Background to this inspection
Updated
2 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This comprehensive inspection took place on 22 May 2019 and was unannounced. The inspection team consisted of one inspector, a nurse specialist and an Expert-by-Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Time Court Residential and Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Our inspection was informed by evidence we already held about the service. We checked for feedback we received from members of the public and local authorities. We also checked records held by Companies House and the Information Commissioner's Office (ICO).
We asked the service to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. All this information was used to plan our inspection.
During the inspection
We spoke with 11 people who used the service and nine relatives about their experience of the care provided. We also spoke with eight members of staff including, the registered manager, deputy manager and six staff members. We reviewed a range of records, which included eight people’s care records and multiple medicines records. We looked at seven staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We requested additional evidence to be sent to us after our inspection. This was received, and the information was used as part of our inspection.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
2 August 2019
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.