Inspection on 28/09/09 for Royal Court

This inspection was carried out on 28th September 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Royal Court 07/10/08

Royal Court 25/09/07

Royal Court 13/02/07

Royal Court 15/05/06

Royal Court 02/02/06

Royal Court 16/06/05

Royal Court 23/11/04

Royal Court 19/05/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Royal Court Rock Mount King Street Hoyland Barnsley South Yorkshire S74 9RP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Shirley Samuels     Date: 2 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Royal Court Rock Mount King Street Hoyland Barnsley South Yorkshire S74 9RP 01226741986 01226741986 admin@royal-court.net None Healthmade Ltd care home 40 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care Home only - Code PC, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 40 Date of last inspection Brief description of the care home Royal Court is a care home providing personal care and accommodation for 40 older people. The homes registered owner is Healthmade Limited. The home is a purpose built single storey building. All bedrooms are for single occupancy and have en suite facilities. An enclosed garden area is provided. There are car parking facilities at the front of the building. Royal Court is located in Hoyland within the Barnsley area and is close to the shopping centre and a doctors surgery. On the day of the site visit the registered manager said the weekly fees were £356.77- £365.00. People pay extra for Care Homes for Older People Page 4 of 27 Over 65 40 0 0 7 1 0 2 0 0 8 Brief description of the care home hairdressing, private chiropody and optical services. People can get information about Royal Court by contacting the manager. The home will also provide a copy of the statement of purpose and the latest inspection report. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection carried out by Shirley Samuels on the 28/09/09 from 9:45am-5:00PM. The previous inspection at this service took place on the 07/09/08. As part of the visit we sought the views of the people using the service, their relatives, district nurses and staff. People completed questionnaires on the day of the visit and handed them to us. We checked a selection of documents regarding peoples care and support, staff records and records that showed evidence of compliance with regulations and standards. An Annual Quality Assurance Assessment (AQAA) was completed by the manager and submitted to us following the inspection. This information provided by the manager told us how the service had developed since the last inspection and what was planned to further develop the service over the next 12 months. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Further consultation with people using the service and their relatives would make sure they were able to contribute to their plan of care. An activities programme could be introduced in consultation with people using the service. This would make sure people are provided with the opportunity for social activity. People using the service could be better informed about the choices at meal times and the complaints procedure could be better followed to make sure all complaints were recorded and investigated. The recruitment procedure would be made safer if they consistently included, seeing and retaining on file, proof of identification and a recent photograph. Staff would be better equip to keep people safe if they received the training they needed to do their job and records of training provided were kept. People using the service and their relatives could be better consulted and given the opportunity to comment on the service. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments were carried out before people moved into the home. This meant the staff had the information they needed to make a judgement about whether or not they could meet peoples needs. Evidence: The records showed that people did not move into the home without having their needs assessed. On each of the files there was an assessment carried out by the home or social worker. From this assessment an initial care plan was developed. The home did not provide intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and social care needs were met. This meant that peoples rights were upheld and they were treated with dignity. Evidence: In the AQAA the manager told us, We have individual care plans for each resident which are completed and updated on a daily basis by staff and are monitored by our Care Manager who is a qualified nurse, we ensure that staff are sufficiently trained to care for residents and attend to their individual needs We found, each person had a plan of care. The information in the care plan was extensive. In some cases key needs were lost in the volume of information. This made it difficult in some cases to identify peoples need and the action required by staff. Care plans were reviewed and changes to the care plans were recorded. There was no evidence on the care plans that people using the service or their relatives were consulted. Care Homes for Older People Page 12 of 27 Evidence: Some people spoken to, however told us they were asked about the things they liked and did not like and about the way they wanted to be cared for. This consultaion was not always reflected in the care plan to assist staff. Some people using the service told us they were not consulted. People told us appointments with health care professionals were made for them. The records showed people had appointments with dentist, opticians, district nurses, GPs and chiropodist. This showed their health care needs were met. The home had a medication policy. Staff responsible for administering medication were trained. There were systems in place to make sure the procedures were monitored, so that people were protected. There was safe storage and administration procedures. Designated staff had responsibility for checking stock received and following up any discrepancies. This meant the medication system was safe. People told us they were treated with respect and dignity. They told us that staff spoke to them a respectful manner, provided what people needed and made sure people were safe. Observations on the day of the visit showed that staff respected people. Staff were observed offering choices, and assisting people in a gentle, attentive and confident manner. This meant peoples rights were promoted Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People could maintain contact with family and friends. There were shortfalls in peoples social and mealtime experience. This meant their needs were not always met regarding daily life and social activities. Evidence: People using the service, relatives and staff told us there was not enough opportunity to take part in activities. People told us there was not enough to do and there was a lack of stimulation. People told us in the main they watched television, talked to each other, read a book or the newspaper. In their questionnaires relatives told us the service could be improved by providing more entertainment, more activities, there are no activities to involve the more able and alert people, no stimulation, should consider appointing an activities co ordinator. In the AQAA the manager told us, We intend to improve on all the social aspects of care for our residents, i.e. trips, entertainment and activities within the Home. People told us they were able to maintain contact with family and friends. People told Care Homes for Older People Page 14 of 27 Evidence: us their friends and relatives were made welcome when they visited. The home was part of the local community and if people choose to and were able they could use the local facilities. People told us that access to local facilities and going out of the home was often with friends and family. People using the service and their relatives, told us in the main the food provided was good. They did tell us there was not always a choice. Some people appeared to know there was choice at mealtimes while others did not. There was a notice board in the dining room this detailed one choice at each meal and did not reflect an alternative or that people could ask for something else if they did not like what was on the board. We looked at the menu for the day of the visit. This did not reflect what was written on the menu board for the lunch time meal. People who needed assistance with eating, were offered this in a dignified way. Staff sat with people and encouraged them to eat and drink. People were not rushed and the mealtime was relaxed. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected from abuse. There were some shortfalls in the complaints procedure. This meant that people did not always feel their complaints were taken seriously. Evidence: The home had a complaints procedure. People told us they knew how to make a complaint if they were not happy. One relative told us they had made complaints in the past and the outcomes were not always satisfactory. They also told us they had made a complaint two weeks ago and they were still waiting for a response. The manager confirmed this. There was however no reference to this complaint in the complaints book. This showed that not all complaints were recorded or responded to in a timely manner. Since the last inspection there had been one safeguarding referral. There was evidence that action had been taken by the home to protect people. The home worked well with other agencies to improve standards and reduce the risk of harm or abuse. The records showed that staff had received training in safeguarding people. This meant staff knew the action to be taken if any allegation was made or if they had concerns about practice. Care Homes for Older People Page 16 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean and well maintained. This meant people lived in a comfortable environment. Evidence: In the AQAA the manager told us, We ensure a safe, secure and well maintained environment for our residents. We found the home was reasonably maintained. At the time of the visit several of the bedrooms were being refurbished. The furniture, furnishings and decor was in the main in a good state of repair. The enclosed garden at the centre of the building was being redeveloped and was inaccessible to people. Relatives commented that this had been ongoing for some time. Peoples bedrooms were personalised. People were able to bring personal possessions and ornaments into the home with them. People told us this made them feel more at home. The home was clean and hygienic. Staff told us they had the equipment and cleaning materials they needed. Care Homes for Older People Page 17 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were shortfalls in the recruitment procedures and staff training records. This meant people could be placed at risk. Evidence: People spoke positively about the staff and the way they were cared for. Staff told us in the main there were enough staff on duty. In the questionnaires relatives told us staff were able to meet peoples needs and that the staff had the skills they needed to do their job. One relative told us The staff keep people safe and watch over them all the time, Its a job I could not do. One relative told us they felt the staff should wear name badges to help relatives and people using the service to identify staff. Some relatives told us there was a difference in the standard of care and support depending on the staff who were on duty. For example. wiping peoples face and hands after a meal and keeping nails and hands clean. People using the service told us staff look after me well nice staff I have no complaints they do the best they can. In the AQAA the manager told us 21 of the 22 care staff had completed the National Care Homes for Older People Page 18 of 27 Evidence: Vocational Qualification (NVQ) level 2 in care. This meant that staff had the knowledge they needed to support people in their care. Three staff recruitment files were checked. They contained some of the information required including, criminal record checks, application form, employment history and references. On two of the three files checked there was no recent photograph as required. Staff told us they had the training they needed to do their job. Training records did not reflect this. The training records were not up to date and it was difficult to identify the staff that had received training without checking individual staff files. Care Homes for Older People Page 19 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were not always consulted about the quality of the service and shortfalls in the health and safety procedures could be improved. This would make sure people were better protected. Evidence: In the AQAA the manager told us,The person in charge of the day to day running of the home has a management qualification i.e. registered managers award Level 4. The manager is also a director of the company. The manager has also undertaken a distance learning course in Dementia Awareness. The care manager is a qualified nurse with over 40 years experience, she has also been a home manager and has worked for the company in various capacities over the last 20 years. In the AQAA the manager also told us they try to obtain the views of people using the service by talking to people using the service and relatives. There was no recorded evidence of this. She told us the response to relative meetings was poor and they were trying to encourage people to attend more regularly. Care Homes for Older People Page 20 of 27 Evidence: People using the service, staff and relatives told us that relative and residents meetings did not take place. This meant they did not have the opportunity to comment on the standard of the service. The manager told us that the other directors visited the home on a regular basis. There was no written evidence of this. There were no reports completed to show that anyone had checked on the conduct of the service, spoke to people using the service, relatives or the staff. Three service users financial records were checked. People told us they were satisfied with the arrangements in place. The records showed income, expenditure, what monies had been spent on and the balance of peoples accounts. There were receipts for each purchase and evidence that the balance of peoples accounts were checked regularly. This showed that peoples financial interest were safeguarded. We observed good moving and handling techniques being used by staff. Lifting and handling equipment was provided and serviced to make sure it was safe. Hazardous substances were appropriately stored and there was written records that showed that the portable and fixed electrical equipment and supplies had been checked. Accidents were recorded and contained all the information required. There was evidence that staff referred people to other health agencies if they had concerns, for example, the falls clinic if people were at risk. The fire extinguishers had been serviced. However the homes fire risk assessment had not been reviewed in the last 12 months to make sure it still covered all the fire risks and action to be taken. This was raised by the fire officer during his visit to the home. The manager and staff told us they had received fire instruction. There were no records of staff fire training. This could place people at risk of harm and was brought to the immediate attention of the manager. At the time of the inspection the manager could not evidence that the gas supply had been checked. Since the inspection the manager has submitted copies of certificates which show the gas supply was checked in 2008 and was safe. Since the inspection a further check of the supply has been carried out for 2009. We were told that the action required following this recent check had been completed. This meant the gas Care Homes for Older People Page 21 of 27 Evidence: supply was safe. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 People must be consulted 10/12/2009 about a programme of activity. Arrangements must be in place to make sure activities take place and that people are enabled to take part if they wish. This is to make sure peoples social care needs are met. 2 16 22 All complaints must be recorded and investigated. This is to make sure complaints are taken seriously and acted upon. 10/12/2009 3 30 18 Staff must receive the training they need to do their job. All training must be recorded and kept up to date. This is to make sure that people are cared for by trained and competent staff. 10/12/2009 Care Homes for Older People Page 24 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 38 13 All staff must receive fire instruction or take part in a fire drill twice a year. Records of training must be recorded, kept up to date and available for inspection. This is to make sure staff know what to do in the event of a fire and to reduce the risk of unnecessary harm to people. 10/12/2009 5 38 13 The homes fire risk assessment must be reviewed and kept up to date. This is to make sure people are protected from unnecessary risk of harm or injury. 10/12/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Key information within the care plan should be easily accessible to staff. People using the service and their relatives should be consulted about the care plan and this should be recorded. People using the service should be consulted about the menu. They should be offered a variety of food and they should be given information about the choices at mealtimes. The re designing and work being carried out on the 2 15 3 19 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations enclosed garden should be completed in a timely manner. To make sure people have safe access to the garden area. 4 5 29 33 Recruitment records must include proof of identification including a recent photograph. A representative of the organisation should visit the home, obtain the views of people using the service, relatives and staff. A report on the conduct of the home should be made,which reflect peoples view and any action to be taken. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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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