Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Camelot House, Wellington Camelot House, Wellington Chelston Wellington Somerset TA21 9HY The quality rating for this care home is: The rating was made on: two star good service 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: Alison Philpott Date: 1 5 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Camelot House, Wellington Camelot House, Wellington Chelston Wellington Somerset TA21 9HY 01823666766 01823667568 info@camelothousenursing.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Camelot Care (Somerset) Ltd care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia 66 66 Over 65 0 0 Conditions of registration: The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Dementia (Code DE) Mental disorder, not including learning disability or dementia (Code MD) The maximum number of service users who can be accommodated is 66. Rooms 1, 2, 3 and 5 can only be used by people who are fully mobile. Date of last inspection Brief description of the care home Camelot House is registered with the Commission for Social Care Inspection to provide nursing care for up to 66 older people who have a dementia or mental disorder. The home is not registered to provide care to people who have a primary diagnoses of a Care Homes for Older People Page 2 of 11 learning disability or to those who require general nursing care. The home is owned by Camelot Care (Somerset) Ltd. The responsible individual is Mr J.Teasdale. The registered manager is Mr Ty Taylor. Camelot Care (Somerset) Ltd was first registered by the Commission in February 2008 and although the directors, Mr and Mrs Teasdale have owned the home since 2003, the change in provider makes this a new service. The home has a Social Services Quality Rating. This year the home have been awarded a 4 star excellent rating from Environmental Health. It has also achieved the Investor in People Award for its commitment to staff training. Camelot House is a detached property situated on the main road between Taunton and Wellington and is on the bus route to both towns. Local amenities, which are close by, include a garage with a small convenience store and two garden centres. The home has recently benefited from major building and refurbishment works which have included a new extension which has been designed to meet environmental recommendations for people with dementia. This unit was registered by the Commission in June 2008. Several improvements have also been made to the existing environment and garden areas. The home has a large car park. We were advised that current fee levels are between 390 pounds & 750 pounds per week. Additional costs met by people using the service include; Hairdressing, personal items/toiletries and chiropody. Some activities incur some costs such as entrance fees, outside entertainers etc. Care Homes for Older People Page 3 of 11 What we found:
This unannounced random inspection was carried out by Alison Philpott and Jackie Dolan for the Commission for Social Care Inspection (CSCI), on 15th December 2008. The visit was to monitor the progress of the home since its last key inspection on 21st July 2008. We viewed the home and spoke with management, staff and people who live at the home. We viewed records including risk assessments, medication, health & safety and undertook observations. Three people have recently moved to the home. We viewed two pre-admission assessments and care plans. Mr Ty Taylor, Registered Manager and Mr & Mrs Teasdale, Directors of Camelot Care (Somerset) Ltd. were available throughout the inspection. What the care home does well: What they could do better:
On the day of the inspection visit, it was found that the home was using assessments received from the authority funding the placement and the care plan from the previous home as the basis for care delivery for two people who had recently moved into the home. The home must ensure that an assessment and initial care plan is written so that staff know how to meet the individuals needs within the homes environment. The pre-admission assessment for one person who has lived in the home for three days identified a history of falls and a high risk of falls. Further to this, the home had completed a handling assessment that stated there was no history of falls. The information had not been transferred correctly into the care plan. Therefore, there was no individual risk assessment to provide staff with information on how to prevent falls and minimise the risk. When there is an identified risk of falls for people living at the home, a detailed falls risk assessment must be undertaken to promote the health, safety and welfare of the person. Care Homes for Older People Page 4 of 11 On viewing one persons Medication Administration Record Sheet, the current dose for one medication was not clear. The manager advised that the Consultant Psychiatrist had changed the dose. The home should ensure that there is clear information for staff to follow when a dose is changed so that they know what dose to administer. This will minimise the risk of an error when administering medicine and protect people who live at the home. The homes medication fridge records showed that the minimum temperature had been around 1 degree for some time. It is recommended that the home has the fridge checked, as the temperature should be between 2 and 8 degrees, to ensure that peoples medicines are being stored at the correct temperature to maintain their quality. We observed staff making preparations for teatime. Staff were assisting people who live at the home into the dining room from 4.30pm onwards. Teatime starts at 5.00pm. During the inspection, soup and sandwiches were not served until 5.15pm. The tables were not set ready for tea. This could cause distress and disorientation for the people who have dementia. In the other wing of the home, five people were sitting in their chairs and eating their food from a bed table placed in front of them, rather than the home making the meal an event in the dining room. We observed that the mealtime appeared to be disorganised and noisy. The home should review the service of food at teatime to ensure that people are able to enjoy their food and mealtime in a more dignified manner. At least seven of the bedrooms in the new extension did not have a lead for the call bell system. The person living in the bedroom would need to identify which button to press on the wall. Therefore, some of the people who live at the home may find it difficult to call for assistance due to dementia or limited mobility. The home should review the system, undertake a risk assessment for each person and provide a suitable means for people to call for assistance, when needed. We viewed two recruitment files for recently appointed staff. For one of the staff, the home had not checked a three year employment gap. For both staff, the employment history on the application form did not match the dates of employment given on references. The home must ensure that the reason for employment gaps is explored and they are satisfied that the references are accurate, to protect people who live at the home. The home had recruited both members of staff through an agency. The agency had undertaken a criminal record bureau (CRB) check for one of the staff. The other CRB check was not available at the time of inspection. The check was sent to CSCI on 17/12/08. It was found that the two staff members were living in bedrooms that are registered by the CSCI. Further to the inspection, the manager confirmed on 17/12/08 that the staff members had moved out of the home. We viewed the fire records and an immediate requirement was issued at the inspection. The weekly fire alarm system test and monthly emergency lighting test had not been undertaken since 14th July 2008. Further to the inspection, the manager confirmed on 17/12/08 the fire system had been tested and the records had been stored elsewhere. Arrangements must be in place to ensure that fire systems are tested and records maintained according to the required intervals to protect the health and safety of people who live at the home and staff. Care Homes for Older People Page 5 of 11 New fire doors have been installed to the sensory room and office. The doors did not have a self closing mechanism or fire paint. Further to the inspection, the manager confirmed on 17/12/08 that the self closing door mechanisms have now been fitted. The home must ensure that the doors are painted to protect people in the event of a fire. We viewed the staff fire training records. It was not clear from the records whether staff had undertaken training within the required intervals. Staff training records must clearly indicate the dates training was received. Further to the inspection, the manager advised that there is another record kept at the home for fire training. It is recommended that the home reviews its record keeping systems to ensure that up-to-date and accurate records are available for the protection of people who live at the home and for the effective running of the service. 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 11 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 7 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 1 38 23 The home must ensure that the new fire doors are painted. This is to protect people in the event of a fire. 23/12/2008 2 38 23 Staff fire training records must clearly indicate the dates training was received. This is to ensure that staff are up-to-date with good practice and know what action to take in the event of a fire to protect people. 23/12/2008 3 38 23 Arrangements must be in 23/12/2008 place to ensure that fire systems are tested and records maintained according to the required intervals. This is to protect the health and safety of people who live at the home and staff. 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 7 13 When there is an identified risk of falls for people living at the home, a detailed falls risk assessment must be undertaken. 22/02/2009 Care Homes for Older People Page 8 of 11 This is to promote the health, safety and welfare of the person living at the home. 2 7 12 The home must ensure that an assessment and initial care plan is written for people who have recently moved into the home. This is so that staff know how to meet the individuals needs within the homes environment. 3 29 19 The home must ensure that the reason for employment gaps is explored and they are satisfied that the references are accurate. This is to protect people who live at the home. 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 22/01/2009 31/12/2008 1 9 The home should have its medication fridge checked, as the temperature should be between 2 and 8 degrees, to ensure that peoples medicines are being stored at the correct temperature to maintain their quality. The home should ensure that there is clear information for staff to follow when a dose of medicine is changed so that they know what dose to administer. This will minimise the risk of an error when administering medicine and protect people who live at the home. The home should review the service of food at teatime to ensure that people are able to enjoy their food and mealtime. The home should review the call bell system, undertake a risk assessment for each person and provide a suitable means for people to call for assistance, when needed. It is recommended that the home reviews its record
Page 9 of 11 2 9 3 15 4 22 5 37 Care Homes for Older People keeping systems to ensure that up-to-date and accurate records are available for the protection of people who live at the home and for the effective running of the service. Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) 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 11 of 11 - 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!
