Care Home: The Victoria Royal Beach

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What the care home does well Victoria Royal Beach provides a comfortable, attractive and homely environment and people tell us that they are happy living there. People have access to good healthcare support, medication is being well managed and the home is working well with other professionals. Some activities are being provided and people tell us that they have a choice of fresh, home cooked meals each day and that they can see their friends and family at any time. People are being cared for by a kind and competent staff team, records are in good order and the home is being well managed. What has improved since the last inspection? The registered manager is currently in the process of updating and reviewing all care plans into a more `user friendly` format. Two new washing machines have been purchased, new flooring has been fitted to the laundry and there is redecoration and refurbishment in communal areas underway. What the care home could do better: The complaints procedure must be updated to provide people with the current contact details of the Commission. In order to provide daily interest and stimulation for people the number of activities on offer should be reviewed. All accidents and incidents that cause injury or have an adverse outcome for service users must be reported to the Commission. Key inspection report Care homes for older people Name: Address: The Victoria Royal Beach 12 Grand Avenue Worthing West Sussex BN11 5AW     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: Annie Taggart     Date: 2 2 0 9 2 0 0 9 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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: The Victoria Royal Beach 12 Grand Avenue Worthing West Sussex BN11 5AW 01903246499 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Victoria Care Elite Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category/ies of service only: Care home only (PC) 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 (OP) Date of last inspection Brief description of the care home Victoria Royal Beach is situated in a quiet residential area within easy walking distance from the seafront and all its attractions. Accommodation is on three floors accessible by a vertical passenger lift. There is a lounge/diner and a quiet reading room. Thirteen bedrooms have en-suite facilities. The Registered Manager is Coral Jackson. The home is one of a number of homes owned by Victoria Care Elite Ltd. Current fees range from approx 400.00 to 700.00 per week 0 9 0 9 2 0 0 8 0 Over 65 20 Care Homes for Older People Page 4 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: 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: In preparation for this visit an Annual Quality Assurance Assessment was sent to the manager for completion and surveys were sent to service users, staff and professionals involved with the home. The AQAA was completed and returned within the given timescales and it contained comprehensive information about the services being provided in the home. Six service user and six staff surveys were returned and comments from these have been used in this report. We looked at the last inspection report and considered any information that we have received about the home since the key last inspection visit. The unannounced visit was carried out at 10am on Tuesday 15th September and lasted Care Homes for Older People Page 5 of 25 for five hours. During that time we spoke with service users both in communal areas and in their private bedrooms and all were positive about the care they are receiving. We tracked four care plans and all supporting documentation such as risk assessments and we saw the system for recording and administering medication. Four staff records were seen and all contained the required documentation and we also saw staff training and supervision records. We spoke to all of the staff on duty and observed staff practice and we saw lunch, the main meal of the day being prepared and served. Records for the running of the business including complaints and concerns, incident and accident reporting, maintenance and fire records were seen and we also saw how service users monies are being managed. One of the providers was in the home for part of the visit and received feedback and full feedback was given to the registered manager, Mrs Jackson following the visit. Care Homes for Older People Page 6 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 7 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 8 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. There is clear and accessible information available about the services on offer in the home. People have their individual needs and wishes assessed and recorded, they are able to visit the home before moving in and contracts of terms and conditions of residency are agreed. Evidence: The home has a Statement of Purpose and Service User Guide in place that gives prospective service users and their families clear information about the services on offer in the home. We saw that comprehensive pre-admission assessments are carried out that cover all the areas of peoples individual needs and wishes and families and healthcare professionals are involved in the process. During the visit family members were visiting the home to view a room and the Care Homes for Older People Page 9 of 25 Evidence: registered manager told us that should they wish to progress with an application, the prospective service user would be assessed in their present accommodation. We saw three contracts of terms and conditions of residency and all had been signed by the relevant service user or their representative. Care Homes for Older People Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs and wishes recorded in a plan of care that is kept under regular review, the home works well with other professionals and medication is being well managed. Evidence: For each person living in the home there is a clear plan of care in place that guides the staff team to the needs and wishes of the people they are supporting. Care plans contained a background history, preferred routines for personal care for both day and night, nutritional assessments, moving and handling guidelines and social and religious choices. The registered manager is currently reviewing all care plans and is replacing them with a more user friendly version and we saw that key workers keep the plans regularly reviewed and updated Records showed us that the home is working well with other professionals and we saw that people have access to the District Nurse team, chiropody, dentists and audiology services. When professionals such as doctors or district nurses visit service users, clear records of the outcomes of the visit are recorded in daily records. Care Homes for Older People Page 11 of 25 Evidence: From looking at records we saw that there are sometimes high instances of falls in the home. Over a period from 6/4/2009 to the day of the visit, for three people we saw eighteen falls recorded, many of them for one person. We asked the registered manager about this and were told that action had been taken by falls to people being risk assessed and appropriate action taken. We were told that other professionals such as care managers were being involved to assist with finding alternative accommodation for two people as the home had identified it was no longer meeting their changing needs. We checked the daily records against accident and incident reporting and saw that although falls and accidents to people are recorded, they are not always being sent as Regulation 37 reports to the Commission unless they are serious. We explained to the registered manager that if people sustain any fall or accident that causes bruising or injury, this should be reported in order to assist with monitoring the home. There is a clear system in place for the administration and recording of medication and records show that the staff receive training. We saw that a list of medication handlers was in place, Medication Recording Sheets (MAR) were current with no gaps and there was a list on homely remedies to be administered agreed and signed by a doctor. Service users told us that they were very well cared for, describing the staff team as kind, caring and really lovely and friendly and in a returned surveys one person said, they are especially kind to me when I feel unwell. Care Homes for Older People Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home tell us that they would benefit from more activities and outings being provided. There is a choice of fresh home cooked meals on offer each day and people tell us that they are treated with dignity and respect. Evidence: From looking at records and at activity plans we saw that there are few structured activities provided to ensure stimulation and interest for people. There is an activities person that comes to the home once a week who provides a sessions on areas such as arts and crafts and quizzes and the other activities we saw recorded were pre-lunch gathering for sherry and reading newspapers. The manager told us that some people do not wish to be involved with structured activities and this was partially supported when speaking to service users. However four people said they would like to have more to do during the day and in a returned service user survey, in reply to a question that asks what the home could do better we are told, maybe a little extra occupational therapy as there is only one hour a week of any form of therapy and no entertainment other than the TV. In the AQAA we are told that mini bus outings are provided but we could not see any Care Homes for Older People Page 13 of 25 Evidence: recent evidence of this. Menus and food records showed us that people are offered a variety of fresh, home cooked meals and that they have a choice of alternatives each day. Peoples nutritional needs are assessed and recorded in care plans and we saw that where there are concerns about people, supplements are provided and recorded and peoples weights are regularly monitored. All of the people spoken to in the home were very complimentary about the meals provided and comments in included, we get lovely food, it could not be better and the meals are always really good, very tasty and we are given a choice. We saw lunch, the main meal of the day being prepared and served and it was freshly cooked and attractively served. Where people needed support with eating we saw that this was carried out in an unhurried and respectful way with people being offered choice. Care Homes for Older People Page 14 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 people living in the home can be confident that their complaints and concerns will be recorded and acted upon and the homes policies, procedures and working practices are designed to protect people from risk of abuse or harm. Evidence: There is a complaints procedure in place, a copy of this is displayed in the home and also forms part of the Service User Guide. We discussed with the manager, Mrs Jackson the need for the procedure to be updated regarding the change of address of the Commission and she said that this would be addressed straight away. We saw the complaints and concerns book and saw that no formal complaints had been received since the last inspection visit. Service users told us that they would feel comfortable making a complaint, one person said, if I am unhappy about anything I speak to the manager and it is put right as soon as possible. From looking at staff training records we saw that all of the staff team have been trained in the protection of vulnerable adults from abuse and the registered manager showed a knowledge of West Sussex Safeguarding procedures. We spoke to the staff on duty including both the care and housekeeping staff who were all aware of their responsibilities and said that they would report any concerns straight away. Two safeguarding referrals have been investigated under West Sussex procedures and Care Homes for Older People Page 15 of 25 Evidence: are now completed with no further to be action taken. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an attractive, homely comfortable and well maintained environment for the people who live there. Evidence: Victoria Royal Beach is situated in a residential area, close to the sea front. The environment is bright, attractive and well maintained and people say that they are happy living there. Communal areas such as the lounge/dining room are bright and well finished and there is a quiet lounge where people can sit if they do not with to watch TV. Gardens to the front and rear of the building are well maintained and accessible and people told us that they liked sitting out there in good weather. Private bedrooms are light, airy and well decorated and have been personalised with furniture and belongings brought to the home by people. There is an ongoing programme of redecoration and refurbishment underway and during the visit the halls and staircases in the home were being redecorated. Two new washing machines have been purchased and new flooring fitted to the laundry. From looking at records we saw that maintenance checks such as hot water temperatures are regularly recorded and the home was very clean and fresh throughout. Care Homes for Older People Page 17 of 25 Evidence: Comments about their home from service users included, one of the reasons I like living here is that it is always so clean, comfortable and is very homely and the housekeepers are brilliant and my room is kept lovely and clean. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are being cared for by a caring and committed staff team who are well trained and well supported. Evidence: On the day of the inspection visit there was a deputy manager, two care staff, two housekeeping staff and the chef on duty, the managers hours were in addition to the rota. In the afternoon and evening two staff are on duty. When speaking to the staff on duty and also detailed in six staff surveys we were told that staffing levels did not always meet the needs of people and examples given of this was that in the afternoon and at week ends when the manager is not on duty to cover, if someone needs two to one attention,for example of they fall and need to be hoisted or need two people to provide personal care, then there are no staff on the floor for that time with service users. Staff also told us that as they now had to carry out some kitchen duties, this also had an effect on the care being provided. One of the providers was in the home for part of the visit and we spoke to her about this. We were told us that the kitchen assistant post had been deleted across all the homes in the group and that as the manager was on duty until 4pm she felt that there were sufficient staff to care for people at all times. When asked about the kitchen duties that the staff team now carry we were told that they were minimal such as Care Homes for Older People Page 19 of 25 Evidence: emptying the dishwasher and making coffees and teas and that at all times service user needs came first. We looked at the records for four staff members and saw that they all contained the required documentation including a current Criminal Bureau Check (CRB )and two references. records showed us that new staff receive an induction in line with the Common Induction Standards and all staff have signed up to the General Social Care Council code of conduct. There is a programme of staff training in place and records showed us that as well as mandatory training and regular updates, courses such as palliative care, dementia awareness, distance learning packages with local colleges and safeguarding people from risk of abuse or harm.In the AQAA we are told that of fourteen staff, twelve hold the NVQ award. There were records to show that supervision and appraisal sessions are held and each day all staff on duty including the housekeeping staff, meet with the manager or deputy to discuss issues and to monitor practice. Service users were very complimentary about the staff team and comments in included, they are lovely,really kind, staff are always kind and helpful and staff are kind,I couldnt be better looked after. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed by a competent and caring manager, records are kept current and in good order and health and safety issues are being addressed. Evidence: The registered manager has worked in the home for a number of years and has the skills, experience and qualifications to manager a registered care home. Both service users and the staff on duty were complimentary about Mrs Jackson, describing her as friendly and accessible. There is a quality assurance system in place that includes families and other professionals and people told us that they were involved in the running of the home by being kept in informed of changes and asked their opinions. Where the home holds monies on behalf of service users, these are kept locked in a safe and records are kept and receipts gained. We checked the records for two people and found them to be correct. Care Homes for Older People Page 21 of 25 Evidence: Regulation 26, registered providers visits are carried out in order to monitor the standard of service being provided and we saw that reports are kept on file in the home. Records such as fire equipments checks, staff fire training and electrical appliance checks were up to date and accident and incidents are recorded and acted upon. As detailed in a previous section of this report, although the manager is sending some Regulation 37 reports, a Requirement has been made for all accidents and incidents that have an adverse outcome for a service user to be reported to the Commission under Regulation 37. 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 1 38 37 The registered manager 30/10/2009 must ensure that all incidents and accident that have an adverse effect on service users are reported to the Commission. This is to ensure that there is a system in place to monitor that the home is being safely manager 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 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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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