Inspection on 04/01/06 for The Court

This inspection was carried out on 4th January 2006.

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

The Court 13/09/06

The Court 17/05/05

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 The Court Rockbeare Exeter Devon EX5 2EF Lead Inspector Louise Delacroix Unannounced Inspection 4th January 2006 10:50 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 The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Court Address The Court Rockbeare Exeter Devon EX5 2EF 01404 822632 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) Mrs Elaine Alison Slater Mrs Vivienne Elizabeth Slater Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability over 65 years of age of places (21) The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To comply with the staffing levels agreed with Devon County Council prior to April 2002 17th May 2005 Date of last inspection 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 DS0000034178.V264785.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over five and a half hours. Seventeen people were living at the home and nine residents, three staff members, the acting manager and the owner contributed to the inspection. During the inspection, people were seen using both communal areas and their private rooms. As part of the inspection, fire records, care plans, quality assurance, staff rotas, staff files and medication administration records were looked at. A tour of the building took place and seven bedrooms were visited. Presently there is no registered manager at the home but there is an acting manager who joined the home in November 2005. She has experience in the health and social care field, and is studying for her Registered Manager’s Award. This report should be read in conjunction with the inspection report for May 2005. On the last inspection report, the scores for standards 10,11,12,13,14,15 were mistakenly not included. All these standards were met. Therefore this information has been repeated in this report and the scores added. What the service does well: What has improved since the last inspection? The content of residents’ daily notes are now more detailed and food hygiene training has been updated. A sluice has been installed. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): In May 2005, standards 1,3,4 were inspected and met. The home does not offer intermediate care. EVIDENCE: The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The health care needs of residents are well met, and the relationship between staff and residents is positive. EVIDENCE: The acting manager has been re-designing the home’s care plans with the aim to provide clear guidance to staff by ensuring information is recorded in one place for easy access. Three care plans were looked at, and all three had up to date risk assessments with appropriate guidance and aims. Daily records have improved with details of residents’ physical and emotional needs. The acting manager is aware that these new style care plans will need to be signed by residents or their representatives, and reviewed monthly. On the previous inspection, residents said that their health needs were well supported and gave examples of visits from district nurses, GPs, chiropodist and optician, which were also detailed in care plans, as well as a regular exercise classes. During this inspection, residents again confirmed that they had access to health care services. These visits were also detailed in care records. The acting manager spoke about steps taken to reduce the risk of pressure areas for one resident, which was confirmed by a member of staff The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 10 and the equipment was seen during a visit to the resident’s bedroom. She said none of the residents had a pressure sore. Discussion took place around the assessment of residents who are selfmedicating, how these residents’ manage their medication and the storage arrangements for their medication in order to ensure the safety of other residents. The pharmacy inspector will be asked to provide further information to ensure the current assessment/review form is worded appropriately. The owner confirmed that a resident who manages all their own medication has lockable storage space to keep it in. Medication administration records were appropriately completed, and the owner confirmed that there were no controlled drugs in the home but that suitable storage was in place, if this should change. Six people, including the owner, have received medication training. On the last inspection, residents 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. During this inspection, one resident said that it was a ‘happy place’ and another person said staff were ‘kind’. Residents appeared relaxed with staff and several said they had no concerns regarding staff attitude. Care plans emphasised the right for residents to have choice and to be involved in decision-making, which also came across in discussions with staff. 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 DS0000034178.V264785.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 and the home’s communication book for staff 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, craft workshops and visiting entertainers. There has also been a speaker from the British Legion. The acting manager consults residents individually and through the residents’ meetings about entertainment. The last residents’ meeting was in December. The home has its own minibus. Several residents 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 and visits from a local school. The owner spoke about the celebrations at New Year’s Eve during which nine residents toasted 2006 with champagne at midnight. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 12 The dining room is attractive and spacious. 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. Residents confirmed that supper is also available. Smaller portions and liquidised meals were seen being provided for those that wanted them. Residents can also choose to keep food in the kitchen if they wish to have particular favourite items. Food is served on a four weekly rota. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were inspected in May 2005 and met. There have been no complaints made to CSCI since this date. EVIDENCE: The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,25,26 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. New carpets have been fitted in the lounge and hall, and on the day of the inspection the windows and front door were being painted. Communal rooms are spacious, homely and well furnished. Residents said that gardens are accessible and well used in the summer. 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 have been fitted to some residents’ bedroom doors. A tour of the building showed that most radiators in the bedrooms have been fitted with covers to prevent the risk of residents being burnt, although four still remain uncovered. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 15 The home now has a sluice and a new washing machine with a sluicing facility in recognition of residents’ changing needs. During the tour of the building, it was observed that communal carpets had not been vacuumed, a hall landing was untidy, two bedroom carpets were stained, and two bathrooms unclean. However, the home was odour free. The owner acknowledged that the previous standard of cleaning had not been maintained and is taking steps to recruit a housekeeper as it has been recognised that the cleaning tasks are too much for one person. (See Standard 27). The Court DS0000034178.V264785.R01.S.doc Version 5.1 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 Staff recruitment procedures promote the protection of residents and the training provided works towards a skilled staff team. However, this small team would benefit from the appointment of extra care and domestic staff to provide improved cover. EVIDENCE: The owner and acting manager recognise that more care staff and a housekeeper need to be recruited. Currently the staff team is working at a reduced number due to long-term sickness and one staff member leaving at short notice. This has meant that staff have had to work extra hours, causing tiredness at times, to ensure residents are supported with appropriate staffing levels. The acting manager and owner have also provided ‘hands on’ cover, which has meant less time is available for office work. Staff have appreciated this and feel well supported. It is to the credit of everyone working at the home that although residents recognised that there was a reduced staff team, nobody spoken to raised this as having affected them directly. On the day of the inspection, there were three care staff members in the morning and at lunchtime, plus the cook and kitchen assistant. In the afternoon and evening, there are two care staff members. This is providing minimal levels of cover. There is one waking night staff while the owner, who lives on site, provides sleeping cover and can be woken, if necessary. Out of the current staff team, there has only been one new appointment. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 17 This file was checked and contained all the necessary documentation, including POVA check and enhanced CRB. Three staff members were spoken to about their training, and training certificates were seen as part of the inspection. All had up to date food hygiene certificates and two care staff members spoke about their range of training i.e. infection control, first aid and moving and handling, as well as specialist courses on the effects of strokes and Parkinson’s. One was aware they had to up date their first aid. The acting manager is planning to audit the skills and training needs of the staff team to ensure their knowledge is up to date and based on best practice. The Court DS0000034178.V264785.R01.S.doc Version 5.1 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): 31,32,38 Residents have the opportunity to be involved in making decisions regarding the home but have not yet received the results of a formal consultation to enable them to be fully involved in this process. EVIDENCE: The home is currently without a registered manager. Feedback about the home is actively sought from residents through questionnaires but the results have not been collated and published in a format suitable for residents and their representatives. The acting manager has held a residents’ meeting since her appointment in November and said she also went round speaking to residents individually if they did not wish to attend the meeting. The home has a good history of consultation with residents. Generally fire records and training were up to date, although discussion took place about how to make the recording clearer. Fire extinguishers were The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 19 checked in October 2005 and a spot check on portable electrical equipment showed them to have been tested for safety. The owner has taken steps to meet the recommendations of a visiting fire officer, including changing the layout of the hallway and a corridor. On the day of the inspection, a first aider was on duty and those fire exits checked were clear. There are clear instructions regarding the safe bathing of residents, including the recommended water temperature and an appropriate thermometer, which showed water was at a suitable temperature. The Court DS0000034178.V264785.R01.S.doc Version 5.1 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x 2 2 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x x x 3 The Court DS0000034178.V264785.R01.S.doc Version 5.1 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. Standard Regulation Requirement 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. Refer to Standard OP7 OP24 OP25 Good Practice Recommendations Care plans should be signed by the resident or their representative, if necessary and should be reviewed on a monthly basis. Locks that are accessible in emergencies should be fitted to residents bedroom doors. There are seven rooms without these locks. Radiators should all be fitted with guards or have 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. There are currently four radiators without guards in residents’ rooms. The owner and manager should contact CSCI to inform of new appointments of care staff and the recruitment of a housekeeper. The manager should be registered with CSCI. Feedback is actively sought from residents but the results DS0000034178.V264785.R01.S.doc Version 5.1 Page 22 4. 5. 6. The Court OP27 OP31 OP33 need to be collated into a suitable format and made available to residents, other interested people and the CSCI. The Court DS0000034178.V264785.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Exeter 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 DS0000034178.V264785.R01.S.doc Version 5.1 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!