Random inspection report
Care homes for older people
Name: Address: Drummuir Nursing and Residential Home 9-11 Northfield Bridgwater Somerset TA6 7EZ zero star poor service 02/02/2010 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 9 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Drummuir Nursing and Residential Home 9-11 Northfield Bridgwater Somerset TA6 7EZ 01278422144 01278420397 drummuir@ashbourne.co.uk www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Caroline Williamson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 38 Number of places (if applicable): Under 65 Over 65 38 old age, not falling within any other category Conditions of registration: 0 Elderly persons of either sex, not less than 60 years, who require general nursing care Up to eight places for personal care Up to two persons of either sex, between the ages of 50-60 years who require general nursing care Date of last inspection Brief description of the care home Drummuir Nursing Home is situated in a quiet residential area close to the town centre of Bridgwater. The home is not purpose built. Drummuir is registered with the Care Quality Commission provide general nursing care for up to 38 older people, although the home can only accommodate a maximum of 31 people. This includes up to 8
Care Homes for Older People Page 2 of 12 0 3 0 3 2 0 1 0 Brief description of the care home people who require personal care. The fee range does not include hairdressing, newspapers, toiletries, optician and some activities. Care Homes for Older People Page 3 of 12 What we found:
This inspection was conducted by one inspector over six hours. The purpose of the inspection visit was to assess progress towards meeting some of the outstanding requirements made at previous inspections with an emphasis on those relating to health and care planning. Concerns have been raised with regard to the homes ability to meet peoples physical needs. As such the Community nursing staff (district nurses) have been visiting the home twice daily to offer clinical support. This support has been ongoing since the beginning of February 2010. This inspection visit was to ensure that the home was making appropriate progress and to ensure that staff are developing and receiving training in order that the home can start to fulfill it roles as a care home with nursing. During the inspection visit we reviewed the care and support plans for three people. One of the care plans viewed had been seen at previous inspections. At this time the plan was unsatisfactory as it did not give clear guidance to staff. At the last inspection the care and support that this individual was receiving was also found to be poor. An immediate requirement had been left at the last inspection visit. On this occasion improvements to the care plans and assessments were found. The care plan was compared to the care that the individual received and again improvements were seen. We viewed two care plans of people who had diabetes to ascertain if improvements in care and documentation had been made. The care plans viewed were of a poor standard and did not give clear guidance to staff on the care needs of the individuals with regards to their diabetes management. This could place the individuals at risk. The daily records showed that on at least one occassion systems were not in place when an indivduals blood sugar levels dropped. One of the individuals reviewed could demonstrate some behaviours which staff found challenging. This included refusing care or not accepting advise with regard to medical conditions. Again there was no clear care plan in place to guide staff on the appropriate action to take when this occurred. There was limited evidence in plan that these issues had been discussed with other health care professionals. The home does not currently have a manager registered with us and has not done so for a significant time period. There is, however, a manager currently in place who stated that she intends to register with us in the near future. The manager told us that the home currently employs only one registered nurse on day duty. Due to this the home is using a large amount of agency staff. The manager told us that some registered Nurses had been employed and that this included a deputy manager. The new staff were awaiting recruitment checks and induction before they commenced employment. The manager told us that she was aware that the care planning at the home remained an issue however that she hoped that this would be addressed when the new staff started working at the home. At the last safeguarding meeting it was agreed that the home would access training in areas such as diabetes to ensure that staff had the skills to meet the needs of people at the home. To date diabetes training had not been completed. Other training had been organised and booked but had yet to be delivered. Due to the ongoing concerns and lack of progress with regard to the care planning and subsequent risk this poses to people living at the home we are currently considering
Care Homes for Older People Page 4 of 12 enforcement action. We will also continue to liaise with the local Adult Social Care agency and PCT to assess the homes ability to care for people currently residing at the home. 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 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 18 All new staff employed should complete a robust induction in line with best practice This will ensure that all new staff are adequately supported and develop the skills to meet the needs of people at the home. 18/02/2010 2 18 All staff should receive all 26/02/2010 mandatory training according to their job role. This may include moving and handling, fire training, Abuse prevention, health and safety and Control of Substance Hazardous to Health (COSHH). This will ensure that staff can meet the needs of people living at the home 3 7 12 The responsible individual is 08/05/2009 required to ensure that each person has been risk assessed and has a suitably detailed supporting care plan in place to ensure all identified needs are met. This is required to ensure that staff can provide the care needed and the person Care Homes for Older People Page 6 of 12 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 using the service is not placed at risk. 4 8 12 People at the home should be supported to complete oral hygiene in line with the assessed need and plan of care This will ensure that peoples preferred level of personal hygiene and maintains peoples comfort 5 8 12 All people living at the home 04/02/2010 should receive an adequate fliud and dietary intake. everyone living at the home should have an up to date weight and nutritional assessment completed. associated care plans should be developed giving clear and specific guidance to staff on the nutritional needs of people living at the home. care plans should give clear guidance on actions to be taken where concerns are highlighted fluid and diet charts should be accurately completed where applicable To ensure that people at the home receive adequate diet and fluids 6 8 12 People who are risk of choking are supported with diet and fluids in line with a completed risk assessment and up to date care plan This will ensure the safety of
Care Homes for Older People Page 7 of 12 18/02/2010 18/02/2010 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 people living at the home 7 8 12 Charts and records used to monitor care such as fluid charts, positional change charts and nutritional charts are completed accurately where applicable This is required so that the health care needs can be monitored and appropriate care and support provided 8 9 13 Action must be taken to ensure that medicines are given as prescribed and that accurate records are kept of all medicines given by staff, including creams and ointments. If regular medicines are not given a reason must be recorded. This is to safeguard peoples health. 9 9 13 If medicines are prescribed with a variable dose the amount given must be recorded. This is so that it is clear how much medicine is needed and has been given. 10 15 16 People on specialist diets should be able to make choices with regard to the meals they receive. This will ensure all people ahve a choice 18/02/2010 18/02/2010 18/02/2010 18/02/2010 Care Homes for Older People Page 8 of 12 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 11 22 13 The management must 18/02/2010 ensure that the home is adequately equipped to meet the needs of people living at the home. This should include weighing scales and hoists used in moving and handling This will ensure that staff can meet the needs of people at the home. This will ensure that safety at the home is not compromised. 12 26 16(2)(j)(k) The registered provider is required to ensure that all areas of the home have a satisfactory standard of hygiene and ensuring that there is no malodour. The management need to ensure that there are adequate numbers of suitably qualified staff on duty at all times. This will ensure that there are enough staff on duty to meet the needs of people at the home. 01/10/2008 13 27 18 18/02/2010 14 30 18 The management of 19/02/2010 Southern Cross Healthcare should complete an audit of the skills of the regsitered nurses. Where training needs are identifed Southern Cross healthcare need to develop a plan as to how these training needs will be adressed Care Homes for Older People Page 9 of 12 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 will ensure that staff at the home can meet the needs of people living at the home. 15 31 37 The home must notify us of any event as described in regaultion 37 of the care home regulations This will ensure that people liivng at the home are protcted and action taken for any shortfalls 16 31 8 The responsible individual is required to ensure that a manager is registered with the Commission. This is required to promote the stable management of the service. 17 33 24 Quality Assurance systems must be more robust. To ensure that shortfalls in the service are identified and action is taken to address them. 19/02/2010 08/04/2009 19/02/2010 Care Homes for Older People Page 10 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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!
