Inspection on 12/09/05 for Ross Court

This inspection was carried out on 12th September 2005.

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

Ross Court 01/03/07

Ross Court 21/02/06

Ross Court 10/02/05

Ross Court 08/09/04

Ross Court 04/03/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Ross Court Overross Close Ross-on-wye Herefordshire HR9 7BQ Lead Inspector Wendy Barrett Unannounced Inspection 12th September 2005 16:15 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 Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ross Court Address Overross Close Ross-on-wye Herefordshire HR9 7BQ 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) 01989 764349 01989 565569 rosscourt@majesticare.co.uk Ross Healthcare Limited Mrs Janet Ivery Auty Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2005 Brief Description of the Service: Ross Court is situated at the end of a cul-de-sac in a residential area on the outskirts of the town of Ross-on-Wye. The home sits in its own grounds. It is easily accessed from the town ring road and M50 motorway. The home is registered to accommodate 31 people over 65 years of age who have needs arising from the normal ageing process at the point of admission. There is a commitment to continue providing a service for any resident who develops additional needs as long as these can be met within the home’s resources. The accommodation has been significantly extended during the previous year. Work is continuing on developing new kitchen and laundry facilities, and installing a new passenger lift. A new sun lounge is also proposed. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that was undertaken between 4.15pm and 8.15pm. It was hoped to spend most time interviewing residents about their experience of the service. This was not entirely successful as many residents were busy watching the English cricket team win The Ashes. It was possible to speak to a few residents and it was reassuring to know that other residents were comfortably occupied in the privacy of their bedrooms. The Care Manager and Head of Care were at work in the home and helped with the inspection. The Facilities Manager was also present. A Senior Care Assistant and care assistant were interviewed. A visiting relative was invited to discuss his views of the service, but he only wanted to say that the service was excellent. Some records were inspected, and other information referred to in this report originates from the Commission’s previous inspection findings. What the service does well: What has improved since the last inspection? Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 6 The new extension is now fully operational and the second stage of building work is well underway. The Care Manager has almost completed work on her Registered Manager’s Award. This is the up to date recognised qualification for Care Managers. The Provider has supplied the home with improved documents for recording each resident’s care programme. Colour coding each section will help staff quickly find the information they need. 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. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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 Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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): 1,2,3,4 and 5. The admission process is well managed. Residents are given clear information regarding the service to help them decide if it will suit them. The home finds out about the prospective resident’s needs and wishes to check if these can be met by the home. EVIDENCE: There is a Statement of Purpose that describes the service provided at the home. Residents also receive a copy of a Service User’s Guide and a contract of residence that forms an agreement between the Provider and the resident. Residents had either been admitted too long ago to remember, or relied on relatives to find a suitable home. They were, therefore, unable to describe any pre-admission work. There is written evidence of comprehensive preadmission assessment work completed by a senior member of staff and also visits to meet prospective residents in their own home. A resident was aware that she did not have to stay permanently at the home if she decided it did not suit her needs. She also recalled that her son was able to visit the home prior to her admission in order to assess whether it would suit his mother. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 9 Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 10. Residents are looked after well in respect of their health and personal care needs. They are fully consulted in planning their care. EVIDENCE: A resident described an introductory visit to meet her new G.P. soon after her admission. She had been able to visit her dentist and optician during the week prior to the inspection. A member of staff escorted her. Another resident was staying at the home for a week’s respite. She described herself as ‘faddy’, but said the service was excellent based on her long experience as a nurse. There were examples of attention to privacy and respect e.g. one resident did not want night staff to open her door at night to check her and this preference was being respected. Another resident had visits from the night staff and said she liked to see them. The Senior Care Assistant and Care Assistant gave detailed descriptions of individual residents needs and preferences. Their accounts included reference to bathing procedures to suit the individual; a key worker system to ensure each resident received satisfactory attention, and recognition of residents’ Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 11 rights to choose whether they wanted to receive care from a male care assistant. A care plan was reviewed with the Care Manager and Head of Care. It addressed all the required elements and was subject to monthly evaluation and review. There is a revised recording system being introduced. This will help staff find relevant information through a system of colour coding the various parts of the record. Other health care professionals were being consulted appropriately e.g. Parkinson’s Nurse, Community Psychiatric Nurse. A resident remembered being consulted by staff about the type of service she would prefer. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 14. The residents are given good support from staff to help them live interesting and varied lives that suit their individual needs and preferences. EVIDENCE: These standards have been met or exceeded in previous inspection reports, and information gathered at this inspection supported this positive assessment. An activities organiser had been at work for three hours on the day of inspection. There would normally have been a second activities organiser throughout the day but she was away on annual leave. These staff help residents get out into the local community for social activities or health care appointments. They also arrange a programme of group or one-to-one activities at the home. A resident said her family ‘can visit whenever they like’. Some residents have been asked to move into alternative bedrooms while the building work is being undertaken. They have been accommodated in the new extension and have been given the choice of staying in these rooms or moving back into their original bedrooms once the work has been completed. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 13 Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints from residents are taken seriously and are dealt with in an open manner in order to protect them from abuse. EVIDENCE: The Commission has not received any complaints about the service. The complaints register records both formal complaints and less serious concerns that have been raised at the home. There have been no complaints registered at the home and the most recent minor concern was raised in 2004. There is information about action taken by staff and this reflects an effective response. A Senior Care Assistant mentioned her attendance at an awareness session on legislation regarding the protection of vulnerable adults (POVA). The Head of Care had also attended this session. An unhappy resident had been introduced to an independent advocate to offer her support. She had also been referred to the Mental Health Team and the Parkinson’s Nurse. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 15 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 The residents live in a high standard of accommodation that is safe and well maintained. The current building work will result in equally high quality facilities that are for staff use e.g. main kitchen. EVIDENCE: The home provides a good standard of accommodation. The gardens had just been awarded a Merit in the ‘Heart of England in Bloom’ competition and a Gold award from the Ross town competition. All areas are furnished, fitted and decorated to a high quality. The current building work has inevitably required some compromises to be made but safety factors are being monitored carefully e.g. a builder was observed asking the Head of Care if he should remove cardboard from the entrance hall carpet. It had been laid to protect the carpet from getting dirty while workmen were walking through and the builder was concerned that residents may trip on it if it was left too long. Prior to the last inspection a resident had commented on the unsatisfactory condition of a stair carpet. The stairs are actually in an area of the building Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 16 that is currently being upgraded and the Provider dealt with the resident’s concern by closing access to the stairway until the work is completed. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 17 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 The residents’ needs are well met by the numbers and skills of the staff and through a well-organised delegation of tasks and responsibilities. EVIDENCE: The staffing arrangements for the day of the inspection reflected a generous level of supervisory, care and ancillary staff to deliver the service. Both of the interviewed staff felt that there are enough staff – ‘always a senior available on the floor’. There is an allocation sheet used to delegate tasks for the day. This helps everyone to make sure each resident receives the care they need on that particular day. Each senior takes a special interest in 5 or 6 residents (this is called key working), and is helped in this work by a designated care assistant. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 18 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 and 37. The home is managed efficiently in a way that safeguards the residents’ interests, rights and safety. EVIDENCE: The Care Manager has recently presented a portfolio of work for assessment. If the outcome is positive she will have achieved her Registered manager’s Award. She has considerable relevant experience. The records sampled during this inspection were being properly maintained and kept secure. The Provider supports the Care Manager by producing computerised analysis sheets etc. that are relevant to Ross Court. A care assistant knew that there were many written policies and procedures available at the home to guide him in his work e.g. complaints, grievances, dealing with aggressive behaviour. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 19 Details of a proposed consultation exercise were forwarded to the Commission in July 2005. A summary report of this review is due to be available before the end of April 2006. Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 4 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x 3 x Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 21 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 OP37 Regulation 24 Requirement The Commission must be supplied with a report in respect of the recent consultation exercise. Timescale for action 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Ross Court DS0000024732.V249725.R01.S.doc Version 5.0 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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