Inspection on 28/01/09 for Breadstone House Care Centre

This inspection was carried out on 28th January 2009.

CSCI 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

Breadstone House Care Centre 29/09/08

Breadstone House Care Centre 25/06/08

Breadstone House Care Centre 22/10/07

Breadstone House Care Centre 30/11/06

Breadstone House Care Centre 16/03/06

Breadstone House Care Centre 22/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Breadstone House Care Centre Breadstone House Care Centre Breadstone Nr Berkeley Glos GL13 9HG zero star poor 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Sharon Hayward-Wright Date: 3 0 0 1 2 0 0 9 Information about the care home Name of care home: Address: Breadstone House Care Centre Breadstone House Care Centre Breadstone Nr Berkeley Glos GL13 9HG 08453455782 Telephone number: Fax number: Email address: Provider web address: denise.mackereth@blanchworth.net Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Blanchworth Care Homes Ltd care home 40 Number of places (if applicable): Under 65 Over 65 40 dementia Conditions of registration: Date of last inspection Brief description of the care home 0 2 9 0 9 2 0 0 8 Breadstone House Care Centre is a registered Care Home with Nursing. It is registered to accommodate older people with dementia. The home is situated off the A38 Gloucester to Bristol road and is approximately 20 miles from Gloucester. It is a detached house situated in attractive grounds. The communal areas are situated on the ground floor. There are 28 single bedrooms (7 with en-suite) and 6 double bedrooms. The home makes information about the service, including CSCI reports available to people through a Service User Guide and Statement of Purpose available in the home. Care Homes for Older People Page 2 of 7 What we found: Two inspectors visited the home on two days to follow up on all outstanding requirements issued at the last key inspection. These related to care planning, activities, staff training and supervision and environmental issues that relate to cleanliness and odours. We also randomly selected two people who use the service to have their care examined in detail. This includes examining care records, speaking to the person, if able, and speaking with staff. We found that the staff had completed re-writing care records into a new format devised by the Registered Provider. People had plans in place for all assessed needs and evidence was found of ongoing reviews. It was found one of these peoples moving and handling assessment needs to clearer about the actual care required and the other person did not have a risk assessment in place for an assessed need. Since the last key inspection an activities coordinator has been appointed and their records were examined as they were on a training course and not on duty on the first day of the inspection. What the care home does well: What they could do better: One person whose care was examined in detail had a care plan that stated they required a pressure relieving mattress. On examination of their bed it was found that they were on a normal divan mattress. The explanation we received from the manager Care Homes for Older People Page 3 of 7 indicated to us that this person had not had a pressure relieving mattress for several weeks, however following the inspection the Registered Provider said that this was not the case and this person had only been without their mattress for that day as their mattress was being cleaned in the laundry area. The divan mattress had been put on the bed for that day only and the staff had made the bed. The other person whose care was examined in detail was found not to have a risk assessment in place for challenging behaviour despite a care plan and a checklist. Some discrepancies were found between the assessment of needs and care plans and between other care plans that would need to be addressed. One persons moving and handling assessment was confusing about the actual assistance required and this needs to be clearer to make sure they are not put at unnecessary risk. Improvements in the cleanliness of the home were observed although one empty room was found to be odourous. A Representative from Blanchworth said that this room was waiting to have new flooring. Accident records were examined from November and December 2008 and it was found that 6 of the 8 skin flap injuries were caused by staff during moving and handling of each person. Two others were found to have also taken place in January 2009. Audits of the accident records were in place but it appeared that no further investigation had been prompted or action taken to minimise these. Two other people were documented as having unexplained bruising on accident records but the information was very limited making it difficult to ascertain size and colour etc of the bruising. The manager said that all staff have undertaken moving and handling training. Due to the number of injuries found the staff in the home needed to be provided with the necessary skills to make sure they are not putting people at risk. Following the inspection the Registered Provider said that the majority of the skin flap injuries happened to one person due to their unpredictable behaviour when being moved by the staff and their family are aware of this. On checking the copies of the accident recored we have it was found that only one of the 6 skin flap injuries was for this person. We are concerned about the numbers of night staff as the Registered Provider has reduced the staffing numbers. From 7pm at night until 7am the following morning there are only 2 members of night staff to undertake many roles to include supervising people, helping them to bed, assisting people with hot drinks and snacks and administering medication. The manager said that the dependency levels of people are high. The layout of the building is large and it is spread out over two floors. A review of night staffing numbers for this time of the evening must be completed to make sure people are not being put at risk. Following the inspection the Registered Provider said that an extra member of staff does stay until 9pm but did agree that this was not recorded anywhere and this has now been rectified. 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 4 of 7 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 5 of 7 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, Care Homes 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 27 17 The registered person must 17/04/2009 maintain accurate records to reflect the staffing levels in the home. To make sure people who use the service are not being put at risk due to a decrease in staffing numbers. 2 30 30 The registered person must make sure that staff have the skills and knowledge pertinent to the assessed needs of people that live in the home This will help to ensure that people who use the service are not put at risk by the actions of the staff. 17/04/2009 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 Care Homes for Older People Page 6 of 7 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 03000 616161 (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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 7 of 7 - 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!