This inspection was carried out on 27th April 2010.
CQC found this care home to be providing an Poor service.
The inspector found no outstanding requirements from the previous inspection report,
but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Dunollie Care Home 31 Filey Road Dunollie Nursing Home Scarborough North Yorkshire YO11 2TP 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 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: Catherine Paling Date: 2 7 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Dunollie Care Home 31 Filey Road Dunollie Nursing Home Scarborough North Yorkshire YO11 2TP 01723372836 Telephone number: Fax number: Email address: Provider web address: DNeuropeancare@aol.com www.europeancare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Manager post vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : European Care (SW) Ltd care home 58 Number of places (if applicable): Under 65 Over 65 58 0 old age, not falling within any other category physical disability Conditions of registration: 0 58 The maximum number of service users who can be accommodated is: 58 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 58 Physical Disability - Code PD, maximum number of places 58 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Dunollie Care Home provides nursing care, social care and accommodation for a maximum of 58 people. Some of these people may be admitted from the age of 40 years old and may have a physical disability requiring nursing care. The service consists of the main house that can accommodate 49 people and The Lodge that can accommodate 9 people. The home is owned by European Care SW Limited and is located on Filey Road in Scarborough, a seaside resort. It is within walking distance of the local shopping area and close to the Italian gardens and Spa complex. It is about a mile away from the town centre. Access to the home is via a steep driveway with car parking facilities outside the main entrance or via steps for pedestrian access. The home is accessible on a level approach from the car park. It is set in extensive, well maintained, grounds that have several patio areas for residents and visitors to enjoy. These are reached from several points around the home without the need to negotiate any steps. The accommodation in the main house is divided into the garden wing, which is specifically designed for people with a physical disability, and the main house for older people with nursing needs. There is a passenger lift access to all floors in the main house. The Lodge is a separate building for older people with personal care needs only. People are provided with information about the service in the form of a service user guide. The most recent inspection report from the Care Quality Commission is available in the home. The current scale of charges range from £344.45 to £771.22 per week. Additional charges are made for hairdressing, chiropody and newspapers. This information was provided at the January 2010 inspection. The home should be contacted directly for up to date information about charges. Care Homes for Older People Page 3 of 9 What we found:
This was an unannounced inspection carried out by two inspectors on 27th April 2010 who were at the home from 10:45 until 15:40. The last full inspection of the service was on 15th January 2010 where continued shortfalls had been identified in the management of people at risk of skin damage; the availability and use of equipment; a lack of consistent recording of the administration of medication and the accessibility of call bells to people. The provider has made representations with regard to the findings of that inspection which are yet to be determined however since the January 2010 inspection we have met with the provider and advised them that we would visit to look at progress in addressing these issues; this was the purpose of this random inspection. On the day of the visit the Programme Manager of the company was overseeing the service while the manager was on leave. The manager has not yet made application to us to be registered. We agreed with the Programme Manager that we would case track the care of four people in total including two whose care had also been looked at in January. The care files we looked at contained a great deal of information and it was not always easy to find the most up to date instructions about care. For example, there was instruction in one persons care plan that their position should be changed every 40 minutes, while another plan in the same records noted that this person had a moulded wheelchair and should be repositioned every 3 hours. This could be confusing for staff and could lead to people not receiving the care they need. In the case of another person the wound chart in their bedroom showed a change in the dressing regime. It was only with the help of the Programme Manager that we could find record of a conversation between nursing staff and the tissue viability nurse (TVN) resulting in the change of dressing. The Programme Manager acknowledged that this conversation should have led to a review and update of the care plan. However, the person was having the correct dressing regime carried out. We found that where people had been assessed as needing specialist equipment because they were at risk of skin damage, the equipment was available and was in use. Where bed safety rails were in use we saw risk assessments were completed and reviewed. We spoke with the TVN before our visit and were told that the management of people at risk of skin damage had improved with the current manager. The TVN felt that referrals were timely and appropriate and that staff follow the advice given. It was a warm day and we saw staff offer fluids frequently to people. We looked at fluid charts for people and although people were being given ample fluids the records of the amounts given did not appear to be accurately recorded. For example, we saw one person being given a drink and the carer recorded 100mls given. When we looked at the measure on the side of the beaker a record of 50mls would have been more accurate. Records of food intake were not detailed enough and suggested that people were not being offered any snacks between meals or any supper. For one person who had refused
Care Homes for Older People Page 4 of 9 breakfast there was no indication that they had been offered anything later in the morning. Staff need to be instructed to be more accurate in their recording as it is not enough to record, for example, All main or 1/2 pud without the information of exactly what people are eating. If the decision is made that diet should be recorded the record should be specific, informative and accurate. The Programme Manager told us that the problem of the call bells not always being accessible to people was being addressed by the purchase of pendants for people to wear around their necks and that delivery was imminent. We checked medication administration record (MAR) sheets and did a controlled drugs check and found these to be satisfactory. However, the use and recording of creams and lotions was not adequate. We found handwritten MAR sheets in peoples rooms which were either not completed at all or showed random ticks indicating when cream had been applied. The details on these sheet were not specific enough. The printed MAR sheet in main medication administration file was completed with a code but no checks being made that creams had been applied. The code F had been recorded with explanatory note of applied by carers. For example, in one persons room there was a handwritten MAR pinned to the wall giving the name of the cream to be applied and the frequency. It was also noted that this cream should only be used when you have a rash and Do not use longterm. There was no date of when this had been prescribed. Other examples were given to the Programme Manager at feedback. We were told that the management of prescribed creams had been identified as an issue and was being looked into. What the care home does well: What they could do better: Care Homes for Older People Page 5 of 9 The Programme Manager told us that new staff appointments have been made and that they are working hard to get a permanent staff team together. Where agency staff are used they are regulars at the home and so that there is continuity and stability for people. Care records should be looked at and sorted out to make sure that staff have easy access to the most up to date information they need to make sure that they are looking after people properly. This will reduce any confusion or risk of people not being looked after in the way they need. The management of the application of prescribed creams needs to be reviewed to make sure that records are accurate and that people are getting their prescribed medication. Records of the food and fluid intake for people should be reviewed to make sure that they provide accurate and informative detail of intake. 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 9 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 9 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 9 13 The management of the application of prescribed creams must be reviewed. This is to make sure that people receive their prescribed medication as required. 11/06/2010 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 7 Individual care records should be reviewed to make sure that staff have easy access to current information about care. This is to make sure that people get the care they need. Care should be taken to make sure that records of food and fluid intake are specific, informative and accurate. This is so that there are clear records of the intake of people who are deemed to be at nutritional risk. 2 7 Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!
