Inspection on 21/02/06 for Ross Court

This inspection was carried out on 21st 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 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 12/09/05

Ross Court 10/02/05

Ross Court 08/09/04

Ross Court 04/03/04

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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 Ross Court Overross Close Ross-on-wye Herefordshire HR9 7BQ Lead Inspector Wendy Barrett Announced Inspection 21st February 2006 09:15 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.V284498.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. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 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.V284498.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 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.V284498.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken between 9.15am and 12.15pm. The inspection focused on a number of key National Minimum Standards that were not covered last time. Action taken to comply with two requirements arising from the previous inspection was also reviewed. The report of the last inspection should also be referenced to gain a comprehensive view of the service. The cook spent some time discussing the catering service and the Deputy Manager assisted with an inspection of medication management. A few residents were met as they waited to be attended by the hairdresser and one resident was interviewed in her bedroom. The Provider’s Operations Manager visited the home during this inspection and the Care Manager was available to assist. What the service does well: What has improved since the last inspection? There is a new main kitchen that is well equipped. The remaining building work is very nearly completed. This will further enhance the quality of the accommodation and facilities. The Provider has been continuing work on a consultation exercise as part of the overall system of monitoring the quality of the service. A report of the findings is on target to be available for residents to read at the end of April 2006. Ross Court DS0000024732.V284498.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. Ross Court DS0000024732.V284498.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 Ross Court DS0000024732.V284498.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): EVIDENCE: Ross Court DS0000024732.V284498.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): 9 There are systems to ensure that medication is managed safely although the home’s policy and procedures need reviewing to ensure the guidance is still relevant to the home and is reflected in everyday practice. EVIDENCE: The Deputy Manager plays a lead role in managing medication at the home. She described a safe system and this was reflected in various records and documentation seen. These included receipt and disposal records plus additional evidence such as risk assessments for self-medicating residents and signed consents for the covert administration of medication. Administration records are kept on pre-printed sheets supplied by the dispensing surgery. Not all boxes for indicating allergies were being completed. Although it is the practice for a second staff member to check transcribed instructions for any errors the evidence would be strengthened if both involved staff confirmed this practice by initialling next to the transcribed entry. A sample stock of a controlled medication was checked and confirmed that the Controlled Drugs register was being accurately completed. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 10 The home has a medication policy and associated procedure although it was apparent that the guidance was not sufficiently familiar to staff to ensure they always follow it on a daily basis. The Care Manager agreed that the policy and procedures is due for review and updating. It would probably be helpful if a copy of any revised documentation was kept in the area where medicines are stored and handled. All staff who handle medication have received accredited training to ensure they have sufficient knowledge and skill to keep residents safe. Ross Court DS0000024732.V284498.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): 15 Meals are prepared by a qualified cook who knows how to plan a wellbalanced, appealing menu and maintain a hygienic kitchen facility. Residents are consulted about their needs and preferences and have the choice of eating in an attractive dining room or in the privacy of their bedroom. They are happy with their meals. EVIDENCE: All residents who were met expressed satisfaction with their meals – ‘yes, the food is good. I see the cook every day and I can tell her if e.g. the fish wasn’t very nice. She is very good’. The communal dining facility is presented to a high standard with tables attractively laid. The cook has considerable catering experience and has obtained 3 City and Guilds certificates of qualification. The Provider had funded a course on cake decoration for her and she was due to refresh her food hygiene training in March 2006. The cook has time to go out into the home and consult the residents about their meals service. There were examples described of consultation with a nutritionist and awareness of individual residents’ dietary needs and preferences e.g. extra red meats for a resident with low iron levels, a supply of goats milk for a specific resident. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 12 The cook was satisfied with the level of kitchen staff allocated and a kitchen assistant felt well supported by the cook. A new kitchen facility has been built recently and provides a much improved, spacious area for preparing meals. This was well equipped, tidy and clean at the time of this inspection. Food was stored in a tidy manner with supplies adequate but not too great. This practice helps make sure stock is rotated promptly. There was fresh produce in stock and the contents of fridges and freezers was well kept e.g. date labelling of prepared foods, separation of raw and cooked meats. The cook explained that residents are offered fruit juice with their lunch and receive fresh fruit salads as part of the standard menu. They can also request whole fruits if they wish. Menus are advertised in the home. They list alternative choices of main meal and afternoon teas. A record of food was being maintained to detail any variations from the standard menu. This record included details of a special Valentine’s night menu – Florida Cocktail, golden chicken, roasted vegetables, and strawberry shortcake. Cleanliness is ensured through the operation of a cleaning rota and associated records. Records of storage temperatures were available. The cook felt that the Provider and Care Manager took note of her requests for additional equipment and gave examples to illustrate her view e.g. provision of egg poacher, more jugs, a steamer. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home is clean and hygienic. EVIDENCE: The home has been subject to a major extension and upgrading exercise. The work was almost complete at the time of this inspection. The cleanliness of the home has been well maintained despite the inevitable disruption during the structural alterations. There are policies and procedures, ongoing programmes of staff training, and appropriate supplies of equipment to deal with infection control. Ross Court DS0000024732.V284498.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): 28 and 30 Staff receive ongoing training to make sure the residents are kept safe. EVIDENCE: The Commission requested and has received copies of staffing allocation and individual staff training records in support of this inspection. The information supplied indicates that the National Minimum Standard for 50 of care staff to achieve a National Vocational Qualification at level 2 has been met. Some staff have also achieved a level 3 award. A number of staff are currently working towards a level 2 or 3 award. Individual staff training records indicate that there is an ongoing programme of health and safety training to ensure each member of staff has up to date instruction in those aspects relevant to their role. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 16 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): 35 and 38 The health, safety and welfare of residents and staff are promoted and protected through the provision of training, written guidance and Provider monitoring systems. The Provider’s willingness to share information and consult with the residents, relatives and other interested bodies e.g. the Commission, strengthens the overall protection of residents. EVIDENCE: It is not the policy of the home to offer safekeeping of residents’ personal money and valuables. This approach is in line with the National Minimum Standards. In exceptional circumstances residents can request cash from a central float and be invoiced later with the regular fee accounts. The Provider has indicated that a report of a recent consultation exercise will be made available to residents and the Commission by the end of April 2006. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 17 The Provider operates a system of quarterly audits of safety factors e.g. premises, catering, laundry, and personal activities. The Commission receives regular reports of work being undertaken at the home between inspection visits. The information contains many examples of through attention to health and safety. Relevant health and safety policies and procedures are implemented and there is a comprehensive programme of staff training that ensures each member of staff receives the training they need to work safely e.g. manual handling, infection control, fire safety, food hygiene. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 18 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 3 Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 19 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 OP9 Regulation 13(2) Requirement Timescale for action 31/03/06 1. OP37 24 The existing medication policy and associated procedures must be reviewed to confirm they reflect current everyday practice. The Commission must be 30/05/06 supplied with a report in respect of the recent consultation exercise. (Previouse timescale extended – held over for review at future inspection) 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 OP9 OP9 Good Practice Recommendations All allergy boxes should be completed on medication administration records, including entries that confirm ‘no known’ allergies. The current practice of a second staff member checking transcribed instructions for medication administration should be confirmed by both involved staff initialling relevant entries. Ross Court DS0000024732.V284498.R01.S.doc Version 5.1 Page 20 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.V284498.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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