Random inspection report
Care homes for older people
Name: Address: Eldon House Eldon House Downgate Upton Cross Liskeard Cornwall PL14 5AJ two star good 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: Gail Richardson Date: 1 9 1 0 2 0 0 9 Information about the care home
Name of care home: Address: Eldon House Eldon House Downgate Upton Cross Liskeard Cornwall PL14 5AJ 01579362686 01579362686 s_hancock@btconnect.com 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) : Sharob Care Homes Ltd care home 20 Number of places (if applicable): Under 65 Over 65 0 10 20 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 10 0 0 The maximum number of service users who can be accommodated is 20. The registered person may provide the following category of service only: Care Home providing personal care only - CodePC to service users of either gender 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 20 places Dementia - (Code DE) - Maximum 10 places Mental disorder, excluding learning disability or dementia (Code MD) - Maximum 10 places Date of last inspection
Care Homes for Older People Page 2 of 9 Brief description of the care home Eldon House is an older property that has been restored and extended to provide care and accommodation for older people. It is situated in a rural area approximately five miles from Liskeard. Accommodation is provided on three floors and comprises 18 single rooms and one double. Four of these rooms are en suite. Access to first and second floor is aided by stair lifts. Communal space is provided on ground floor in a sitting room and a dining room. An additional lounge is available on the first floor. There is level access to the exterior with its extensive grounds. Car parking is available off road next to the home. Sharob Care Homes Ltd also runs a domiciliary care service. Care Homes for Older People Page 3 of 9 What we found:
This was a random unannounced inspection which took place over three hours on the 19th October 2009 by Regulation Inspector Gail Richardson. The random inspection is part of a review as a results of a safeguarding concern raised. The purpose of the inspection was to ensure that peoples needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that care plans in the home are detailed and provide staff with clear instruction to meet all the identified areas of need. A tour of the home took place and a selection of the bedrooms and all communal areas were seen. As this service has not been inspected previously by Gail Richardson , this was to enable orientation to the home. There were people currently residing at the home 12 receiving personal care. We spoke to three people using the service and two members of staff, the care manager was available throughout the inspection as the registered manager was not available. There were three care staff available, one cook and one cleaner on duty. We looked at fourteen care plans and some assosiated documentation. What the care home does well: What they could do better:
The care plans were seen to be detailed in some areas, some areas required more detail to ensure that staff have a clear plan of care to follow. These areas included more detail in mobility plans, identifying how much help people needed and if they resided on the ground or upper floor. Further detail is needed of the help they need to access other areas and floors of the home. Further detail was also needed in areas such as catheter care, allergic reactions and management of weight loss/gain . By providing a good level of detail any changes are identified quicker and appropriate changes in the care given and care planned can be provided. Each care plan has a risk assessment. Some areas of risk had been identified and a plan of care put in place to support that risk safely. Some areas of risk were seen which did not have the assosiated plan of care. Risk assessments were also not recorded when
Care Homes for Older People Page 4 of 9 reviewed. Some were dated back to 2007 with no evidence of any reviews or updates. The Care Manager reviews each persons care plan on a monthly basis and signs each daily record to confirm it has been read. The key worker system in place also inputs into the monthly review. We discussed with the Care Manager that it would be benificial to keep a record in each persons care plan that confirmed that the care plan had been reviewed and any changes or updates undertaken. This will provide a clear audit trail of changes in care and would be useful for staff to see changes in dependancy. This process would also identify that risk assessments had been reviewed and updated to reflect changes in peoples risks. It was observed that one person had acted in a manner which may have placed them at risk. They had been recorded as doing this on three occassions. because the file is not reviewed until the end of the month this situation was overlooked for a period of two weeks. It is required that as changes are identified that the risk assessment and care plan be updated immediately and not left to the end of month review as this may place the person at risk. The care plans identified the input of visiting health professionals on the daily record. At the end of each month these daily records are stored in an archive. It is recommended that the care plan includes a record of each health professional visit and outcome. This will provide an overview and may be benificial to enable staff to review incidences and repeated occurances quickly. This will also provide an immediate record of any medical or health related intervention. The care plans maintained records of personal care provided, and a record of weights. Two people were noted to be monitored for weight loss and the care plan indicated that each person was to be weighed weekly. This record was stored on a shared document. We discussed that this form of data sharing should be transfered to each persons individual record to enable an overview of weight changes to be immediately evident at the monthly review. 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 9 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 9 13 Hand written entries to the 01/07/2008 MAR sheets should be witnessed by two signatories. Care Homes for Older People Page 6 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 7 15 The registered manager is 23/11/2009 required to ensure that all areas of identified need have a care plan in place. This care plan must be reviewed regularly and all changes documented as they occur. This is required to ensure that the person recieves the care they need. 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 The registered manager is recommeded to ensure that each persons weight is recorded individually in their care plan. This will provide an overview of each persons weight for inclusion in the monthly care plan review. The registered manager is recommended to record an overview of visits by visiting health professionals in each persons care plan. This will provide a clear audit trail of reviews and treatment provided. The registered Manager is recommeded to ensure that all areas of risk are reviewed monthly and any changes
Page 7 of 9 2 7 3 7 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 documented and an assosiated plan of care put into place. 4 7 The registered manager is recommended to provide a documeted audit trail of each months care plan review. This will provide an audit trail of changes and developemnts in the persons care and wellbeing. 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. 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 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!
