Inspection on 15/09/09 for Felixstowe Care Home Ltd - Merryfields

This inspection was carried out on 15th September 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Felixstowe Care Home Ltd -... 29/07/09

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Random inspection report Care homes for older people Name: Address: Felixstowe Care Home Ltd - Merryfields 7 Mill Lane Felixstowe Suffolk IP11 7RL new service which has yet to be given a quality rating 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: Tina Burns Date: 1 5 0 9 2 0 0 9 Information about the care home Name of care home: Address: Felixstowe Care Home Ltd - Merryfields 7 Mill Lane Felixstowe Suffolk IP11 7RL 01394285528 Telephone number: Fax number: Email address: Provider web address: sue@felixstowecarehome.co.uk Name of registered provider(s): Name of registered manager (if applicable) Ms Sally Ann Royal Type of registration: Number of places registered: Conditions of registration: Category(ies) : Felixstowe Care Home For The Elderly Ltd care home 10 Number of places (if applicable): Under 65 Over 65 10 10 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is: 10 The primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE(E) The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Felixstowe Care Homes Ltd - Merryfields has been registered as a care home since 9th July 2009. It is currently registered to accomodate four named people with dementia but an application has been submitted to the Commission to increase the numbers to ten. The home is situated in a residential area of Felixstowe close to the town centre and sea front. There is an enclosed garden at the rear of the premises with seating and flowerbeds and a car park at the front for staff and vsitors. All areas of the home are wheelchair accessible. Shared facilities include a lounge, sun room, dining room and two shared bathrooms. All bedrooms are single with ensuite toilet and wash handbasins. Care Homes for Older People Page 3 of 11 What we found: This random inspection was undertaken by Tina Burns, Regulation Inspector and Karen Howman, Local Area Manager. The purpose of the visit was to see how the service was operating since our last random inspection on 29th July 2009. We particularly wanted to see what action had been taken to adress the requirements we made about CRB checks and staff recruitment records, the staff rota and medication procedures. The responsible individual, Mrs Suzanne Bolton and the registered manager, Ms Sally Ann Royal, were present at the time of our visit and fully contributed to the inspection process. At our last visit we were concerned that residents records did not include any evidence of local authority assessments and pre admission assessments undertaken by the home were sparse and did not include enough information to develop a needs led person centred care plan. At this visit we could see that where applicable copies of local authority assessments had been requested. There had been no further admissions due to the homes conditions of registration and no changes had been made to the homes pre admission assessment tool. The manager and owner agreed to review the homes assessment process in light of their application to increase to ten places. Since the last inspection the personal belongings and items of clothing belonging to a prospective resident had been returned to their family and we were advised that the individual concerned had remained in an alternative residential home. At our last visit the care plans we looked at did not clearly specify the needs and preferences of each resident or the tasks that needed to be undertaken by staff. At this visit we could see that all four care plans had been developed and were more detailed and logically set out. We did find that one persons care plan did not include enough information about their unusual behaviour in the mornings and how assistance should be given at this time. However, the individual concerned and their relative told us that they felt the care and support provided was very good. Mrs Bolton and Ms Royal agreed to ensure that the care plan was developed to include clear information about the behaviour displayed and the strategys in place to provide appropriate support and assistance. They confirmed that the care plan would be signed and agreed by all relevant parties. We spoke with three residents, one visitor and two members of staff and we observed interaction between staff and residents. We spent some time with one member of staff who was able to demonstrate to us that they had a clear understanding of residents needs and prefered routines. They had got to know residents well and interacted with them patiently, sensitively and respectfully. We were advised that one resident who had initially displayed highly challenging behaviour had now settled well and no longer required specialist intervention. Further more they had become firm friends with another resident. The three residents that we met looked happy and well cared. Comments we received from people we spoke with included; We are so happy with the care ...., its brilliant, Oh, I am happy yes and They are very friendly and very helpful. Since our last inspection the home had taken delivery of their new medication trolley although they were still waiting for their controlled drugs cabinet to arrive. The deputy Care Homes for Older People Page 4 of 11 manager talked us through the homes procedures for handling and administering medication and confirmed that all medication is administered to residents direct from the original packaging. A monitored dosage system is used so in most cases this is straight from the blister pack. They told us that secondary dispensing does not take place and the practice we observed at the previous inspection has not reoccured. We looked at the Medication Administration Records (MAR sheets) for the three residents that were prescribed medication and found that they were appropriately completed. We discussed good practice guidelines after which they told us they would add some further information to the MAR sheet folder, for example sample signatures of staff responsible for administering medication, individual medication profiles and guidelines for dealing with medication errors. One of the homes residents was at day care but the remaining three were at home at the time of our visit. Although there was no structured activities taking place at the time we observed one person actively watching television and talking with staff and visitors, another was watching television in their room by personal choice and the third was seen talking with staff and wandering freely around the indoor communal areas and rear garden with discreet support and assistance from staff. The notice board in the entrance to the home had an activities programme displayed with an activity planned for everyday. It included; Hoopla, scrap booking, arts and crafts, baking, gardening, films, exercises and bingo. The deputy manager told us that they made sure that they provided an activity everyday but the programme was flexible according to what people might be interested in doing. They told us that they had spent time the previous day playing hangman and this had really got people engaged as they were given various clues that might interest them, to help them think of letters and words. It was also noted that since our last visit there was a more comprehensive record of activities maintained in peoples files. Since our last visit several changes had been made to make the environment more suitable for people with dementia care. Mrs Bolton told us that most of the changes were made at the request of the CQCs regional registration team. They had painted contrasting colours around all doorways and strategically placed clearly visible pictorial signs throughout the building. Residents doors included framed pictures or photographs which they had selected for the purpose of recognition. All handrails had contrasting strips running next to them to assist with orientation. Purpose built stairgates that had been installed for safety reasons were not being used following concerns that they were regarded as a restraint, however they remained in place and fixed in the open position and an appropriate risk assessment regarding their use had been completed. Mrs Bolton confirmed that since our last visit she had asked for advice from the Environmental Health Agency about the management of soiled and dirty linen. Consequently the homes procedures had been reviewed and been amended to reflect the advice given and guidelines for staff to follow were clearly displayed in the laundry area and the linen cupboard. We saw a copy of the homes food safety inspection and health and safety inspection which had been undertaken on 13th August 2009 by Suffolk Coastal District Council. Several requirements and recommendations had been made but all matters had been addressed. Care Homes for Older People Page 5 of 11 At this visit we spent time with the manager discussing staff training and assessing whether there had been compliance in relation to the requirements from the previous random inspection about staff recruitment. They confirmed that they were no longer using agency staff and told us that two carers had left but they had recruited an additional senior carer and three care assistants. The recruitment records for new starters showed that application forms had been completed but in two instances there was no evidence on file that gaps in employment had been explored as part of the recruitment process. In one case the manager advised that they had received a reference from the persons last employer however this period of employment was not detailed on the application form. The application form identified that the person had worked in a previous care setting however the manager had not obtained a reference from this provider who would be able to comment on the persons work with vulnerable adults. Two references had been obtained for each new starter. Each recruitment file contained evidence of identity, including documents with photographic ID such as passport and driving licence. The manager confirmed that they intended to take photographs of all staff however this had not been done at this stage. There was evidence that PovaFirst checks had been obtained for all new staff. Two of the staff had started work just prior to the inspection and it was noted that they did not yet have a full CRB. We discussed with the manager that it is good practice to wait for a satisfactory CRB disclosure prior to starting a new member of staff and the fact that starting on a Pova First check was designed to be used in exceptional circumstances. Both carers had a signed induction to the home checklist on file. The manager told us that all other staff had a full CRB in place and the files of three carers who had only a PovaFirst at the last random were inspected and CRB disclosures seen. At the last random inspection one of the Directors who had regular contact with residents was found not to have a CRB and no PovaFirst check had been undertaken. A full CRB disclosure was available at this inspection. At the last random we raised concerns that in some instances the manager had provided the professional reference for staff who had also worked at the home where the manager was previously employed. In one instance the manager had obtained a further character reference for one staff member and a reference from a previous employer of another carer was delivered to the home at the end of this visit. The manager advised us that she had asked another carer to get a further reference however there was no audit trail in this persons recruitment records to confirm this. No further reference had been sought in respect of three other staff and the manager confirmed that she considered that she had been their last employer and also that it may be difficult to obtain references from their previous care home. We discussed the fact that the manager should have requested references from the home. Discussion with the manager and examination of staff rotas confirmed that it was usual practice to have two carers and the manager on duty in the morning and one or two carers and the manager in the afternoon. One staff member provided waking night cover and one sleeping in cover. The rotas showed that where staff had only had a Pova First check they were on duty with a carer with a full CRB disclosure. However there were potential difficulties in the rota for later the same week where on one day the manager would be working with two new staff with Pova First checks only and this would make adequate supervision difficult. It was also noted that a new staff member with only a Care Homes for Older People Page 6 of 11 Povafirst check was on the rota to cover a waking night with no one to supervise. The manager stated that the rota had been changed since the previous day and that she was aware that this would need to be addressed. We noted that the rota had been amended with correcting fluid rather than crossed and amended clearly and in one instance the manager advised that whilst the rota said one person had slept in, this shift had in fact been undertaken by the responsible person. The rota identified the roles of all staff although full names were not used. The rota did not include a list of codes and abbreviations however the manager was able to explain who would have been on waking night or sleeping in duty and who was the keyholder on each shift. At the last random inspection training records were found to be difficult to follow and certificates of recent training had not yet been received. At this inspection the manager was able to provide copies of certificates of attendance relating to food hygiene, drug administration, safeguarding of vulnerable adults and moving and handling for the majority of staff. Some courses had been undertaken in their previous employment whilst others had attended training at Merryfields in July 2009. The manager confirmed that they needed to book training in these areas for some staff that had not yet received any training and refresher training for some others. No dates had as yet been planned but they advised that at this stage they were no residents requiring assistance with moving by hoist. Two funeral awareness days were booked and planned for staff in November and December 2009 and blister pack training through Boots the Chemists had been arranged for senior carers on the 1st October 2009. The manager stated that she, the deputy manager and two carers had undertaken the twenty week dementia awareness course through Otley College however they were unable to evidence this through certification. Another carer had undertaken a dementia awareness course with a previous care home. The manager advised that they had contacted Otley College to enrol six carers and the responsible individual onto the twenty week course but dates had not been confirmed by the college. The manager also told us that she had been looking at courses on the Mental Capacity Act and Deprivation of Liberty Safeguards as well as challenging behaviour and unisafe however as yet no dates planned. We expressed concern that some staff had not undertaken dementia training and although it was planned there were no fixed dates. Ms Bolton agreed to address this as a matter of priority and has since confirmed that a programme of dementia training has been implemented for all new staff plus any existing staff that have not had dementia training. She confirmed that an in-house session on dementia care will take place shortly, facilitated by the homes deputy manager. All members of staff will be given a copy of the handbook Working with Dementia even if they had not been present at the meeting. Those who have not yet done so will start on a Dementia Awareness distance learning course with Otley College. The date is to be confirmed. What the care home does well: People live in a comfortable and homely environment. The atmosphere is warm and friendly and residents are treated with respect. People tell us that they are happy living there and consider themselves well cared for. Comments we received included; We are so happy with the care ...., its brilliant, Oh, I am happy yes and They are very friendly and very helpful. Care Homes for Older People Page 7 of 11 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 11 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 9 of 11 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 10 of 11 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 11 of 11 - 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!