Care Home: Country Court

What the care home does well The home has a friendly and pleasant atmosphere, which staff worked hard to maintain. People commented in discussions and in surveys that staff looked after them well and completed tasks when they asked them to. There is the right amount of staff on duty to meet the needs of the people who live at the home. Staff ensure that people are only admitted to the home after their needs have been assessed so they can be sure their needs can be met. They obtain assessment information from care management teams. People are able to have trial visits and short stays at the home before they need to make a decision about permanent residence. There were plenty of activities provided to offer stimulation to people. People liked the meals provided and said they had plenty to eat and drink and that the food was, `very good`. The home was clean and tidy with no malodours. The staff dealt with niggles and concerns quickly to prevent them turning into complaints. Staff receive regular formal supervision and have access to a good range of training. What has improved since the last inspection? The home need to keep detailed information and records about the people who live there so staff can care for them properly and meet their needs, these records are called care plans. The care plans have been update since the last inspection and contain lots of good information about people`s needs. The home have improved the way they handle medication and this is now much safer. The staff now receive training about the specific need of older people for example training about dementia and how this affects older people. The home told us in the AQAA those areas that they think have have improved since the last inspection: "We have encouraged more families to take meals with their relatives within the home. We have introduced professionally run sit and be fit exercise sessions and have found an improvement in the general wellbeing of the residents who participate, we have also increased the regularity of pictures of days gone by, again another professionally run resource that encourages reminiscing. We have continued to monitor our service and make adjustments as necessary". What the care home could do better: The care plans should include information about people`s past lives. This will help staff to better understand people and help them meet their needs more effectively. Sometimes staff have to start working at the home before a fully enhanced Criminal Record Bureau Check has been received this is called working to an initial Independent Safeguarding Agency (ISA formally POVA) check. The manager should use a form for senior staff to sign which would evidence that the person was under close supervision at all times while working under an ISA check. The manager must consult with the fire officer about the use of door wedges and follow any advice or recommendations made. The practice of wedging fire doors open puts people at serious risk of harm in the event of a fire. The home told us in the AQAA that they are intending to introduce the following: "Our main project for the next few months will be to set up the reminiscing corner for our residents both with or without dementia and to look into buying a small animal, possibly a rabbit for the residents to enjoy". Key inspection report Care homes for older people Name: Address: Country Court Southcoates Lane Hull East Yorkshire HU9 3TQ     The quality rating for this care home is:   two star good 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: George Skinn     Date: 2 1 0 1 2 0 1 0 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 24 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Country Court Southcoates Lane Hull East Yorkshire HU9 3TQ 01482702261 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: countrycourt2005@yahoo.co.uk Pearl Dusk Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Exception statement - permitted to provide care for one named person under pensionable age. Date of last inspection Brief description of the care home Country Court is purpose built building, which provides care for up to thirty-four older people, who may also have dementia. The home is situated to the East of the city of Hull, with shops, health facilities, community services and public transport all easily accessible. All accommodation is on the ground floor with all rooms providing single accommodation. Nine rooms have en-suite facilities. The home has three bathrooms and one shower room. There is a large lounge, a dining room and a small conservatory. A additional quiet lounge also has a small conservatory attached. An inner courtyard is available and accessible for residents to use should they wish to sit outdoors. A small car park is available at the front of the home. Care Homes for Older People Page 4 of 24 1 2 0 5 2 0 0 9 0 0 Over 65 34 34 Brief description of the care home There is no top-up fee, people have to pay for chiropody, hairdressing, newspapers and toiletries. Care Homes for Older People Page 5 of 24 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: two star good 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence these sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment AQAA. Comment cards returned from people who live at the home, relatives and staff. A visit to the home was carried out by one inspector which lasted six (6) hours. During Care Homes for Older People Page 6 of 24 the visit we spoke with the people who live at the home, their relatives and staff. We also looked at records relating to the people who live at the home, staff and management activities. We also looked at care practices where appropriate, and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. The date of the last inspection was 18th February 2009. The current weekly charge is 359.50 pounds with no top up charge. The manager was available to assist throughout the day. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 24 The care plans should include information about peoples past lives. This will help staff to better understand people and help them meet their needs more effectively. Sometimes staff have to start working at the home before a fully enhanced Criminal Record Bureau Check has been received this is called working to an initial Independent Safeguarding Agency (ISA formally POVA) check. The manager should use a form for senior staff to sign which would evidence that the person was under close supervision at all times while working under an ISA check. The manager must consult with the fire officer about the use of door wedges and follow any advice or recommendations made. The practice of wedging fire doors open puts people at serious risk of harm in the event of a fire. The home told us in the AQAA that they are intending to introduce the following: Our main project for the next few months will be to set up the reminiscing corner for our residents both with or without dementia and to look into buying a small animal, possibly a rabbit for the residents to enjoy. 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 24 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 24 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. Peoples needs are assessed prior to moving into the home. Evidence: We looked at a sample of files which belonged to the people who live at the home and we saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care, which is a specialist service aimed at maximising peoples independence and return home after a hospital admission. Care Homes for Older People Page 11 of 24 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. People have a detailed plan of care which instructs staff how best to care for them. People are protected by the homes procedures for handling medication. Evidence: We looked at four (4) care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan and these contained risk assessments around the area of falls, tissue viability, nutrition and diet. The care plans did not include any information about the persons past life. This is important information. Having this information helps staff to understand someones current behaviours and values. We saw that people who live at the home can access health care professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses. Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. When we spoke with the staff they were clear about how to maintain someones Care Homes for Older People Page 12 of 24 Evidence: dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when caring for those people who have dementia. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a life style of their own choosing, and are enabled to keep in contact with relatives and friends. People are provided with food that is wholesome and nutritious. Evidence: When we spoke with the people who live at the home they said they could make choices about daily activities, what food they preferred to eat, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome and they had good relationships with the staff. We saw that a wide selection of activities are arranged for the people who live at the home to take part in if they wish these included; reminiscence, one to one discussions, bingo, quizzes, table games dominoes, crosswords and nail care. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked weather permitting. When we spoke with the people who live at the home about the food they told us it was very good. The people who live at the home are asked what they would like for Care Homes for Older People Page 14 of 24 Evidence: lunch and tea as a choice is available for both. We saw that the food provided on the day of the visit was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. Catering staff had been awarded an A for safe food management in the Local Authoritys scores on the doors assessment system and had also gained a Healthy Heartbeat Award. Menus rotated over a four week period and alternatives were available to the main meal provided. Catering staff have information on peoples likes and dislikes and special diets are catered for. Care Homes for Older People Page 15 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the way the home handles complaint and the procedures in place for handling any allegations of abuse. Evidence: We saw that no complaints had been received by the home since the last inspection. The CQC have received no complaints about the home since the last inspection. The home has been the subject of two (2) investigations by the Local Authority Safeguarding Team both are now resolved. We asked the people who live at the home if they knew who to complaint to; they told us that they did and were aware they had the right to make complaints telling us they would talk to their key worker or the manager. The home has a policy and procedure in place for Safeguarding Adults, the staff interviewed were aware of this and all had received training about the Protection Of Vulnerable Adults (POVA). Staff were able to describe what they would do if they suspected any abuse was occurring. Care Homes for Older People Page 16 of 24 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. People live in a well maintained and clean environment. Evidence: The home was clean and tidy and free from any malodours. Communal areas consisted of a dining room set out with individual tables and chairs, which led into the main lounge. There was a small conservatory attached, sufficient for four to five easy chairs. The conservatory also had two dining tables and chairs, these have now been moved and wheelchair access is easier. In addition the home had a quiet lounge used for activities or for people to see their relatives. Communal rooms were nicely furnished and decorated in a homely style. The home had three bathrooms and one shower room, all appropriate to meet the needs of the people who live there. The home had thirty four bedrooms, all of which were single occupancy. Nine of the bedrooms had en-suite facilities. Those bedrooms checked were clean and tidy and personalised to varying degrees. Care Homes for Older People Page 17 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by staff who are provided in enough numbers and trained to meet their needs. People are protected by the home recruitment and selection procedures. Evidence: We saw that the people who live at the home are cared for by staff who are sufficiently trained and who are provided in enough numbers to meet their needs. We looked at staff recruitment files and we saw that these contained evidence of references being taken from previous employers and evidence of enhanced Criminal Records Bureau (CRB) checks being undertaken. Recruitment files showed us that a check has been carried out by the Independent Safeguarding Authority (ISA formally POVA) as part of the CRB check prior to staff working at home. The manager told us that while the staff are working at the home on the strength of an ISA check they are on induction and supervised closely by a senior member of staff while the full CRB check comes through. It is recommended that this is recorded and senior staff sign to confirm they have supervised the staff member on that shift. We saw that staff receive mandatory training about how to keep people safe which Care Homes for Older People Page 18 of 24 Evidence: included lifting and handing, health and safety, basic food hygiene, what to do in the event of fire and first aid. We saw that staff also receive training about specific needs of older people. We saw that some staff had received training about dementia and how this affects older people. Staff told us that they had enjoyed this training and it had given them a better understanding of dementia. We saw that staff receive regular supervision and developmental opportunities to attend further training. When we spoke with staff they said they found the training excellent and were pleased that they were encouraged to attend lots of training, as they felt this gave them the skills needed to care for the people who live at the home. Care Homes for Older People Page 19 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which managed and run in their best interests. Effective management systems, policies and procedure keep people safe from harm and ensure their health and welfare. Evidence: The manager is registered with the CQC and has a lot of years experience in caring for older people. She is still undertaking the registered managers award but hopes to have this finished within the coming year. She is supported by the owners in many administrative tasks like recruitment and finances. When we spoke with staff they told us that the management team was approachable and they found them supportive, they were confident if they had any concerns these would be listen to and taken seriously. We saw that all the equipment used in the home was serviced on regular basis and within the manufactures guidelines. We saw that regular fire drills were undertaken Care Homes for Older People Page 20 of 24 Evidence: and staff received training about what to do in the event of a fire. We saw that many of the fire doors around the building were wedged open. This put people at risk if there was fire. The manger needs to consult with the fire safety officer as to the best course of action and follow any advice given or recommendations made. The home continues to have a well established quality audit system in place which gives people who live at the home, their relatives, and health care professionals opportunity to contribute to the running of the home. A report is produced and timescales are in place for the achievement of any shortfalls in the service. We did not look at the finances as there have no issues raised in the past about this area. The AQAA which was returned by the home prior to the site visit was well completed and told us about areas for improvement. Care Homes for Older People Page 21 of 24 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 22 of 24 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 38 12 People must be protected in the event of a fire and the manager must consult with the fire safety officer about the use of wedges and follow any advice or recommendations made. This will ensure people are safe 05/04/2010 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 Peoples past life histories should be recorded in their care plans. This will help staff understand people and their behaviours better. A record should be kept of the supervision of staff who are working under an ISA first check. 2 27 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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