Inspection on 08/02/06 for Richmond Court Nursing Home

This inspection was carried out on 8th February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Richmond Court Nursing Home 18/09/07

Richmond Court Nursing Home 14/12/06

Richmond Court Nursing Home 13/06/05

Richmond Court Nursing Home 01/03/05

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

CARE HOMES FOR OLDER PEOPLE Richmond Court Nursing Home 33/35 Beeches Road West Bromwich West Midlands B70 6QE Lead Inspector Mrs Mandy Beck Announced Inspection 8th February 2006 09:30 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 Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Richmond Court Nursing Home Address 33/35 Beeches Road West Bromwich West Midlands B70 6QE 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) 0121 500 5448 0121 553 7357 Richmond Court Nursing Home Ltd Craig Hill Care Home 42 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (11) of places Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Staffing levels meet the Residential Forum tool requirements in relation to service users dependency. Staffing levels should be assessed separately for two units using the residential staffing forum tool. The Proprietors will not reduce staffing levels without prior agreement with the CSCI. Service users within the category OP and DE(E) may be 55 years and over. 13th June 2005 Date of last inspection Brief Description of the Service: Richmond Court is a 42 bedded home catering for 31 residents who have dementia and 11 residents who are elderly. On the ground floor there are two lounges and two dining rooms. There are thirty four rooms in total of which twenty one are en suite, seven doubles and twenty eight singles. The home has five bathrooms and two shower rooms. The home has a passenger lift that enables service users to access the first and second floor. A range of aids, which include handrails, grab rails, hoists and other specialist equipment are available to meet the needs of dependent service users. Outside the home is a large garden with level patio area. The home also has parking facilities available to the side of the home. Richmond Court is situated ten minutes from the town centre of West Bromwich and is on the local bus route. It is five minutes from the local motorway networks making it very accessible Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection between the hours of 09:30 and 16:30 hours. The judgements in this report are made using evidence supplied by the home in their pre inspection questionnaire, 7 comment cards and through discussions with the registered provider and manager. Four residents files were seen for case tracking purposes and to assess the progress made towards meeting the outstanding requirements from the previous inspection. A tour of the premises was also conducted in order to see the newly refurbished environment. The inspector would like to thank the registered provider and manager, staff and residents at Richmond Court for their hospitality throughout the inspection What the service does well: What has improved since the last inspection? Since the last inspection the home has taken positive steps to meet the previous requirements. The registered manager has worked hard to develop staff files and ensured that all staff have required mandatory training. As previously mentioned the refurbishment of the premises is now near completion and has been tastefully done. The statement of purpose and service user guide have both been updated to include all required information. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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 Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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): 1,2,4 Each resident can be assured that when they enter Richmond Court their needs can be met and that they will have the required information to make a choice about living there. Each resident has a written statement of terms which is signed by them indicating their understanding of the service to be provided for them. EVIDENCE: The statement of purpose and service user guide have both been updated since the last inspection, it provides prospective residents with a clear idea of the home’s aims and objectives in providing a quality service. There is a slight amendment required; the registered manager needs to include his relevant qualifications and experience. The terms and conditions for each resident have been revised and new contracts are in place awaiting signatures from residents or their representatives this will ensure that residents are aware of the conditions of their stay at Richmond Court. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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): 7,8,10.11 Residents are treated with respect and their dignity is promoted at all times. They can be assured that their health care needs will be met and all care for residents is set out in an individual care plan. Residents can be assured that their dignity will be respectfully maintained in the final stages of their lives. EVIDENCE: Residents files were seen each file had the required information, there were risk assessments in place that addressed pressure sore development risk, nutritional screening risk, falls and moving and handling risk assessments, if a resident was identified at being of risk they had an appropriate written management plan that aims to minimise the risk to them. For example one resident was noted to have lost weight recently, the risk management plan clearly identified a course of action, included talking to other professionals such as the dietician and speech and language therapist to review the residents needs and address the weight loss problem. There was further evidence in the files that residents have their psychological well being reviewed on a regular basis by the mental health team this helps to ensure that residents receive appropriate care for their individual needs. The Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 10 home has a low incidence of challenging behaviour and all of the residents seen during the inspection appeared relaxed and happy. Care plans generally included all of the residents needs identified within the assessment. They require some fine tuning to ensure that all identified needs have a plan. For example one resident was identified to suffer from constipation and took medication to relieve the symptoms but there was no plan to manage this. Staff currently record residents bowel movements in a daily communication book whilst it is pleasing to note this is being done it makes if difficult to identify when individual residents may be constipated. After discussion with the registered manager a new system of recording will be introduced to make it easier to identify those residents who may be constipated to ensure timely treatment is administered. All care plans and risk assessments are reviewed on a monthly basis, due to the level of understanding that some of the residents have because of their dementia it is difficult for them to indicate their understanding of their planned care and therefore difficult for them to sign to indicate their agreement with it. In such instances the home seeks to include relatives in the care plan reviewing process. It was evident that residents are referred to community specialist services such as community mental health nurses, dieticians, speech and language therapists and chiropody should they require them. This helps provide a multi agency approach to individual care and a timely response to care needs. Medicine administration was not assessed during this inspection however the previous requirements were looked at and found to be met. Staff were seen throughout the day talking respectfully to residents, knocking doors before entering rooms and toilets this helps to ensure that residents privacy is maintained. It was pleasing to note that each of the residents files seen their wishes had been recorded for the final stages of their life and as such residents can be assured that they will be cared for sensitively and with respect at the time of their death. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection EVIDENCE: Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 12 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 during this inspection EVIDENCE: It is noted however that the address of the Commission for Social Care Inspection has now been included within the homes complaints procedure. This was a previous requirement now found to be met in full. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 13 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 Residents live in a well maintained and safe environment as a result residents appear relaxed and comfortable in their surroundings. EVIDENCE: Since the last inspection there have been many changes to the internal environment. The home has been tastefully decorated throughout and new furniture supplied to every bedroom, lounges and dining rooms. It also benefits from motion sensitive lighting in corridors this is both energy saving and also ensures that when residents leave their bedrooms during the night there is always adequate lighting to help reduce risk of falls or of residents getting lost. The home sought the advice of the Alzheimer’s society with regard to internal decoration and colour design and this advice has been followed. There are neutral colours throughout with green and blue chairs, red doors and appropriate signage. Signs are both pictorial and in word, the manager is Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 14 currently arranging for signs in other languages to ensure the needs of all their residents are addressed. Every bedroom has been supplied with new furniture, there are some very minor repairs required to the environment and these are being worked into the homes plan for repair and refurbishment. At the time of inspection the garden fencing was being replaced this will ensure that residents are able to access the garden and enjoy the outdoors if they wish to do so. The registered provider and manager are to be commended upon the hard work and attention to detail within the internal environment, the changes are having a positive effect upon residents and this was seen during the inspection all residents were relaxed and calm and happy in their surroundings. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 There are sufficient staff on duty to meet residents needs and maintain their safety. EVIDENCE: The home has two units Oak and Beech both units are staffed separately. There were sufficient staff on duty to meet residents needs. Four care staff in total on both morning and afternoon shifts and three night care staff. The registered manger is available in addition to these numbers. At present the home does not use a recommended tool to determine the level of staff in relation to the number of residents. the registered manager will obtain one from one of their sister homes in the near future. There are also sufficient staff to provide laundry services, domestic services and maintenance. The home also employs a cook. The manager is currently supporting his staff as they progress through their NVQ level 2, five staff have now completed this and three staff are currently studying towards their NVQ level 3. Once the current staff have completed their NVQ level 2 the home will meet the required standard. Recruitment and selection of staff is generally completed in a manner that will assure residents that they will be cared for by staff with appropriate skills and knowledge to do so. Care needs to be taken to ensure all gaps in employment Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 16 history can be explained and are documented. Every new member of staff is registered with Skills for Care to complete their induction within the required time period and is given a copy of the GSCC code of conduct. Staff are also encouraged to take part in supervision on a two monthly basis during these sessions staff are given the opportunity to discuss training needs they feel they have and their performance overall. The registered provider has now secured training for the manager and senior staff to cover the principles of supervision and equip them with the skills to carry it out with staff members. Other areas of improvement targeted by this training will be interviewing skills and techniques and disciplinary proceedings. Staff receive training by the care manager which focuses on dementia and gives staff a basic understanding of what dementia is and how care staff can improve the care of those residents who have dementia. This is positive practice and ensures that staff have a basic knowledge, the registered provider and manager should now consider building upon these existing skills with the provision of accredited training for dementia care. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The home is run in the best interests of the residents by a manager who is competent and caring. Residents can be assured that their monies will be held securely. The health, safety and welfare of residents and staff is promoted at all times EVIDENCE: The registered manager is qualified and competent to run the home, he has appropriate experience and has completed his NVQ level 4 and Registered Managers Award. The manager is familiar with the conditions and diseases of old age but would benefit from further dementia care training to build upon existing skills and to explore ways of developing the quality assurance process for people with dementia. The home has regular residents meeting and minutes of these meetings are available to read, other visitors to the home are encouraged to give their views Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 18 and suggestions on improvements or changes they feel may benefit the residents. The manager needs to develop the residents questionnaires and try to capture the views of all interested parties in the community such as relatives, doctors, district nurses and other health professionals. Once this has been done a clear programme of planning – action – review can begin. An action plan for improvements can be made and results published. At present the manager completes care plan and medication audit on a monthly basis. The area manager also conducts regular audits which focus on the safekeeping of residents monies. This helps the home plan improvements that will improve the service provided to its residents. Service users monies were seen they are kept securely within the home and there is a record of all transactions and receipts indicating where monies have been spent. All of the files seen were balanced and all monies could be accounted for. Since the last inspection the manager has made great improvements in the provision of mandatory training for all of the homes staff. Certificates for training were also seen in staff individual training files. The home is well maintained and certificates for all relevant checks were seen, these included fire safety, legionella testing, central heating and boilers and electricity. On the day of the inspection the hoists were all being serviced ensuring that equipment is in sound working order. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 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 2 3 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4,5,5 Requirement The registered manager must include details of his qualifications and experience in the statement of purpose and service user guide. Timescale for action 30/03/06 2. OP7 12,15sch 3(3m) The registered manager must 01/04/06 ensure that 1.care plans are implemented for all health needs Each service user has their own identified list of homely remedies that they may receive. Two members of staff sign when placing medicines in the Dump Box 01/04/06 3 OP9 13(2) 13 (b) 4 OP19 23,12,13 The registered individuals must address: 1.The marked/split lino in the toilets and bathrooms 2.The rusty bedpan rack in utility room top floor must be repaired or replaced. 3.peeling paint and cracked surfaces on the vanity units in all DS0000063155.V274915.R01.S.doc 01/10/06 Richmond Court Nursing Home Version 5.1 Page 21 bedrooms must be addressed. 4. worn carpet in G27 must be replaced. 5 cracked tiles in shower room top floor and bathroom ground floor to be repaired. 6 worn lino must be repaired replaced in shower room to reduce risk of cross infection (top floor) the home must include the above in their refurbishment programme To ensure the Home obtains a copy of the staffing guidance issued by the Department of Health (DoH) The registered person must ensure that gaps in employment history are explored. The registered manager must develop the quality assurance system to include a plan – action – review cycle and ensure that all points in standard 33 are met 5 OP27 18(1) (c) 01/04/06 6 OP29 18,19 01/04/06 7 OP33 24 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP30 OP33 Good Practice Recommendations Consideration should be given to seeking accredited training in dementia care to build on existing skills. The registered manager considers the introduction of a suggestions box. Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Richmond Court Nursing Home DS0000063155.V274915.R01.S.doc Version 5.1 Page 23 - 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. 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