Inspection on 01/12/08 for Richard Cox House

This inspection was carried out on 1st December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Richard Cox House 07/03/07

Richard Cox House 16/01/06

Richard Cox House 28/06/05

Richard Cox House 27/01/05

Richard Cox House 16/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Richard Cox House Dog Kennel Lane Royston Hertfordshire SG8 7AB     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: Bijayraj Ramkhelawon     Date: 0 1 1 2 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 24 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 24 Information about the care home Name of care home: Address: Richard Cox House Dog Kennel Lane Royston Hertfordshire SG8 7AB 01763249111 01763243758 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Lee Type of registration: Number of places registered: Quantum Care Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Richard Cox House was first registered with Hertfordshire County Council on 1st July 1992. It is a large two-storey building in quiet residential area of Royston, within walking distance of all local amenities. It is divided into four units, three on the ground floor and one on the first floor. The first floor is served by a passenger lift. Each unit has its own lounge/dining area and domestic style kitchenette. All residents have a single bedroom. There is a hairdressers salon, a conservatory, a large day care area, several offices and a central kitchen. Outside the home is limited car parking and there are two garden courtyard areas to the rear. The purpose of the home is to provide a high standard of care in a homely, friendly and safe environment. The aim is to treat residents as an individual and help them live as full a life as possible. They will assist Care Homes for Older People Page 4 of 24 Over 65 29 29 29 0 0 0 Brief description of the care home residents to fulfil their social, emotional, spiritual and psychological needs. The fees for this service range from £420.14-£522.34 per week (this was correct as of 01/12/08). A copy of the Statement of Purpose, Service users Guide and the last inspection report are available at the care home. Care Homes for Older People Page 5 of 24 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: This unannounced key inspection was carried out on the 1st December 2008 and took one whole day. It included talking to people using the service, visitors and staff, examining care plans, staff files, staff training records, fire safety procedures, administration and management of medicines, maintenance records, all other relevant records and documents and a tour of the premises. The home has completed an Annual Quality Assurance Assessment (AQAA). This is a self assessment document that looks at how the service is meeting the needs of residents and also provides us with some numerical information. Information from this assessment has been reflected in the report. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: The home must ensure that the hot water system is repaired and maintained in good working order so that hot water is available throughout the home. It should also ensure that bathrooms are not used as storage so that residents and staff have easy access to these facilities and are not at risk of injuring themselves. The lingering odours at the entrance of Tree Top unit are identified and eliminated so that the health of residents and staff are not put at risk. The badly stained and worn carpet in the bedroom 6 of Tree Top unit should be replaced so that the residents dignity and health is not put at risk. Care Homes for Older People Page 8 of 24 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 24 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 24 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. Pre-admission practices ensure that prospective residents can be sure that the home fully understands their needs. Evidence: A written Statement of Purpose and a Service User Guide was in place and both documents were available to prospective and current residents and their relatives. People living in the home and their relatives spoken to confirmed that they were encouraged to visit the home prior to admission. Care plans examined showed that an assessment of needs of the residents was carried out either in their own homes or places of residence prior to an offer of placement was made. Care Homes for Older People Page 11 of 24 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 using the service can be confident that their health and personal care needs would be met appropriately because care plans are detailed, well documented and updated to reflect individuals changing needs. Evidence: Three care plans were examined and these showed to be comprehensive and included residents details on admission, assessments of needs, risk assessments, nutritional assessments using the body mass index, activity plans, daily progress report, care plan monthly reviews, weight charts and other health care observations so that individuals identified needs are met appropriately. The records for the management and administration of medicines were kept in good order, thus indicating that there is a robust system in practice to safeguard residents well-being. People using the service spoken to said that staff treated them with respect and their right to privacy was maintained. Staff spoken to said that they respected the wishes of people who were terminally ill and responded appropriately and sensitively in all situations when offering palliative care. Care Homes for Older People Page 12 of 24 Evidence: As stated in the AQAA, the manager will within the next twelve months implement the new care plan format for all residents and will devise a sytem for gathering more information on each resident with the involvement of families. Care Homes for Older People Page 13 of 24 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 using the service can be confident that their identified needs would be met appropriately and that they would be enabled to live the lifestyle they chose. Evidence: The home has dedicated activity co-ordinator now in post who plans and arranges all the activities for the residents on their behalf. A programme of events is displayed each month in the reception area and on each unit. Staff said that residents were also reminded of activities taking place on a daily basis. Residents spoken to said that there was a variety of activities provided for them. Some said that they preferred to keep themselves occupied with their choices of activities including watching TV, listening to music and reading. External entertainers are invited to visit the home on a monthly basis. The links with the community include regular church visits, school choir visits the home and trips to the local shops. Residents are offered the opportunity to manage their own financial affairs on admission and safe keeping of valuables is explained. Personal belongings were evident in individual bedrooms. Care Homes for Older People Page 14 of 24 Evidence: There is a five-weekly seasonal menu with choices of cooked meals provided including alternatives. We saw that the lunch was served unhurriedly with assistance and encouragement given by staff. Tables were laid nicely and a choice of drinks was available. People spoken to were complementary of the food provided. Each resident has a food preference sheet on their care plan, which details likes and dislikes as well as allergies in relation to food and drink. Care Homes for Older People Page 15 of 24 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 using the service can be assured that their concerns and complaints would be listened to and acted upon. Evidence: A copy of the complaints procedure was available to people living in the care home. Those spoken to said that they were aware of the complaints procedure but would prefer to speak to a member of staff or the manager if they had any concerns. Staff files examined and staff spoken to confirmed that they have received training on safeguarding adults. No complaint has been received in the last twelve months. However, seven compliments were received during the same period. Care Homes for Older People Page 16 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from a comfortable environment that is mainly well maintained and clean. Evidence: The home was kept clean and generally well maintained. A rolling programme of re decoration was maintained. The manager said that new carpets are provided and bedrooms are decorated to residents choice of colour in all vacated bedrooms for prospective residents. However, the bathroom in Tree Top Unit, was being used as storage with wheelchairs, boxes, hoists that blocked access to the bath and washing areas. To promote peoples dignity, the lingering odour at the entrance of this unit that must be identified and eliminated and the carpet in bedroom 6 in the same unit should be replaced as it was badly stained and worn. The area behind the washing machines including wires, pipes and connections in the laundry were covered with thick layers of dust. These areas should be kept reasonably clean as it can affect the health of people working in the laundry room. Residents and staff said that the home has had ongoing problems with the boilers where hot water is not available throughout the home at any given time. One resident commented that there were on accasions when staff had to boil the kettles so that residents could be given a wash (residents and staff confirmed that this was not the practice now). Overall, people using the service said that they were happy with their rooms but the problem with the hot water needs to be sorted Care Homes for Older People Page 17 of 24 Evidence: out. However, an email received on the 29/12/2008 from the manager stating that the home has got a new pump in place and the hot water is now adequate. Staff said that they had attended training in infection control and sanitizing gel is provided at the entrance of each unit which promotes and maintains good hygiene practices. As stated in the AQAA, the manager will within the next twelve months provide new carpets for the lounge dinners on Philips and Poppins units as well as new lighting and decorating for both areas. Care Homes for Older People Page 18 of 24 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 living in the home can be assured that their identified needs would be met appropriately by trained and competent staff. Evidence: Adequate level of staff are rostered on duty to care for and support the number of residents living in the home. Residents spoken to were complimentary about the support they received from staff. A rolling programme of staff training was in place and staff spoken to confirmed that they had attended all the mandatory and other relevant training including Dementia and Safeguarding Adults which ensures that staff are competent and have the necessary skills to meet peoples needs and safeguard them from abuse or harm. Staff files examined showed that staff have gone through a thorough recruitment procedure and that written references have been taken and CRB checks carried out prior to an offer of employment was made to ensure that vulnerable people are protected. Staff also confirmed that they received induction training and formal supervision. Care Homes for Older People Page 19 of 24 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 living in the home can sure that the home is well managed and they will be enabled to express their views. Evidence: The home has a new manager since August this year who stated that robust systems and processes are being put in place to ensure that residents receive a good quality of care and services. Feedback we received from people living in the care home, their relatives and staff was positive. The management communicate a clear sense of leadership within the home and have an open-door policy where staff could see them at any time with any issues or concerns they may have. People living in the care home and their relatives have commented positively on the good practices and quality of service provision. However, concerns have been raised in relation to the ongoing problems with the hot water system which has been long standing (see Evidence Summary- Outcome area- Environment) Care Homes for Older People Page 20 of 24 Evidence: The records for the management of peoples money showed that receipts for all expenditures and money received from relatives were being logged and accounted for, thus ensuring that staff were managing residents money in a responsible and protected way. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people living in the care home and staff are promoted and protected. These records are accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. We have been kept informed of all accidents and admissions to hospital appropriately as required by legislation. Regular checks on hot water temperatures showed that the system was not producing hot water to the required level. Moving and handling equipment were recorded. A valid insurance certificate was displayed in the reception area and this offered cover of no less than five million pounds and expires on the 1st July 2009. Care Homes for Older People Page 21 of 24 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 22 of 24 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 1 21 13 Bathrooms must not be used 16/01/2009 for storage. So that residents and staff can have easy access to these facilities and are not put at risk. 2 26 13 The lingering odour at the entrance of Tree Top unit must be identified and eliminated. So that peoples dignity and health are not put at risk. 16/01/2009 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 26 Badly stained and worn carpet in the residents bedroom should be cleaned and/ or replaced. The areas behind the washing machines that are layered with dust should be cleaned. The hot water system should be repaired to ensure that hot water is supplied throughout the home. 2 38 Care Homes for Older People Page 23 of 24 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 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!