Inspection on 14/10/09 for Edgelea Care Home Ltd

This inspection was carried out on 14th October 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Edgelea Care Home Ltd 16/11/09

Edgelea Care Home Ltd 06/08/09

Edgelea Care Home Ltd 03/03/09

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Random inspection report Care homes for older people Name: Address: Edgelea Care Home Ltd 14-16 Half Edge Lane Eccles Manchester M30 9GJ one star adequate service 03/03/2009 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: Susan Jennings Date: 1 4 1 0 2 0 0 9 Information about the care home Name of care home: Address: Edgelea Care Home Ltd 14-16 Half Edge Lane Eccles Manchester M30 9GJ 01617890430 01617896000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Edgelea Care Home Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 37 Number of places (if applicable): Under 65 Over 65 37 0 old age, not falling within any other category physical disability Conditions of registration: 0 37 The registered person may provide the following category of service only: Care home with nursing - Code N To people 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 Physical disability - Code PD The maximum number of people who can be accommodated is: 37 Date of last inspection Brief description of the care home Edgelea Nursing Home provides nursing and residential care for 37 older people or people with physical diabilities. Accommodation within the home is situated on the ground, first and second floors in single and double rooms. There is car parking space Care Homes for Older People Page 2 of 18 0 3 0 3 2 0 0 9 Brief description of the care home available at the front and the side of the home but this space is unsuitable for people to sit out in. Roof space has been converted to a roof garden. There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are, and what people can expect if they decide to live at the home. Information provided during this visit showed that the fees for the home are three hundred and seventy three pounds and eighty pence to four hundred and seventy six pounds and eighty pence per week with added expenses for hairdressing, chiropody, toiletries, newspapers and outings. Care Homes for Older People Page 3 of 18 What we found: This random inspection was carried out to check compliance with a Statutory Requirement Notice issued on the 4th September 2009. The inspection was carried out by two inspectors and took place on the 14th October 2009. During our visit we looked at a sample of peoples care plans, we spoke to people living at the home, visitors and staff we also walked around the home. We saw that people were sat in the lounges and conservatory relaxing and some people were making cards with the activity organiser, people were nicely dressed, their hair was combed and most of the men were clean shaven. We saw a sample of peoples care plans. All of the care plans had been renewed since the last inspection and we saw that they had worked hard to improve them, however they needed additional work to make them more detailed. For example one persons care plan stated that they needed to use specialist equipment. The care plan did not tell us what this equipment was or how it was to be used. We saw another care plan of a person who took all fluids and food via a feeding tube in their stomach (PEG). Staff were able to tell us how to clean the PEG site but the care plan did not give any detailed information on how to do this. This detailed information is needed to make sure that any risks to people were reduced. They told us that care staff were responsible for cleaning PEG sites but that they did not rotate the PEG tube. This is done to make sure that it does not get stuck in the skin and cause infection, pain and discomfort to the person. This was a clinical task and was done by one of the trained nurses. PEG sites are prone to infection if they are not cleaned correctly, all care staff should receive specialist training in how to clean PEG sites. They told us that one persons PEG site dressing had come loose and needed changing. The qualified nurse told us that she had asked the staff on duty the previous night to change this dressing but that it had not been done. The deputy manager should make sure that all staff were made aware of their responsibilities regarding the care of the people living at the home. We saw that original needs assessments had been taken out of the new care plans and had been stored in a separate file held in the ground floor office where they were still available to staff. The needs assessment is an important document that should be retained in the care plan for easy staff reference. The deputy manager and the nurse on duty told us that they wanted to get all the care plans onto the new format and then look at the detail in each one individually. We recommended that they completed them one at a time with the person or their representatives to make sure that they were detailed and person-centred. This is to make Care Homes for Older People Page 4 of 18 sure that care plans gave information about how the person wanted to be cared for. They told us that they have employed an activity organiser and that they were going to take a life history from people to help them improve information in the care plans. We spoke to staff and found that they did have an awareness of peoples individual needs that was not reflected in the care plans. It was recommended that they focus on developing the care plans further to make them person-centred and to reflect staffs knowledge of how people were supported. We saw one care plan where the person needed their drinks thickened to a custard consistency. The care plan stated any signs of aspiration or coughing staff should give five slaps. The deputy manager told us that this meant that staff should pat the person on the back, they told us the information had been written by a member of staff from overseas who had used the wrong word. They should consider the interpretation of English when writing care plans to make sure that there were no misunderstandings about how staff should respond to peoples care needs. We saw that risks had been identified and that risk assessments had been written in relation to moving and handling and diabetes. We saw that where people had diabetes a record of blood monitoring had been kept. We saw one persons care plan gave information to staff about what they should do if blood sugar levels dropped below a certain level. We saw that the persons blood sugar levels were being recorded twice a day. They told us that they have set up a new regime for diabetes. They told us that all trained staff have received training from the diabetes nurse. This means that they were competent to take blood sugar readings and to identify when a referral to the specialist nurses was needed. They told us they had new equipment for testing blood sugars and they have agreed a system with the diabetes nurse where they email her the test results and she will advise them of the action they need to take. We saw that the quality of information in care plans varied. We looked at one persons care plan and saw it gave staff good information on how to communicate with the person for example, maintain eye contact and speak slowly. We looked at another care plan that stated the person refused oral care but did not give any information about how to manage this situation. We saw that some people needed pressure area care but we did not see any body mapping tools. These are drawings of a body and are used to record where pressure sores were on the body and if they were healing or not. They must make sure that they develop a clear method of monitoring pressure sores and recording any improvements or deterioration. We saw that one person had a turn chart. This was a record of the times staff had provided pressure area care/relief. We saw that staff should have provided relief every 2 hours. We saw that they had not been fully completed and that there were gaps in the record. This means that it was difficult to establish if the appropriate care was being given. We did not see staff providing pressure relief to the person when we were sat in the lounge. When questioned about pressure relief they told us they had not had time. We saw that a record of peoples weight was kept on a chart in the ground floor office. This means that staff were able to identify if a person was loosing or gaining weight and Care Homes for Older People Page 5 of 18 seek support from health care professionals. They told us that they had made a referral to the dietitian for one person who had been loosing weight. We sat in the ground floor lounge when we arrived. We saw one person who needed all fluids thickened. We saw a member of staff helping them to eat their porridge we saw that this was quite a thin consistency and the person was coughing quite a lot whilst eating. We spoke to staff who told us that all liquids were thickened with two scoops of thickener unless they were told otherwise. We saw that when staff brought mid morning drinks they did not help this person to drink but left the drink on the table. By the time staff came to help them the liquid had thickened too much to drink. This means that this person may not be getting enough to drink. They should make sure that they provided the support people needed in relation to maintaining a good fluid intake and use fluid balance charts to monitor that people were having enough to drink. We saw one person who looked withdrawn and upset. We saw a member of care staff approach the person to ask if they were alright. The carer was sympathetic and kind and sat with the person talking to them and offering reassurance. There were activities going on and the carer asked the person if they wanted to join in or to sit quietly and read. The person chose to read and the carer went and got a newspaper. They told us that an activity organiser had been employed since the last inspection. We saw people sat in the lounges making birthday cards. People told us that they play cards, do arts and crafts and bingo. One person told usI liked the bingo yesterday another said there is much more going on these days and it is getting better now another said we have not been out yet but there is more going on. We saw staff interacting with people, however they were very busy and did not have a lot of time to spend with people on an individual basis. They should look at the staffing hours based on the needs of the people living at the home to make sure they have enough staff on duty at times of high activity. We saw that some people needed support from staff to eat their meals. We saw that this was done in a sensitive way. We saw staff sitting beside the person they were not rushed and were able to enjoy their meal at their own pace. We saw that staff were talking to people during the meal and encouraging them to eat. The owner told us that they had plans to improve the roof terrace with new garden furniture for next summer. This is so that people can sit outside and enjoy the nice weather. We spoke to one person living at the home. They told us I have not got any concerns at the moment but I know how to make a complaint, I would speak to the person in charge and tell them I was not happy and they did give me something when I arrived but I am not sure where I have put it. We spoke to a visitor who told us I would inform the manager if I was unhappy about the care. We noticed that one person had a bruise on their left thumb. We looked at this persons care plan and saw that care staff had reported to senior staff about the injury and had made an entry in the daily record when they noticed the bruise. However, the senior staff had failed to follow up on the incident. We advised the deputy manager and the provider that we would be making a referral to the safeguarding team at Salford City Council to Care Homes for Older People Page 6 of 18 investigate this injury further. Any unexplained injury to a person must be reported and investigated using the local safeguarding procedures. We saw that liquid soap and paper towels were provided throughout the building. We saw that when staff were helping people with personal care they used protective clothing such as gloves and aprons. This helps to reduce any risks of infection. We walked around the home and saw that it was clean and tidy with no unpleasant odours. We spoke to one visitor who told us that there have been a lot of improvements in the home in the past few months and that it is getting better. We saw that there were enough housekeeping staff on duty to keep the home clean and tidy. They have provided a small seating area for visitors at the entry to the home. This has tea and coffee making facilities so that people can sit with their visitors and enjoy a drink. We saw that some areas had been redecorated since the last inspection. They had replaced the floor covering in the conservatory with laminate flooring. This made the room look much cleaner and people told us that they liked the changes. We saw that the carpets in the lounges and communal areas had been replaced. This made the areas much more comfortable and pleasant for people living at the home. We saw that some bedrooms were still not decorated. The owner told us that the refurbishment programme should be completed by November 2009. They told us that they had ordered dining chairs so that people could sit at a table to eat their meals if they wanted to. The owner told us they planned to put dining tables in the conservatory and once the meals were finished this space could also be used for activities. This means that people will have the opportunity to move from their armchairs if they want to and will make mealtimes a more social occasion. They told us that three care staff attended moving and handling training and that they were accessing more training. We spoke to some of the staff. One carer told us I went on moving and handling training last week. We saw staff using hoists, they worked in pairs and appeared to be using the equipment properly. We did see a recent accident report where a persons feet had slipped through the footrest on the hoist causing them to slip off the sling. We recommended that refresher training in moving and handling be provided to all staff. They told us that the acting manager was off sick and they have appointed a deputy manager. We discussed the long term management arrangements with the owner and advised them that they must have a registered manager. They told us that they have interviewed two people but that they were not successful. They told us that they were advertising for a manager in the local newspaper and with employment agencies. The following requirements and recommendations were made during this inspection, other requirements and recommendations made at the last inspection were not looked at during this visit. Care Homes for Older People Page 7 of 18 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 8 of 18 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 13 All parts of the home to which service users have access are so far as possible free from hazards to their safety. Unecessary risks must be identified with the use of risk assessments and actions taken to eliminate those risks to people living in the home. 30/09/2009 2 7 13 Unless it is impracticle to 30/09/2009 carry out such consultation the registered person shall after consultation with the service user or a representative of his prepare a written plan the service user plan as to how the service users needs in respect to his health and welfare are to be met. The regiastered person shall make the service users plan available to the service user keep the service users plan under review where appropriate and unless it is impractical to do so carry out such consultation with the servicew user or a representative of his revise the service users plan and notify the service user of any such revision. Page 9 of 18 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 Each person living at the home must have a care plan that clearly identifies their care needs any identified risks and the action required to meet them. 3 7 15 Unless it is impractical to 30/09/2009 carry out such consultation the registered person shall after consultation with the service user or a representative of his prepare a written plan as to how the persons needs in respect of health and welfare are to be met. The plan must be kept under review, where appropriate and unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his revise the service users plan and notify the service user of any such revision. Care plans must contain sufficient detail on all aspects of a persons care needs to enable staff to offer appropriate support. 4 8 12 The registered person shall 30/09/2009 ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users to make proper provision for the care and where appropriate treatment education and supervision of service users. The registered Page 10 of 18 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 person shall make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users They must make sure that the peoples health and social care needs are fully met. 5 9 13 The registered person must 30/09/2009 make sure that medication is managed in a safe and appropriate manner to make sure prople are kept safe. In order to make sure that people receive their medication as prescribed they must make sure that medication records are kept up to date and accurate. 6 16 22 The registered person must ensure that any complaint made is fully investigated. All complaints must be recorded to show that they have been dealt with in line with the homes policies and procedures. 7 19 13 unecessary risks to the health and safety of service users are identified and so far as possible eliminated. Equipment used by people living at the home must be kept in good repair to minimise the risks of harm. 28/09/2009 17/09/2009 Care Homes for Older People Page 11 of 18 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 8 19 23 There must be adequate sitting, recreational and dining space provided seperately from the service users private accommodation. Advice must be taken from the local fire officer with regard to having a dining table placed in the corridor outside the lift to make sure people living in the home have a safe environment. 21/09/2009 9 26 13 The registered person shall 30/09/2009 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. There must be suitable risk assessments and actions taken to prevent infection and toxic conditions at the service. Actions must be taken regarding improving the cleaning schedules at the service. All areas that are unclean must be improved to reduce risks and improve the environment so that people are not put at risk. 10 27 18 The owner must make sure that there are enough staff to meet peoples needs. Staffing levels must be reviewed regarding the necessary resources and hours needed for developing and providing activities and 05/10/2009 Care Homes for Older People Page 12 of 18 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 for the ongoing cleaning of the service. They must assess the dependencies of the people at the service and how they measure the ongoing staffing levels to meet the needs of the people living there. 11 29 19 The registered person shall 21/09/2009 not employ people to work in the home unless he has obtained the information and documents specified in paragraphs 1-7 of schedule 2. To ensure the safety of people living at the home a robust recruitment procedure must be adhered to at all times. There must be evidence that thorough safety checks have been undertaken before anybody is offered work. 12 30 18 The registered person shall make sure that staff have the appropriate training for the work they are to perform. Staffing levels must be reviewed to make sure that there are enough staff available at all times to meet the health and social care needs of people living in the home and to ensure that the cleanliness of the home is maintained. 13 35 20 The registered person shall 28/09/2009 Page 13 of 18 05/10/2009 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 not pay money belonging to service users into a bank account unless the account is in the name of the service user to which the money belongs and the account is not used by the registered person in connection with carrying on the management of the care home. There must be clear financial care plans and up to date policies relating to the management of the monies held on behalf of the people who live at the service. People should be supported with various options that meet their individual needs or advised as to how they can support them with their financial needs. 14 36 18 The registered person shall 30/09/2009 ensure that people working in the home are apprpriately supervised. In line with the homes policy and procedure staff must recive supervision. This must include night staff to make sure that good care practices are used. 15 38 23 The registered person after 28/09/2009 consulting with the fire authority shall make adequate precautions against the risk of fire including the provision of suitable fire equipment. Care Homes for Older People Page 14 of 18 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 Staff practices at the home must not compromise peoples health and safety. Care Homes for Older People Page 15 of 18 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 8 17 To make sure that people receive the appropriate healthcare. They must make sure that they develop a method of monitoring pressure sores and recording any improvements or deterioration. 30/11/2009 2 8 12 In order to make surre 30/11/2009 people living in the home are kept safe at all times. They must make sure that the correct consistency is achieved for those people who require thicked fulids and food this is to make sure the risk of aspiration is minimised. 3 18 13 To make sure that people living at the home are kept safe from harm. Any unexplained injury to a person must be reported and investigated using the local safeguarding procedures. 30/11/2009 Care Homes for Older People Page 16 of 18 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 2 3 7 7 7 The needs assessment is an important document that should be retained in the care plan for staff reference. They should use fluid balance charts to monitor that people were having enough to drink. They should make sure that turn charts were completed in line with the care plans to show that pressure area care is being provided. They should consider the use language when wrting care plans to make sure that there are no misunderstandings. It was recommended that they focus on developing the care plans further to make them person-centred and to reflect staffs knowledge of how people were supported. We recommended that they complete the new care plans with the person or their representatives. The deputy manager should make sure that all staff were reminded of their responsibilities regarding the care of the people living at the home. They should look at the staffing hours based on the needs of the people living at the home to make sure they have enough staff on duty at times of high activity. All staff should receive refresher training in moving and handling. To make sure they have the appropriate skills and knowledge, all care staff should receive specialist training in how to clean PEG sites. 4 5 7 7 6 8 7 27 8 9 30 30 Care Homes for Older People Page 17 of 18 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 18 of 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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