Inspection on 28/11/08 for Regency Residential Home

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Regency Residential Home 6-8 Rosslyn Road Watford Hertfordshire WD18 0JY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yoke-Lan Jackson     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Regency Residential Home 6-8 Rosslyn Road Watford Hertfordshire WD18 0JY 01923244130 01923816325 sudera@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) RNJ Care Limited Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home Regency Residential Home is a care home registered for 30 people in the Old Age category. It had a new provider, RJN Care Limited, registered with the Commission since June 2008. The home is situated in Watford close to the main shopping centre. The two storey Edwardian building was once a hotel. All floors are served by a lift. On the ground floor, some features of the hotel such as the bar and some bar furniture have been retained. The bar area is the lounge and diner. Next to this is the main lounge. There is a smaller lounge designated the TV room. Next to this is a small Care Homes for Older People Page 4 of 25 Over 65 30 0 Brief description of the care home conservatory overlooking the car park, situated to the back of the building. The administrative office, the kitchen and the laundry are all on the ground floor. There are bedrooms on every floor and they are of varying size. There are two double bedrooms. The bathroom and toilet facilities are nearby. All the bedrooms have a washbasin and 12 of them have en suite toilet facilities. The home is managed and staffed by a multicultural team. The back garden consists of a lawn and a border of mature plants. The garden has garden furniture and seating for the service users. The garden is wheelchair accessible. The home charges £425 - £450 per week. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide. A copy of these and the most recent inspection report are available in the home. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Regency Residential Home was inspected on 28/11/2008 for the first time since its registration following the change of provider on 05/06/2008. The two company directors were present. One of the directors is currently the home manager. There are currently 27 people in residence. The inspection began with a tour of the premises. Time was spent observing how the care staff interacted with the residents and included a lunchtime observation. Staff, residents and visitors were spoken with. The inspection ended with a thorough discussion with the new management team. During the site visit, relevant documents were examined and information received by Care Homes for Older People Page 6 of 25 us was reviewed. This included the Annual Quality Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us with some statistical data. Additional information was received from the written survey forms distributed to some people who live in the home and to some relatives of people who use the service. What the care home does well: What has improved since the last inspection? This section is not applicable as this is the first inspection since the change of provider. Care Homes for Older People Page 8 of 25 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A prospective client can be assured that a comprehensive pre-admission assessment will be carried out before they are admitted to ensure that the home can meet all their care needs. They have the information they need to make an informed choice about using the service. Evidence: The home has a Statement of Purpose, a copy of which was submitted to us at registration. Each new admission was given a Service User Guide. The pre-admission documents were seen in the admission folder for three recent admissions. They were informative and included copies of documents from the funding local authority. The assessment process was carried out by one of the directors, who is currently managing the home. The residents seemed settled in their new home. The manager said that their condition has improved since admission. Care Homes for Older People Page 11 of 25 Evidence: One of the residents was originally admitted as a respite but they have since chosen to stay permanently and their choice was respected by both the service and the funding authority. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that their healthcare, personal care and social care needs will be positively met. They can be assured that their rights to privacy will be respected and that they will be protected by the homes medication policy and procedure. Evidence: During the site visit, the care plans for two recent admissions were examined. The written care plans reflected the care needs identified with risk assessments where appropriate. However, they are not currently written in person-centred format. The management is currently changing all written care plans to a person-centred format to ensure that care is identified and delivered in a manner that upholds the persons individuality whilst meeting their care needs. A key worker is assigned to each resident on admission so that continuity of care is provided. Daily care and events were documented in a separate folder and were kept up to date. The management ensures that all relevant notes are filed in the residents Care Homes for Older People Page 13 of 25 Evidence: personal record file at the end of the month. The management have worked hard over the last five months to ensure that every resident is appropriately cared for. Each resident has their healthcare needs and medication reviewed by their own doctor. The district nurse is attending to a resident who was admitted to the home with cellulitis and leg ulcers. Since the site visit, the manager has reported that the doctor and district nurse team have assessed the wound site which is now improving. The physiotherapist had attended to residents with restricted mobility and assessed them for proper walking aids. As a result new zimmer frames have replaced old ones. An additional wheelchair and two electronic hoists, including a standing hoist, have been purchased to assist residents with limited mobility. All members of staff attend mandatory training and refresher courses to ensure that they are meeting residents care needs. A trained member of staff administers medication. All medicines are stored in a drug trolley that is securely attached to the wall in the office when not in use. There is a Controlled Drug Cupboard but there are no controlled drugs in use at the present time. The Medication Administration Record (MAR) charts were examined and all gaps were accounted for. However, handwritten notes were not always signed and dated by the author. There were two cases of repeat prescriptions for paracetamol tablets (written as and when required) which have been referred to the doctor for review as the named residents had not been taking them for sometime. It was noted that the supplier pharmacist had used sticker labels on two MAR charts. Since the inspection, the manager has spoken to the supplier pharmacist to discontinue this practice and will ensure that medication is safely labelled in accordance with the safe practice guidelines of the Royal Pharmaceutical Society. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be supported to pursue personal interests, engage in communal activities and have close links with their friends and family as part of their chosen lifestyle. They can be assured that a healthy diet is promoted which meets their nutritional needs and expectations. Evidence: Residents wishes and preferences are respected and they are given choices in the daily living routine in the home. They are encouraged to have close links with their family and friends. Two members from the local church were seen visiting a resident and they spent time together in one of the lounges. There was a choice of activities on the day of the unannounced site visit. A member of staff and three residents were playing a card game. Another member of staff led a group exercise with catch a ball competition. One of the participants is over 100 years old. Some residents were seen conversing among themselves as they watched television together. The atmosphere was peaceful and homely. Members of staff were present in the communal areas throughout the day. The management have reviewed the activity programme and improvements have been Care Homes for Older People Page 15 of 25 Evidence: made to the delight of both residents and their relatives which was reflected in the written comments received by us. The home manager and selected members of staff will be attending activity courses to enhance the recreational and therapeutic activities offered to residents. A log book is kept of the activities that each service user has been involved in. Under the new management, a chef has been employed and therefore care workers are no longer deployed to prepare hot meals for the residents so that they can spend more time with the residents. The meals provided are wholesome and nutritious and there is a choice of menu. On the day of the site visit, most of the residents were in the dining room enjoying a three course meal. The main meal of the day was fish and chips with either peas or baked beans and there were second helpings available to those that wanted them. In general residents gave positive feedback about the meals served. A resident felt that the peas could taste better. The manager reassured him that she will look into this and perhaps change the brand of peas purchased. There were two residents who preferred a late lunch and three had lunch in their bedroom as they wished. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be listened to and that any concern raised will be investigated and appropriate action will be taken. Evidence: The home has a robust Complaints Policy and Procedure. Staff said they have training concerning the safeguarding of vulnerable adults. The home follows the joint agency procedure specified by Hertfordshire County Council Adult Care Services. A residents meeting is held regularly and minutes of the meeting are taken. There is a suggestion book for anyone to raise their concerns about the care and service. The management handle concerns raised by residents or their relatives promptly and appropriate changes have been made. The home is not involved in the residents finances. However, the management assist each resident with their personal allowances. Proper accounting records are kept. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they live in a safe environment and that the management is working towards making the environment comfortable and more homely to live in. Evidence: The premises appeared clean and tidy. Under the new management there is a maintenance and refurbishment programme planned for 2008/2009. All servicing records have been kept up to date, including lift servicing and equipment used by individuals. All old commodes and old zimmer frames have been replaced with new ones. All the taps in each residents bedroom have been replaced with new ones that are easier to turn on. An additional wheelchair and two new hoists have been purchased, including a standing Oxford hoist. The home has had inspections by the Hertfordshire Environmental Agency and by the Hertfordshire Fire Service Authority and their reports have been positive. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the service has a thorough recruitment process to help keep residents safe and that there is an effective staff team who will support them. They can be assured that the management will continue to improve the skill mix of staff to ensure that the quality of care for all residents will continue to improve. Evidence: Staff are adjusting to the change in management since the change of provider. The home has recruited additional staff with diverse backgrounds and experience to ensure that the skill mix of staff is appropriate to the assessed needs of the residents. New posts created under the new management include a new chef, an increased number of domestic workers and more care workers and senior care workers. The homes recruitment policy and practices comply with legislation. All new recruits are checked against the Protection of Vulnerable Adults (POVA) list and they have Criminal Record Bureau checks and clearance before commencing work in the home. The home manager said that the recruitment process is thorough to ensure the safety of residents. The staff records examined were kept up to date. The home follows the Skills for Care training programme and all care staff have NVQ2. Care Homes for Older People Page 19 of 25 Evidence: There are opportunities for staff to progress to NVQ3 and management skills. All members of staff have had in-house training with an external organisation. Topics include Dementia Awareness, Communication Skills, Safer Moving and Handling, Infection Control, POVA, Safeguarding Procedure and First Aid. A further training programme has been arranged for the coming months including Person-Centred Care Plans, Prevention of Pressure Sores and other relevant topics in order to meet the specific care needs of the people who live in the home. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the care and service provided will continue to improve under the new management and that their welfare and health and safety will be promoted and protected. Evidence: This is the first key inspection under the new provider, RJN Ltd. One of the directors is currently managing the service until a suitable home manager can be recruited. The standard of care and service provided is well maintained. Each member of staff is given the providers handbook on its policies and procedures which all staff are required to follow to ensure the safety and protection of people who live in the home. The new provider has an annual development plan, a copy of which was submitted to us. All the plans scheduled for the first six months were on target. The directors intend to send out written survey questionnaires to all residents, their relatives and others as Care Homes for Older People Page 21 of 25 Evidence: part of their annual quality assurance and monitoring system. Their first report will be produced in 2009. The premises have been risk assessed and made safe and all servicing records have been updated. Records for the protection of residents are well maintained and kept in accordance with the Data Protection Act 1998. The Annual Quality Assurance Assessment (AQAA) forms issued by us were returned on time for this inspection. They were informative and information provided was included in this report. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 9 It is recommended that care plans are written in personcentred format to reflect the person-centred care provided. To ensure medicines are administered safely, and to enable case tracking of written information, it is recommended that all handwritten notes on the Medication Administration Charts be signed and dated by the author. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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