CARE HOMES FOR OLDER PEOPLE
Rebecca Court Rebecca Court 9 Staithe Road Heacham King`s Lynn Norfolk PE31 7EF Lead Inspector
Mrs Jacky Vugler Unannounced Inspection 6th December 2005 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 Rebecca Court DS0000035200.V272038.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. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rebecca Court Address Rebecca Court 9 Staithe Road Heacham King`s Lynn Norfolk PE31 7EF 01485 570421 01485 572910 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) Norfolk County Council-Community Care Ms Glynda Jermy Care Home 36 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (36) of places Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. That Norfolk County Council undertakes a review of the windows with a view to replacement of those which are causing discomfort to the Service Users. The review to be carried out by the end of March 2004. Wheelchair users may be admitted only to rooms of at least 12 sq m, rooms numbered 10, 11, 24, 32, 33, 35, 36, 49, 50, 61, 62, 65, 66 & 67 as at 31 March 2003. 19th July 2005 2. Date of last inspection Brief Description of the Service: Rebecca Court is a care home providing personal care and accommodation for thirty-six (36) older people. The Home does not provide nursing care. It also has two day care places each day of the week, including weekends. The Home is owned by Norfolk County Council-Community Care.The home is located in the village of Heacham, which is between Kings Lynn and Hunstanton. Rebecca Court is a large detached building set in its own grounds. Accommodation is in thirty-six single rooms on the ground and first floors. A small passenger lift is available. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection taking place on a weekday. The Manager Ms Glynda Jermy was present throughout the day. Preparation for this inspection had taken place at the CSCI office. Records were viewed and a tour of the building was undertaken. Ten residents were spoken to, either privately or in small groups. Two members of staff were spoken to. Comment cards were not left at the close of this inspection as some had been completed recently for the CSCI and the home has just completed a quality audit questionnaire and is in the process of completing a Christmas questionnaire. What the service does well: What has improved since the last inspection?
A new call system has been implemented and this allows the Manager to monitor the time it takes for staff to answer the call bells (2 minutes on average). The Manager said that it has been agreed for the home to have a new hoist, some new bedroom carpets and ground floor toilet flooring. The home has changed its registration to accommodate eight residents with dementia and has therefore increased its staffing levels. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 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. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The admission process is well managed and residents are given clear information regarding the home. EVIDENCE: The home does not accommodate residents for intermediate care. All appropriate information is gained from other healthcare professionals prior to admission. The Manager or a Care Co-ordinator visit the prospective resident and they, and their family, are encouraged to visit the home where this is possible. At this point they are given detailed information about the home. Residents said that staff had helped them to settle in well. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 10 Residents’ are looked after well in respect of their health and personal care needs. However, further attention needs to be given to the completion of all care plans. EVIDENCE: The care plans viewed varied in their content, some were well completed and regularly reviewed and others not so well completed, for example, the resident had not signed it, there was no photograph, the social history was not completed. Although the care plans continue to improve, they all need to be completed to ensure that residents’ needs are met. This requirement is therefore repeated. All of the residents spoken to said that the staff protected their privacy and treated them with respect. A resident said “they treat us with respect, just like a family, they are very kind”. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 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): 14 The residents are able to exercise choice and control over their lives. EVIDENCE: The residents spoken to all commented on the choices available to them. For example, one resident said the staff ask, “what are you going to wear today”? Another said, “I can walk around and sit where I like in the home”. One resident said “I sometimes watch television until late and I go to bed when I like”. During the inspection residents were seen to move around the home freely. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 11 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): These standards were not assessed on this occasion. EVIDENCE: Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 12 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, 21 & 25 Service Users do not live in a well maintained environment. EVIDENCE: These standards were assessed in order to follow-up the progress made in complying with previous requirements. There are various requirements and recommendations from previous reports, which are repeated. These are beyond the control of the Registered Manager and have been reported to the Property and Procurement Department at County Hall. For example, the recommendations to redecorate bedrooms and repair and redecorate the areas damaged by the use of wheelchairs are repeated in this report. There is also an outstanding condition of registration concerning windows throughout the home with a view to replacement. At the point of registration of this local authority home, a condition of registration was imposed, which required Norfolk County Council to review all of the windows with a view to replacement of those, which were causing discomfort to the residents. This
Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 13 should have happened by March 2004. To date the Commission has not received the results of this review (if indeed it has properly taken place) and the Commission has not received any plans for removal of the windows. This is now extremely urgent as the home is being operated in contravention of its Conditions of Registration. The Manager said that one bedroom is awaiting refurbishment and the window will be refurbished at that time. Work has not yet started on upgrading the patio area so that it is a safe and attractive area for the residents to sit in. However, the Manager said that its use has now been agreed and a decision is awaited from the District Manager. The requirement for this is therefore repeated. The recommendations for the bedrooms to be redecorated where necessary and for hand basins to be provided within each toilet area remain outstanding. The Manager said that this work would commence in the New Year as they have now recruited a handyman. Following the last inspection, the unguarded towel rail in the ‘flat’ has been removed and replaced with a suitable radiator and the electric cooker in the ‘flat’ has been disconnected. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 The resident are in safe hands, the home promotes staff training. EVIDENCE: Three members of staff have started the NVQ level3 Care Co-ordinators course. Six members of staff have completed the NVQ level 2 and a further four are in the final stages. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Residents’ financial interests are safeguarded. EVIDENCE: The residents’ financial records were well kept. Receipts were kept and a record of income and expenditure. The residents’ signatures were obtained for any cash given to them. The monies of nine residents were randomly checked and found to be correct. Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 1 2 X X X X x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 17 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 OP7 Regulation 15 Requirement The Registered Manager must ensure that the service user plans continue to contain detail about the individual needs of the service users. (Previous timescale of 19/07/05 not met). The Registered Person must ensure that there is a plan for replacing windows throughout the home. (Previous timescale of 30/09/05 not met). The Registered Person must ensure that the patio area next to the dining room receives attention so that it is a safe and attractive area for the service users to sit in. (Previous timescale of 31/10/05 not met). Timescale for action 28/02/06 2. OP25 23(2)(p) 31/03/06 3. OP19 23 (2) 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations
DS0000035200.V272038.R01.S.doc Version 5.0 Page 18 Rebecca Court 1. 2. 3. Standard OP10 OP19 OP19 It is recommended that hand basins are provided within each toilet area. (This is a repeat recommendation) It is recommended that the redecoration of the bedrooms be completed as soon as possible (This is a repeat recommendation) It is recommended that any wheelchair damage to doorways be repaired and redecorated (This is a repeat recommendation) Rebecca Court DS0000035200.V272038.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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