Random inspection report
Care homes for older people
Name: Address: Centenary House 70 Charlton Road Shepton Mallet Somerset BA4 5PD two star good service 30/10/2008 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: Justine Button Date: 2 2 0 4 2 0 0 9 Information about the care home
Name of care home: Address: Centenary House 70 Charlton Road Shepton Mallet Somerset BA4 5PD 01749342727 01749342727 caremanager@centenaryhouse.co.uk 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) : Centenary Care Homes Ltd care home 16 Number of places (if applicable): Under 65 Over 65 16 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodates is 16. The proposed refurbishment of the first floor must be complet and deemed `fit` for purpose by the CSCI, which will include a further site visit, with no more than four bedrooms being added which meet or exceed 12 sq m before they can be used for prospective service users. Suitable access, other than stairs, to the first floor must also be available for service users. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Centenary House currenty provides residential care services for up to 13 people over the age of 65.
Care Homes for Older People Page 2 of 12 3 0 1 0 2 0 0 8 Brief description of the care home The home faces a busy road but is within walking distance to the centre of Shepton Mallet. There is a convenience shop in a garage next door and a large supermarket nearby. There is car parking in front of the home. The home comprises the original house and a later extension. All service users rooms are on the ground floor. The first floor is currently unoccupied. Many of the bedrooms have individual access to a pleasant garden and two have access to a side patio. There is a double bedroom with en-suite facilities. There are two lounges, a pleasant conservatory overlooking the garden and a dining room. There are two communal bathrooms, one has been redecorated and fitted with a spa bath. The shower room has been refurbished and now has a good sized walk in shower cubicle. The fees at the home are 390 to 430 pounds per week. Care Homes for Older People Page 3 of 12 What we found:
This random inspection was conducted in response to concerns raised to us (CQC). The concerns related to the financial viability of the home, food and meals, staff training and induction, staffing levels at the home particularly at night and the general day to day running of the home. As result of the random inspection we shared our findings with Somerset Social Services under the safeguarding policy. Social Services have the responsibility to investigate any concerns that may have a detrimental effect the people living at the home in order to safeguard their interests. Two joint meetings (CQC and Social Services) have taken place with the current manager and the directors of Centenary Care Homes LTD to discuss the identified issues. Following these meetings it has been agreed that Somerset Social Services will review the care and support afforded to individuals living at the home and to conduct interviews with the staff to ascertain their views on the care delivered. An additional meeting with the company has been arranged once this additional information has been gained. What the care home does well: What they could do better:
During the inspection and subsequent meetings with the company it could not be confirmed that all incidents such as falls or accidents had been documented appropriately. Staff at the home need to ensure that all incidents are documented clearly in the daily records, accident forms are completed as required and that we (CQC) are informed of any event that adversely effects people or individuals living at the home. One of the concerns raised with us related to the care and supported afforded to people living at the home over night. During the period between January and March 2009 the home did not have a manager in post. The home currently has one waking and one sleeping night staff member on duty over night. Staffing numbers at the home were such that there was difficulty in covering the sleeping night staff. Due to this, one of the directors of the company, covered this shift by sleeping in the flat situated on the upper floor of the home. It has been confirmed that this director has no qualifications, work experience or training in order to complete direct hands on care. During the meeting with the company, the director gave assurances that he did not deliver any hands on care at this time. An on call arrangement had been agreed with staff who live locally if any emergency situation had required a second member of staff to attend. This has yet to be confirmed with staff. As a result of the issue covering the night staffing arrangements a staff member has agreed to live in the flat with her partner. There is no separate access or entrance to the flat. In order to access the upper floor flat people living or visiting this area have to use the main entrance to the home. This could place people who live at the home at risk from unknown people entering the home. It not be confirmed that the company has consider how to safeguard people living at the in these circumstances. During the meeting with the directors it was agreed that a Criminal Record Bureau check would be completed for the partner of the staff member who is living in the flat. A
Care Homes for Older People Page 4 of 12 tenancy agreement would be developed that clearly sets out the areas of the home the individual living in the flat would be able to access and the arrangements for people visiting the flat. In addition it was confirmed that these arrangements had not been considered in the homes fire risk assessment. It was agreed that the fire risk assessment would be updated and that both the staff member and her partner would be made aware of the evacuation procedures in the event of a fire. It was agreed that the smoking policy would be clearly outlined in any tenancy agreement. It was agreed that these documents would be reviewed at the next meeting. The concerns raised to us expressed that the food provided was not adequate and that people living at the home had to ask that family members get fish and chips to supplement the food the home provided. Feedback from people living at the home, during the key inspection conducted in October 2008, was that the food was of a good standard. This was confirmed during this random inspection. The issue was discussed with the directors during the meeting with them. The directors confirmed that the cook had left employment however the standard of the food had remained good. The directors confirmed that one incident had taken place where one individual living at the home had not liked the food provided and had requested that her family went to get fish and chips. The provider stated that this was was a one off incident relating to one individual only. The standard of food will continue to be reviewed in line with our regulatory role. It was apparent, however, that during the period that the home was without a cook and currently at weekends that staff and the Responsible individual cook meals at the home. It is clear that not all staff who cook and prepare meals have received Basic food Hygiene training. This is required to ensure the health and well being of people living at the home. One incident of direct verbal abuse has been raised with us. This incident requires additional investigation and has yet to be confirmed. In the meantime adequate safeguards have been agreed with the directors of the company to protect people living at the home. The concerns raised with us expressed issues with regard to staff training and induction. At the key inspection in October 2008 we were informed that a new induction programme which meets the required elements had been implemented. It was clear at the random inspection and from the concerns raised, that staff who had commenced this programme have not completed this. As such new staff have not completed an appropriate induction programme. This is required to ensure that staff have the skills and competencies to meet the needs of the people living at the home. During the meetings with the providers and during the random inspection it was made clear that no staff training has been undertaken for a period of time. Some staff now require some updating training. The manager has no budgetary control and was unaware of the budget available for staff training. The directors of the company explained to us that there would be no restrictions made for any mandatory training. It was agreed that they would clarify this with the manager. In addition it was agreed that the manager would develop a training matrix to identify any training required by staff. A plan would be submitted to us (CQC) detailing any deficits in staff training and the details and timescales of any training arranged to meet these deficits. The concerns raised with us expressed concerns with regard to the financial viability of the home. This included a number of unpaid bills and invoices. If the home is not financially viable then this could place people at risk. This was discussed with the directors of the service. The directors stated that the number of people living at the home
Care Homes for Older People Page 5 of 12 had been low over the previous twelve months and as such the income was not as they had predicted during the year of trading-2008. The Directors stated Regardless of this, during our first year, we have invested in considerable capital assets and equipment for the benefit of the residents in the Home. Furthermore, we have made no budgetary control on provisions and have kept up to date with payments to all service providers to the Home. We have made the residents needs and their continued wellbeing our number one priority and our standards of care have remained high. In order to consider this aspect of the home we have written to the directors to formally request additional information with regard to the homes financial viability. People who own care homes or care home comapnies are required to complete regualr visits to the home to ensure the quality of the care provided. These visits have to be documented. This is required under Regualtion 26 of the Care Home Regulations 2000. We have requested that the directors forward us copies of these visits for the last six months. As a result of this random inspection and subsequent meetings a number of requirements have been made. These will be discussed at the safeguarding meeting arranged by Somerset Social Services and reviewed at the next inspection conducted by us. 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 12 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 7 of 12 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 26 The registered Provider will supply copies of any regulation 26 visits made in the last six months To assess how the home is being monitored by the company 27/05/2009 2 25 The company will provide the 01/06/2009 commission with a bank reference expressing opinion as to the companys financial standing. This will give assurances that the home is financially viable and that people living at home are assured of a continued place to live. 3 18 13 It is required that an 20/05/2009 enhanced criminal record Bureau and POVA check is completed for the individual living in the flat upstairs. Confirmation and outcome of this CRB check will be forwarded to The Care Quality Commission Care Homes for Older People Page 8 of 12 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 This will safeguard the people living at the home. 4 19 23 A fire risk assessment should 08/06/2009 be completed to include the flat area and consider the risk of smoking in the upper floor flat. This should comply with the requirements of the local fire service. To ensure that the current fire arrangements adequate protect people living at the home. 5 27 18 The company will ensure that 20/05/2009 at all times, including nights, suitably qualified, competent and experienced persons are working at the care home in numbers as in appropriate numbers to meet the needs of people living at the home This will ensure that the needs of the people living at the home will be met. 6 30 18 The manager will develop a training plan. This plan will be submitted to CQC detailing and including timescales of any training arranged to address any identified shortfalls . This will ensure that staff can meet the needs of the people living at the home. 7 30 18 It is required that all staff 08/06/2009 receive an induction within six weeks of appointment to their posts including training
Page 9 of 12 08/06/2009 Care Homes for Older People 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 on the principles of care,safe working practices, their role and the particular needs of the people who live at the home. The manager of the home to submit a plan detailing how this will be achieved. This will ensure that any new staff can meet the needs of the people living at the home. 8 37 37 The registered person will 20/05/2009 ensure that we, the CQC, are informed of any incident, serious injury, illness or event that adversely affects people living at the home This will help to ensure that the health safety and well being of people at the home can be considered and safeguarded. 9 38 13 It is required that all staff 24/06/2009 who prepare and cook meals have undertaken basic food hygiene training. This will ensure that food is stored and prepared in such a way to reduce the risk of food poisoning. Care Homes for Older People Page 10 of 12 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 11 of 12 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 12 of 12 - 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!
