CQC report explained · a residential care home
What the CQC found at Royal Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2018
Royal Court was rated Good; inspectors found safe, kind and well-organised care, with improvements since the previous inspection.
Inspectors visited on 7 and 8 August 2018 without telling the home in advance. They spoke with people living there, relatives, visiting professionals and staff. They reviewed care records, complaints, staff recruitment files, audits and maintenance records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were managed, medicines were given safely, people were treated with kindness and dignity, and care plans contained useful information.
The report says the home had improved since the previous inspection in August 2017. Problems with risk management, records, complaints, notifications and quality checks had been addressed, and the home was meeting the legal requirements at this inspection.
Risks were managed
Inspectors found that risks were assessed and acted on. This included falls, choking, pressure ulcers and behaviours that could put people at risk.
“Risks to people's health and safety were identified, assessed, monitored and managed in a way which kept people safe.” from the report
Kind and respectful staff
Staff were seen treating people with patience, kindness and respect. They protected privacy and supported people in a personal way.
“We observed a kind and caring approach from staff towards the people they looked after.” from the report
Personalised care
Care plans included people's life histories, preferences, relationships and beliefs. People were involved in planning and reviewing their care.
“People's personal preferences and their life histories were explored to help ensure their care and support was provided in a personalised way.” from the report
Improved leadership
The home had introduced stronger audits and an improvement plan. Staff described better teamwork and a calmer working environment.
“Improved management and quality monitoring processes had resulted in a calmer and more organised home, which was fully compliant with all of the legal requirements.” from the report
Activities and end of life care
Activities were offered at different levels and matched people's interests and abilities. Inspectors also found that end of life care aimed to be dignified and comfortable.
“People had opportunities to take part in activities which they enjoyed and which met their abilities and interests.” from the report
Some delays with call bells
minorOne person said there could sometimes be a long wait for help because staff were assisting others. Inspectors observed call bells being answered without too much delay.
“Sometimes there is quite a gap before they come around but that is usually because they [staff] are having to deal with other people in trouble.” from the report
Some corridors needed more dementia-friendly signs
minorThe home had added signs and landmarks, but managers knew that more work was needed in some corridors to help people find their way.
“Managers were aware that some further work was needed in some corridors to help people orientate themselves.” from the report
More end of life training planned
minorSome staff had completed end of life training, but the manager planned to provide more. Ask how this training is now kept up to date.
“Although the registered manager had plans for more training to be delivered.” from the report
Not every interaction was equally personal
minorMost feedback about staff was positive, but a few people said some staff only completed basic checks and did not spend time listening.
“One or two [staff] just do the basics, knock my door and ask if everything is alright but never stay to talk or listen to more than my answer” from the report
- 01How quickly are call bells answered now, and how do you monitor any delays?
- 02What further work has been done to help people living with dementia orientate themselves in the corridors?
- 03What end of life training have staff completed since this inspection, and how is their competence checked?
- 04How are care plans kept up to date when a person's needs, medicines or professionals change?
- 05How do you check that staff spend enough time talking with people, rather than only completing basic care tasks?
This was an unannounced inspection of the whole care home and all five CQC areas were rated Good; the report also records that breaches found at the previous inspection had been met. This explanation was written from the published report of 27 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2017
Rated Requires Improvement; inspectors found kind care, but important safety, record-keeping and management problems.
This was an unannounced inspection on 29 and 30 August 2017. It was the first inspection under the provider that took over the home in August 2016. Inspectors spoke with people, a relative, staff and managers, and checked care records, medicines, complaints and management records.
The home was caring, with staff who treated people kindly and respectfully. People were supported with food, drink, medicines, activities and access to health professionals. The home was clean, and there were enough staff overall, although staff were sometimes stretched during busy mealtimes.
The main problems concerned people living with dementia. Risks linked to agitation and behaviour had not always been fully assessed or reviewed after incidents. Care plans, mental capacity records and complaints records were incomplete in places. The provider's checks had not identified all these problems. The overall rating of Requires Improvement means the home was not consistently meeting the standards inspectors expected.
Kind and respectful staff
People said staff were caring, sympathetic and helpful. Inspectors saw calm, patient and respectful interactions, including when people were confused or distressed.
“People were cared for by staff who genuinely cared for them and were interested in them as individuals.” from the report
Activities and community links
People could choose from group and one-to-one activities. The home had also developed links with local swimming, library and church groups.
“People had opportunities to socialise and take part in activities of their choice.” from the report
Support with health needs
Staff worked with health and social care professionals when people needed additional help. Dietary needs and health concerns were monitored and referrals were made where needed.
“Staff worked with other health care and social care professionals and agencies to support people's health needs.” from the report
Clean and maintained home
Inspectors found the home clean and saw systems for infection control, fire safety and equipment maintenance.
“People lived in a safe and well maintained environment.” from the report
Risk plans were not reliable
seriousRisks linked to agitation and behaviour had not always been assessed, reviewed or clearly explained to staff. Similar incidents were not always thoroughly reviewed to prevent them happening again.
“Risks to people's safety had therefore not always been assessed, reviewed and plans were not always in place to ensure staff knew how to keep people safe.” from the report
Required records were incomplete
seriousRecords did not always show how mental capacity decisions had been made or how representatives had been involved. Care records also lacked some important guidance for staff.
“Comprehensive records of the assessments carried out and decisions taken in relation to people's care and treatment were not always fully completed.” from the report
Busy mealtimes
needs fixingStaff sometimes had too many needs to manage at once during mealtimes. Inspectors also found practical problems with tables, cutlery, drinks, lighting and access to napkins.
“At the 'breakfast club' we observed 11 people seated at dining room tables waiting for their breakfast to be served.” from the report
Quality checks missed problems
needs fixingThe provider's monitoring systems did not identify all the shortfalls found by inspectors. This meant problems with safety and records were not always corrected promptly.
“The provider's quality monitoring process had not always been effective in identifying all the shortfalls we found.” from the report
- 01What specific changes have been made to behaviour risk assessments and care plans since this inspection?
- 02How do you now review incidents involving agitation or distress, and how do you make sure lessons are acted on?
- 03How are mental capacity assessments and best-interest decisions recorded, including the involvement of relatives or legal representatives?
- 04What changes have been made to staffing and supervision during busy mealtimes?
- 05How are complaints investigated, recorded and followed up with the person who raised them?
This was an unannounced comprehensive inspection covering all five CQC questions, including discussions with people, staff and managers and checks of care, medicines, complaints and management records. This explanation was written from the published report of 13 December 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Royal Court
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016
Registered with the Care Quality Commission on 1 September 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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38 live-in carers within about an hour of Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
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