Random inspection report
Care homes for older people
Name: Address: Allendale House Residential Care Home 11 Milehouse Lane Wolstanton Newcastle Staffordshire ST5 9JR one star adequate service 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: Peter Dawson Date: 2 0 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Allendale House Residential Care Home 11 Milehouse Lane Wolstanton Newcastle Staffordshire ST5 9JR 01782627388 01782740466 allendalehouse@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Marcia Patricia Anderson care home 17 Number of places (if applicable): Under 65 Over 65 0 17 0 dementia old age, not falling within any other category physical disability Conditions of registration: 5 PD in bedrooms 7,8 & 9 only. 5 0 5 The maximum number of service users who can be accommodated is: 17 The registered person may provide the following category 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 (OP) 17 Dementia (DE) 5 Physical disability (PD) 5 Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Allendale House is a privately owned residential care home, located close to the villages of May Bank, Wolstanton and within close proximity to Newcastle-under-Lyme. Access to the village and main town is via a main bus route. The Home is registered to provide care for up to seventeen older people. There were 11 people resident at the time of this inspection. It is also registered to care for five people with dementia care needs and five people with a physical disability. The property is a large detached Victorian house that provides spacious accommodation. There is a pleasant secluded garden area. The Home is owned by Mrs Marcia Anderson who is also the Registered Manager. The weekly fees for people at Allendale House is in the range GBP350 GBP425 further information is available in the homes Statement of Purpose. Care Homes for Older People Page 3 of 11 What we found:
This service was last inspected on 6th July 2009 when it was awarded 1 Star Adequate. In December 2009 a Safeguarding referral made anonymously alleged: A member of staff had intimidated a person in the home. Call bells were disconnected at night time. Rooms were cold and not adequately heated. Three anonymous complaints were received December 2009/January 2010 alleging: People not bathed regularly. Not helped with eating and drinking. No choice of rising/retiring times, people being told to rise at 5.30am - 6.00am. Moving & Handling training not provided for staff. Only 1 member of staff on duty at night. People working in the home without appropriate checks. This random inspection was carried out to further investigate the allegations and complaints made. Upon arrival we were told that access to the office, including medication was not possible. Night staff had failed to hand the relevant key to day staff and gone off duty. Phone numbers for night staff not available. An ex Care Manager delivered a key to the home at 10.10 am allowing access to the office. Medication had therefore not been given at the required time. A requirement is made to ensure that access to medication stored in the home must always be available. We found in the large lounge area that includes 3 linked areas, that the rooms were cool. The hands of 3 people felt cold and four said that they were not warm enough. People did have blankets to keep them warm covering the lower parts of their body. We saw that the thermometer in one part of the lounge recorded 22C but some areas certainly felt colder. We found that two radiators in one of the 3 areas were cold. The Manager said that these were linked to the kitchen radiator and turned off due to excess heat in the kitchen area. Three radiators in the other two recessed areas were extremely hot when touched but had wooden radiator covers, clearly significantly reducing the heat output into the room. These issues must be addressed by the home and adequate temperatures in the communal areas maintained at all times. A requirement is made in relation to this concern. We found that in many bedrooms the radiators were cold, although people were not using their bedrooms throughout the day. Whether this was from choice or due to no heating was not clear. The home should review the question of access to adequately heated bedrooms during the day. We found that the front door security was protected by a star key lock. Visitors leaving had to call staff to unlock the door and let them out. It is important that this door can be unlocked at any time and would present a security risk, for instance, in the event of fire. A requirement is made to ensure people can leave the building at any time. The Manager intended to permanently place a key at the door point of exit. We looked at care plans and daily records and found that the necessary improvements made to care plans seen at the last inspection had been maintained. They contained good information that included necessary information. This included Continence care, nutritional assessments, risk assessments, skin integrity, dependency assessment and
Care Homes for Older People Page 4 of 11 there was a night plan for each person. Social care plans included activities, likes and dislikes including rising/retiring time. There were clear instructions to staff about meeting assessed needs. Care plans had been reviewed on a monthly basis. We looked at nutritional food and fluid intake charts established for some people. Some were good, others had not been completed fully. An example was a person recorded having breakfast and drinks, then nothing recorded for lunch time or the afternoon. Most have early morning drinks prior to breakfast and these had not been recorded. Some improvements could be made in this area We saw hot drinks being given to people throughout the day and also saw that each person had a cold juice or water drink beside them at all times. There were tables between lounge chairs to accommodate drinks, one person had a collection of biscuits and confectionery on her over-chair table. People confirmed they always had drinks available to them, including at night in their bedrooms and they were able to eat and drink without assistance. Rising and retiring times were seen in care plan, mostly people would rise around 8am some earlier and some later. This was confirmed in conversation with several people during the inspection, some saying they had risen at 6-7 am throughout their lives and wanted to continue to do so. One person arrived for breakfast at 11am and confirmed that was her chosen time. People confirmed that they wakened naturally and never woken by staff. We looked at the records of 2 people who did not have baths. One record showed the person did not have baths prior to admission and had been offered but refused baths but there was no evidence of washing/personal care on a daily basis to address this. Another care plan defined regular baths, some recorded bed bath it was not clear if some recordings were a bath or bed bath. The personal care for washing was not adequately recorded. We had no reason to believe that the personal care for people was inadequate this was confirmed in observations and discussion with people during the inspection. In relation to medication we found that the daily checks by the manager that had been established at the last inspection were still being carried out and evidenced. We found that a senior carer administering medication who had been recently appointed had been given training in another home by staff and not had specific accredited medication training. We looked at the homes complaints record and found no entries, although a relative had confirmed that they had made a complaint about inadequate heating previously. It is important that all complaints are recorded, investigated in the specified timescale and outcomes and actions recorded. We looked at a sample of staff files. The records for a person employed from 2006 showed a start date before a POVA or CRB or two references had been obtained. It was difficult to clarify the reasons for this in retrospect. Another staff file seen showed only 1 reference obtained and no proof of identity was present. The records of a staff member recently suspended did not include any reference to this. It is important that this information is recorded in staff files regardless of the outcome of the suspension. The home needs to improve the documented recruitment procedures.
Care Homes for Older People Page 5 of 11 We looked at staff training and found that 3 people had not had Moving & Handling training the past year. This training is important, should be provided to all and updated annually. The home have recently employed 2 staff members who are both approved Moving & Handling Trainers. This should easily resolve this shortfall. We looked at the call bell system in most bedrooms and found all were connected. Some were tested and we found that one did not operate correctly due to an intermittent fault that will be resolved. People we spoke with said that they did use the call system in their bedrooms and had not experienced any problems in relation to them. We looked at the staffing rotas and spoke to staff on duty. We found that there was always one waking night care assistant on duty and another person sleeping-in and on call. There were no exceptions to this that we could see or ascertain. When we arrived for this inspection at 09:30 am we found only 2 people on duty - the Registered Manager and a Senior Carer. We were told and confirmed in looking at the staff rota, that two other carers had been rostered to work, one had phoned the previous night to report that she was sick the other had not arrived for duty that day but sent home as she was not well. The Manager contacted two other staff members who arrived to work during the morning. What the care home does well: What they could do better:
Adequate room temperatures must be maintained at all times in the communal areas of the home. Some people using the service and visitors have complained that heating is inadequate. This must be resolved within 1 month. Medication must be available in the home at all times to ensure people have the medication prescribed for them at specified times. People must be able to leave the building at all times by the front (main) door. This is particularly important in the event of fire.
Care Homes for Older People Page 6 of 11 Improved recording of staff recruitment and ongoing records is necessary. Where people do not have baths, personal care, including washing should be recorded as proof of good hygiene and ongoing care. Some aspects of nutritional recording could be improved as evidence of the homes positive input in that area of care. Complaints should always be recorded with outcomes of investigations and recorded timescales. Moving & Handling training must be available to all staff. Good practice determines this training should be repeated annually for all staff. 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 7 of 11 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 8 of 11 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 9 12 Medication must be available 27/01/2010 in the home at all times This will ensure people have the medication at the time prescribed to ensure good health 2 25 23 Adequate heating must be maintained at all times. This will ensure the well being of people using the service. 20/02/2010 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 2 3 4 8 8 9 16 It is important to provide a record of the daily personal care given to people. Recording of daily food and fluid intake could be improved. Ensure that all staff administering medication have received accredited training All complaints should be taken must also be recorded Care Homes for Older People Page 9 of 11 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 5 6 29 38 Recruitment documentation could be improved and staff files must record any suspensions or disciplinary actions. Moving and Handling training must be provided for all staff with recommended annual updates. Care Homes for Older People Page 10 of 11 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
