Inspection on 11/06/09 for Astoria Park

This inspection was carried out on 11th June 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Astoria Park 25/08/09

Astoria Park 03/03/09

Astoria Park 21/04/08

Astoria Park 27/11/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Random inspection report Care homes for older people Name: Address: Astoria Park 15 Park Crescent Peterborough PE1 4DX zero star poor service 03/03/2009 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: Elaine Boismier Date: 1 1 0 6 2 0 0 9 Information about the care home Name of care home: Address: Astoria Park 15 Park Crescent Peterborough PE1 4DX 01733555110 01733898497 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) : Southern Cross Healthcare (Focus) Limited care home 59 Number of places (if applicable): Under 65 Over 65 0 59 dementia old age, not falling within any other category Conditions of registration: 59 0 The maximum number of service users who can be accommodated is: 59 The registered person may provide the following category/ies of service only: Care Home with Nursing - Code N 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 Dementia - Code DE Date of last inspection Brief description of the care home Astoria Park is a registered care home to provide care, mainly for people over 65 years of age, some with nursing and mental health needs. The home is in a converted building with accommodation arranged on three floors. There are fifty-three single bedrooms and three double bedrooms. Fifty-five bedrooms have en suite facilities and one bedroom has the sole use of facilities situated a short distance away. Astoria Park Care Homes for Older People Page 2 of 10 0 3 0 3 2 0 0 9 Brief description of the care home is situated in a suburb of the city of Peterborough approximately 10 minutes walking distance from the city centre and overlooking a large public park. Information about the fees, including those for additional costs, can be obtained from the home. A copy of the inspection report is available at the home or via our website at www.cqc.org.uk Care Homes for Older People Page 3 of 10 What we found: We case tracked two of the people who live at the home and we spoke with and observed other people who were not part of our case tracking. Case tracking is an inspection method where we speak with certain people, visit their rooms, speak with the staff who are looking after them and compare the information within the peoples records with what we have seen and heard. A requirement was made following our key unannounced inspection (KU) of the 3rd March 2009 and this was regarding care plans and care records. We looked at two care records of the people who we case tracked and we found that generally this requirement has been met. We found information within the care plan accurately reflected what the person and staff told us with the exception of some deficiencies. For a person who had declined the offer of being weighed since 28th November 2008, their care plan stated that the person was to be weighed each month. The monthly evaluation of this care plan noted that there was no change to be made within the plan of care although we found recorded evidence that, because of the person not choosing to be weighed the home had used a different method to assess the persons weight, by the measurement of part of the persons upper arm. This change in how the persons weight was assessed was not recorded in the care plan. When examining a persons medication administration records (MARs) (this person was not part of our case tracking) we found they had been prescribed a mix of pain killers although there was no care plan to tell staff when the medication was to be given and how to monitor the effectiveness of such medication. When speaking with one of the people, who we case tracked, we found that the person was able to tell us what they liked, such as staying in bed and having their meals there. The care plan told us that this was the case and it was also confirmed by the staff. This indicated that the persons care plan was accurate and the staff were competent and knew about the persons individual needs. The staff told us how they would complete and sign the care records and their responses indicated that they had an understanding that to sign any record on behalf of another member of the staff was unacceptable practice. We found no evidence that there was falsification or corruption within the care records that we examined. There remained some deficiency in both of the care plans that we saw as we saw insufficient evidence that active consultation had taken place with the person about their care plan; rather the persons relatives had been actively consulted. The Interim Manager stated that the care plans were clinical and arrangements were in place to change the way the care plans were written to become more person centred. Due to the improvements made within the standard of care plans and record keeping we consider that the requirement has been met and we expect action to be taken by the home to improve the deficient areas that we have identified. We made a requirement about protecting people from harm to their health, welfare and safety with records to the standard of health and personal care. We saw that the people were wearing clean clothes and that their hair and finger nails were clean. Those people who had bare legs told us that they were warm enough. Care Homes for Older People Page 4 of 10 During our case tracking we saw that one of the people had greasy-looking hair and the staff told us that the hairdresser visited the person once a week, in their room, to wash their hair. We were told that the hairdresser was currently on annual leave and that although there was equipment available to wash peoples hair in bed the staff said that they had not used this. The Interim Manager informed us that she had taken action when she found issues about managing a persons diabetes and, although we did not case track any person with such a condition, we were satisfied with what the Interim Manager told us. We saw, as part of our case tracking, that the people had been seen by health care professionals such as a dietician, a speech and language therapist and general practitioners. Before this inspection we received information that told us the Community Modern Matrons had visited the home most days of the week to support the people and the staff in providing safe health and personal care. We were also informed that, due to the improvements in the standards of care there has been a reduction in the number of days that the Modern Matrons are now visiting the home and this was confirmed by the Interim Manager. The requirement about health, welfare and safety has been met. We looked at the medication and medication records for several residents in the home and watched medicines being given to some people. The management of the home undertake regular checks of the accuracy of medication records which is good practice. These checks have picked up some errors in the recording and the Interim Manager told us that these had been investigated and resolved although no record of this action taken was made. We found that records made when medicines are given to people have improved and consider the requirement made following the inspection on 3rd March 2009 has been met. We noticed, however, that three people had run out of their medication and so they had not been able to continue with their treatment as prescribed. This had already been identified by staff in the home and was being followed-up so we have not made a requirement on this occasion. When we watched medicines being given to people we saw that the record made to show they had received their medication was filled in before they had actually taken the medicines, not afterwards. This is poor practice and we discussed this with the Interim Manager. We expect this to be managed be the home without the need to make a requirement. We found action had been taken to improve the standard of the bathroom tiles and this improvement included a refurbishment of the bathroom area where the bathroom had been converted to a shower and toilet room and there were new replacement wall tiles provided. We saw that there was ongoing refurbishment throughout the home. We expected action to be taken to reduce the risk of infection as, during our inspection in March 2009, we saw dirty coats hanging outside the kitchen area and these were for any person to put on before going into the kitchen. We saw during this June 2009 inspection that there were no dirty coats outside this area. Care Homes for Older People Page 5 of 10 In June 2009 we received a written complaint about staffing issues. We spoke with two groups of staff and we looked at the staff roster for the week beginning the 26th May 2009. We found that the views between the two groups of staff varied: the first group were satisfied with the improved staffing numbers and said that the staff morale had recently improved due to improved staffing and improved management of the home; the second group of staff had less positive views and said that they were unable to provide person centred care, including offering choice to the people and considered that due to the way their work was organised they felt stressed and dissatisfied with the standard of care they were able to provide. The staff and the Interim Manager stated that the current key worker system is out of date and is to be reviewed. Information provided in the written complaint and from what some of the staff told us, indicated that that there might be a reduction in the numbers of staff working on the floor when other members of the staff are attending training. We discussed this with the Interim Manager who stated that staff attend (paid) training in their days off and was not aware that there was such a reduction in the numbers of staff, as alleged. We examined the staff roster, for the week beginning of the 26th May 2009, and found that there was planned sufficient numbers of staff on duty although on the 30th May 2009 there was a reduction in numbers due to a member of the staff being sick. We timed the response of call bells and found that the call bells were answered within 10 minutes. The people we spoke with said that they did not have to wait more than 10 minutes for the staff to answer their calls for assistance. We expected the overall management of the home to improve and we have found evidence to suggest that this improvement has been made. Although the former Manager remains registered (we have no record to request cancelling this persons registration) the home is currently managed by an Interim Manager. A vacancy has arisen for both a deputy manager and permanent home manager and we were told, by the Interim Manager, that action has been taken to fill both of these vacancies. What the care home does well: What they could do better: Care plans are to be implemented and updated to accurately reflect the change in the assessed needs of the people. We have made no requirement on this occasion as we expect action to be taken by the home to ensure that peoples needs are met with staff being able to follow clear guidance. The outcome of any investigation into omissions in medication records must be recorded to provide accurate records of whether medication has been administered or not. Supplies of medication must be ordered early enough to allow for continued treatment. We have made no requirement on this occasion as we expect action to be taken by the home. Care Homes for Older People Page 6 of 10 The way the staff organise their work should be reviewed so that people can be confident that their needs will be met in a person centred way. We must receive a written request to consider the cancellation of the registration of the former home Manager; this is so that a new certificate of registration can be issued. 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 10 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 10 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 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 Care Homes for Older People Page 9 of 10 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. 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