Inspection on 24/11/08 for Goldenley

This inspection was carried out on 24th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Goldenley 13/02/09

Goldenley 14/08/07

Goldenley 27/09/06

Goldenley 12/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Goldenley 11-15 Richmond Avenue South Benfleet Essex SS7 5HE The quality rating for this care home is: The rating was made on: three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Michelle Love Date: 2 4 1 1 2 0 0 8 Information about the care home Name of care home: Address: Goldenley 11-15 Richmond Avenue South Benfleet Essex SS7 5HE 01268758487 01268758176 christine.webster@excelcareholdings.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Goldenley Healthcare Ltd care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 0 0 Over 65 28 38 Conditions of registration: The service users` bedrooms with an area of less than 10 sq.m will be used only following a written assessment. The assessment should include consideration of whether the facilities in the room are suitable for, and acceptable to the service user, taking into account their mobility needs. The service user plan should reflect the assessment of findings. Date of last inspection Brief description of the care home Goldenley is a purpose built home providing accommodation for up to 38 older people. The Registration category permits the home to provide care to older people and a number of these may have dementia. The layout of the premises consists of two separate lounges. One is a very large lounge and the other is smaller. There are also a few small areas scattered around the home with one or two chairs for residents use. The lounges are separated into resident needs. None of the bedrooms have ensuite Care Homes for Older People Page 2 of 10 facilities. Goldenley is situated close to the local shopping area of South Benfleet. There is good bus and train links to the area. There is limited parking to the side of the property, but two public car parks are very close if needed. Care Homes for Older People Page 3 of 10 What we found: As part of this inspection, 6 care files were examined. Records show there is a formal care planning system in place to help staff identify the care needs of individual residents and to specify how these needs are to be met by care staff. Records show that further development of the care planning and risk assessment process is required as shortfalls identified, potentially place people at risk of not having all of their care needs met and provides staff with inaccurate and not up to date information about individual people who live at Goldenley. This refers specifically to the care file for one person detailing they had poor dietary needs,could be reluctant to eat and/or drink, required assistance to eat their meal and required to be weighed monthly. The latter did not correspond with the formal nutritional screening tool dated February 08, as this detailed the persons weight should be monitored and recorded fortnightly. Records showed the resident was not weighed fortnightly or monthly. Professional visitors records showed that healthcare professionals were contacted and provided advice/interventions in November 08, however dietary records and daily care records (current and archived) showed the resident had been experiencing a poor diet for some considerable time and little proactive measures had been undertaken by the staff team at the home until recently. The care file also recorded the residents GP had prescribed supplement drinks, however the Medication Administration Record (MAR) showed for a period of 7 consecutive days and 4 consecutive days, the resident did not receive these, as they were not available, have run out and awaiting script. No risk assessment was devised for the above, detailing how the risk to the resident was to be dealt with and/or minimised. Where nutritional records and daily care records showed that a poor dietary intake was taken by the resident, little and/or no information was recorded to evidence if food was reintroduced later in the day. The care plan for the same person detailed they were at high risk of developing pressure sores. Whilst we acknowledge the care plan recorded specialist equipment in situ, no risk assessment was devised evidencing preventative measures to be undertaken. This was not an isolated case and another care plan also showed the above poor recording in relation to their pressure area care and poor dietary intake. The nutritional risk screening tool for this person showed that over a 5 month period, the resident had lost approximately 8KG, however there was little evidence to show what interventions had been provided by care staff. Additionally nutritional records were noted to not be completed consistently by care staff. The care file for another person was examined in relation to their pressure area care. The care file recorded the resident as being immobile, spending the majority of their time in bed and requiring positional changes to their position every 2 hours. A formal assessment was completed pertaining to pressure area care and this stated the resident was at very high risk. No risk assessment was completed for the above detailing the interventions to be provided so as to minimise the risks and there was evidence to show that the person did not have their position changed as per their care plan requirements. Healthcare records for some people did not always record outcomes for people, following a visit by a healthcare professional. Care Homes for Older People Page 4 of 10 The care file for another person recorded them as experiencing a number of seizures as a result of low blood pressure since June 08 (as advised by the manager). No records were available to show that the persons blood pressure was being regularly monitored and/or recorded and no care plan/risk assessment was devised for this area. Medication Administration Records were also examined as part of case tracking processes for the above people. The daily care records showed for one person that their pressure sore caused them to experience regular pain and as a result of this a course of antibiotics were prescribed. The manager confirmed that a short course of antibiotics were prescribed (Flucloxacillin) on 27/8/08. The MAR record was requested and this showed that 28 tablets were received on the above date, however only 21 tablets were actually administered. No evidence was available to provide a rationale for the above. Medication Administration Records also showed for some people that they did not receive their medication as this was not available. Additionally one person did not receive their Lactulose for a consecutive period of 10 days as unable to open bottle. The records for one person showed they were prescribed Alendronic Acid Tablets, once weekly. Whilst we recognise no specific instructions were recorded from the pharmacy on the medication administration record in relation to this particular medication e.g. to be administered at least 30 minutes before food/sit upright for 30 minutes, the manager and senior carer confirmed the above medication was being administered at the same time as the persons other medications and not necessarily prior to the person having food. We were advised as part of Regulation 37 notifications that a recent medication error had taken place, whereby a resident had taken another persons medication. Following discussion with the manager, we were advised that the member of staff involved in the incident had undertaken Boots Foundation and Advanced medication training and had recently been assessed as to their continued competency. No evidence was available to show what action was taken by the manager as a result of the above incident. 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 10 Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, Care Homes 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 13 Risk assessments must be devised for all areas of assessed risk. So that risks to individual residents can be minimised. 16/12/2008 2 7 15 Care planning at the home must identify, and be effective in meeting all residents assessed needs and be regularly updated/reviewed to reflect the most up to date information. This will ensure that people living in the care home have their care needs met and that staff have the information to provide appropriate care. 16/12/2008 3 8 12 The health and welfare of 16/12/2008 individual residents needs to be promoted and actively managed. This refers specifically to ensuring that where people require support, records are updated, staff have the skills to recognise when to contact healthcare professionals and Care Homes for Older People Page 8 of 10 to provide appropriate interventions. So as to ensure residents health and wellbeing are maintained. 4 9 13 Residents must be protected 16/12/2008 from harm by having their medication administered safely and in accordance with the prescribers instructions. So as to ensure residents health and wellbeing. 5 9 17 When medication is not administered to residents, records clearly record this, the rationale why they are not and any action taken to address the above. So as to provide a clear audit trail of the actions taken to ensure that people receive their medication. 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 16/12/2008 1 7 Records relating to nutrition, weights and positional changes should be completed accurately and in line with peoples care needs. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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. 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