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Inspection on 29/09/09 for Bearwood Nursing Home

Also see our care home review for Bearwood Nursing Home for more information

This inspection was carried out on 29th September 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also 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

There are better arrangements for the management of medicaton.

What the care home could do better:

All staff require training in safeguarding to ensure they are all aware of the local policy and procedures to protect and promote the well being of vulnerable people living in the home. A bedrail safety risk assessment must also include a clincial risk assessment. Where staff consider the use of bed safety rails following completion of a risk assessment they must ensure they have suitable equipment so people are not put at risk. Staff should have training in how to carry out a risk assessment plus the use and maintenance of bed rails to ensure each person is safe.

Random inspection report Care homes for older people Name: Address: Bearwood Nursing Home 86 Bearwood Road Smethwick West Midlands B66 4HN one star adequate service 02/06/2009 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: Karen Thompson Date: 2 9 0 9 2 0 0 9 Information about the care home Name of care home: Address: Bearwood Nursing Home 86 Bearwood Road Smethwick West Midlands B66 4HN 01215588509 01215555182 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) : Bearwood Nursing Home Ltd care home 74 Number of places (if applicable): Under 65 Over 65 0 74 dementia old age, not falling within any other category Conditions of registration: 74 0 The maximum number of service users who can be accommodated is: 74 The registered person may provide the following category 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: Dementia (DE) 74, Old age, not falling within any other category (OP) 74 Date of last inspection Brief description of the care home Bearwood Nursing Home provides nursing care for up to 74 elderly people. The home is a two-storey building with the second floor accessed by a passenger shaft lift. Bedrooms are on both floors with a mixture of double and single bedrooms some of which have ensuite facilities. There is a large lounge and dining room on the ground Care Homes for Older People Page 2 of 11 0 2 0 6 2 0 0 9 Brief description of the care home floor and two lounges/ dining rooms on the first floor. There is a car park at the front of the home and patio/gardens to the rear. The home is close to local shops and amenities and is on a local bus route. The fees at the home range from between £475 and £575 per week and are dependent on the needs of the residents and the room that they occupy. Hairdressing, toiletries, newspapers, Non National Health Service chiropody and physiotherapy are not included in the fee but are available at the home for an additional charge. Top up fees apply to Social Service funded EMI nursing residents. For up to date fee information the public are advised to contact the home. Care Homes for Older People Page 3 of 11 What we found: The reason for this inspection was to monitor compliance with statutory requirements issued following the key inspection in June 2009. Two inspectors visited the home, one of these was the specialist pharmacy inspector. The outcomes is as follows: The pharmacy inspector found that the overall management and control of medication within the service was good. We saw that medication was stored securely in locked treatment rooms and medicine trolleys. We saw records that showed medication was stored within the recommended temperature ranges for safe storage. This means that medication is safe and the people who live in the service are protected from harm We spoke to staff who were knowlegeable and aware of the medication that was being given to people who live in the service.We were shown records of training and assessment that staff had undertaken for the administration of medication. This means that medication is administered by trained staff to ensure people who live in the service are given medication as directed to the person it was prescribed, labelled and supplied for. We looked at the medication administration records and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We found that other medication records were generally up to date. For example, we saw current records for the receipt and disposal of medication. The date of opening of boxes and bottles of medicines were usually recorded and balances of medication were carried forward from old records to new records. These records helped to ensure there was a clear audit trail of medication. We found that counts and checks made on medication were accurate, which showed that people who live in the service were being given medication as prescribed by a medical practitioner. We found detailed information relating to medication available in the care plans for individual people living in the service. This information included any changes made by a medical practitioner. The written information was clear, up to date and ensured that staff could access the information at any time. We looked at the number of slide sheets available in the home to ensure that people living in the home could be moved safely. We counted nine slide sheets in total which were in the bedrooms we visited. The management team had not recieved up to date training in local safeguarding policies and procedures. Ten other staff members were due to attend a local safeguarding training course in October 2009. At the time of the visit the management team were not enrolled on this safeguarding course, which had been a requirement of the key inspection in June 2009. During our visit the management team were enrolled on the course. This will ensure all staff in the home are aware of the local safeguarding policies and procedures to ensure peoplw are protected. The bed safety rail risk assessment had not been reviewed since they key inspection in Care Homes for Older People Page 4 of 11 June 2009. The bed safety rail risk assessment in use is not a clinical risk assessment, but an equipment safety check. We also found from the sample of five peoples records seen that two people had bed safety rails fitted to their bed without any form of risk assessment. There were sixty-six people living in the home at the time of the visit of which fifty seven people had bed safety rails fitted to their beds and in use. Bed safety rails are fitted as standard to beds in the home and not placed on the bed following a risk assessment. We found a number of people living a the home with bed safety rails on their beds, but were informed they were not in use. The bed safety rails not in use were removed by the management team in the home at the time of our visit. The homes management team advised us that they had obtained information from the Health and Safety Executive about bed safety rails and would be looking at the advice with a view to changing practice in the home. A requirement had previously been made in relation to bed safety rails and we have discussed our findings with our enforcement team. The home has been given more time to meet this requirement, but if this does not occur we will consider enforcement action and the home have been notified of this. What the care home does well: 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 11 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 8 13 Before bedrails are put into place there must be undertaken a risk assessment of the persons suitability for such equipment and the home must ensure systems are in place for monitoring and maintaining bedrails This will ensure that no ones rights are restricted and their safety is also promoted and maintained 24/07/2009 Care Homes for Older People Page 6 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 30 18 Staff working at the home 30/11/2009 must receive training and have an awareness of how to carry out a bedrail clinical risk assessment that is commensurate with their role in the home. To ensure the health and well being of people living in the home. 2 38 12 Alternative arrangements to bed safety rails must be available if risk assessment indicate these are not appropriate. To ensure the health and safety of people living in the home. 30/11/2009 3 38 12 Bed rails must be fitted according to manufactures instructions and records must be in place to demonstrate they are checked for safety on a regular basis. To ensure the health and 30/11/2009 Care Homes for Older People Page 7 of 11 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 safety of people living in the home. 4 38 24A An improvement plan is required to ensure action is taken to meet the CQC requirements. The registered provider must be accountable for health, welfare and safety. 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 21/10/2009 1 7 Mouth care practice needs to be reviewed, to ensure equipment is readily available and the home can demonstrate people have received mouth care. (Recommendation first made June 2009 not checked at this visit) Care plans should be based on a thorough assessment of needs, this should contain detailed information of how to meet peoples needs in an individual manner. ( (Recommendation first made June 2009 not checked at this visit)) Catheter care practice must be reviewed in the home to ensure it meets best practice and does not place people at risk of harm. (Recommendation first made June 2009 not checked at this visit) All trained staff working at the home should re-familarise themselves with NMC Record Keeping document to promote and protect the well being of people living in the home. (Recommendation first made June 2009 not checked at this visit) The hours allocated for activities should be reviewed to enable the service to broaden the range of activity provision and opportunities for people living at the home. (Recommendation first made July 2007 not checked at this Page 8 of 11 2 7 3 7 4 7 5 12 Care Homes for Older People 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 visit) 6 15 The English meals menu need to be reviewed to ensrue they meet cultural expectations and taste. (Recommendation first made June 2009 not checked at this visit) The management team need to review their complaints log and ensure that information is easily retrievable and available for auditing. (Recommendation first made June 2009 not checked at this visit) It is recommended that the home obtains a copy of the Department of Health guidance Mental Capacity Act 2005 core training set published July 2007 and staff are provided with training so they are aware of their responsibilities and peoples rights are protected. (Recommendation first made June 2009 not checked at this visit) New chairs stored in the communal areas should be moved to a more suitable area, to allow people living at the home to enjoy the lounge environment. (Recommendation first made June 2009 not checked at this visit) A refurishment programme should be drawn up to act as a guide and demonstrate when redecoration and refurishment is to take place. (Recommendation first made June 2009 not checked at this visit) The home should ensure that numbers of care staff with NVQ2 or above is 50 percent or more, to ensure and demonstrate a basic level of care knowledge has been achieved and can be delivered to people living in the home. (Recommendation first made June 2009 not checked at this visit) The management team should carry out exit interviews for staff who are leaving to see if there are any patterns or trends that could account for the high staff turnover. From this they may be able to put systems in place to reduce the number of staff leaving the home. (Recommendation first made June 2009 not checked at this visit) A review of training provided in specialist areas needs to be carried out to ensure their are suffiecient staff with the knowledge and skills to meet individual requirments. Page 9 of 11 7 16 8 18 9 19 10 19 11 28 12 29 13 30 Care Homes for Older People 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 (Recommendation first made June 2009 not checked at this visit) 14 33 The quality assurance system in place should be reviewed to ensure that it is robust enough to pick up any issues or concerns so these can be put right quickly. (Recommendation first made June 2009 not checked at this visit) 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). 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