Inspection on 07/03/06 for Reardon Court

This inspection was carried out on 7th March 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 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

Reardon Court 10/07/06

Reardon Court 26/09/05

Reardon Court 12/01/05

Reardon Court 14/07/04

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

CARE HOMES FOR OLDER PEOPLE Reardon Court Cosgrove Close London N21 3BH Lead Inspector Jane Ray Unannounced Inspection 09:45 7 March 2006 th 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 Reardon Court DS0000033461.V271231.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. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Reardon Court Address Cosgrove Close London N21 3BH 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 8447 9980 020 8350 4807 London Borough of Enfield Mr Mark Whitbread Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Nine of the 36 places are provided specifically for Intermediate Care in a separate dedicated flat. Nine of the 36 places are provided specifically for short term respite care in a separate dedicated flat. One service user specified to the Commission and who is under the age of 65 may continue to be accommodated in the home until discharged. The Commission for Social Care Inspection must be informed as soon as that service user is discharged. The provider must undertake a programme of measures that will achieve full compliance with the National Minimum Standards for Older PeopleStandards 19-26 - Environment, or those equivalent standards that may be published at the time, as required by Regulation 23(1)(a); 23(2)(a to p); 23(4)(c) and Regulation 16(2)(c)(g)(j)(k) - by 1st October 2004. In order to promote the health and safety needs of service users living in Reardon Court. The provider must ensure that the home complies with all requirements contained in the relevant Health and Safety legislation and further must undertake a programme of measures that will achieve full compliance with National Minimum Standards for Older People - Standard 38 - Safe Working Practices, or those equivalent Standards that may be published at the time, as required by Regulation 23(1)(a); 23(2)(a to p); 23(4)(c) and Regulation 16(2)(c)(g)(j). One specified service user who is under 65 years of age may be accommodated in the home for respite care. The home must advise the registering authority at such times as the specified service user attains 65 years of age or vacates the home. One specified service user who is under 65 years of age may be admitted to the intermediate care flat for rehabilitation. The home must advise the registering authority at such time as the specified service user vacates the home. 4. 5. 6. 7. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 5 Date of last inspection 26th September 2005 Brief Description of the Service: Reardon Court is a purpose built care home providing a service to elderly people. The service is divided into four flats or units, each providing a specific service. There are two units, 11 and 12, for permanent service users who have a diagnosis of dementia. Unit 29 provides intermediate/rehabilitation care service and unit 30 provides respite care. Reardon Court also provides a range of other services such as day centre, sheltered accommodation and an outreach service. Reardon Court is a quiet, secluded residential area close to open land, transport links and the shops and services of Winchmore Hill. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Reardon Court took place on the 7 March 2006 and was unannounced. At the time of the inspection the registered manager was on leave and the inspector was assisted very competently by an assistant manager and other members of the senior management team. The inspector spent time in all four of the registered units and was able to speak at length to twelve service users. Throughout the visit the inspector was also able to speak to the staff on duty who were all very helpful. The inspector looked at a number of documents including staff recruitment and training records as part of the inspection process. What the service does well: What has improved since the last inspection? At the last inspection there were 21 requirements that the home needed to meet to comply with the National Minimum Standards for Older People. Of these requirements 15 have been fully completed. This has included ensuring medication is recorded fully when it is received by the home and medication for service users in the respite unit is held in properly labelled bottles or boxes. Unit 11 has a new door entry system approved by the local fire service and the fire alarm has been upgraded. Staff training has been implemented on adult protection and mental health. Food is being properly stored in the fridges in the flat kitchens. Risk assessments are in place for service users who have cot sides on their beds. The weighing machine has been repaired and new electric beds have been hired as required. Carpets have been cleaned and some redecoration has taken place. The kitchen in flat 30 has been upgraded and the refurbishment of the kitchen in flat 12 is programmed to start and be Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 7 completed by the end of April 2006. At the time of the inspection the work on providing non-slip flooring in showers and bathrooms was underway along with refurbishing the showers in flats 29 and 30. This work is due to be completed by the end of April 2006. 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. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 8 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 Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 9 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): 2,4 and 5 The service users are able to visit the home as part of the moving process to see if they like the service. The managers at the home have comprehensive information on the service users to allow them to decide if the service can meet their needs prior to their admission. EVIDENCE: Since the last inspection four new service users had moved into flats 11 and 12. The inspector met these four service users and looked at the information the home had received prior to their admission. This showed that assessments had been sent to the home prepared by care professionals and other care providers as part of the assessment process. In addition the home had carried out it’s own initial assessment on each of the service users. The inspector spoke to each of the service users. Two were able to confirm that they had been able to visit the home as part of the admission process. One said that the staff had done “everything they could” to make her feel welcome and to help her settle at the home. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 10 The four service user records were inspected and these all contained a completed document giving the terms and conditions between the home and the service user so they were clear about what the home would be providing. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 11 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 and 9 The service users are supported to receive a high standard of personal care and their specific individual needs are recognised and incorporated in their care plans. Medication is being handled appropriately although where the medication is stored is warmer than the recommended temperature. EVIDENCE: Throughout the inspection the inspector was able to observe that the service users were well dressed and presented. A hairdresser was visiting the home at the time of the inspection. Service users commented that they received the support they needed to have baths and showers. They also said they were satisfied with the laundry service. Four care plans were inspected in flats 11 and 12. These reflected the individual needs of the service users. One service user in flat 11 has behaviour that can be quite challenging especially when receiving personal care and the care plan included clear guidelines on how staff should support the person with these needs. Two service users in flat 11 have cot sides on their beds and appropriate risk assessments are in place for this to ensure they are used properly and safely. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 12 The assistant manager showed the inspector how medication is signed for when it is delivered to the service. The manager on duty at the time signs to confirm the medication has been received. The medication in the respite unit was inspected. This was all held in the bottles or containers provided by relatives that were clearly labelled and where the doses were recorded to be administered by the staff. The assistant managers all confirmed that medication is not being decanted into dosette boxes unless this for the use of service users who self-administer their medication. The assistant managers explained that the medication is still stored in cupboards that are slightly above the recommended temperature. There are plans to provide medication fridges and this was due to be piloted in flat 11 during the following week. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 13 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 and 15 Service users are supported to enjoy a range of activities based on their individual interests. The food is very nutritious and enjoyed by the service users, but the fridge in flat 30 needs to be kept clean. EVIDENCE: The inspector spoke to the service users and staff as well as visiting the day service based at Reardon Court. It was observed that in the flats the activities are based on the individual service user interests including music, reading the newspaper, crosswords, manicures and singing. In addition anyone in the residential units is able to access the day service where there are a much wider range of activities including games, quizzes and creative activities. Service users are also supported by relatives and staff to access the local shops. During the inspection the lunch was being prepared and each flat had a different menu but the meals were all nutritious and incorporated fresh produce. The service users all commented on how much they enjoyed the food. One service user said she felt so much healthier since she moved to the home as she is now eating a good diet. She also said that the home is able to provide her with a gluten free diet. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 14 The fridges in each flat were inspected and food was all stored appropriately. The fridge in flat 30 was dirty and needed to be cleaned. At the last inspection there was a good practice recommendation that one service user in flat 11 has their food pureed separately to enhance it’s appearance and taste. This has been tried and was not appropriate for this individual. This has been recorded with an appropriate care plan in the service users case notes. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 15 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): 18 The staff have received the training needed to enable them to understand and follow the vulnerable adults protection procedures. EVIDENCE: Staff training records were inspected for four staff, one from each flat. These staff had all received adult protection training and this was recorded in their training records. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,25 and 26 The environment is clean, homely and there is evidence of a programme of ongoing maintenance. There are some outstanding environmental improvements required and definite timescales for this work are not yet available. EVIDENCE: The inspector toured the four flats and looked mainly at communal areas including the kitchens, laundry and bathroom facilities. Since the previous inspection a number of environmental improvements have taken place. This has included repairing the weight machine in flat 11, cleaning the carpets in room 4 of flat 11 and in the hallway of the same flat, and hiring two electronic beds to meet the specific needs of two service users. In addition at the time of the inspection work had started to replace the tiled floors in the bathrooms and showers with a non-slip alternative. Work had also started to refurbish the showers in flats 29 and 30 to meet the mobility needs of the service users. Since the last inspection the kitchen in flat 30 has been Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 17 refurbished with new flooring, base units and sink and the kitchen in flat 12 is due to be refurbished by the end of April 2006. There is however some outstanding work where costings have been prepared but no definite date for the work has been confirmed. This includes the refurbishment of the bathrooms in flat 11 and 30, the modernisation of the laundry rooms in flats 11 and 12, and the replacement of the blinds in flat 29. This work is listed as a restated requirement in this inspection report. The flats were all clean and tidy and free from offensive odours. The flats are centrally heated and a comfortable temperature. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The service has adequate numbers of staff on duty. These staff have had the appropriate recruitment checks to safe guard the service users. Staff are supported to receive the necessary induction and ongoing training but copies of this training must be available in their staff records. EVIDENCE: The inspector looked at the rota and the numbers of staff on duty during visits to the flats during the inspection. This showed that there were adequate numbers of care and ancillary staff available in each of the flats. There are 42 staff working in the residential services and the training records show that 21 of these staff have completed the NVQ level 2 in care and 12 are in the process of studying for the NVQ level 2 and 3. This means that 50 of the staff have an NVQ in care qualification and this percentage will increase. The recruitment records were inspected for four members of staff recruited since the last inspection. The recruitment checks were complete for all these staff including a CRB disclosure, two written references and a copy of ID. The induction records were also inspected for the four recently employed staff. The induction consists of a short checklist covered in the first few days and then a comprehensive induction based on the TOPPS guidelines. For two of the staff their TOPPS induction records could not be located. These records should be kept in the staff members file. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 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): 31,33,35,36 and 38 The home is well managed by a stable and competent management team. The views of service users and relatives are sought through a quality assurance system. Service users personal finances are appropriately managed in the home. Some staff need to have regular supervision. EVIDENCE: The service has a registered manager with many years experience. The manager is supported in this task by a stable and skilled senior management team. This team enables the service to be managed to a consistently high standard. The senior managers all have clear lines of accountability and areas of responsibility. The quality assurance report was inspected. This collated responses to questionnaires sent to service users, relatives and other people associated with Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 20 the home. This survey was completed in 2005 and was very comprehensive. The report does not however show what action was taken in response to the comments made. For example one person had responded that they would like to see food that reflected their culture served twice a week but it was not possible to tell from the report if this had been implemented. The service user finances were inspected. The administrator explained that most of the service users arrange for their relatives to manage their finances. Four service users have their money managed by their care manager. The home just holds spending money for the service users. Individual records are kept for each service user and receipts are available for all expenditure. The records for four service users were inspected and were satisfactory. Staff supervision records were inspected for all the staff who work in flat 30. There are nine staff and of these only four have a record of receiving regular supervision. The other staff have not been supervised since August and September 2005. The training records were inspected for four staff from each of the flats. These records showed that the staff have received appropriate health and safety training including moving and handling, food hygiene and first aid. At the previous inspection it was identified that some doors are propped open and need to be fitted with magnetic door closers to ensure the flats are safe in the event of a fire. The assistant manager explained that this work has been costed but there is no date for this to be implemented. Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 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 3 x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 3 1 x x 1 3 1 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 1 x 1 Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13(2) Requirement The registered person must ensure that the temperature of all areas where medication is stored is maintained below 25oC. The medication refrigerator must be maintained between 2-8oC when in use to store items requiring refrigeration. The registered person must ensure that the fridge in flat 30 is kept clean at all times. The registered person must prepare an action plan with time scales showing the refurbishment of the bathroom facilities in flats 11 and 30 and forward this to the CSCI. The timescale from the previous inspection of 18/12/05 was not met. The registered person must ensure the blinds in all bedrooms in flat 29 are replaced. The timescale from the previous inspection of 01/01/06 was not met. The registered person must ensure the laundry rooms of flats 11 and 12 are modernised and DS0000033461.V271231.R01.S.doc Timescale for action 30/06/06 2. 3. OP15 OP21 13(3) 23 (2)(a) 31/03/06 31/07/06 4. OP24 23 (2)(c) 31/05/06 5. OP26 23 (2)(d) 31/12/06 Reardon Court Version 5.0 Page 23 6. OP33 24(1)-(3) 7. OP36 18 (2) 8. OP38 23(4) redecorated. The timescale from the previous inspection of 01/03/06 was not met. The registered person must 15/04/06 prepare an action plan from the quality assurance exercise showing what action has been taken in response to the comments received. The registered person must 31/03/06 ensure that all staff have regular supervision. This is an immediate requirement at this inspection as the timescales from the previous two inspections have not been met. The registered person must fit 31/05/06 magnetic door holders if fire doors need to be left open. 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 Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Reardon Court DS0000033461.V271231.R01.S.doc Version 5.0 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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