Random inspection report
Care homes for older people
Name: Address: Anglebury Court 21 Bonnets Lane Wareham Dorset BH20 4HB zero star poor service 06/04/2009 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: Jo Johnson Date: 3 0 0 7 2 0 0 9 Information about the care home
Name of care home: Address: Anglebury Court 21 Bonnets Lane Wareham Dorset BH20 4HB 01929552585 01929551984 c.fairlie@dorsetcc.gov.uk www.dorsetforyou.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) : Dorset County Council care home 36 Number of places (if applicable): Under 65 Over 65 0 36 dementia old age, not falling within any other category Conditions of registration: 36 0 The maximum number of service users who can be accommodated is 36 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home Anglebury Court is a purpose built facility situated within level walking distance of the centre of the small town of Wareham which has shops, a cinema, library, churches etc. Anglebury Court is located next to the local Social Services Offices and a day centre. The home benefits from some of the day centre facilities, particularly transport for
Care Homes for Older People Page 2 of 9 0 6 0 4 2 0 0 9 Brief description of the care home social outings. The home accommodates up to 36 older persons including 15 specialist dementia places, 31 in permanent beds and 5 short term care places. All accommodation is on ground floor level; there are 28 single bedrooms and 4 double bedrooms. All bedrooms have en-suite shower rooms with toilet and washbasin. The home is arranged on a unit basis incorporating 4 bungalows with a central service corridor known as The Street. Each bungalow has 7 single and one double bedroom, one bathroom and a lounge/dining room with kitchenette. There are 2 laundry rooms, each shared by 2 bungalows. Up to date fee information may be obtained from the service. Care Homes for Older People Page 3 of 9 What we found:
Since the last inspection there have been no new admissions into the home. On the day of the inspection there were 21 people living at the home, this is 12 less than at the key inspection. We looked at the assessments for four people including the individual who was readmitted into the home from hospital and three people from different living units at the home. There were comprehensive pre-admission assessments completed for the person who was readmitted following two stays in hospital. The assessment covered all of the individuals areas of need and has been used to update their care plan. The risk assessment for this individual had not been updated on their re-admission to the home and still included risks from an individual who is no longer living at the home. The individual had been seen by the GP and District Nurses and was receiving end of life care. The care records did reflect that end of life care was being provided. However, there was not any specific plan detailing the care such as two hourly turning, mouth and skin care and what support the district nurses were providing. The acting Manager took immediate action to ensure that the risk assessment was updated and end of life care plan was put in place. The assessments and care plans for the three other people had been updated and reviewed to reflect their current needs and how staff are to meet them. They were clear and easy to follow and included descriptions of how staff were to communicate, support and care for people. The care plans seen now include the information from peoples assessments and included descriptions of what staff need to do to care for people. The acting manager told us that care plans are now being reviewed on a monthly basis. Up to date risk assessments were seen for three of the four people whose records were looked at. The areas risk assessed were falls, pressures area, nutrition and moving and handling. Additional areas of risk were also assessed in relation to risks from other people and or following any allegations of abuse. Body maps have not been completed for each new mark or injury recorded on individuals or following any allegations abuse. There is not any established way of reviewing body maps after recording to see whether any further marks or bruising have presented. The daily records have improved greatly and now reflect the care and support people receive and how they have been spending their time. Staff spoken with told us that the record keeping training they had attended meant that they understood what and how they needed to record about people. There was evidence in both the medical records and the care records that people had been referred to health professionals when required. Health professionals are now recording for each individual and these records are kept in the office. This means that it is easier to see whether appropriate health care and advice is being sought for people living at the home. However, these records are still seperate to all of the other information about individuals.
Care Homes for Older People Page 4 of 9 Following the last key inspection there was an increase in adult protection safeguarding referrals. This was following an increase in understanding of what constitutes adult protection and a change in management and staff culture. The acting manager and staff have co-operated fully with the investigations and improved practices to prevent recurrence of any incidents. The acting manager has been informing us by both telephone and regulation 37 notifications about any incidents at the home. We received an anonymous complaint about staffing levels in the evenings. We looked at the staffing rotas and discussed this with the acting manager. The staffing levels have remained the same as they were at the key inspection with five staff on duty through out the day plus a duty manager. We spoke with people and staff at the home. They told us that they were happy with the staffing levels and that they much prefer the small teams of staff that now work on each living unit. The activities co-ordinator also told us that at a recent residents meeting that people had voiced the opinion that things were better at the home, they liked the fact that there are now small teams of staff that know them well and that they do not have to tell them what care and support that they need. What the care home does well: What they could do better:
A seperate body map must be completed for each new injury or mark and following any allegations of abuse. This is to make sure that there is an accurate pictorial record of individuals following accident, incidents or injuries. Body maps should be reviewed 24 hours following the initial recording. This is to monitor whether any additional injuries, bruising or marks have developed. End of life or palliative care plans should be put in place when health professionals have determined people are approaching the end of their life. This is so staff can provide the care and support to people, respect their choices and help them feel comfortable and secure. Risk assessments should be reviewed following any re-assessments of needs. This is so that any risks are minimised and staff know what action to take to keep people safe. The requirement showing as outstanding from the last inspection was not assessed at this
Care Homes for Older People Page 5 of 9 inspection as it was within its original timescales. This requirement will be assessed at the next key inspection. 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 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 33 24 The overall management of 01/10/2009 the home must improve, and develop effective ways of assessing and monitoring the quality of the service. This is so that shortfalls are identified, are improved on and the quality of the service is kept under constant review. Care Homes for Older People Page 7 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 7 17 A seperate body map must be completed for each new injury or mark and following any allegations of abuse. This is to make sure that there is an accurate pictorial record of individuals following accident, incidents or injuries. 04/09/2009 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 7 Body maps should be reviewed 24 hours following the initial recording. This is to monitor whether any additonal injuries, bruising or marks have developed. End of life or palliative care plans should be put in place when health professionals have determined people are approaching the end of their life. This is so staff can provide the care and support to people, respect their choices and help them feel comfortable and secure. 2 7 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. 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 9 of 9 - 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!
