Inspection on 07/03/07 for Richard Cox House

This inspection was carried out on 7th March 2007.

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

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

Other inspections for this house

Richard Cox House 01/12/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Richard Cox House Dog Kennel Lane Royston Hertfordshire SG8 7AB Lead Inspector Mrs Alison Butler Key Unannounced Inspection 7th March 2007 10:00 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 Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 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. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richard Cox House Address Dog Kennel Lane Royston Hertfordshire SG8 7AB 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) 01763 249111 01763 243758 www.quantumcare.co.uk Quantum Care Limited Mrs Sandra Lee Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (29), of places Physical disability over 65 years of age (29) Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: Richard Cox House was first registered with Hertfordshire County Council on 1st July 1992. The fees for this service range from £407.89-£560.00 per week (this was correct as of 08/03/07). 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 hairdresser’s 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 residents to fulfil their social, emotional, spiritual and psychological needs. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written following a visit to the service, attending the home’s yearly forum and from information that has been gained from previous inspections or has been know to the Commission for Social Care Inspection. The majority of the time was spent observing and talking with residents and staff. Care records were also examined. What the service does well: What has improved since the last inspection? A number of areas have been redecorated since the last inspection and the lighting has been improved and better meets the resident’s needs. Medication has improved and the company have employed a pharmacist who carries out a full audit. This was carried out in December and no major issues were found. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 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 Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to Richard Cox House. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate assessments have been carried out to ensure the needs of the residents can be met in the home EVIDENCE: From examination of two files they showed that the manager had carried out a pre-admission assessment. These provided details of their needs and how they should be met. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recorded information is generally good. Residents receive a good quality of care from knowledgeable and caring staff. EVIDENCE: The two care plans examined contained detailed information about the residents needs and the support that they require to enable staff to meet their needs. Each individual page within the care plan should contain the individual’s name and date of birth to ensure that if it is not placed back in the file, it is obvious to whom it belongs and no mistakes will be made. More detailed information regarding the word ‘regular’ would enable staff to better care for individuals (for example two hourly etc.). A discussion took place where it was difficult to weigh some residents. In these circumstances, alternatives should be looked into (for example the use of a tape measure to identify other means for gauging their weight gain or loss) and observations should be recorded in the monthly review. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 10 Good interaction was observed during the inspection, residents spoken to made comments “they are lovely carers” “ they try their best” “ they care for us” “ couldn’t ask for better” “can be a little slow answering the bell but they are busy”. A risk assessment must be put in place for the resident who uses a reclining chair. A generic risk assessment has been completed for the use of cot sides but this should be written for the individual and ensure all information is relevant to the individual service user. A full medication audit was carried out in December 2006 and the only concern raised was a large amount of eye drops was held. These have since been returned to the supplying pharmasist. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Visitors are welcomed and contact is maintained within the local community. Residents are encouraged to make choices about their lives. EVIDENCE: Residents spoken to during the inspection stated that their families and friends were able to visit at any reasonable time. Families spoken to at the home’s forum also felt that the home was very welcoming and the atmosphere is very relaxed. Staff are very helpful and kind, they feel they are kept informed about issues and are able to ask questions and feel these are answered appropriately. A group of residents who suffer from dementia were drawing and colouring pictures and they were very much enjoying this. Another resident was reading the daily newspaper and updating everyone on the news for the day. A short quiz was also held in which the residents had to name colours associated to the questions. One resident appeared to be asleep and although a cup of tea was placed in front of them no further interaction was made, on checking the daily notes they had slept well during the night. It is felt that they may benefit Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 12 from a walk in the garden as they enjoyed being outside. On the evening of the forum the manager informed me that a number of residents are now going outside for a small daily walk around the garden. The residents were happy to allow the inspector to join them for lunch, and this was a very enjoyable experience; they were each served by the care staff and offered vegetables of their choice. The residents spoke about their life at Richard Cox and that they sometimes went to the day centre to take part in various activities. They were complimentary about the food at Richard Cox and that they are asked about their likes and dislikes. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place for the protection of the residents. EVIDENCE: There is a copy of the complaints procedures available. Relatives and residents spoken to feel able to make their views, issues and concerns known and feel they would be dealt with effectively. The manager had responded well to an allegation of abuse and the correct procedures were followed which resulted in a good outcome with all information recorded appropriately. Relatives attending the homes forum were very happy with the care provided at Richard Cox House. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, well maintained and regular maintenance checks are carried out on services and equipment. EVIDENCE: The environment of Richard Cox provides a warm and welcoming atmosphere. There has been new carpet laid in the corridor of Phillips and Ermine units. The lounge in Ermine has also had new flooring laid. New kitchens have been fitted in Poppins & Phillips. Lighting throughout the home has been improved which better meets the needs of those whose eyesight is not as good as it may have been in their younger days. There are proposals to divide the large lounge in Ermine to make two smaller areas and purchase a fireplace. The manager has applied for a grant to improve the bathrooms to make using it a much more pleasant experience for the residents. This will be looked at, at the next inspection. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 15 The manager has been provided with a new office by using the day centre bathroom, which was no longer in use as a bathroom. This in turn has created other areas to use for storage. The laundry facilities are able to meet the resident’s needs. Residents were happy with the laundry service provided and felt that it is a quick. Policies and procedures are in place for the prevention of infection. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers and their deployment are able to meet the needs of the residents. Recruitment procedures are robust and offer protection to the residents living at Richard Cox House. EVIDENCE: The rotas showed that staffing levels were able to meet the care needs of the residents at the time of this inspection. Residents felt their needs were usually met, although sometimes they had to wait a little due to care staff being busy. A relative brought up at the forum that she felt that there was reduced staffing levels at weekends. The manager stated that there is the same number of care staff on as during the week, the rotas showed that they have the same number of care staff although there is no administrator on at weekends and it is the administrator who would usually greet them on arrival. They were satisfied with the answer and felt that the staff may have been busy dealing with other residents. A rolling programme for training is in place, this ensures that staff are kept updated and they keep in line with current good practice. Previous inspection shave shown that staff are only employed after all the relevant checks have been made and are held with individuals files. There is a full induction programme in place and the manager is responsible for ensuring that this is carried out. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good management structure in place. The health welfare and safety of residents, staff and visitors to the home is protected most of the time. EVIDENCE: The manager continues to ensure that staff receive appropriate training and also ensures that she to updates her own skills and competency. All statutory records were available for inspection and were well maintained Examination of the fire records showed that the testing had been carried out appropriately. Accident and incident records were examined and these are well maintained and the Commission for Social Care Inspection have been notified as required of all those that adversely affect the well being of the residents. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 18 Previous inspections have shown robust procedures are in place to protect the financial interests of residents the company also employ a financial auditor who carries out an annual audit in their homes. Policies and procedures are in place for the management of residents’ finances. A generic risk assessment is in place for a resident who requires the use of cot sides, but this should be individualised to ensure that it is relevant to them. A risk assessment must be in place for the resident who uses a reclining chair to ensure that it is safe and meets their needs. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 19 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X X 2 Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 OP38 Regulation 13(4)(b) & (c) Requirement A risk assessment must be completed for the residents who uses a reclining chair Timescale for action 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP8 Good Practice Recommendations Where generic risk assessments have been written these should be individualised for a specific residents and there environment. Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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 Richard Cox House DS0000019508.V332111.R01.S.doc Version 5.2 Page 22 - 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!