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Time Court Residential and Nursing Home Good

Reports


Inspection carried out on 22 May 2019

During a routine inspection

About the service

Time Court Residential and Nursing Home is a care home providing personal and nursing care to 50 people aged 65 and over at the time of the inspection. The service can support up to 56 people.

People’s experience of using this service and what we found

People’s care, treatment and support promoted a good quality of life. Assessments had taken account of people choices. People were supported to access the healthcare services they needed. There were arrangements to ensure that people’s nutritional needs were met. People’s dietary requirements, likes and dislikes were assessed and known to staff. However, the environment was not fully adapted to meet the specific needs of people with dementia. We have made a recommendation for the service to seek advice regarding this. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

People were protected from abuse and avoidable harm. Staff understood different types of abuse, which meant they could spot the signs of abuse and report accurately to relevant authorities. There were also effective systems and processes in place to minimise risks to people. Each person's care plan had several risk assessments and measures to reduce risk. People told us they received their medicines on time and as prescribed.

People were supported and treated with dignity and respect. They were involved as partners in their care. People and their relatives confirmed that staff were kind and caring. They were supported to maintain their independence. Their care records contained information about their choices and independence. People’s care plans recorded and addressed their specific needs in relation to equality and diversity issues. However, we found the food menu did not fully cater for different cultures and cuisines. There was evidence the service was working to address this.

The service planned personalised care that met people’s needs, preferences and interests. People’s records set out their preferences and addressed their individual nutritional needs and risks. There was a programme of activities organised by the service. People attended a variety of activities, which they enjoyed. However, people told us outdoor activities were limited. The service was working to improve opportunities for outdoor activities. Each person’s preferred method of communication was highlighted in their care plans, which showed people’s communication needs had been considered.

Methods of monitoring the quality of the service were in place. There was an ongoing effort to improve the service. Regular checks and audits had been carried out in areas related to maintenance of the premises, health and safety, medicines management, infection control and management of accidents and incidents.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

The last rating for this service was Good (published 25 November 2016).

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 20 October 2016

During a routine inspection

This comprehensive inspection took place on 20 October 2016 and was unannounced. At the last inspection in November 2013 the provider was meeting the regulations in all the areas we looked at.

Time Court is a residential home that provides accommodation and personal care for up to 56 people. The service comprises of five units, including a nursing unit and an intermediate care unit. At the time of our inspection there were 41 people using the service.

There was a registered manager in place who had been registered manager at the home for three years. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

At this inspection we found that people were protected from the risk of abuse because staff had received safeguarding training and were aware of the action to take if they suspected abuse had occurred. The provider undertook checks on staff before they were employed to ensure their suitability for the roles they were applying for. There were sufficient staff on duty to meet people’s needs. Risks to people had been assessed and where risks had been identified, action had been taken to reduce the level of risk. People’s medicines were managed safely.

Staff were supported in their roles through training, supervision and an annual appraisal of their performance. They were aware of the importance of seeking consent from the people they supported and the service acted in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) where appropriate. People were supported to maintain a balanced diet and had access to a range of healthcare services when needed.

People were treated with kindness and consideration by staff. Staff respected people’s privacy, and people were consulted about their care and treatment. People had care plans in place which were person centred and reflected their individual needs and preferences. They were aware of how to raise a complaint and told us they were confident the registered manager would address any concerns they raised appropriately.

People, relatives and staff told us the service was very well run and spoke very highly of the registered manager. The service achieved very positive outcomes for people. The service had a clear set of values in place which staff were committed to delivering. The provider and registered manager demonstrated an excellent commitment to developing staff and made innovations to service provision in response to people’s feedback. People were empowered to be involved in the day to day running of the service. The provider had quality assurance systems in place which helped identify issues and drive continuous improvements within the service.

Inspection carried out on 23 November 2013

During a routine inspection

During our inspection we found that up to date individual care plans were in place for people using the service which addressed their care and support needs and protected them from risks. We found that people using the service and their relatives were very positive about the care they received. One relative told us "My X is very happy here. They like it so much they don't want to leave."

We found that people were asked for their consent before they received any care or treatment and staff acted in accordance with their wishes. There were procedures in place to assess where people did not have the capacity to consent and the provider acted in accordance with legal requirements. We observed staff asking people what they wanted to eat and what they would like to do.

We saw that staff were friendly to people using the services and visitors. This was confirmed by relatives we spoke with who told us "They can't do enough for my X here. I am happy they are well looked after."

We found communal areas and bedrooms areas to be clean and tidy. We saw that there were effective cleanliness and hygiene procedures in place to prevent the risk and spread of infection. The provider had created an environment which was suitably designed and well maintained.

We found there were effective systems in place to continuously monitor and improve the quality of service provision. The most recent audit was carried out in October 2013.

Inspection carried out on 18 December 2012

During a routine inspection

People using the service and their relatives we spoke with told us the care and treatment people received was satisfactory. They said they were involved in decisions about treatment and care and had been involved in reviews of care plans. They told us the staff were very good, although most added that the service provided by temporary staff was not as good. They told us there were enough staff on duty. One person said; “When there’s lots of agency staff they get very busy, and while everything does get done, it makes you think twice about asking for something”. One relative told us; “The staff have always treated my mother with kindness. She’s always well turned out. She’s content.”

We found people using the service were involved in decisions about their treatment and care and were treated with dignity and respect. Medicines were managed safely and there were sufficient suitably qualified, skilled and experienced staff to meet people’s needs. Records were fit for purpose and stored securely.

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

Inspection carried out on 15 December 2011

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

The majority of people using the service said that staffing levels were good. Some people told us that at night they did not always see staff.

Inspection carried out on 16 August 2011

During an inspection in response to concerns

We received concerning information that the home was understaffed during the night shift.

People spoken to during our visit told us that, at night, staff were often busy and as a consequence they had to wait if they required any assistance.

Inspection carried out on 11 April 2011

During an inspection in response to concerns

All of the people spoken to during our visit were complimentary about Time Court and their staff. Some of the comments received about the service included; “staff are very gentle and kind”, “staff are respectful and are good” and “[the home is] excellent”. People unhappy with the service being provided have referred their concerns to an appropriate authority.

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