided with a signed copy of the terms and conditions of their stay at Queensway. Provide a suitable trolley for use in residents rooms to stabilise oxygen cylinders to prevent them being knocked over. Put in place generic and individual risk assessments where keypads door locks are used to demonstrate that the interests, rights and safety of residents have been considered and regularly reviewed. Refer regulation 13(7)(8) Introduce a laundry procedure setting out the systems in the home and actions required by staff to include a safe system for cleaning behind the washing machines and driers. Recruitment procedure amended to include a full employment history on the application form. DS0000063303.V290642.R01.S.doc Version 5.1 Page 23 4. OP26 5. OP29 Queensway House Residential Home Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Queensway House Residential Home DS0000063303.V290642.R01.S.doc Version 5.1 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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