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Archived: River Court Care Home Requires improvement

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Reports


Inspection carried out on 15 March 2016

During a routine inspection

River Court is a purpose built nursing and residential care home. The home is located on the outskirts of Watford Town Centre. It has the capacity for up to 120 elderly or frail residents, some of whom live with dementia and it also provides nursing care/palliative care.

There were 116 people living at the service on the day of our inspection. River Court consists of four units, Hampermill, Gade, Chess and Colne. We did not visit one of the units due to an outbreak of infection of which 10 people had been affected.

The service has a registered manager in post although they were not present on the day of this visit. They were registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. However, a relief manager provided the management support and guidance on the day of our visit.

We last carried out an inspection of the service on 18 October 2013 due to concerns raised regarding the administration of medicines. At this inspection we found the service was meeting this standard. The last scheduled inspection carried out at this service was 24 May 2013 where the service was found to be meeting the required standards.

At this inspection we found some areas of the environment were poorly maintained and found to be dirty. This included soiled armchairs and a strong smell of urine in one of the units where people lived.

People told us they felt safe and secure living at River Court. Generally we found staff were knowledgeable in recognising signs of potential abuse and knew how to report concerns both within the organisation and externally if required.

Assessments were undertaken to identify any risks to people who received a service and to the staff who supported them. There were sufficient numbers of staff available to meet people’s individual support and care needs at all times, including during the night and at weekends. People received appropriate support from staff to enable them to take their medicines.

People and their relatives felt confident to raise any concerns and told us they were confident any concerns would be resolved without delay. People received their care and support from a staff team that fully understood people’s health and care needs and who had the skills and experience to meet them.

We found that people who used the service were not always treated with dignity and respect but their privacy was maintained.

The activities programme provided did not always reflect the individual needs of people who used the service and could benefit from being improved.

Safe and effective recruitment practices were followed to make sure that all staff were of good character, and were suitable to work in a care home environment as well as being fit for the roles they were being employed to carry out. Staff records confirmed checks had been made which ensured they were safe to work with vulnerable adults before a position was offered to them.

Staff were well supported by the management team and received an induction from senior staff when they first started working at the home. They received on going training and support to enable them to perform their roles effectively. Staff had regular individual supervision meetings, team meeting and had an annual appraisal to review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

People’s views about the service were gathered using surveys and verbal feedback. Feedback was used in a positive way to improve the quality of the overall service. The majority of people we spoke to were positive and complimentary about all aspects of the service.

Relatives, staff an

Inspection carried out on 18 October 2013

During an inspection to make sure that the improvements required had been made

At our previous visit, we found there were concerns relating to the administration and record keeping relating to medication. We revisited the location early in the morning to check that the required improvements had been made. We carried out the visit to check that people had not been given their 8am medication between 5.30am and 7.30am or too early in the morning. We reviewed the records and spoke to staff, and we were able to see that the required improvements had been made and the morning medication round commenced as close to 8am as possible. The Medication Administration Record (MAR) charts confirmed that people were being administered their medication at the prescribed times.

We noted that medication that was being administered at the times detailed on the MAR charts. We did however see that on one unit an error had occurred where a medication had been signed as given. However when we spoke to the staff concerned they explained the error and said the medication had not been given but it had been signed in error. The provider may wish to note that that the mistake should have been crossed out and the correct information recorded. This lack of remedial action meant that the person may not have received their medication as prescribed and recorded on the MAR chart and this could have put the person at risk of adverse effects associated with not receiving their medication at the correct time.

Inspection carried out on 28 June 2013

During an inspection in response to concerns

The Care Quality Commission had received concerning information regarding the administration of medication. We arranged to carry out a 'responsive review' of compliance at the location to check compliance with the regulations. We found that people were not always receiving their medication at the prescribed times. The provider is required to protect people against the risks associated with the unsafe use and management of medicines.

We found that people did not always have their medicines at the times they needed them and in a safe way. People were at risk of 'adverse effects' associated with receiving their medication at times other than those prescribed and the effects and changes to their condition including side effects and or adverse reactions. Medication that was being administered was not recorded accurately and did not reflect the 'actual times' people were given medication. This meant that people could have suffered 'ill effects' as a result of this practice.

Inspection carried out on 24 May 2013

During a routine inspection

River Court is divided into four units which provide care and support to people with differing needs. There is a nursing care unit, a dementia unit and two residential care units.

During our visit on 24 May 2013 we spoke with people who used the service and visiting relatives who told us they were happy with the service they received.

We spoke with two relatives who felt that the staff were very kind and helpful towards their relatives. However, another relative we spoke with on a different unit felt that the home did not always attend to the personal care of their relative in a way that promoted their wellbeing.

We observed that the home looked clean, and many of the rooms had been personalised with people’s own furniture, and personal items. This showed that people were respected as individuals and that the staff had taken the time to explore people’s life experiences and interests.

We noted that there were appropriate arrangements in place for people to receive their prescribed medicines.

People told us that they enjoyed their meals, and could have hot or cold drinks whenever they wished. We observed that soft drinks and a variety of snacks were available for people to help themselves, and staff also offered them to people who were less mobile.

Inspection carried out on 3 September 2012

During a routine inspection

People told us that generally they are happy with the service they receive at River court. A visitor told us that it was ‘not the same as having their loved one at home but it was the next best thing’. Another person told us the food was alright, but they were looking forward to the menus being changed to give people a bit more variety.

Inspection carried out on 18 April 2012

During an inspection to make sure that the improvements required had been made

The people who use the service told us that the staff are lovely, absolutely the best and that they would do anything for you. They said that they like living in River Court and that they have a busy life there. The said that the staff in the home treat you like their family and that this was really nice.

Inspection carried out on 6 December 2011

During an inspection in response to concerns

The people who use the service told us that they are happy at River Court and that are well taken care of. They said that the food was good and it was impossible to be hungry as there was so much food on offer. One person told us that they had put on weight since coming to live in River Court. We were told that the staff were lovely and that ‘nothing was too much trouble’ and that they are all ‘lovely girls’.

People told us that they were looking forward to listening to the Christmas carols later on the day of the visit. A visitor told us that their relative was very well cared for and that they were very happy with the care given. We were told that the manager and all the staff were easy to talk to and that they would have no problem approaching them with a complaint.

People told us that they feel safe and that all the staff were easy to talk to if they had a problem.

The people who use the service told us that they are happy at River Court and that are well taken care of. They said that the food was good and it was impossible to be hungry as there was so much food on offer. One person told us that they had put on weight since coming to live in River Court. We were told that the staff were lovely and that ‘nothing was too much trouble’ and that they are all ‘lovely girls’.

People told us that they were looking forward to listening to the Christmas carols later on the day of the visit. A visitor told us that their relative was very well cared for and that they were very happy with the care given. We were told that the manager and all the staff were easy to talk to and that they would have no problem approaching them with a complaint.

People told us that they feel safe and that all the staff were easy to talk to if they had a problem.

Reports under our old system of regulation (including those from before CQC was created)