Random inspection report
Care homes for adults (18-65 years)
Name: Address: Iona 104 Well Street Biddulph Stoke on Trent Staffordshire ST8 6EZ 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: Rachel Davis Date: 2 6 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Iona 104 Well Street Biddulph Stoke on Trent Staffordshire ST8 6EZ 01782523396 01260289107 Iona@imladris.me.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) : Ms Jill Stockdale-Fisher care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is: 6 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 care needs on admission to the home are within the following categories: Learning disability (LD) 6 Date of last inspection Brief description of the care home Iona is a care home for adults providing personal care and accommodation for six people with a learning disability. One place can be used to provide a service for someone with both a learning disability and mental health needs. The home is owned and managed by Jill Stockdale - Fisher The home is situated close to local amenities very close to Biddulph town centre. There are good public transport links to the home. The building is a semi-detached house with a lawned garden area and patio. There is
Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home one single ground floor bedroom with a shower cubicle, a further three bedrooms are on the first floor, two shared and one single. There is a bathroom on the first floor. The communal rooms provide adequate lounge and dining space. Details of the weekly fees for accommodation were not available at the time of the inspection visit and the reader may wish to contact the service directly for this information. Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
The focus of inspections undertaken by the Care Quality Commission is based upon outcomes for people who use the service. The inspection process considers the homes capacity to meet regulatory requirements, national minimum standards and aspects where the service requires further development. We carried out this random inspection visit to confirm whether the service had met with the seven requirements we made during our last key inspection in August 2009. All the matters looked into have the potential to affect the health, safety or welfare of the people who use the service. This random inspection visit lasted approximately six hours. This visit was unannounced, this means the staff or people using the service did not know we were coming. We looked specifically at the management of privacy and dignity, medication practices, the recruitment and training of staff, and the implementation of suitable policies and procedures. This is because these were the issues where requirements were made at the last inspection held in August 2009. We looked at plans of care and records relating to medication procedures, we also saw information about the revised medication policy. We checked the staff training and recruitment procedures. We spoke with everyone who uses the service and the staff on duty. We also had a number of discussions with the provider, Jill Stockdale-Fisher, who is also the registered manager. What the care home does well:
This is a random inspection and therefore not all the core standards are assessed. This means we do not look at all aspects of life in the home. The requirements made at the last inspection have been complied with, this means the outcomes for people who use the service have improved within these areas. We were able to observe staff talking with people who use the service, they were respectful and polite. The staff told us there have been improvements at the home, they said; The staff are closer now, we work as a team. Things were institutionalized here it was like we had two staff groups and one would not support the other. We now all get on well, some of the staff have left, and we now all know where we are and what needs doing. There was evidence to confirm that the consistency of the staff and their approach has had a positive effect on the people who live at Iona. We found when we checked the rotas enough staff are on duty. This means there are adequate staff available to people who use the service. We were also able to verify the manager is at Iona at least five days a week, in August we were advised Jill was only on site one day a week. Jill, the manager and owner of Iona confirmed she considered things were in place that obviously, following the inspection in August, were not. An example of this being recruitment practices, at the time of the key
Care Homes for Adults (18-65 years) Page 4 of 10 inspection these were poor and left vulnerable people at risk. We looked at the file for the last person to be recruited. The new file contained two written references, identification, a Criminal Record Bureau enhanced disclosure and an Independent Safeguarding Authority (ISA) first check. This means staff have been suitably vetted prior to working with vulnerable adults. We were also able to evidence that staff had worked alongside established staff before working as part of the staff numbers. This is known as shadowing and enables staff to understand their role and ask experienced staff any questions. The training certificates and staff files now reflect that the staff have received training in the recognition of abuse, this was a previous requirement. It means people who use the service now receive support from suitably trained staff. The manager has ensured they now have a comprehensive medication policy, although it is not yet completed. This was also a requirement. The medication policy and procedure will give staff members guidance when they are supporting people with medication. This means staff have clear information and instruction to follow. We found the service had purchased and installed a new medication cabinet, which is just big enough to accommodate the medication currently on the premises. The home have a copy of the Local Authority safeguarding adults procedures. This ensures the service has all the up to date information readily available and is confident they have followed the correct procedure. What they could do better:
We observed the manager giving medication that was put in a tot and taken to the person using the service. This is not good practice, medication should not be dispensed and carried to the person. We need to ensure that due to the size and nature of the service we remain proportionate with our requirements and recommendations. We therefore recommend the home develops a risk assessment if they are to continue with this method of dispensing. The service needs to provide medication when required protocols and include information about as and when medication within their policy. This is so they represent what the prescriber intended for the administration of these medicines. This will mean having closer contact with the doctors of the people who use the service in order to develop safe and effective information that is current and up to date. We saw some records from the pharmacist where medication was not being offered to the person using the service. The manager told us this was because the records were not accurate. Clarity of information must be in place to protect everybody involved with medication administration and the people living at Iona. The service must ensure they have written evidence to verify the staff administering the medication are confident and competent to do so. Following initial training there are no records to confirm the staff have been assessed by the home as competent to continue to administer medication safely. This needs to be evident so we are confident the people living at Iona are suitably protected.
Care Homes for Adults (18-65 years) Page 5 of 10 We can confirm the requirements have been met and the manager is now at Iona on a regular basis to provide consistent leadership. However, the responsible person now needs to ensure that all information is readily available. The manager could not find a Regulation 37 notification that should have been sent to us following an incident, nor could she find a recent accident report that we asked to see. The manager needs to be confident that records are in place and available for inspection. We have asked the manger to resend these. The responsible person needs to ensure they have the time to verify that all practices and processes within the home are regularly monitored for effectiveness. 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 Adults (18-65 years) Page 6 of 10 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 Adults (18-65 years) 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, 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 20 13 Regulation 13(2) 02/04/2010 Ensure that where written medication protocols are in place the written prescription accurately reflects the instructions. This is so all medication is administered safely, correctly and as intended by the prescriber, to meet individual health needs. 2 37 37 Regulation 37(1) The registered person must be able to produce documentation to confirm the Commission have been notified regarding specific events that may affect peoples health safety and welfare. This means all parties have the required information to initiate any necessary communication. 02/04/2010 Care Homes for Adults (18-65 years) Page 8 of 10 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 20 The service must ensure staff administering the medication are confident and competent to administer medicines to the people who use the service. This means people are suitably protected. A risk assessment should be in place if secondary dispensing to a person using the service is to continue. This means everyone is clear on the procedure to follow and suitably protected. The medication policy should include information on the management of errors and when required medication. This means the staff have a consistent approach and clear guidelines to follow. The home should clearly evidence that staff are appropriately supervised between the receipt of a Independent Safeguarding Authority ( ISA First record) and the subsequent Criminal Record Bureau enhanced disclosure. 2 20 3 20 4 34 Care Homes for Adults (18-65 years) Page 9 of 10 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 Adults (18-65 years) 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 Adults (18-65 years) Page 10 of 10 - 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!
