Inspection on 17/05/05 for The Court

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Court 13/09/06

The Court 04/01/06

The Court 21/12/04

The Court 04/08/04

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 The Court Rockbeare Exeter Devon EX5 2EF Lead Inspector Louise Delacroix Announced 17 May 2005 10:00 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 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. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Court Address Rockbeare Exeter EX5 2EF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01404 822632 Mrs Elaine Alison Slater and Mrs Viviennne Elizabeth Slater Mrs Carol Ann Jackson Care Home 21 Category(ies) of OP Old age (21) registration, with number PD(E) Physical disabilities - over 65 (21) of places The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 December 2004 Brief Description of the Service: The Court is a three storey detached Georgian House situated in the village of Rockbeare, East Devon. It is next to the parish church, with the primary school and post office close by. Residential care can be provided for up to twenty-one older people, which includes people who may have a physical disability. However, the manager and provider generally chooses to run with an occupancy of seventeen. There are nine single rooms with en-suites and eight double rooms with en-suites. The accommodation is on the ground and first floors. There is a shaft lift between the floors. On the ground floor there is a large lounge and a separate homely dining room. The lounge has large windows overlooking the countryside, as do many of the bedrooms. Easy chairs are also in position around the home to offer different places for residents to sit. The garden is beautifully kept and enjoyed by the residents. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over seven hours with fifteen of the seventeen residents contributing with their views about the service. One of the owners, the manager, two visiting health professionals and two members of staff were also involved in the inspection. The report is based on discussion with people living and working at the home, comment cards, observation, tour of the building, care records and records relating to the safe running of the home. During the inspection, a number of residents took part in a gentle exercise group and later watched the Queen’s speech. Other residents chose to stay in their rooms or go out with visitors. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made during this inspection but there are areas for further improvement, which include covering further radiators, providing more appropriate locks on residents’ bedroom doors and fitting a sluice. Food hygiene training needs to be up dated for some staff. Daily records in residents’ care plans need more detail. The results of the quality assurance survey should be published. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 standard(s) 1,3,4 People who move to the home receive clear information about the service to enable them to make a choice about whether or not they might wish to live in the home. Thorough admission processes ensure the home is able to meet the needs of residents. EVIDENCE: The statement of purpose and service user’s guide is clear, well laid out and details the appropriate information. The home encourages that prospective service users’ relatives read out the documents to them if they have visual difficulties. This service can also be repeated by the allocated keyworker within the home. The A-Z guide for service users is detailed and has a user-friendly style. Three residents’ care files evidenced the commitment of the manager to establish a detailed assessment of need. The assessments cover all aspects of care, including oral health, continence, medication usage, communication, diet, social interests and religious needs, and also include assessments tools for highlighting the vulnerability of residents to pressure areas and skin care. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 9 The staff group is generally stable with a good mix of experience and age, with residents saying they felt confident in the staff and that the standard of care was very good, with support from external health professionals. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10,11 There is a comprehensive care planning system in place but records detailing how the daily care needs of residents have been met are limited. The health care needs of residents are well met and the relationship between staff and residents is positive. There is recognition and appropriate action taken to meet of the changing needs of residents. EVIDENCE: Residents sign their care plans and can choose to have a copy kept in their room, these were seen during a tour of the building. Risk assessments are up to date with clear guidance and the plans reviewed on a monthly basis, which is good practice. However, daily records do not portray the individual lifestyles of the residents due to generic comments such as ‘no problems’. Residents said that their health needs were well supported and gave examples of visits from district nurses, GPs, chiropodist and optician, which was also detailed in care plans, as well as twice weekly exercise classes. Until recently one resident has been going swimming. A visiting health professional said communication with the home was good and advice was followed. Risk assessments highlight residents’ pressure care needs, equipment for the prevention of pressure sores was seen being used by residents and staff knew how to recognise skin problems and the action needed to be taken. Residents The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 11 said they felt staff treated them courteously and with respect. For example, when they had a bath. They also felt their privacy was respected. Examples given were staff knocking before entering their rooms, mail being unopened and being able to see visitors privately. They spoke about a personal touch. Residents’ ‘last wishes’ are recorded and staff spoke about how less experienced staff are supported to provide appropriate care for residents who are dying. Several residents have moved rooms as their care needs have increased so that they are nearer night staff and can access the communal areas. Several residents felt staff responded flexibly to their changing needs. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The routine of the home is flexible and promotes activities, while the ethos of the home encourages residents to make their own decisions and maintain their independence. The meals in this home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: The visitors’ book showed that visitors regularly visit the home, which residents confirmed. Residents were observed creating their own routines in the home and said that their decisions were respected. For example, joining in with activities and where they eat their meals. Residents spoke about the success of a visit from the RSPB and how the manager consults them individually and through the residents’ meetings about trips and speakers to the home. They were also positive about a fortnightly trip to the shops to maintain their independence and links with the local community i.e. regular religious services. Comments were generally favourable about the quality of the food and the choice offered, which was observed as staff discussed the teatime meal with residents. There is a clear menu on display in the attractive dining room and residents confirmed that supper is also available. Smaller portions and liquidised meals were seen being provided for those that wanted them. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 standard(s) 16,1,7,18 Residents’ are confident that they are listened to and that their requests would be acted upon if they had a complaint. Staff have an understanding of adult protection procedures and residents safety and rights are protected. EVIDENCE: A number of residents said they would feel comfortable talking to the manager if they had a complaint and one said that she was ‘approachable’ but all were keen to emphasis they had no complaints. No complaints have been received either by the home or the CSCI since the last inspection. There is a clearly displayed complaints policy and the manager takes a pro-active role in ensuring that residents can discuss problems in a group, individually or through questionnaires about the service. Residents confirmed that they were able to vote, if they wanted to, at the last general election. Two members of staff confirmed that they had watched a video highlighting poor and abusive practice, and discussed what they had learnt. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 standard(s) 9,20,23,24,25 Residents are provided with a homely place to live but not all aspects of residents’ privacy and safety are met, although work is in progress. EVIDENCE: Monthly audits evidence a programme of routine maintenance and the action taken. Residents spoke positively about the new carpet for the lounge and stairs that are soon to be fitted as they appreciated the thought put into their surroundings. Communal rooms are spacious, homely, clean and well furnished. Residents said that gardens are accessible and well used. Residents said they liked their rooms and many portrayed a real sense of it being their private space, complete with their own personal possessions and in some cases their own furniture. Most rooms have large windows that overlook the surrounding countryside. Locks that are accessible in emergencies are currently being fitted to residents’ bedroom doors. A tour of the building showed that some radiators have been fitted with covers to prevent the risk of residents being burnt. Risk assessments were seen in care plans, and residents, who have been assessed as vulnerable, have had radiator covers fitted in their rooms first. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff recruitment procedures promote the protection of residents and the training provided works towards a skilled staff team. EVIDENCE: A cleaner is now employed five days a week and a resident said they appreciated the care the cleaner took over their belongings and other residents said the home was always clean. Residents said staff were always available and they never had to wait long for help. Half of the care staff group have an NVQ and a staff member spoke about how this training has had a positive impact on them professionally and personally. The manager had produced a yearly audit of staff training needs and during the inspection it was recognised that food hygiene refresher training was needed for some staff. Two members of staff said that they had received mandatory training i.e. moving and handling training and infection control, and current training in medication. Two staff files contained appropriate references and forms of identification, as well as POVA and CRB checks. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,36,37,38 The manager is committed to improvement and involves staff and residents in this process but residents and interested parties have not yet received the results of this consultation to enable them to be fully involved in the process. EVIDENCE: Feedback about the home is actively sought from residents but the results have not been collated. The manager is clear that the residents come first and a resident said that she ‘did a good job’. The manager has shown a real commitment to improving and maintaining standards within the home by creating a clear and up to date auditing system to monitor the service and through her supervision sessions with staff. The manager up dates her own training and acts as an assessor for staff. Through discussion, it was clear that she recognises when to adapt her style of approach, both for residents and staff. Residents appreciate the open approach of the manager and staff spoke about her availability. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 17 Records inspected indicated regular safety and fire checks are carried out. Regular fire instruction and drills are recorded. Records are well maintained and stored appropriately. The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 2 2 x STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 3 x 3 3 3 The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 19 No 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 Regulation Requirement No requirements made. Timescale for action 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. 3. 4. Refer to Standard 33 7 24 25 Good Practice Recommendations Feedback is actively sought from residents but the results need to be collated and made available for residents, other interested people and the CSCI. Daily records should be more detailed and not contain generic statements like no problems. Locks that are accessible in emergencies should be fitted to residents bedroom doors. Radiators should all radiator guards or low surface temperatures. The providers have started a programme of fitting radiator covers to prevent the risk of burns. The inspector strongly recommends that this work be completed as soon as possible. Refresher training in food hygiene should be provided for the relevant staff. 5. 30 The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 The Court D54 D06_s34178_thecourt_v218395_170505 stage 4.doc Version 1.30 Page 21 - 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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