Inspection on 14/09/06 for Richmond Court Residential Care Home

This inspection was carried out on 14th September 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 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

Richmond Court Residential Care... 09/04/08

Richmond Court Residential Care... 24/04/06

Richmond Court Residential Care... 08/12/05

Richmond Court Residential Care... 05/01/05

Richmond Court Residential Care... 23/06/04

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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 Residential Care Home Richmond Court 94 Richmond Road Compton Wolverhampton West Midlands WV3 9JJ Lead Inspector Keith Salmon Key Unannounced Inspection 14th September 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 Residential Care Home DS0000030036.V311694.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. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Court Residential Care Home Address Richmond Court 94 Richmond Road Compton Wolverhampton West Midlands WV3 9JJ 01902 421381 01902 427761 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) Rosecare Limited Ms Carolyn O’Brien Care Home 30 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (30) of places Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old age, not falling into any other category, including females from the age of 60 years. 24th April 2006 Date of last inspection Brief Description of the Service: Richmond Court is a large, semi-detached, Victorian building with a modern extension. Accommodation is provided over three floors, accessed by a passenger lift, and comprises 28 single bedrooms and 1 double room with 20 bedrooms having en-suite facilities. There is a lounge and dining room on the ground floor, plus a conservatory and library/visitors’ room on the first floor. The Home benefits from a large, well-maintained garden to the rear of the premises and car parking facilities to the front. At the time of this Inspection fees for care ranged from a minimum of £336 per week up-to a maximum of £386 per week. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection commenced at 09.30 a.m., concluded at 1.00 pm (a total of 3.5 hours) and was conducted by Mr Keith Salmon. Present for the Home was Ms. Carolyn O’Brien (Registered Manager). This was the second ‘Key’ Inspection of 2006 and sought mainly to review progress on improvements noted at the previous ‘Key’ Inspection (April 2006) that followed the Inspection of December 2005 at which a number of ‘Requirements’ were cited. This Report is based on observations made during a tour of the Home, a review of care related documentation, staff duty rotas, and staff files, plus a range of other documents/records reflecting the general operation of the Home. The Inspectors also held 1:1 discussions with Ms. O’Brien, 8 Residents, and several members of Staff. What the service does well: What has improved since the last inspection? Of seven ‘Requirements cited at the previous Inspection four had been met in full, i.e. Completion of the process of replacing light fittings in some corridors An audit of all exposed hot water pipes and, where risk of possible burning is identified, appropriate remedial action taken Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 6 The introduction of an on-going redecoration/refurbishment programme, complete with planned ‘action’ dates The taking out of use the two “small baths” located on each of the upper floors. Also good progress has been made with regard to the ‘Requirement’ for the Home to have a minimum ratio of 50 trained members of Care Staff who have achieved NVQ Level 2 or equivalent. Evidence was seen which shows that a very high proportion of Care Staff have recently completed an accredited course and are awaiting final confirmation of achievement. 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 Residential Care Home DS0000030036.V311694.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 Richmond Court Residential Care Home DS0000030036.V311694.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. EVIDENCE: ‘Case Tracking’ involving the review of 5 Residents’ Care Plans/Files, (i.e. those relating to the two most recently admitted Residents, plus 3 selected at random), demonstrated all potential Residents have their care needs assessed by the Registered Manager prior to taking up residence. Richmond Court Residential Care Home DS0000030036.V311694.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 at least once during a 12 month period. 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. The model of Care Plan, utilised by the Home, is of a design, which is easy to read and comprehensive. The care provided by the Home is effective in meeting the Residents’ assessed care needs, and is delivered considerately and effectively. The storage, administration, and disposal of medicines are in accordance with accepted good practice. EVIDENCE: At the previous Inspection a number of ‘Requirements’ were cited under Standards covering Health and Personal Care. These being: − The need for entries to Residents’ care records to be made in greater detail − To ensure that Residents were able to avail themselves of frequency of baths/showers in keeping with their individual needs/desires − To reduce (excessive) stocks of eye medications As a component part of the ‘Case Tracking’, 5 Residents’ Care Plans/Files were reviewed and discussions held with the respective Residents. This process provided evidence of the Requirements having been fully met. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Leisure opportunities are provided, which are consistent with Residents’ capabilities. The Home facilitates achievement of desired lifestyle through Residents conducting the pattern of their day, where possible, as they wish, including contact with family and friends, and continuation of religious practices. There is a daily choice of attractive and nutritious meals. EVIDENCE: Individual care records, and discussions with Residents, demonstrated Residents are able to choose which of the programmed ‘events’ they wished to partake in. In addition, the Inspector was shown an ‘Activities Log’, which recorded attendance/involvement by Residents. The Home has a full and varied programme of activities, which are planned and organised jointly by Residents and Staff. This process is facilitated by use of a ‘Key Worker’ system, and through regular Residents’ meetings, which are supported directly by Staff and the Minutes of these meetings was reviewed by the Inspector. Residents, who were able, informed the Inspector they enjoyed and valued these Meetings whilst also recognising “…. they are difficult to Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 11 arrange, and even more difficult to get people to speak about what they would like.” Activities include local trips out, with Relatives and/or Staff, traditional games such as cards, dominoes, bingo and skittles, music and dancing, entertainment by visiting musicians and singers - including old-time sing-alongs, which the Residents informed the Inspector they particularly enjoy, musical chairs, quizzes and seasonal celebrations. Birthday celebrations for individual Residents are a regular feature. The general consensus of Residents was the range, quality and choice of food provided was very good and the Home caters for those Residents who have individual preferences/dislikes. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The interests of Residents are protected through ready access to information relating to advocacy services and the Home’s Complaints Procedure. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: Complaints Procedure details are included in the Service User Guide and are displayed prominently for the benefit of visitors. There are policies and procedures in place intended to provide protection for vulnerable people. These fully meet the requirements of this Standard and staff training files confirm the topic is covered both at induction and through on-going staff training. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 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): 19,20,21,22,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home provides a generally safe, well-maintained environment with communal rooms, and bedrooms that are generally satisfactorily decorated with furnishings being in good order and presenting a ‘domestic’ ambience. The gardens are easily accessible at all times of year. Specialist equipment, consistent with meeting the assessed care needs of Service Users and the demands of tasks carried out by Care Staff, and is appropriately serviced and maintained. The cleanliness and general state of repair in the Home is good. EVIDENCE: As ‘Required’ at the previous Inspection the Home now has an ongoing refurbishment/redecoration programme and a tour of premises showed that it is being actively, and effectively, applied. It can be reported that there has been significant improvement, in the general levels of décor. Specifically progress on other Requirements issued April 2006 in relation to the general environment was found to be as follows: Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 14 Light fittings in corridors have been replaced with a type which is more domestic in character and which afford better light provision. A ‘Risk Assessing’ audit of all exposed hot water pipe has been carried and, where risk of possible burning is identified, appropriate remedial action has been taken. Provision of suitable bath/shower facilities and replacement of baths in two assisted bathrooms (which have been taken out of use as agreed with CSCI) has not yet been undertaken – however the home is in discussion/seeking quotes from a plumber and work is expected to commence in the near future (target date for completion of 31 December 2006 agreed with owner). Work to ensure all bathrooms have effective extractor fans installed has not yet been undertaken although Inspector saw a costed estimate for the work. A completion date has been agreed between the Owner and the Inspector for 31 December 2006 Also satisfactory work has also been undertaken in the light of the home being now Registered to accommodate a small number of Residents with dementia. This work included making the home more ‘secure’ to e.g. pad button locks on exits, new gating at the head of garden steps and an increase in the height of some garden walls. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers on duty and skill-mix were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home in providing training for Care Staff is satisfactory, and in accordance with individual Staff Member’s learning needs. EVIDENCE: The current staffing rota and those from the immediately preceding weeks were examined and compared with the Home’s daily ‘signing-on’ sheet. These demonstrated Staffing numbers and skill-mix enable a service provision, which meets the care needs of the Service Users. This judgement was made in the light of a re-evaluation of staffing requirements by CSCI at the Unannounced ‘Key’ Inspection undertaken at April 2006. At that time revised levels of staffing/skill-mix were agreed which took into account occupancy levels at a given date, and also levels of dependency. At was seen that, at the time of this Inspection, application of the agreed levels enables the staff to deliver satisfactory levels of care. A ‘Requirement’, cited at the previous Inspection, related to the Home working towards the target of 50 of Care Staff attaining a minimum of NVQ Level 2. Historically the Home’s achievement in this area has been poor and has Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 16 recently been exacerbated by Staff with NVQ Level 2 moving on to other employment or retirement. However, in recent times the Home has worked well in obtaining training places for Care Staff on NVQ Level 2 courses (reflected in Staff training files). It was reported to the Inspector that a number of Care Staff have recently submitted their final work to the supporting college and were awaiting the award of NVQ level 2. When this process is completed the number of care Staff with NVQ level 2 (or higher) will be 19, which will represent 83 of Care Staff. Richmond Court Residential Care Home DS0000030036.V311694.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is well managed by the Registered Manager, Ms. Carolyn O’Brien, and provides an ambience, which is warm, friendly, and inclusive with the central purpose being ‘the best interests of Residents’. Operationally, it is well organised with lines of accountability being clearly defined and observed. The views of Residents and other interested parties are sought by the Home and acted upon. Service Users are safeguarded by the financial procedures operated in the Home. All Staff are subject to effective support with regular supervision, and appeared involved and happy in their work. Health and Safety Policies/Procedures/Practices were satisfactory. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 18 EVIDENCE: Observation by the Inspector, together with comments from Residents and Staff suggest the Home is currently being well managed. Written reports from regular attendance at the Home by the Proprietor demonstrate evidence of good support for the Manager. The Home conducts financial management of small amounts of cash for a few Residents, and records of transactions are maintained in accordance with the Standard. All other records were seen to be secure and well maintained. The Home’s practices in the context of health, safety and welfare of Residents, Visitors, and Staff were seen to be in accordance with the Regulations, i.e. COSHH requirements were satisfactory, with maintenance and servicing of equipment regularly undertaken, and appropriately documented. Records are maintained for hot water supply to baths, and water tested during the Inspection was satisfactory. Evidence was also seen which showed all bedrooms have a general ‘health and safety check’ undertaken every Monday morning. Hot water pipes that were previously assessed through the Home’s own audit as posing a potential hazard to residents have received protective cladding. Richmond Court Residential Care Home DS0000030036.V311694.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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 2 3 x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 3 3 Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP21 Regulation 23. (2)(j) Requirement All bathrooms must have effective extractor fans installed. Timescale for action 31/12/06 2. OP21 23. (2)(j) Work to provide a suitable bath/shower facility on one of the upper floors (to replace the and replacement of baths in two small bathrooms which have been taken out of use as agreed with CSCI) must be completed. The Registered Providers must ensure a minimum ratio of 50 trained members of Care Staff achieve NVQ Level 2 or equivalent. 31/12/06 3. OP28 18. (1) 30/09/06 Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 21 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 OP12 Good Practice Recommendations The Registered Providers may wish to consider appointing an Activities Organiser for the Home. Richmond Court Residential Care Home DS0000030036.V311694.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. 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