Random inspection report
Care homes for older people
Name: Address: Charlotte Rose House 1 Norwood Road Skegness Lincs PE25 3AD one star adequate 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 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: Sue Hayward Date: 1 6 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Charlotte Rose House 1 Norwood Road Skegness Lincs PE25 3AD 01754762119 Telephone number: Fax number: Email address: Provider web address: pcoulson@chaucerhouse102.wanadoo.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lonrush Ltd care home 20 Number of places (if applicable): Under 65 Over 65 19 0 old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 1 Charlotte Rose House formerly known as Chaucer House is a home providing personal care to people who are over the age of sixty-five. It is situated in a residential area of Skegness within a short car ride of the town centre. Local services are within walking distance of the home and include a hotel-restaurant, post office and shops. The home is a detached three-storey building with accommodation for people who use the service on both ground and first floor levels. There is a passenger shaft lift and stair lift for access to the upper floors. There are fifteen bedrooms, five of which are shared occupancy, although at present no one shares a bedroom. To the front of the premises there is a patio area for sitting out and a small lawn and seating area to the rear. There are no on-site parking facilities for cars although on-street parking is available at
Care Homes for Older People Page 2 of 12 Brief description of the care home the front and side of the home. The home is registered to provide personal care for up to twenty people, nineteen older and one younger physically disabled person. Eight people were living in the home at the time of the inspection. The current fees for the home range from £360 to £446 per week with additional charges made for hairdressing, dry cleaning, social transport and personal effects. Information about the day-to-day operation of the home and fees, as well as a copy of the last inspection report, is available in the main entrance hall of the home. Care Homes for Older People Page 3 of 12 What we found:
This service previously had a key inspection which was carried out on 13 July 2009. At that time it received a quality rating of a one star or adequate service. This inspection, which was announced the day prior to visiting was what we call a random inspection and was done in response to information we had received which raised concerns that some specific standards may not be met, which may affect the health, safety and welfare of people using the service. We visited the home and looked at the specific standards that we felt related to the concerns raised. These were mainly concerning health and personal care, daily living activities and the attitude of staff and the manager of the service. We spoke to the manager, two staff members on duty, three service users and a visitor. We looked at the care records of three people who use services, and a sample of other records kept, which help to determine whether standards are being met effectively. We also looked at the history of the service and any correspondence we had had prior to visiting. The main findings of our inspection we have set out below under the standard headings we inspected. HEALTH AND PERSONAL CARE Concerns were raised with us prior to the visit that people who live in the home were not getting the attention they needed. This matter was referred to the local authority safe guarding adults team but was closed after there was insufficient information gathered to progress the matter further. All three personal files we checked on this occasion contained care plans which included basic information about peoples care needs although all lacked some aspects of important information, such as the significant relationships of people who live in the home and how they were to be supported with them, how a persons wishes in respect of personal care needs was to be met and how risks and needs were to be monitored in relation to a persons skin condition. We had told them at our previous inspection that they must ensure all care plans are reviewed so that they contained up to date and person centred information about peoples needs and wishes. The manager acknowledged that this work still had to be done and also that care records needed to include more information to show how peoples care needs are met. They have been given a timescale of 30 September 2009 in which to make sure this matter is addressed and the manager agreed to respond to us in writing as to how they intended to achieve this. Whilst we found shortcomings in recording systems the people we spoke to made positive comments about the personal care they received, for example its like a family here, the staff are wonderful. A visitor told us they had noticed that people who live in the home did not have to wait long for attention from staff. Staff we spoke to had a good knowledge of peoples care needs. DAILY LIFE AND SOCIAL ACTIVITIES Concerns were raised with us about how staff support people who live in the home to
Care Homes for Older People Page 4 of 12 have contact with their visitors and whether the privacy and dignity of people was fully respected by staff and the manager. Two of the people we spoke to said they could have visitors when they wished and they were free to show affection as they wished. A visitor also confirmed this. However, one person who lives in the home said that they were unable to have one set of visitors, visit in the privacy of their own bedroom although could see them in communal areas. We saw there is a visitors policy in place and both staff we spoke to knew of it and peoples rights to have their wishes respected with regard to receiving visitors in private or in their bedrooms if they wished. Procedures made reference to the rights of people in relation to their visitors however lacked any reference to how any concerns would be dealt with if they arose. People who live in the home told us that they felt staff handled their mail and personal telephone calls in a way which respected their privacy. For example, a person told us that they had their own telephone and could make calls in private, when and where they wished. For people who do not have their own telephones the manager and staff confirmed mobile handsets are available for people to use. People told us they were able to go out with visitors when they wished and staff spoken to verified this, however we saw in the personal records of one person a record indicating a visitor had been told they would be unable to take a person out if they were late returning them again. This was discussed with the manager who said this was not the case, the matter had been addressed and apologies given to the people it concerned. A visitor told us that they were made to feel welcome, offered drinks and meals when they visited and would also feel comfortable enough to ask staff for drinks if necessary. The visitor said they were accompanying their relative on a trip organised by the staff on the day of the visit. We observed staff and the manager assisting people who live in the home to get ready for the trip. We noticed they spoke to people in a polite and respectful manner. We noticed that a person who lives in the home commented to staff how grateful they were for their support. COMPLAINTS AND PROTECTION Three matters of concern have been raised with us since the last key inspection. Two were passed to the local authority to look into under their own procedures, although after a visit to the home there was insufficient evidence to support a safe guarding adults investigation. Additionally we received concerns that due to staff smoking in the home, there was a smell of cigarette smoke emanating into the lounge. We referred this matter for a company representative to investigate. The response we received about this matter was not satisfactory to show that a thorough investigation had taken place. There were no records produced on the day to show how this matter had been dealt with. We did however notice on the day of our visit, that the home smelt fresh and clean and we saw there is a covered area provided outside the building for staff and residents to use should they wish to smoke. We saw there is a complaints policy on display in the entrance hall although this did not
Care Homes for Older People Page 5 of 12 contain accurate and up to date information about us and how we can be contacted, which is important information for people to know should they wish to do so. The manager agreed to address this matter. People who live in the home and the visitor we spoke to told us they would feel comfortable to speak to the manager should they have any concerns. STAFFING We had received information which raised concerns about the staff and managers attitude to some visitors, that people in the home were not always spoken to in a respectful manner and that they were not always receiving timely support with their toileting needs. Comments from people who live in the home indicated they felt their physical needs were being met and they did not have to wait long for staff to assist them when they needed support, for example one person told us staff are very busy but that does not mean you have to wait long for attention. Comments also indicated they knew who was in charge and would feel comfortable to raise concerns and felt action would be taken to try and resolve them. Staff were also of the view that current staffing levels enabled peoples needs to be met and a comment was made residents needs come first here. Whilst no concerns were raised by two people we spoke to who live in the home one person was of the view that the attitude of staff and the manager toward one set of visitors was not as good as toward others. During discussion, a staff member made a personal view and judgement about a relationship known to us. We checked the most recent report of a visit to the home by a company representative. This showed that the visit had included talking to some people who live in the home and staff but no issues had been raised with the representative during the visit. What the care home does well: What they could do better:
Care plans must be reviewed so that they detail peoples individual needs and wishes accurately. This is so that people who live in the home can be sure staff know their needs and how to meet them well. There needs to be better systems in place to show that any concerns and complaints
Care Homes for Older People Page 6 of 12 have been thoroughly investigated. This is so that people who live in the home are well protected. The visitor policy needs some review so that it makes reference to what action should be taken should the behaviour of any visitors adversely affect any people who live in the home. All staff and people who live in the home should be aware of the policy so that the rights of people who live in the home are fully respected with regard to visitors. Further arrangements should be in place to monitor staffs awareness of the principles of respecting the rights and individual lifestyles of the people who live in the home. 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 7 of 12 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 7 15 Care plans must be reviewed 30/09/2009 to make sure they reflect accurately peoples needs and how they are to be met. This is to make sure peoples needs and wishes are fully identified and known. 2 15 17 Records of meals must be kept in sufficient detail to show the full range of meals provided. This is to make sure that it can be demonstrated that the meals provided are well balanced and nutritious. 30/09/2009 3 29 19 A thorough recruitment 24/09/2009 procedure must be followed for all staff, which makes sure they are employed only after all necessary checked have been completed including obtaining satisfactory POVA and CRB checks. Staff must not be employed prior to a CRB check being received unless there are exceptional circumstances, which put the health, safety and welfare of people who use the service at risk, in which case CQC must be notified.
Page 8 of 12 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 people who live in the home are well protected. 4 38 13 There must be records in 30/09/2009 place to show risk assessments of the environment have been carried out. Where identified actions must be taken to reduce any risks identified. This is so peoples health and safety is promoted. Care Homes for Older People Page 9 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 16 22 The complaints procedure must be reviewed to make sure that it contains clear and accurate information about how we can be contacted. Records of any complaints raised must be kept to show details of any investigations and any action taken. 06/11/2009 This is to make sure that people are clear about how to raise any matters and they can feel confident their concerns will be taken seriously, listened to and acted upon. 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 10 Arrangements should be in place to make sure staffs awareness of the principles of respecting individual needs,
Page 10 of 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 rights and lifestyles is kept up to date. 2 13 The visitors policy should be reviewed to include information about the procedures for staff to follow should the conduct of any person visiting the home adversely affect any people who live in the home. Effective arrangements should be in place so that staff and people who live in the home are fully aware of their rights with regard to visitors. It is recommended the way in which care records are being kept are reviewed so that they contain sufficient detail to show the care given and how the needs of people are being met. 3 13 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!
