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Inspection on 06/05/10 for Carrington House

Also see our care home review for Carrington House for more information

This is the latest available inspection report for this service, carried out on 6th May 2010.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

From returned surveys and contact made to us before this visit eight out of ten people living at the home and their relatives, feel that the food at the home is of a good standard. One person felt that the alternatives that were offered were insufficient and had concerns about the amount of drinks that were offered. We spoke to a further 6 people at this visit to ask their views about this area. All stated that they were satisfied with the meals provided. We saw that risk assessments had been completed in relation to nutritional needs. We also looked to see for one who had been assessed as being at risk of wight loss, had been referred to a dietitian and that supplements were in place if needed.This had been done, the supplements were stored in a locked cupboard alongside the medication in the home, the name of the person and details on how often they should be given were seen to be in place. However we did advise the service that a checking system should be introduced. This system would audit the stock of supplements, this would mean that it would be identified immediately if a person had not received a supplement when they should have and management could take immediate action to address this. We also looked at the storage of medication as we had made requirements in this area at the last inspection, these were noted to have been met. Observations were made during the visit and this included the serving of lunch. Eight people sitting in one of the lounges all had drinks available to them when we arrived, staff were seen to offer help to people who needed it so that they consumed any food or drink that had been given to them. We had been notified through both the number of notifications sent to us by the service and through Central Bedfordshire Council that there had been a high number of slips,trips and falls at the home. Prior to this inspection we requested documentation from the home to show what they were doing to reduce this. The information that they supplied showed that they undertook monthly monitoring, in addition if a person had frequent falls then they were referred to a falls clinic.

What the care home could do better:

We made observations during the visit in one of the communal areas, we sat for 1 hour and 10 minutes in this area, 8 residents were sat in this lounge. During that time there were no staff present for 35 minutes of that duration. On examination of staff rotas theses showed that sufficient staff numbers were on duty and this is supported by a report from Central Bedfordshire Council following a monitoring visit that they undertook, however there is a need to look at how those staff are deployed within the home. There is a need for staff to be located in areas where they are able to offer immediate assistance if for example someone was at risk of falling, this could result in prevention of that slip, trip or fall if they were in the immediate vicinity. We examined records for two people who were receiving treatment for wound care, dressings of these wounds were undertaken by a District Nurse and notes of these treatments were kept in the home. Risk assessments had been undertaken relating to risk in this area and care plans were in place detailing the treatment and support needed to be provided. We also checked that pressure relieving equipment was in place. However where instructions were given for the person to be moved/turned/change position no records had been maintained that this had been carried out. Staff confirmed verbally that it was, but there is a need to document this and include the time and who did this. This will provide a clear audit of support that has been provided. The Acting manager has been in post at this home since September 2009. A request had been made by the company to transfer an application that they had submitted for this manager at another home. On the day of inspection through contacting our registration Department direct, they confirmed that we had not received this application. There is a need for the Acting manager to submit an application to be registered. The type of reporting that the service has been making to us under regulation 37, needs to be looked at by management. Specific guidance is given on what we need to be notified of and headings are given to direct homes in this. Examples of what we should be notified of include a serious injury. However events are being reported to us under regulation 37, to the point where the service has added a heading, for example a person slipped and there was no injury. The approach means that management are not demonstrating their ability to fully manage and be responsible for the service. Matters that are deemed part of the day to day running of the home must be managed by the service. anything that goes wrong it would allow for them to say we reported it. In reporting day to day events where there is no requirement to report, places the commission in a position of managing the service instead of regulating it.

Random inspection report Care homes for older people Name: Address: Carrington House Carrington House Vandyke Rd Leighton Buzzard LU7 3HQ one star adequate service 19/05/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Katrina Derbyshire Date: 0 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Carrington House Carrington House Vandyke Rd Leighton Buzzard LU7 3HQ 01525853211 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Resicare Homes Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 0 60 0 dementia old age, not falling within any other category physical disability Conditions of registration: 60 0 60 The maximum number of service users who can be accommodated is 60 The registered person may provide the following categories of service only: Care Home only - Code 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 - Code OP Physical Disability - Code PD Dementia Code DE Date of last inspection 1 9 0 5 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home The service was newly registered in May 2008. It can accommodate 60 people over 3 floors. There are lounge areas throughout to ensure people who use the service can meet relatives in private. The service offers a choice of bath and shower facilities. There is a garden area which has garden furniture and is used for barbeques in better weather and a conservatory. The hairdresser has use of a designated hairdressing room which caters for people who use a wheelchair. There is also a craft room to be used as people who use the service wish. Care Homes for Older People Page 3 of 9 What we found: This unannounced random inspection was undertaken on 6th May 2010 by one Regulatory Inspector. The reason for this inspection was to focus on the areas of nutrition, falls, wound care and management at the home. Information supplied to the Care Quality Commission (CQC)from various sources including social services, surveys from people living at the home, staff and notifications from the service were all used to inform our judgement as well as this visit. During the inspection some of the communal areas of the home were seen alongside some of the individual accommodation. The inspector spent time with some of the people who live at the home in one of the lounge areas. The care of two people was looked at in detail. Through discussion, observation and reading records, we tracked the experiences of a sample of people who use the service. The acting manager was present throughout the inspection. What the care home does well: From returned surveys and contact made to us before this visit eight out of ten people living at the home and their relatives, feel that the food at the home is of a good standard. One person felt that the alternatives that were offered were insufficient and had concerns about the amount of drinks that were offered. We spoke to a further 6 people at this visit to ask their views about this area. All stated that they were satisfied with the meals provided. We saw that risk assessments had been completed in relation to nutritional needs. We also looked to see for one who had been assessed as being at risk of wight loss, had been referred to a dietitian and that supplements were in place if needed.This had been done, the supplements were stored in a locked cupboard alongside the medication in the home, the name of the person and details on how often they should be given were seen to be in place. However we did advise the service that a checking system should be introduced. This system would audit the stock of supplements, this would mean that it would be identified immediately if a person had not received a supplement when they should have and management could take immediate action to address this. We also looked at the storage of medication as we had made requirements in this area at the last inspection, these were noted to have been met. Observations were made during the visit and this included the serving of lunch. Eight people sitting in one of the lounges all had drinks available to them when we arrived, staff were seen to offer help to people who needed it so that they consumed any food or drink that had been given to them. We had been notified through both the number of notifications sent to us by the service and through Central Bedfordshire Council that there had been a high number of slips, Care Homes for Older People Page 4 of 9 trips and falls at the home. Prior to this inspection we requested documentation from the home to show what they were doing to reduce this. The information that they supplied showed that they undertook monthly monitoring, in addition if a person had frequent falls then they were referred to a falls clinic. 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 set out on page 2. Care Homes for Older People Page 5 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 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, 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 8 13 The deployment of staff in the home must be reviewed to ensure safe levels of supervision and support to service users. This will assist in the prevention of some slips, trips and falls. 25/06/2010 2 8 12 There must be an audit trail 25/06/2010 to show that support has been provided to people in accordance with their wound care needs. This will demonstrate the times and frequency that a persons position has changed. 3 31 8 An application must be 30/06/2010 submitted for the acting manager to be considered as the Registered manager. There is a requirement for care homes to have a Registered manager in charge of the day to day management of the service. Care Homes for Older People Page 7 of 9 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 4 31 37 Notifications submitted to CQC must be in accordance with Regulation 37. Day to day occurrences within the home would be managed by the service. 25/06/2010 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 1 9 An additional system should be implemented that would audit the stock of supplements, this would mean that it would be identified immediately if a person had not received a supplement when they should have and management could take immediate action to address this. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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