This inspection was carried out on 2nd February 2010.
CQC found this care home to be providing an Adequate 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: Guardian Care Centre Longton Road Trentham Stoke On Trent Staffordshire ST4 8FF one star adequate 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: Yvonne Allen Date: 0 2 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Guardian Care Centre Longton Road Trentham Stoke On Trent Staffordshire ST4 8FF 01782644800 01782644950 ms@guardiancare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Elizabeth Sexton Mr Robert William Stanway Type of registration: Number of places registered: Conditions of registration: Category(ies) : Nightingale Group Limited - The Guardian Care Centre care home 143 Number of places (if applicable): Under 65 Over 65 0 0 143 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 143 143 0 143 The maximum number of service users to be accommodated is 143. 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 Homes for Older People Page 2 of 9 care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 143 Dementia (DE) 143 Physical Disability (PD) 143 Mental disorder (MD) 143 Date of last inspection Brief description of the care home Guardian Care Centre comprises of three modern purpose built buildings, New House, Selwyn House and Mayfield Unit. It is situated in the suburban area of Trentham, Stoke on Trent and is within easy walking distance of local bus services and has good access to road networks. The home offers ample parking space and enjoys accessible gardens and its own protected private patio garden. Selwyn House is a modern purpose built two storey units providing nursing care for seventy-nine older people. Garden View first floor provides forty beds for elderly mentally ill persons aged 60 years and over. Garden Walk ground floor provides thirty-nine beds for frail elderly people also aged sixty years and over. The two floors are connected by a shaft lift. Accommodation is provided in mainly single rooms with 95percent having en-suite facilities. Both floors have their own dining room and communal areas and there are sufficient and appropriately adapted washing and bathing facilities. New House is a modern purpose built two-storey unit providing nursing care for up to forty-four people - young physically disabled adults over the age of eighteen years and younger people with learning disability. Court View first floor currently provides twenty-two beds for young adults with physical andor learning disability. Court Walk ground floor currently provides twenty-two beds for young physically disabled people and young physically disabled people with complex nursing care needs. The two floors are connected by a passenger lift. Accommodation is provided in mainly single rooms. All of the rooms have en-suite facilities. Both floors have their own dining room and communal areas and there are sufficient and appropriately adapted washing and bathing facilities. There is a central kitchen situated in Selwyn House and there are satellite kitchens to both floors in New House. Mayfield Unit is a new twenty-bedded unit. This is a modern, state of the art unit. Care Homes for Older People Page 3 of 9 What we found:
Prior to this Random Inspection visit we had carried out a Key Inspection visit to the service on 13th October 2009. We then carried out a Random Inspection at the service on 29th January 2010 to check whether the service had complied with the requirements we had made in the Key Inspection report. We identified that these requirements for improvement had all been met by the service. We carried out this Random Inspection of the service on 2nd February 2010 as a result of a Safeguarding referral we had received from the Older Peoples Mental Health Team Stoke-On-Trent. The referral was from a relative of a person living on Garden View dementia care unit and contained the following allegations and concerns There have been several incidents which the family are unhappy with especially in respect of unexplained bumps and bruises. The family brought their relative home for the day as they often do at weekends and he was very drowsy and lethargic all day and ate very little. Two days later the home rang the family to say that an ambulance was coming to pick their relative up as he had bumped his head. Staff at the home said they did not know what had happened. Their relative was seen by the doctor at the hospital who diagnosed a chest infection for which he was treated by antibiotics. He was brought back later that day and he had a large visible bruise on his head. The relative states that this is the third incident since he has been living in the home. Other incidents were reported by family to the home. The relative stated that the doctor who visited the home implied that the bruise could not have been caused by a fall and thought it was suspicious and likely to have been caused by an implement. The family have observed smaller marks and bruises on their relatives hands over the months which are consistent with grab marks. Their relative who lives in the home is confused unable to remember how these accidents happened. Following a Strategy discussion with the Older Persons Mental Health Team representative, we carried out this unannounced random inspection. We met with the person who lives in the home and looked at his care plan records. We also looked at records of accidents and incidents. We held discussions with the prospective manager of the service Mr Stanway and the nurse managers. We identified that there were no witnesses to the accident which caused the bruise on the head. This bruise was recorded in the care plan and an accident form was completed, again with no witnesses. We also identified that staff did not send for medical attention
Care Homes for Older People Page 4 of 9 on the day that this head injury was sustained. The GP visited the following day and sent the gentlemen into hospital for further investigations. Staff were aware that this gentlemen had not been well whilst he had visited his relatives at home over the weekend, two days prior to the bruise being found. All this information was documented and, according to care plan records, the gentleman was being monitored, including having observations of his vital signs taken. The unit manager showed us how she checked the furniture in the persons bedroom immediately after he had been found with the blood stained bruises on his head. She explained that, if he has knocked his head on a piece of furniture in the bedroom then this would also have contained a smearing of blood. She could find no evidence of this. There was no written evidence of the GP stating that this injury was caused by an implement or was suspicious and the unit manager had not heard the GP say this. The gentleman was diagnosed with a chest infection and given antibiotic therapy and recovered back in the home. We also identified that there have been several incidents over the past twelve months of the gentlemen having been found with bruises, some new bruises and some old bruises. These incidents totaled seven in all with three different significant bruises found. These incidents of unexplained bruising were not referred as a Safeguarding at the time. There was also documentation of several incidents identifying that, at times, the gentleman wanders around the unit and displays inappropriate sexual behavior to wards other female residents and staff. Again, there were no records to confirm that these incidents have been referred as a safeguarding. Also, up until recently, the provision of staff on the unit has not allowed for extra supervision of the gentlemen. This has recently improved with a better staffing ratio. We looked at the care plan records in detail and found that relevant risk assessments had been developed and updated regularly. We met with the gentlemen and asked if he thought he was well cared for to which he replied yes. We asked him about the bruise on his head and he told us that he could not remember anything about it or even that he had a bruise. What the care home does well:
Care plan records are detailed and contain relevant information about how the service meets the needs of the people who live there. These records are regularly reviewed and updated to ensure that peoples changing needs are monitored and met. Garden View unit now has an improved staffing ratio which should allow for closer supervision of people who live on the unit, including this gentleman. The prospective manager Mr Stanway has introduced a weekly audit of all falls sustained by people who live in the home. Mr Stanway has also been very active in improving staff knowledge and understanding of
Care Homes for Older People Page 5 of 9 the Protection of Vulnerable Adults including knowledge of the local Safeguarding referral policies and procedures. 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 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 8 12 12(1) The registered person 17/02/2010 shall ensure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of people who live in the home. The service must seek medical attention without delay where a person living in the home has received a head injury or other serious injury 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 8 of 9 Reader Information
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