Care Home: Regents Court Care Home

What the care home does well As reported above the service provides a good service in many areas. Information is available to people regarding the service they can expect to receive if they reside at Regents Court. Information is also available regarding people`s right to raise a concern or make a complaint regarding the service provided. The management of medicines is overall good ensuring that people receive their prescribed medication. People are able to engage in a range of activities and daily living skills within the home. Changes to routine and the environment have taken place in order to make the service more person centred and suitable for people with a dementia type illness. The service has good recruitment procedures to ensure that only suitable staff are employed to work within the service. What the care home could do better: As detailed above some improvement is needed in relation to care planing and risk assessments to ensure they are an accurate reflection. The service needs to improve on ensuring that identified needs are followed through to ensure that people are safeguarded. The service is making arrangements to provide a new storage area for medication. Attention needs to be given to ensure that medicines are stored within a safe temperature range. Further improvement is needed to some areas of the environment such as corridors and bathrooms. Records need to be reviewed to ensure they are an accurate reflection of staff training. Random inspection report Care homes for older people Name: Address: Regents Court Care Home 128 Stourbridge Road Bromsgrove Worcestershire B61 0AN two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Andrew Spearing-Brown Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Regents Court Care Home 128 Stourbridge Road Bromsgrove Worcestershire B61 0AN 01527879119 01527872631 c.wood@alphacarehomes.com www.alphacarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karen Sheila Hancox Type of registration: Number of places registered: Conditions of registration: Category(ies) : Alpha Care Homes care home 37 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: Age: Dementia (DE) age 55 and above. 37 The maximum number of service users who can be accommodated is: 37 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 37 Date of last inspection Brief description of the care home Regents Court is a purpose built, two storey home, located close to Bromsgrove town centre and provides personal and social care to a maximum of 37 older people with dementia. Accommodation is on two floors. Access is provided to both floors by way of either stairs or a central passenger lift. The home is divided into two separate units, Care Homes for Older People Page 2 of 11 Brief description of the care home Victoria and Albert. All bedrooms are fully furnished and include a wash hand basin; some rooms have en-suite facilities. All baths and showers are assisted and hoists are used where necessary. The home has three lounges, two dining rooms and a Snoozelan room. Residents are free to access all communal rooms on both floors. A garden including a patio area is available. Car parking is available to the rear of the property. The home is part of a group of homes owned by Alpha Health Care limited. For up to date information upon the current fees and additional charges the reader should contact the service directly. Care Homes for Older People Page 3 of 11 What we found: This inspection was unannounced. Therefore nobody within the home knew we would be coming. The inspection was carried out by one regulatory inspector and a pharmacy inspector. The last key inspection at Regents Court was carried out during January 2009. The outcome of that inspection was that we rated the service as Good. Since the key inspection we have received a number of notifications from the service, some of which the service also appropriately referred to the local authority under safeguarding procedures. As a result this inspection was carried out to ensure that the service was still maintaining the standard of care we previously reported upon. During our visit we looked at some documentation such as care records, medication records and staffing records. We spent time having a look around the home and observing what was happening. We spent time with the registered manager and other members of staff. We had some brief discussions with some people living at the home. Information is provided by the service for people who may potentially move into Regents Court. We saw a copy of the homes Service Users Guide within the bedrooms we looked at. The guide states that it is available in large print if needed. The homes Statement of Purpose states that All service users are assessed prior to admission and the Care Home Managers decision about the homes ability to meet the Service Users needs is required prior to the admission of the Service User to the home. We viewed the care plans, daily records and risk assessments regarding some people living at Regents Court. We saw that care plans are reviewed on a regular basis. However the reviewing of care plans does not always reflect changes or events which have happened since the previous review. Within the daily notes of one person we saw continual reference to the person wanting to go home and indications that the person was getting distressed as a result. No care plan existed to guide staff as to the strategies they should use in order to reassure the resident concerned. Another record stated that a relative had given staff more medical information however it was difficult to establish what this information was or where it was recorded. We also saw some conflicting information regarding either an allergy or dislike to certain food. Information within the kitchen about dietary needs did not include any details regarding this person. On another care plan we saw an entry saying that staff need to ensure that teeth are brushed morning and night. The manager informed us that the resident concerned has no teeth. We saw a number of risk assessments. These are reviewed but it was not possible to establish when handwritten changes to the initial assessment were done. The scoring on the risk assessments were not always added up correctly, resulting in an incorrect finding upon the risk. Care Homes for Older People Page 4 of 11 Records showing that professionals are called upon as necessary to ensure that medical care needs are met. We did however see a small dressing on one persons leg of which nobody on duty seemed to have any knowledge. We found that there was good documentation and recording of medicine records. We looked at the majority of medication administration record (MAR) charts and overall found that they were documented with a signature for administration or a reason was recorded if medication was not given. We saw that the times of administering medicines were clearly highlighted on the MAR charts. We were shown records, which showed that regular weekly checks were made by the service on peoples medicines to ensure they were being given safely and as prescribed. Overall, there were arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labeled and supplied for. We looked at one persons medicine records and checked that the amount given matched the documented records. We saw that the person was prescribed ten different medicines. We found that the checks for all ten medicines were correct, which means that the records showed that the person had been given their medicines as prescribed. We looked at the care plan for this person. We found that a doctor had recently reviewed one of the medicines on 26th April 2010. We also saw a record dated 8th February 2010, which documented that the person should be weighed every two weeks due to weight loss. We found a record of weight being recorded monthly but they were not dated with a specific date. For example, Jan 10 was recorded. We looked at three months weight records and saw that the person was losing weight. This means that the person was not having their weights checked every two weeks and the dates were not specific and therefore their health and welfare was not safeguarded. Medicine storage temperatures were not always available. Therefore we could not check if medicines were stored at the recommended room temperatures. Medicines should be stored at a temperature of 25 degrees or below to ensure their safety. We saw that a medicine trolley storing peoples medicines was stored on the ground floor in a stairwell. It felt very warm but there were no temperature records available to ensure medicines were stored safely. We were informed by the manager that a new medicine storage area had been identified but it was not available yet. Medication that would require special storage in a controlled drug cabinet was available and met the safe storage requirements following the Misuse of Drugs (Safe Custody) Regulations. Information about peoples medicines were generally recorded in their care plans and any medicine that was prescribed on a when required or as needed basis was detailed in each persons care plan to ensure the person was safe from harm. For example, we looked at two peoples medicine records who were prescribed a medicine for anxiety. In both care plans we saw detailed information to inform staff under what circumstances the medicine needed to be given. We saw that records were available which documented the dates the medicine was given and the reason why it was given. This means that information about peoples medicines were available to safeguard their health and welfare. Within one bedroom we saw a chart to be completed by carers once a cream was applied. The chart had gaps upon it. Two opened tubs of cream were in the bedroom. Taking into Care Homes for Older People Page 5 of 11 account the instruction to apply liberally twice daily and the amount of cream remaining within the tubs the manager agreed that it would appear the cream is not always applied as directed. We saw a board in the hallway stated the days activities, these were hairdressing and manicures. When we arrived at the home the board was showing the activities from the day before. These activities were colouring, dominoes, film and music. During our visit we observed a number of members of staff sat with residents carrying out hand massages and nail painting. It was reported to us during the visit that the breakfast system has changed. Described as Go with the Flow breakfast is served when residents are ready for it rather than having a set time. For people who are going to have their breakfast in their bedroom residents are asked what they want. This is then written down on a restaurant style order slip. We saw staff taking people a full cooked breakfast including sausage, bacon, mushrooms, baked beans and toast on a tray. The Statement of Purpose states that the home believes that if people wish to make a complaint, register a concern or make a suggestion they should find it easy to do so. It also states that the home looks upon complaints as an opportunity to learn, adapt, improve and provide better services. The procedure within the Statement of Purpose states that people may, at any time contact the commission regarding their concerns or complaints. The information within the Service Users Guide and a separate leaflet is not however so clear regarding peoples right to contact the commission at any stage. We saw a file containing details of concerns and complaints received. The registered manager had recorded the action taken in order to resolve the matter although it was evident that the manager had not always formally responded to the complainant. We took the opportunity to have a look around the home. The former dining room is now called Rummaging Room. This room contains a piano, an ironing board, dolls, soft toys and a table for people to sit at while engaged in craft activities. The manager has plans to develop a kitchenette within this area. As a hot water machine is available a tea trolley is no longer used. The chairs within lounge areas are arranged to encourage interaction between residents. Within one lounge is a Wii consul, however the disk could not be found during our visit so it could not be used. Communal toilets have signage on the door. Toilet seats are red therefore matching the pictorial image on the door. The manager informed us that she plans to improve the communal bathrooms as they currently appear clinical. Personal protective equipment (PPE) such as gloves and aprons were available in each of the bathrooms. Despite the availability of PPE we brought some matters to the attention of the manager regarding infection control for example finding dirty combs, and both a razor and bar of soap in these areas. Some corridors look tired and need to be redecorated. Outside of each residents door is a frame for people to display personal items such as photographs and other memorabilia. We saw a display of a wedding dress and hats in a corridor. In addition some coats and scarfs were available along the corridor for people to pick up and use. The home has a good recruitment process which makes sure that the required checks are undertaken prior to a new member of staff starting work. We saw that the service ensures it has a CRB (Criminal Records Bureau) disclosure and written references in place. Having these checks helps to reduce the risk of someone who is unsuitable gaining Care Homes for Older People Page 6 of 11 employment within the home. A training matrix was available however it had mistakes upon it and therefore needs to be reviewed. For example the information regarding staff who either hold or are working towards an NVQ was incorrect. We noted some gaps on the matrix but we were assured some of these were incorrect in that staff members had attended training in areas such as moving and handling. The majority of staff, other than newly appointed appear to have therefore received training in moving and handling, and fire. The number of staff who have received training on conditions linked to older people was lower, for example diabetes and Parkinsons. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 6 15 Regulation 15 Care plans covering identified care needs must be in place and up to date. This is to ensure that staff have suitable guidance for them to fulfill their duty and ensure needs are met. 31/05/2010 2 9 13 Regulation 13 (2) The service must ensure that medication is stored at the correct temperature recommended by the manufacturer. This is to ensure that medication does not deteriorate which can make the medication ineffective and possible harmful to people living in the home. 31/05/2010 This is to ensure that medication does not deteriorate which can make the medication ineffective and possibly harmful to Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 people living in the home. 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 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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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