Inspection on 19/05/09 for Haven Lodge Residential Home

This inspection was carried out on 19th May 2009.

CQC found this care home to be providing an Poor 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haven Lodge Residential Home 04/08/09

Haven Lodge Residential Home 22/04/09

Haven Lodge Residential Home 16/02/09

Haven Lodge Residential Home 06/11/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Random inspection report Care homes for older people Name: Address: Haven Lodge Residential Home Wakefield Road Normanton Wakefield W Yorks WF6 1BP zero star poor service 16/02/2009 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: Steve Baker Date: 1 9 0 5 2 0 0 9 Information about the care home Name of care home: Address: Haven Lodge Residential Home Wakefield Road Normanton Wakefield W Yorks WF6 1BP 01924220013 01924895464 traceybed1@yahoo.co.uk 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) : Carestream Limited care home 32 Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care home only - Code PC; to service users of the following gender: Either, whose primary needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Haven Lodge is situated in Normanton on the main road between Wakefield and Castleford and is on a bus route. Set in its own grounds, there is parking provided to the front and side of the home and a large walled garden area at the back, accessible to people living at the home. 1 6 0 2 2 0 0 9 Care Homes for Older People Page 2 of 12 Brief description of the care home The home is registered to Carestream Limited although is currently in the hands of the receivers and is being run by the administrators. The home provides a service for up to thirty-two older people. In relation to the accommodation, there are two main lounges and a good size dining area. In addition, there is a large conservatory at the back of the home which people can use at their leisure. All the bedrooms are single and there are good toilet, bathing and washing facilities. There is a pleasant reception area. Outside, there is good access to the home at the front and back. Ramps are in place. Inside, there is access to the first floor by means of two stair lifts. The home is generally spacious. The provider makes information about the service available to enquirers when initial enquiries are made, and a copy of the Service User Guide, on admission to the home, which includes the Commission for Social Care Inspection contact details. The weekly fees in February 2009 are £388. Hairdressing and chiropody are charged extra to these fees. Care Homes for Older People Page 3 of 12 What we found: During the visit we examined the medication policy & procedures, the current medication administration record (MAR) charts, and the medication ordering, storage and handling arrangements. The medication procedures we were shown are not comprehensive or up to date. Clear medication procedures based on current legal and professional guidance help staff to work consistently and may reduce the risk of medication error. Although some recent training has taken place, further staff training, regular competency assessments and spot checks of practice would ensure all staff worked consistently in line with current professional best practice guidance. There are very few administration gaps on the MAR charts meaning that people living in the home can expect to receive their prescribed medicines correctly. There is inconsistency in handwritten entries and changes made to medication. To make sure there is an accurate record the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. Similar requirements are needed for a change of dose or cancelled medicines. Details of the person authorising the change should also be included. This makes sure that there is an accurate record of any changes or of new medicines. Two people self-administer their inhalers. There is no record of an agreement and risk assessment for these medicines. It is important that a robust risk assessment is done to make sure the person is able to safely administer their medication as intended. Medicines are stored securely in a locked trolley and cupboard in an office which is locked when not in use. The temperature was suitable for medication storage at the time of this visit and written records of the temperature are kept to demonstrate that this is usually the case. Advice should be taken to make sure that the controlled drugs cupbaord and lock meet current safe custody requirements. This is necessary to ensure that additional security needed for this type of medicine is in place. Although clean and tidy, the storage space available for medicines is small and cramped making it difficult for staff to handle and record the use of medicines effectively or safely. One person taking a variable dose of a medicine has an individual care plan in place to guide staff. This good practice should be developed to produce individual medication care plans which reflect the personal preferences and lifestyle choices of people living in the home. This reduces the likelihood of people refusing medicines or of doses being missed. What the care home does well: What they could do better: Risk assessments and agreements should be in place for people who wish to selfmedicate. Further medication training and written procedures which follow current professional best practice guidance should be intoduced to help all staff understand what is expected of them. The way handwritten entries and changes to MAR charts are made should be improved to make sure that all the correct information is recorded. Care Homes for Older People Page 4 of 12 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 12 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 3 14 People should not be admitted without first being given confirmation, as a result of assessment, that their needs can be met at the home. To make sure that people are not put at risk by being admitted to a home where staff are unable to meet their needs. 10/04/2009 2 7 15 Care plans must be up to 10/04/2009 date and include details of the actions staff need to take to make sure that the needs of the people who live at the home are met. To make sure that staff know how to support people to meet their needs in the way they would prefer. 3 8 13 A safe system for moving 10/04/2009 and handling people must be in place at the home. To prevent people being harmed. 4 8 12 Proper provision must be 10/04/2009 made to ensure the health, welfare and treatment of people who live at the home. Care Homes for Older People Page 6 of 12 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 To make sure that people receive the care they need to promote their health and well being and comfort. This includes timely referrals to healthcare professionals and carrying out prescribed treatment. 5 9 13 Arrangements must be made 10/04/2009 for the safe handling and administration of medications in the home. To make sure people receive the treatment they are prescribed and are safe. 6 10 12 Arrangements must be made 10/04/2009 to promote and ensure the privacy and dignity of the people who live at the home. So that peoples privacy and dignity is not compromised. 7 12 16 People who live at the home 10/04/2009 must be consulted about their social interest and the home must make arrangements to enable people to engage in activities either within the home or outside the home. To make sure that people who wish to, have as active and fulfilling lifestyle, considering their personal preferences, as they need. 8 14 12 People living at the home must be offerred choice and 10/04/2009 Care Homes for Older People Page 7 of 12 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 enabled to make decisions about their care and lifestyle. So that people have choice within their lives. 9 15 16 People must be provided with 10/04/2009 choices of wholesome and nutritious food which is varied and suited to the needs of the individual. So that people receive the nutrition they need which meets with their personal choice. 10 16 22 All complaints must be investigated and responded to as per the homes complaints procedure. So that people have confidence that their complaints will be taken seriously and managed appropriately. 11 18 13 Arrangements must be made, by training staff or other measures, to prevent people being harmed or suffering abuse or being placed at risk of harm or abuse. To keep people safe. 12 25 23(4)(a)13(4) The registered person must ensure that there are arrangements in place for completing fire system and running hot water temperature check in the 30/11/2007 10/04/2009 10/04/2009 Care Homes for Older People Page 8 of 12 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 absence of the person designated to do them to ensure people are safe. 13 30 18 Staff working at the home 10/04/2009 must receive training appropriate to the work they are to perform. This must include moving and handling, fire and adult protection training. To make sure people are cared for safely. 14 33 24 A system for reviewing and 10/04/2009 improving the quality of care provided at the home must be established and maintained. So that the services provided to people can be improved. 15 38 11 The home must be conducted in a way which promotes and makes proper provision for the health and welfare of service users. So that people are safe. 10/04/2009 Care Homes for Older People Page 9 of 12 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 9 13 Arrangements must be put in 30/06/2009 place to support people to keep and take their own medicines (selfadministration) within a risk management framework. This will make sure that those people who wish to keep and use their own medicines are able to do so safely and without putting others at risk. 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 9 Individual medication care plans should be developed and agreed which reflect the personal preferences and expressed lifestyle choices of people living in the home. These care plans should be regularly reviewed in line with changes in peoples medication, health and wellbeing. Competency assessments and spot checks of practice should be carried out and recorded so that all staff are seen to be working in line with current best practice. 2 9 Care Homes for Older People Page 10 of 12 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 3 9 The medication policy and procedures should be updated in line with current professional guidance so that staff understand how to handle and administer medicines safely. Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information is recorded so a person receives their medication as prescribed. 4 9 Care Homes for Older People Page 11 of 12 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. 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