Random inspection report
Care homes for older people
Name: Address: Bosworth 6 Southdown Avenue Preston Weymouth Dorset DT3 6HR zero star poor service 24/11/2008 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: Susan Hale Date: 2 6 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Bosworth 6 Southdown Avenue Preston Weymouth Dorset DT3 6HR 01305833100 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Derek Edwin Luckhurst,Mrs Christine Wells,Mrs Meryl Susan Hodder Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Conditions of registration: 0 One named service user (as known to the CSCI) within the category of LD(E) may be accommodated to receive care. Date of last inspection Brief description of the care home Bosworth Residential Care Home is located in a quiet residential area of Preston, about 2 miles from the centre of Weymouth. The home looks out over a wildlife reserve and has views of the sea and Portland. The home is registered to accommodate a maximum of 22 older persons over the age of 65 years. Bosworth offers 18 single and
Care Homes for Older People Page 2 of 14 2 4 1 1 2 0 0 8 Brief description of the care home two double sized bedrooms, spread over two floors; as the house is set on a hill, a number of first floor bedrooms have direct access to the garden. The home has a passenger lift which gives level access to the main area of the first floor; six bedrooms on this floor have access via 3 steps on the landing. On the ground floor there are communal lounges and a dining area, together with a bathroom and WC. The current fees range from 329 to 570 pounds. The registered manager told us that the fee structure is flexible. Additional charges are made for hairdressing and chiropody. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Care Homes for Older People Page 3 of 14 What we found:
We looked at the pre admission assessment and care plans for two people who had moved into the home since the last visit. Records showed that both prospective residents had been seen by a representative of the home before they moved in. The pre admission assessment contained good detail and enough information for the home to make a judgment about whether the persons needs could be met at Bosworth. The assessment recorded who had completed the assessment, who had been present and the prospective resident had been asked to sign their agreement with the assessment findings. Both files contained a care plan but the level of information in each plan varied. The first plan looked at contained a photograph of the person, a care plan which contained good detail about the residents needs and good information about their family and who was important to them. However it did not contain a falls risk assessment although the pre admission assessment clearly recorded that the person had had three falls before they moved into the home. A pressure sore risk assessment had been undertaken but the assessment tool used was incomplete and did not give staff any information or guidance on what to do with the assessment score. It did not provide staff with information about what measures to put in place to reduce the risk of skin breakdown. On the second care plan looked at some information was clear and informative such as the care plan relating to communication. However, although the person had been living at the home for five weeks some sections of the care plan including medication, skin condition and social and therapeutic activities had not been completed. The mobility care plan did not give enough information to staff on the level of assistance that person would need to get in and out of a chair, the bath or if they needed assistance to use the toilet. The nutritional risk assessment had not been completed other than to record the persons weight on admission. The pressure sore risk assessment had not been completed and although the person had been living at the home for five weeks there had been no evaluation of the care plan to check if it met the residents needs. A recent incident had occurred at the home and this had been recorded and promptly reported to the Commission. It was clear from the records checked that appropriate action had been taken. The pressure relief policy has been updated since the last inspection so that it reflects current good practice advice. The advocacy policy has been updated since the last inspection and makes it clear that people can contact external agencies. The whistle blowing policy has been updated since the last inspection and now includes the contact details of the Commission and Public Concern at Work. The complaints policy has been updated since the last inspection and now makes it clear that complainants are able to contact the Commission at any stage of a complaint. The complaints log is now stored securely in the office.
Care Homes for Older People Page 4 of 14 The policy relating to managing aggression by residents has been updated and now includes references to staff training in de escalation techniques. We looked at the adult protection policy. It did not give examples to staff of what could be considered abusive practice. The policy did not give staff any information about how to report any allegations that may be received. The registered provider told us that all residents now have a jug of fluid and a glass in their private rooms. 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 14 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 The registered person shall 30/09/2009 ensure that unnecessary risk to the health or safety of service users are identified and so far as possible eliminated. This refers to risk assessments for pressure sores and moving and handling (Previous timescale of 30/07/2009 not met) This is to ensure that risks are identified so measures can can be put in place to reduce the risk. 2 9 13 The registered person must ensure that all prescribed medication including creams and ointments are given as prescribed. This is to make sure service users receive prescribed medication. Not assessed at this inspection. 30/05/2009 3 12 12 The registered person shall 30/05/2009 as far as practicable enable service users to make decisions with respect to the care they receive.
Page 6 of 14 Care Homes for Older People 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 This is to make sure that the routines in the home are flexible to suit the people who live there as far as possible. Not assessed at this inspection. 4 19 13 The registered person must 30/04/2009 ensure that all dental tablets are kept securely. This is to reduce the risk of ingestion. Not assessed at this inspection. 5 19 23 The registered person must ensure that all parts of the home are reasonably decorated and the physical design and layout meet the needs of the service users. To ensure that peoples needs can be met and the accommodation provided is of a reasonable standard. Not assessed at this inspection. 6 27 18(1)(a) The registered person must 02/01/2008 ensure that at all time suitably competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. (This must include sufficient
Page 7 of 14 30/06/2009 Care Homes for Older People 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 domestic staff to undertake cleaning duties.) Not assessed at this inspection. 7 29 19 The registered person must ensure that all applicants complete a rehabilitation of offenders declaration.The application form must make it clear that all convictions including those that are spent must be declared. This is to protect people who live at the home from the risk of abuse. Not assessed at this inspection. 8 30 18(1)(c) (i) The Registered Person must 02/01/2008 ensure that the persons employed by the Registered Person to work at the care home receive training appropriate to the work they are to perform including structured induction training. (The induction training must include the Skills for Care Common Induction Standards. Training must be given before a new member of staff undertakes moving and handling procedures with any resident.) Not assessed at this inspection. 9 38 13 The registered person shall ensure that all staff 30/07/2009 30/04/2009 Care Homes for Older People Page 8 of 14 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 undertake mandatory training. This refers to moving and handling and first aid. To make sure staff have the skills and experience necessary. Not assessed at this inspection. Care Homes for Older People Page 9 of 14 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 1 3 All documentation should be fully completed. This recommendation was first made at the key inspection in November 2008. 2 7 All care plans should be reviewed monthly and updated as necessary. This recommendation was first made at the key inspection in November 2008. 3 8 All service users should have a risk assessment in relation to nutrition undertaken on admission and thereafter as necessary. This recommendation was first made at the key inspection in November 2008. 4 12 Serious consideration should be given to publicising a weekly programme of events to residents so that they know what is happening and when. Not assessed at this inspection. Care Homes for Older People Page 10 of 14 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 12 People living in the home should have the opportunity to go out into the community in line with their interests and aspirations. Not assessed at this inspection. 6 15 Serious consideration should be given to displaying the menu. Not assessed at this inspection. 7 18 Urgent consideration should be given to make sure that the adult protection policy is in line with locally agreed multiagency procedures. It should include clear information about how to make referrals to the appropriate agencies. Consideration should be given to making sure that dental tablets are stored securely to make sure there is no risk of ingestion. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. 8 19 9 19 Serious consideration should be given to the appropriateness of using the private room that is only accessible via the office once it becomes vacant. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. 10 19 Serious consideration should be given to the use of electrical extension leads. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. 11 26 All the waste bins should be lined, lidded and foot operated to reduce the risk of cross infection. This recommendation was first made at the key inspection Care Homes for Older People Page 11 of 14 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 in November 2008. Not assessed at this inspection. 12 26 Serious consideration should be given to improving ventilation in the laundry and providing appropriate laundry equipment suitable to the volume of laundry and the needs of people living at home. Equipment should be able to wash at appropriate temperatures to control the risk of infection. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. 13 26 Toiletries should be kept in residents private rooms to reduce the risk of cross infection. This recommendation was first made at the key inspection in May 2009. Not assessed at this inspection. 14 33 All policies and procedures should be reviewed and updated to make sure they reflect current good practice advice and legislation. This recommendation was first made at the key inspection in May 2009. Not fully assessed at this inspection. 15 35 Serious consideration should be given to having two staff signatures on all service users personal money transactions. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. 16 38 Serious consideration should be given to auditing and evaluating the accident book. This recommendation was first made at the key inspection in November 2008.
Care Homes for Older People Page 12 of 14 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 Not assessed at this inspection. 17 38 All cleaning fluids that are decanted into alternative containers should be clearly labelled with COSHH information. This recommendation was first made at key inspection in May 2009. Not assessed at this inspection. 18 38 The infection control policy should be checked to make sure that it reflects current good practice advice and current legislation. This recommendation was first made at the key inspection in November 2008. Not assessed at this inspection. Care Homes for Older People Page 13 of 14 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 14 of 14 - 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!
