Inspection on 09/04/08 for Richmond Court Residential Care Home

This inspection was carried out on 9th April 2008.

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... 14/09/06

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 Sue Woods Key Unannounced Inspection 9th April 2008 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 Richmond Court Residential Care Home DS0000030036.V361844.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.V361844.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 richmondcourt@hotmail.com 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 (10), Old age, registration, with number not falling within any other category (30) of places Richmond Court Residential Care Home DS0000030036.V361844.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. 14th September 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 £349 per week up-to a maximum of £399 per week. Consultation with people who live at the home takes the form of regular surveys that also annually seek the views of relatives and their representatives. Residents meetings enable people to discuss issues and make suggestions for improvement and the manager and proprietor also meet informally with people to gain direct feedback as to the quality of the service. People who use the service and their representatives are able to gain information about the home from the Statement of Purpose and Service User Guide. Inspection reports about this service can be obtained direct from the provider or are available on our website at www.csci.org.uk Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The unannounced key inspection of Richmond Court took place on 9th April 2008 with a return visit on the 10th April to meet with the manager and the proprietor. The inspection lasted seven and a half hours in total. The inspection reviewed all twenty two of the key standards for care homes for older people and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the inspection we, the commission, met with a number of people living at the home, two relatives, a hairdresser and with all staff on duty at the time of the visit. The inspector also handed out surveys for completion by staff following the first visit. Five were returned. Support for the inspection came from the senior care worker on day one and from the manager and the proprietor on day two. Three care files were reviewed in detail and extracts were seen from others. Other records referred to within the report were also seen. Prior to the inspection visit the registered manager completed and returned an Annual Quality Assurance Assessment (AQAA). The AQAA was very detailed and accurately reflected the service offered by the home. What the service does well: People who live at Richmond Court told the inspector that it is a ‘good home’. Staff feel that it is a ‘Nice place to work’ and visitors to the home think ‘it’s a lovely place’. People feel that their privacy and dignity is respected and everyone who spoke with the inspector felt that a strength of the home is that ‘residents are always listened to’ and that improvements are made to the service as a direct result of what they say. People think that the food is either very good or excellent and that staff ‘welcome people with a smile’ Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 6 Staff feel that they have good support and training opportunities and that the manager is very approachable. A visiting professional said ‘I wouldn’t have a problem with my relative coming here’. The home receives many written compliments. One comment reflected a number of when it read ‘ many thanks for your kindness’. The letters suggest that staff and managers ‘go the extra mile’ for the people they support and their friends and relatives. The manager also sees this as a strength of Richmond Court. What has improved since the last inspection? 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. Richmond Court Residential Care Home DS0000030036.V361844.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.V361844.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): Standard 1, 3 and 6 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Effective procedures are in place to ensure that the home can meet the care and support needs of someone who comes to live at Richmond Court and that their move to the home is a positive experience. EVIDENCE: We spoke with someone who had recently moved into the home and he was very pleased with the way that the move went. He felt that staff were sensitive to the fact that he was moving into residential care and were able to meet his care and support needs. His assessment, carried out by the manager, was thorough and staff said that they felt that they were provided with enough information to enable them to meet peoples care needs upon admission. The manager reported that everyone who is referred to the home via a Social Services Department is supported by a professional assessment of need. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 9 The home provides good information in writing to people prior to their admission. The service user guide was very easy to read and informative of the services offered at the home. The home does not offer intermediate care. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans reflect people’s assessed and changing needs enabling staff to offer effective care and support. People living at Richmond Court are protected by effective systems for the administration and monitoring of medication however people may be vulnerable if staff do not always follow recording procedures. EVIDENCE: People who live at Richmond Court and who spoke with us were very complimentary about the care that they receive. Staff were described as ‘very caring’. Through observations and from feedback it was evident that people are treated with respect. Care is offered discreetly and in private. One person said that staff always knock at the door before entering. Three care plans were reviewed in details as part of this inspection and extracts were seen from others. Plans focussed around individual needs and Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 11 likes and dislikes were well recorded, as were individual preferences as to when and how care and support is to be given. Care files seen were well organised and up to date. There was clear evidence that they are regularly reviewed by the senior team. Discussions with the staff team at the time of the inspection and following observations of care practice identified that there are inconsistencies as to how people are ‘moved’ from one place to another within the home. Manual handling assessments were not available to support safe practice and as a result people receiving a service and the staff team are vulnerable to injury. This situation was discussed fully with the manager and following the inspection she assured CSCI that she had completed manual handling assessments and committed to ensure that they are all followed consistently in future. Copies of the new recording formats were sent to CSCI for review following the inspection. People’s health care needs were seen to have been recorded and systems were in place to monitor changing health needs. Arrangements for the recording and administration of medication were seen to be good and monitoring systems were in place to ensure that all medication is accounted for. Staff who administer medication have been trained to do so. The administration of medication was generally well recorded however on one occasion this was not the case. The proprietor stated that he would investigate this omission and take any necessary action to improve processes. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at Richmond Court are able to choose their life style, social activities and keep in contact with family and friends People enjoy a varied diet according to their assessed needs and individual choice. EVIDENCE: People living at Richmond Court take part in a range of activities both within and outside of the home. For example on the day of the inspection one person was going to play dominoes. One man had been for a walk and one woman was enjoying listening to music in her room. Two residents felt that more activities would improve the service and the home has recently appointed an activities coordinator to organise more structured activities on a daily basis. In addition outside entertainers visit the home monthly and people access individual activities of their choice with family and friends. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 13 One staff member commented that ‘the home does well as there are lots of activities and entertainment for the residents which they really enjoy’. Three other staff also made similar comments. Visitors to the home told the inspector that they are always made very welcome. Regular social events prove very popular with people living at the home and their friends and relatives. Residents meetings take place regularly and provide an opportunity for peoples view to be voiced and listened to. Improvements to the home have been made as a result of these meetings. The most recent example being the new flat screen TV in the lounge. We spent time talking with the cook who had a very good knowledge of the likes, dislikes and dietary needs of people living at Richmond Court. She was also very popular with the people living at the home. One person said that if he had a problem she would be the person he would talk to. The cook spends time talking with people and incorporates favourite dishes into the menus. People who spoke with the inspector said that they liked the meals. A number of people commented that the meals are ‘excellent’ and particularly liked the fact that they could choose an alternative if they didn’t fancy what was on offer. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 14 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): Standard 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Richmond Court have access to a complaints procedure and other opportunities that enables their views to be listened to and the home involves outside agencies as appropriate. EVIDENCE: People living at Richmond Court, relatives, visiting professionals and the staff team all felt comfortable to make a complaint if necessary. Everyone thought that the manager was approachable and the complaints procedure is readily available. Some people named staff members that they would confide in. The home has also introduced a suggestions box for more informal complaints and suggestions. Staff were aware of complaints procedures and what to do if they witnessed something ‘untoward’ in the care home. Staff praised the recent training ‘It couldn’t happen here’ as being particularly effective. However a situation arose at the time of the inspection that may suggest that not everyone is comfortable to report concerns or use the whistle blowing procedures. This situation was discussed fully with the manager at the time of the inspection and CSCI will monitor the progress of the subsequent referral to the local safeguarding adults team. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 15 Likewise a complaint was brought to our attention at the time of the inspection that the manager stated she was previously unaware of. No formal complaints have been received by the home over the last twelve months and staff and relatives gave examples of how minor issues are responded to quickly and effectively to everyone’s satisfaction. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Richmond Court is clean and well maintained providing the people who live there with a comfortable place to live. EVIDENCE: At the time of the key inspection the home was clean and tidy. Bedrooms were personalised and no hazards were identified. Some rooms were in the process of being redecorated and the hall, stairs and landing have recently been redecorated. Staff who completed surveys said that the environment is an area where they have noted improvements over the last twelve months. The sensory garden is particularly popular. Staff with responsibility for the cleaning of the home were knowledgeable of their roles although not Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 17 necessarily some of the paperwork that they were required to refer to. The manager stated that she would address this issue. The hot water temperatures in the baths could not be accuately taken at the time of the inspection, as staff did not have access to thermometers. It was agreed that the water in the bathroom on the downstairs floor was particularly cool. Following the inspection the manager reported that the proprietor has ordered a review of the entire hot water system and until this is completed the downstairs bathroom will be out of use. (It was reported that this bathroom was not used very often anyway) Thermometers have also been purchased and are now readily available for staff to use every time they run a bath for someone. The Environmental Health Officer visited the home on August 2006 and awarded them 4 stars. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at Richmond Court benefit from being supported by a well trained and committed staff team enabling their needs to be effectively met within the home. EVIDENCE: All staff who spoke with the inspector said that enjoyed working at the home. They felt they had good support and training opportunities. Staff gave examples of ongoing training courses and certificates seen at the time of the inspection reflected that mandatory training takes place and is updated when required. Staff are aware of good practice processes within the home however on occasion these practices are being compromised in order for staff to support individuals as they request. Staff files were well organised and contained all required information. Supervision records were available but the format is in the process of being changed to include written information as to staff performance, strengths and needs. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 19 Staff felt that they received a good induction when they started work although no written records were seen on the day of the inspection to support this. However a copy of the induction booklet was sent to CSCI following the inspection for review. The AQAA completed by the manager stated that ‘88 of staff now have achieved NVQ 2 or above with 2 more staff currently working towards it’. The AQAA also suggested that all staff receive training in dementia and in challenging behaviour to support increased dementia numbers. This information reflected records seen and discussions held with individual staff members. Staff felt that staffing levels were sufficient to currently support the twenty five people living at the home and people who spoke with us said that staff did not have to rush personal care tasks and had plenty of time to sit and chat with them. Observations at the time of the inspection reflected a good rapport between staff and people living at the home and staff had time to check on people and respond to individual requests for support. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at Richmond Court benefit from being supported by an approachable and caring management team enabling them to lead a good quality of life. The health and safety and welfare of people living at the home and the staff team is generally promoted and protected. EVIDENCE: The manager of Richmond Court is well qualified and well respected by people who live at the home, the staff team, relatives and the proprietor. The manager believes that the home ‘goes the extra mile’ for the people they Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 21 support and this was demonstrated to be the case at the time of the inspection. The manager carries out weekly health and safety checks within the home and reports any issues to the proprietor. Issues identified at the time of the inspection such as the cleaning of the kitchen tiles and the poor picture quality on the TV were all taken on board by the proprietor who made a commitment that they would be addressed. The proprietor supports the manager but also gives her some autonomy. Both the manager and the proprietor think this arrangement is effective. The home has recently joined the Alzheimer’s Society and this provides them with valuable information about the illness and also about local community resources. The home has a very effective quality assurance process that enables people living at the home to express their wishes informally and formally. People feel that they are listened to. Accidents and incidents are recorded and follow up actions identified; however the manager was advised to review the storage of information in line with data protection legislation and guidance. The deputy manager showed the inspector how the home manages money for people when required. The deputy manager felt that the procedure was robust and protected people from error. The manager and the proprietor monitor the process. Following the inspection the manager contacted CSCI to advise that all issues discussed at the time of the inspection had been addressed. This reflects the homes commitment to improving the service although a more proactive approach will further improve the overall quality of the service. Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 22 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 4 X 4 X X X 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 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 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 3 Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 23 NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Richmond Court Residential Care Home DS0000030036.V361844.R01.S.doc Version 5.2 Page 25 - 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. 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