Care Home: Queens Court Care Home

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What the care home does well People who use the service told us they are `happy living here`. Their comments included `there is enough to do`, `the food is good`, `I have all I need in my room`, `staff help` and `I have plenty of visitors`. Queens Court provides a very pleasant, safe and well maintained environment for the people who live there. The service provides good information to help people decide if it is the right place for them. Care plans are developed from assessments and kept under review, ensuring staff have up to date information to meet people`s needs. End of Life care is very well managed, ensuring staff have the knowledge and skills to provide care and support to people and their families at this time. A variety of activities and outings during the day and evening ensure people`s social and leisure needs are met. Staff have appropriate training, ensuring they provide appropriate care to people who use the service. What has improved since the last inspection? The service has been accredited for the Gold Standards Framework for End of Life Care, to enable them to provide appropriate care and support to individuals and their relatives at this time. The service has started to complete life story books with people who use the service, this gives staff good details of people`s life history and helps keep important dates and events `live` for the individual. The social programme is provided in large print, making it more accessible for people who use the service. The manager told us staff have completed training in maintaining a safe environment, which has resulted in them taking more care when moving equipment around to prevent damage to the walls and door frames. A window has been put between the dining room and the kitchen, giving people the opportunity to watch the chef preparing meals. The bathrooms have been made more homely with the addition of small tiles, pictures, shelves and ornaments. The service has developed a newsletter which is available in the entrance corridor and given to people who use the service. This keeps people up to date with activities and staff at the home. What the care home could do better: The manager has developed an action plan to continue improvements with particular attention to how fitness can be addressed and more person centred care. There is an on-going programme of maintenance and redecoration which will continue to keep the home at an excellent standard. Key inspection report Care homes for older people Name: Address: Queens Court Care Home 32-34 Queens Road Wimbledon London SW19 8LR     The quality rating for this care home is:   three star excellent 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: Emma Dove     Date: 1 5 0 6 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 25 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 25 Information about the care home Name of care home: Address: Queens Court Care Home 32-34 Queens Road Wimbledon London SW19 8LR 02089715019 02088711536 queenscourt@barchester.com www.barchester.com Barchester Healthcare Homes Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Shaaron Caratella Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service only: Care home with nursing (CRH - N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Queens Court is a care home which can provide nursing for forty-three people over the age of fifty-five. Forty people are currently living there. The home is owned and managed by Barchester Healthcare Homes Limited, who have similar services in the Merton and Richmond area. Care Homes for Older People Page 4 of 25 Over 65 0 43 43 0 Brief description of the care home Accommodation is provided over three floors. A large restaurant, two lounges and eight single bedrooms are on the ground floor. Sixteen bedrooms a large lounge, shower room, toilets and a hairdressers room are on the first floor. The second floor has the remaining seventeen bedrooms, a small lounge, shower room, bathroom and a staff office. Thirty-eight bedrooms are single, with three double rooms. A lift serves all floors. People who use the service have access to a well-maintained garden to the rear and side of the building. Queens Court is situated in a residential area of Wimbledon, close to shops, public transport systems, churches of a number of denominations, a cinema, theatre and other leisure facilities. Trained nurses and care staff are on duty twenty-four hours a day. Three meals are provided with drinks and snacks available between meals. Information about the Care Quality Commission is available in the Statement of Purpose and Service Users Guide. The weekly fees are from £990. Care Homes for Older People Page 5 of 25 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out over six hours on the afternoon and evening of the 15th June 2010. One compliance inspector visited, spoke with people who use the service, staff, the manager and looked at records. Surveys were sent to people who use the service and their representatives. We received two completed surveys, comments from these are included throughout this report. We received an annual quality assurance assessment (AQAA). This gave us very good information about what the service does well, areas that have improved over the last year and plans for development over the next year. We looked at other information received from the service since the last inspection in August 2007. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 25 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 9 of 25 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. The service understands the importance of providing good information to people who are choosing a care home. It has developed a clear Statement of Purpose and Service Users Guide which detail the specialist services provided. People are welcome to visit the home to help them make the decision to move in. Admissions are not made until a full assessment of need has been completed. Evidence: The manager told us that prospective residents and relatives have access to good information about the home to help them decide to move in. We saw the Statement of Purpose and Service Users Guide include information about the services provided, routines and some key policies. People who use the service and their relatives told us the information they had helped them decide to move in. The Service Users Guide includes photographs, making it more real and accessible to people who are choosing a home. Care Homes for Older People Page 10 of 25 Evidence: The manager told us they complete detailed assessments before admission. We saw pre-admission assessments in case files. The manager said they contact the GP if a person is admitted from hospital to ensure there get a full medical history. The admission process includes people being invited to look around the service. The manager wants to increase the time people stay when they visit. This will give them more opportunity to meet people who live there and key staff who will be providing care and support. Care Homes for Older People Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal and healthcare support using a person centred approach. Staff are trained and confident in health care matters. Good medication polices and practices ensure peoples health needs are met. The service is very good at providing end of life care with open discussions at the time of admission, during the development of care plans and ongoing at reviews. Evidence: The manager told us that all residents have a care profile with a comprehensive care plan, which identifies personal and social needs. We saw care plans developed with individuals from assessments. People who use the service confirmed that they meet with staff to discuss the care and support they need and receive. Care plans cover areas of: communication; personal hygiene; mobility; moving and handling; tissue viability; nutrition; breathing; pain; mental health; sexuality; social interests; hopes for the future and a section detailing the individuals life story. Care plans we looked at clearly identified peoples needs and how staff should provide support. The recording in the area of sexuality needs to be reviewed to ensure it is Care Homes for Older People Page 12 of 25 Evidence: relevant. The life story work is excellent and gives staff clear information about the individual and what has been important to them during their life. We saw albums contain photographs, newspaper articles and information to help keep things live for people. One person told us they enjoyed looking through their album with staff and remembering events. Staff are aware that some information may be upsetting for people and are able to give individuals appropriate support if necessary. We saw that care plans are reviewed monthly or if there are changes in need. We saw records of reviews held every six months, involving people who use the service, their relatives or representatives and staff. The manager told us that any new admissions, people discharged from hospital and those who are unwell are cared for by a qualified nurse. Staff seek advice from medical professionals when required. Medication is well managed. Medication Administration Record Sheets (MARS) are up to date and signed by staff. Medication in blister packs is labelled as the MARS. We saw medication had been administered as directed. Medication is securely stored. The count of three medications for one person balanced, the amount received, tablets administered and number left in packet were correct. One person told us staff look after their medication properly. The home has received full accreditation with commended status for the Gold Standards Framework, around End of Life Care. The manager told us she gets a weekly report from staff and said there are weekly and monthly meetings updating on any changes and ensuring full handover of information about individuals. There is a memorial table in the library with infomation and photographs of people who have died recently. There is also an area of the garden which has a memorial plaque. The service has a memorial tea and service for family members, relatives and friends of individuals as a part of the goodbye process. The practice in this area is excellent and the service should be commended for the work they have achieved over the last two years. Care Homes for Older People Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to enjoy a full and stimulating lifestyle with a variety of activities during the day and evening. There are regular outings to various places of interest in the local community. Meals are balanced and cater for individuals cultural and dietary needs. Mealtimes are a relaxed social occassion. Evidence: The manager told us that people who use the service live as they choose. Routines are flexible and the environment is conducive to ensuring people have choice. In surveys, two people told us there is always and two said usually enough to do. One person was not sure if there were activities available to them. People told us they have enough to do during the day and evening. One person said they dont join in with much but said there was lots to do. Two relatives told us in surveys that the service supports people to live the life they choose. We saw people in the garden, meeting with visitors, watching television, listening to the radio, singing along to music and reading during the course of our visit. We saw staff sitting and talking with individuals. The manager said they have introduced evening activities which have been well received so far. We saw the evening activity to be scrabble and kareoke and people said they enjoy these activities. Care Homes for Older People Page 14 of 25 Evidence: We saw a variety of magazines available around the home, on tables in corridors and lounges. The home subscribe to The Daily Sparkle which is a reminiscence magazine, today in history that has pictures and articles to stimulate conversation. We saw rummage boxes in corridors and lounges, with a variety of different articles in for people to look at and talk about. The manager told us they have a church service every fortnight. One person said they enjoy the church service. One person told us they dont go to the service. The manager told us people who use the service can access an advocacy and befriending service and volunteers are available should they be required. Visitors are made to feel welcome. People who the service said they have visitors who are offered refreshments and kept up to date with information about the service. The manager told us that they provide a varied and nutritious menu with a 5 star dining experience for residents and their guests. Wine and aperitifs are available in the dining room and in the activity lounge before meals. Birthdays are celebrated in the way the individual prefers. We saw the menu displayed in the entrance and dining room both accessible to people who use the service. Staff were aware of the menu for the evening meal and were able to talk with people about the meal during the afternoon. We saw an evening meal to be a leisurely social occassion with people offered the choice of meal and served and supported in a dignified manner. Care Homes for Older People Page 15 of 25 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. The service has a clear complaints procedure which is available to people who use the service and their representatives. Staff complete training in safeguarding. Evidence: People who use the service told us they would speak with the manager if they had any concerns. One person said they had raised a concern and felt it was dealt with appropriately. The manager told us she is available and walks around the home daily to speak to people. People who use the service told us they see the manger regularly and said she is available if they want to raised issues. The complaints procedure is included in the Service Users Guide. The manager said they have not received any complaints in the last year. We have not received any complaints or concerns in the last year. Staff complete training in safeguarding as a part of their induction and do updates through the local authority. Staff demonstrated awareness of their responsibility around safeguarding. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation and the manager work to ensure the physical environment meets the needs of the people who live there. Queens Court provides a homely, clean, safe and well maintained environment for people who live, work and visit the home. Most bedrooms are single and people are encouraged to bring small items of furniture, pictures, ornaments and belongings to make them feel at home. There is a selection of communal areas where people can take part in activities, sit quietly and meet with visitors. Evidence: Queens Court was purpose built in 1995. The manager told us that people who use the service are encouraged to personalise their bedrooms. Most bedrooms are single, shared bedrooms are generally for married couples or people who choose to share. We saw bedrooms personalised to individuals taste with lots of people bringing items of furniture and having their own pictures, photographs and ornaments. People who use the service are happy with their rooms and said they have the furniture and equipment they need. There is an activities lounge on each floor with a library, music room and lounge with cinema sound and a large television available. There are small seating areas in corridors on each floor with magazines, books, photographs and rummage boxes, ensuring people have something to do wherever they sit. The restaurant is on the Care Homes for Older People Page 17 of 25 Evidence: ground floor and has doors out to the garden. There are two areas of garden, both have seating, umbrellas to provide shade and plants, making the areas welcoming and attractive for people. We saw bathrooms and shower rooms have been made more homely with coloured tiles and the addition of pictures and ornaments. Making the bathing experience less clinical and more relaxing for the people who live there. The manager told us they have purchased new pictures for each floor. There are photographs of recent events in the entrance corridor and activities lounge. A large board in the entrance corridor had photographs and information about events at Ascot, which is updated when different events take place. One visitor said they feel the service should have hand cleansing facilities at the entrance of the home, like in hospitals. Care Homes for Older People Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff available to meet peoples needs. Staff have good training opportunities to ensure they can meet the needs of the people who use the service. Staff recruitment is thorough. There is a detailed induction process for new staff, ensuring they have the information needed. Evidence: One person said staff listen and help as required. Comments about staff included staff are good, shes nice, staff help and nothing is too much trouble. Relatives told us in surveys that staff always and usually have the skills and knowledge to meet peoples needs. We saw some good interactions between staff and people who use the service. Staff demonstrated a good knowledge of people who use the service and how to meet their needs. The manager told us that new staff are recruited and inducted appropriately to ensure the continued safety of people who use the service. We saw staff recruitment files to contain an application form, two written references and a clear enhanced Criminal Records Bureau (CRB) check. Staff told us they had the appropriate checks before they started work. The manager told us that 63 of care staff are trained to NVQ level 2 or above. There is on-going training in Dementia Care to NVQ Level 3. Three senior staff have Care Homes for Older People Page 19 of 25 Evidence: completed Leadership in Dementia Matters. The Home has a commended accreditation for End of Life Care. Two members of staff are currently taking part in a pilot course with the NHS for End of Life of Care. Staff receive a thorough induction in accordance to their needs, Skills for Care and the organisations policies. There is a welcome booklet for new staff which details the important information given to staff during their induction. There are regular staff meetings and daily handovers to ensure information about individuals and any changes in need are communicated to all staff. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager has the required qualifications and experience and is committed to continuous improvement and development of the service. Good systems are in place for quality assurance. The annual quality assurance assessment contained good information about the service which is fully supported by evidence. Health and safety is well managed. Evidence: The manager is registered with the Commission and has the knowledge, experience and qualifications to manage the service. She is a qualified nurse, specialising in the care of older people and is in the process of training to develop her knowledge and understanding further. The manager demonstrates a strong commitment to improving the quality of care provided to improve the life experiences of the people who use the service. The organisation has good systems in place to check quality assurance. A representative from the organisation completes an unannounced visit every month to Care Homes for Older People Page 21 of 25 Evidence: talk with people who use the service, staff and observe staff practice at the home. Any issues from this monthly visit are raised with senior staff or the manager and are addressed. Residents and relatives meetings are held every three months, giving people the opportunity to comment about the care and support provided and be involved in planning for the future. There is a regular newsletter Queens Court News which includes photographs of recent activities and outings, information about staff and any achievements. The systems to ensure regular health and safety checks are completed are good with the gas safety and portable electrical appliances tested every year and the fire alarm tested every week by staff. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 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 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 The section of care plans covering sexuality should be reviewed, to ensure they are relevant and the individuals needs are recorded. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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