Inspection on 12/10/05 for Royal Court

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Royal Court 17/07/06

Royal Court 20/02/06

Royal Court 14/03/05

Royal Court 17/11/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Royal Court Fiddler`s Green Lane Cheltenham Glos GL51 0SF Lead Inspector Mrs Janice Patrick Unannounced Inspection 12th October 2005 09:10 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 Royal Court DS0000016568.V254806.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. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Royal Court Address Fiddler`s Green Lane Cheltenham Glos GL51 0SF 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) 01242 221853 Bromford Housing Group Mrs Susan Elizabeth Charlton Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (4) of places Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2005 Brief Description of the Service: This Care Home is purpose built and is divided into six units of self contained flats offering independent living for those over 65yrs of age with personal care available as required. The flats vary in size but all contain an inner lobby, bathroom, airing cupboard, lounge and kitchenette. There are communal dining rooms in each unit and one main lounge. A well equipped hairdressing room is also on site. Communal bathrooms are equipped with specialised bath hoists and some adapted toilets. All doorways are wheelchair friendly. In addition there are two passenger lifts giving access to all floors. The forecourt, which has been planted with shrubs and flowers, can be enjoyed in the warmer weather. There is ample, level parking and the local bus route into Cheltenham Town runs outside the Home. There is also a local grocery shop nearby. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector between the hours of 9:10am and 1:40pm. The Home Manager was on duty as was the training co-ordinator. Staffing of the Home was generally discussed and rosters inspected. A selection of staff recruitment records were inspected including staff training and supervision records. The Home’s Quality Assurance system was discussed and some documentation read. Additions to the Complaints Procedures were discussed. Four residents were spoken with and their accommodation seen. What the service does well: What has improved since the last inspection? What they could do better: Be more aware, earlier on in a resident’s care planning of what is ‘particularly important’ to that ‘individual’ when they are not able to be so independent. Perhaps develop a more person centred approach to care planning. Provide more cleaning. Utilise the Quality Assurance system provided as a manageable, working tool. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 6 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. Royal Court DS0000016568.V254806.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 Royal Court DS0000016568.V254806.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 Potential residents and visitors are provided with ample information about the Home to help them make an informed decision about their future care. EVIDENCE: The Home’s Statement of Purpose was seen in the reception area. This contains information about the Bromford Housing Group, Royal Court and outlines some of the group’s key policies and procedures. Each existing resident has been recently issued with an updated copy of the Service Users Guide, called the ‘Welcome Pack’ at this Home. This information is similar to the Statement of Purpose, but summarised and more specific to Royal Court. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 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): 10 The residents’ right to privacy and dignity is definitely considered by staff in this Home and upheld during care intervention, but there maybe a need to focus on this subject and ascertain whether all residents feel this is afforded to them at all times. EVIDENCE: Staff undertake both induction and foundation training prior to their NVQ Award and the subject of a resident’s right to privacy and dignity is covered in all 3 trainings. As the Inspector moved around the Home, she saw that the doors of flats were closed if care was being delivered to an individual inside and staff were heard to be polite. Comments from two residents however, suggested that what they considered or perceived as being important to them, when it came to their privacy and dignity, maybe different to what the staff have, genuinely presumed, is important. One resident had already expressed frustration on this subject. After talking with this person the Inspector recommended, that more specific information be collected, about what was important to this individual and that this be Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 10 incorporated within a care plan. The plan should then be agreed upon by the resident and reviewed in the same manner on a regular basis. Another resident felt grateful for being in the Home and perceived the staff’s ‘busyness’ when attending to her, as being directly linked to the fact that she was old and a nuisance. She liked the staff, however there had never been any communication between her and them regarding how she felt. Two other residents confirmed that the staff always speak to them politely and carry out any care tasks in private. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 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): 12 & 13 Although for some residents it is clearly not easy for them to live in a care home, the general impression is they do have the ability to make choices on a day-to-day and social basis. . EVIDENCE: One resident confirmed that she has visitors most days, friends that she has known most of her life. She was seen to be organising her own visit by her GP and making other social arrangements. She said that she is free to attend social events within the Home if she wishes and if she does not, this is not a problem. Another resident said she enjoyed the social events and was looking forward to the chocolate demonstration in the afternoon. One resident enjoyed keeping contact with her family via her own phone in her flat. She confirmed that the care staff are always happy to dial the number for her as her eyesight has deteriorated, although the phone did have enlarged numbers. The Inspector spoke with another very independent resident who confirmed that the staff are giving her lots of encouragement to go out and carry on her life as she chooses. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 12 The Home offers some form of activity Monday to Friday. A church service is held once a month. Keep fit is held twice a week. One resident confirmed that she had been taken out for some fresh air in her wheelchair, but she has chosen not to go again as the weather has got colder. The Inspector is aware from past discussions with residents that opportunities arise to go into Cheltenham, the pub and to the local shop, either independently, with friends or with their keyworkers. Staff tend to concentrate their efforts on the residents who do not have relatives to take them out. The Home does not have its own transport and any large outings are paid for through its own fundraising events. This summer saw trips to Evesham Country Park. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 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): 16 The Home’s Complaints Procedure has been reviewed and is now very robust and should enable anyone wanting to make a complaint to do so and be reassured that his or her concern will be taken seriously. EVIDENCE: Following a complete review of the Complaint Policy and Procedures some additions have been made. Arrangements have been made to make it easy for residents and visitors to complain direct to the Company’s head office if they choose. The procedure for complaining to the Manager is also still in place. All residents have been issued with an updated Complaints Procedure. One resident has taken up the opportunity to make a complaint and has had an initial response. All complaints and concerns are documented and audited by the Home’s Operations Manager. The CSCI have received one complaint, which is ongoing since the last inspection. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 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 environment would benefit from more thorough cleaning to improve the general standards for the residents. EVIDENCE: One aspect of a recent complaint was the lack of cleaning. The Manager, who agreed this was down to a lack of domestics, has upheld this and is actively recruiting to replace vacant domestic hours. Carpets in several flats had debris on them. One confirmed that her lounge carpet was being vacuumed once a week at present and that she did not feel this to be frequent enough, although she was aware of more cleaners being recruited. Other areas of the Home were clearly having basic cleaning carried out, but were not as spotless as they usually are. The laundry was observed to be in its usual tidy state and the floor had just been washed. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 15 Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 16 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, 29 & 30 Further recruitment of staff will ensure that all the residents’ needs are met. Good recruitment and training procedures are followed to ensure that vulnerable residents are protected. EVIDENCE: Staff rosters were seen. The Manager confirmed that there are enough staff on duty to meet the residents’ needs. She agreed that the present cleaning team were struggling, but hoped this problem would be rectified once new staff were started. There are some care vacancies at present and these are being covered by the Home’s own staff. Evidence requested at this inspection shows that the night staff answered 31 calls and completed hourly checks on 3 residents during a night shift. Taking into account the size of the Home, there is minimum staffing at night. This staffing has remained the same for several years. It is a recognised fact that the needs of residents within care homes have increased substantially in the last few years. It is therefore recommended that the needs of residents at night are monitored on a regular basis to ensure needs continue to be met adequately. A selection of recruitment files were inspected. These were on staff that were at varying stages of recruitment and who had not yet commenced work at the Home. Photographs and medical disclaimers were yet to be collected. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 17 Royal Court DS0000016568.V254806.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): 33 & 36 The Home is run in a way that has the residents’ interests at heart; however, more robust use of the Quality Assurance Tool would help the team focus on and identify areas that could be improved. Adequate supervision arrangements for staff ensure that the Home maintains a good standard of care. EVIDENCE: There is a Quality Assurance System in place that has been designed to link in with the National Minimum Standards for Care Homes. Some basic auditing has been carried out this year, but the tool has not been completed since 2004. A questionnaire was sent to all residents in April 2005, but as yet the information has not been collated. The return was poor, although some Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 19 relatives replied. There were no replies received from external health care professionals. An additional questionnaire is designed to collect the views of the resident following the admission process. The Manager explained that a lack of time and a need to cover care shifts had been a factor in not being able to give attention to the Quality Assurance System this year. The Inspector recommended that following successful recruitment, specific areas should be chosen for audit, up to the end of the auditing year, but that these should be completed and manageable actions devised. It is also recommended that the Quality Assurance System be reviewed to ensure it is user friendly and able to be effective. Staff receive adequate supervision both in a structured format, that is recorded and through ‘in house’ training. The Home’s layered management structure also provides day-to-day supervision of practice. The Manager receives supervision from her company line Manager and externally for her personal development. Royal Court DS0000016568.V254806.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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 x 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 3 X X Royal Court DS0000016568.V254806.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 OP10 Regulation 12 (4)(a) Requirement The Manager must take every opportunity to ensure that the residents’ privacy and dignity is upheld. The Home must be cleaned adequately. The Manager must make arrangements to review the quality of care and services offered at the Home. And: Forward a report to the Commission, making the findings available to the residents/representatives. Timescale for action 01/12/05 2 3 OP26 OP33 23 (2)(d) 24 (1) & (2) 01/12/05 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP10 Good Practice Recommendations Specific information should be collected from the resident DS0000016568.V254806.R01.S.doc Version 5.0 Page 22 Royal Court 2 3 OP33 OP27 discussed at this inspection and included within a care plan that has been agreed by her. How the Quality Assurance System is used should be reviewed and amendments made if required, to make it an effective working tool. The residents’ needs at night and the size of the building must be reviewed on a regular basis to ensure staffing levels are adequate. Royal Court DS0000016568.V254806.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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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