Inspection on 30/06/08 for Royal Garden Hotel

This inspection was carried out on 30th June 2008.

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

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 Garden Hotel 11/06/09

Royal Garden Hotel 12/06/07

Royal Garden Hotel 19/12/05

Royal Garden Hotel 24/01/05

Royal Garden Hotel 02/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Royal Garden Hotel 1 Princess Avenue Bognor Regis West Sussex PO21 2QT Lead Inspector Liz Palmer Unannounced Inspection 30th June 2008 10:15 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 Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royal Garden Hotel Address 1 Princess Avenue Bognor Regis West Sussex PO21 2QT 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) 01243 841026 martin@royalgarden.net www.royalgarden.net Crescentworth Limited Manager post vacant Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2007 Brief Description of the Service: The Royal Garden Hotel is a care home providing personal care and accommodation for thirty-six persons (OP) of old age not falling within any other category. Crescentworth Limited owns the home. The responsible individual on behalf of the company is Mr C Lindsell. The Royal Gardens Hotel is purpose built and provides a high standard of accommodation throughout. It is positioned in Bognor Regis over looking the Marine Gardens and sea front. Shops and other local amenities are close by. The property is equipped with a 12-person passenger lift to all floors and has an assisted spa bath and shower units. The fees for the home range between £480 and £750, which are dependent on the size, location and view from the room. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection included a site visit to the home over a period of five hours. During this time two staff were interviewed and manager assisted with the inspection. Two directors, one of whom is the responsible individual were present for parts of the inspection. Three service users were met and spoken to, others were observed during the inspection. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the home’s Annual Quality Assurance Assessment (AQAA) that they completed and returned to us. What the service does well: What has improved since the last inspection? Some improvements have been made to the recruitment procedures, including ensure staff have suitable checks before starting work in the home. Training has improved and the requirements regarding staff having fire training and health and safety have been met. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience adequate quality outcomes in this area. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. Standard 6 does not apply. EVIDENCE: The initial assessments of two new residents admitted to the home were sampled. They contained information about the person’s care needs and anything issues relating to mental well being. General health, mobility, religious needs and information relating to medication are also recorded. One person who was recently admitted has dementia, there was not enough information recorded at the time of admission and assessment to make a judgement about whether the person’s needs could be met in the home or Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 9 whether they would impact on the other people living there. The manager and director felt they could meet the person’s needs and have involved a mental health advisor to work with them in providing suitable care. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have their health and personal care needs met in a way that respects their views and upholds their right to privacy. People are encouraged to live the life they chose, however they could be at risk due to the unstructured approach to risk assessment. EVIDENCE: Three care plans were looked at. These are drawn up from the initial assessments undertaken prior to moving in. The care plans are basic and clear. They contain information about allergies, care needs, what the person can do independently and anything to avoid. Other details included what time a person likes to go to bed, some social history and any current hobbies and Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 11 interests. They are kept under regular review and changes are made as necessary. People spoken to confirmed that they are supported to pursue their hobbies and received the daily paper of their choice. They said they were treated with respect and that staff were kind and caring. They said staff knock and wait before entering their rooms and speak to them in a respectful way. Daily records were seen and showed evidence of people being given choices and their independence being promoted. However, there is a potential risk due to a lack of written risk assessments. For example, people going out unaccompanied where there is a risk of them forgetting where they live or falling. There was some evidence that risks have been assessed however no documentation was in place to support this. This was discussed with the manager and director who agreed that better documentation would better protect people. This was highlighted at the last inspection and remains an issue that needs to be addressed therefore a requirement has been made. People who use the service are all registered with a local General Practitioner (GP). Records showed evidence of medical needs being followed up and referrals to other professionals when needed. Two residents spoken to during the inspection said they could ask staff to seek medical help when they needed it and said they felt safe and well cared for in the home. The storage and recording of medication was sampled. The medication is stored in a lockable filing cabinet in the office. The deputy stated that this is kept locked at all times when the office is unmanned. No errors or omissions were seen on the records. The home uses Nomad pack system that is made up and delivered by a local pharmacy. Residents that wish to administer their own medication are supported to and have signed to say they are responsible. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 – 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have a wide range of activities on offer in the home and they are happy with the choices. Everyone is satisfied with the food provided. EVIDENCE: A range of activities is available in the home. A weekly activity programme includes music, bingo and fitness. Residents’ birthdays are celebrated by the home and people are encouraged to join in if they wish. Residents are consulted on the activities and they always have the choice whether to join in or not. People are also encouraged to pursue their own hobbies and remain independent as far as possible. Those who are able go out to the local shops. Others are accompanied on walks. There are residents’ meetings held every three months, minutes of these were sampled. Topics discussed included food, activities and whether a pedestrian crossing is needed outside the home. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 13 Residents said their visitors are welcome and given drinks and meals when the visit the home. Some residents have their own telephones to enable them to keep in touch with friends and family. Residents spoken to said they felt they had choice and control of their lives. Residents said they enjoyed the food and there was always a choice. Residents can choose where to eat and some prefer to eat in their rooms. Food preferences, dislikes, allergies and nutritional and dietary requirements are recorded in residents’ care plans. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to complain and are protected by the home’s policies for safeguarding them. However, they would be better protected if staff received appropriate training. EVIDENCE: A complaints procedure is displayed in the home. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. One resident gave examples of minor concerns that had been resolved to their satisfaction. Residents were observed making requests and expressing their views during the inspection. There was an open and relaxed atmosphere and staff dealt promptly with requests. The AQAA states that four complaints have been made in the last twelve months all of which have been resolved within the given timescale. One complaint is still ongoing, the home is dealing with this. At the last inspection we made a requirement for all staff to receive training in safeguarding adults to ensure that people who use the service are protected. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 15 Staff say they have not received this training and records confirmed this. The manager and responsible individual of the home were unaware that ‘safeguarding’ was the new term for ‘adult protection’ and have therefore not complied with this requirement. They say they thought they had ‘safeguarded’ by providing training in Fire Safety, First Aid and Health and Safety. They also said that staff receive information about safeguarding as part of their induction. The home has a policy on safeguarding and those spoken to were aware of their responsibilities to report any safeguarding issues. Another requirement has been made and the responsible individual has assured us this training will be undertaken. There are no ongoing safeguarding issues in the home. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a clean and homely environment, which is well maintained. EVIDENCE: The inside and outside of the home are maintained to a high standard. Residents say their rooms are cleaned regularly and staff were seen to be wearing suitable gloves and aprons. A resident commented on the high standard of hygiene promoted in the home. Residents’ rooms were individually decorated and evidence of people bringing in their own belongings was seen. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 17 The rooms are fitted with Yale locks and rooms are lockable from the inside. There are master keys to be used to enter rooms in the case of an emergency. Suitable laundry facilities are available and allow residents involvement if they wish and a home maintenance programme is in place to ensure continuous update and improvement. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements for recruiting and training staff have improved, however these improvements must be maintained to ensure that people are protected and receive the care they need in a consistent manner. EVIDENCE: The home employs a mixture of staff skills and experience. Staff have clear designated roles, for example, there is a manager, deputy, senior care staff, care staff, cook, laundry staff and a maintenance person. During the inspection there were suitable numbers of staff on duty to attend to the needs of service users. Residents spoken to said there were usually enough staff on duty during the day and night to meet their needs. They said call bells were answered promptly and one said ‘nothing is too much trouble’. Staff were observed interacting in a positive and respectful manner with residents. The two staff spoken to during the inspection were confident and competent at their jobs. They spoke confidently about the needs and preferences of individual service users. There is on going training provided including Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 19 mandatory courses such as, first aid, food hygiene, infection control, health and safety and fire training. Staff are supported to undertake National Vocational Qualifications (NVQs). The home currently has 45 of it’s staff having or working towards NVQ level 2, or above. Their AQAA states training could be improved, however it does not state how this will be achieved. We made a requirement at the last inspection for all staff to receive fire training. This has been achieved. At the last inspection we made a requirement for Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks to be made on all staff before they started work, as this was not routinely being done. The files of three new staff were sampled at this inspection and all had evidence a CRB and POVA check being done before they started work. Other evidence of their recruitment procedures included an application form and a request for references. However, one file only had one reference and another had two personal references and none from their previous employer. The manager stated that they had chased up the second reference and had as a result of that started requesting three references in case one is not returned. Better tracking of the references would ensure that gaps in the recruitment file would be filled within a reasonable time. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs met by staff that are caring and sufficient in numbers however, gaps in training places them at risk. EVIDENCE: The home had to be reminded to send us their AQAA and when we received it the information very basic and did not tell us all the things we needed to know. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 21 The AQAA did not give us any evidence of a clear plan for improvement in the next twelve months. The current manager has recently completed his registered manager’s award although no application has been made to us for his registration. Residents spoke highly of the management of the home and said they felt it is well run and they are in safe hands. They said the manager is friendly and approachable as are the directors. Regulation 37 notices are sent to the Commission with regard to significant events in the home. No residents’ money is held by the home. On the sampling of fire records for the home it was found that these are up to date. Gaps in the training for dementia and safeguarding adults potentially puts people at risk and these needs to be addressed by the responsible individual of the home. Improvements to care plans and risk assessments would also better protect the people who are more vulnerable in the service. At this inspection and the one previously, the home has shown that it is not keeping up to date with current and changing policy and legislation in relation to running a care home. For example, not being up to date with Adult Services’ new term for Adult Protection and not being up to date with guidance relating to CRB and POVA checks. Also the lack of information in the AQAA may suggest a lack of knowledge and understanding about the importance of this document. Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement The registered person must ensure that care plans are detailed to include any risks to residents and how these risks have been minimised. The recruitment procedures must be followed to ensure residents are protected. The registered person must ensure staff are trained in order to meet the needs of residents. This includes dementia and safeguarding adults training. Timescale for action 20/08/08 2 3 OP29 19 18 20/08/08 30/09/08 OP30 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 Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Royal Garden Hotel DS0000014697.V365475.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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