Inspection on 01/09/10 for Karistos

This inspection was carried out on 1st September 2010.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Karistos 04/08/10

Karistos 26/07/10

Karistos 02/06/10

Karistos 17/03/10

Karistos 10/12/09

Karistos 12/11/09

Karistos 09/11/09

Karistos 22/10/09

Karistos 07/07/09

Karistos 25/07/08

Karistos 29/08/07

Karistos 01/03/07

Karistos 09/05/06

Karistos 18/11/05

Karistos 09/06/05

Karistos 14/12/04

Karistos 01/07/04

Karistos 09/03/04

Karistos 28/10/03

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Random inspection report Care homes for adults (18-65 years) Name: Address: Karistos 29 Chantry Road Moseley Birmingham West Midlands B13 8DL zero star poor service 02/06/2010 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: Lisa Evitts Date: 0 1 0 9 2 0 1 0 Information about the care home Name of care home: Address: Karistos 29 Chantry Road Moseley Birmingham West Midlands B13 8DL 01214424794 01214424794 karistosnh@yahoo.co.uk www.karistos.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Gursharn Singh Surdhar,Mr Surjit Singh Surdhar,Dr Harminderjeet Singh Surdhar Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 17 Number of places (if applicable): Under 65 Over 65 0 physical disability Conditions of registration: 17 The maximum number of service users who can be accommodated is: 17 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 needs on admission to the home are within the following categories: Physical disability (PD) 17 Date of last inspection Brief description of the care home Karistos Nursing Home has 17 beds and is registered to provide care to younger adults for reason of physical disability. The home is situated in Moseley and is within short Care Homes for Adults (18-65 years) Page 2 of 11 0 2 0 6 2 0 1 0 Brief description of the care home walking distance of shops and bus routes. There is one car parking space at the home, other cars would need to be parked on the road at the front of the building. It is a large three storey converted house and bedrooms are available on all floors. A passenger lift provides access to all floors of the building. There is a lounge and separate dining room. The accommodation consists of four shared bedrooms; nine single bedrooms and two have en-suite shower facilities. Wheelchair access and a platform lift have been provided to the front of the building, as the steps are rather steep. There is a garden to the rear of the home with a small patio area, which is accessible via the dining room. However, the incline to the garden makes it difficult for people to use it. Corridors in the home are narrow and do not provide easy access for people who may require assistance with their mobility. There is a shower room and assisted bathing facility to meet the needs of the people living in the home. The home has three hoists to assist people with mobility problems and has specialist mattresses to help prevent peoples skin from becoming sore. Information is available about the services and facilities on entering the home and this includes a copy of the most recent inspection report, for anyone who may wish to read this information. Current fee rates range from £500 - £800 per week and this information is provided in the service user guide. These fees are reviewed annually. Additional costs include newspapers, hairdressing, clothing and personal effects, chiropody, dentist and optician. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: The focus of this inspection undertaken by the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We last visited the home on a random unannounced visit on the 4th August 2010. Following that visit we issued the home with a Notice Of Proposal to cancel their registration. This is due to the ongoing concerns about the quality of the service provided. This document is at a draft stage and is subject to representations from the providers. Written representations will be looked at using the Care Quality Commissions appeals process. This random visit was undertaken by two inspectors over three hours. There were twelve people living at the home and one of these people was in hospital. The home did not know that we would be visiting. The reason for this visit was to review the management arrangements, as the registered manager had left employment at the home. We also reviewed some of the outstanding requirements from previous visits to the home, to see how the home were working towards their own improvement plans. During this visit we looked at peoples bed rails. We reviewed that the lift and the cooker were in working order. We spoke with the new acting manager and spoke with one of the providers. We looked at two staff recruitment files and briefly spoke with three staff and one person who lives at the home. We looked at peoples medications. At the end of this visit we left an immediate requirement, regarding two sets of bed rails that were in use in the home. An immediate requirement means that the home have a short timescale to make things safe to ensure that people living there are safe. We visited the home again two days later to check compliance with the immediate requirement. These are our findings: A new manager had been appointed and had only been working at the home for a week at the time of our visit. The manager is a Registered Mental Nurse and has experience of working in care homes. The manager had acted as a unit manager in her previous employment but this is her first role as a home manager. We looked at the maintenance records for the bed rails. We found that weekly checks had been completed for six people in the home who required the use of bed rails. We visited each of these peoples rooms and found that four of the six beds had rails that fitted safely. We found that one bed rail was broken. We saw that this had been recorded in the maintenance request book the previous day, but it was of concern that we were told, the maintenance person only comes to the home on a Thursday or Friday unless asked to come in. The manager was not aware that the rail was broken and the maintenance person had not been called to repair this. We looked at one other persons rails and we Care Homes for Adults (18-65 years) Page 4 of 11 found that they did not fit the bed safely. We were able to move the rail along the bed and there was a gap which could be a potential entrapment risk. This was an outstanding requirement from the key inspection in June 2010. One persons bed rail bumpers were soiled and this was brought to the attention of the manager on the day of the visit. We left an immediate requirement for these to be made safe. We visited the home again two days later and found that new profiling beds had been purchased to replace these two sets of rails so that people were safe. This is a reactive approach as this had been a previous requirement which should have been addressed prior to this visit. We had been told that the cooker had been faulty for one day but was now in working order. We reviewed the cooker and found that it was in full working order. The home had a good stock of food supplies so that people should have a choice of meals. We looked at the medication administration records (MAR) for eleven people who lived at the home. We looked at boxed medications and controlled drugs. We found that the medication was mostly well managed. All medications had been signed for when administered. There were two audits that had some discrepancies and it was recommended to the provider that audits of boxed medications should be completed to ensure that all people receive their medication as prescribed. The Controlled Drugs were stored and recorded appropriately. We looked at two staff files. These contained most of the information to ensure that people were safe from harm. Both files had two references but one of them did not have a reference from the last employer. One of the providers told us that before the previous manager had left they had completed together an audit of the staff files so everything should be there. One of these files had been identified at our previous visit as not having a reference from the most recent employer but this had not been addressed. One file had a Nursing and Midwifery Council (NMC) confirmation of Personal Identification Number (PIN) written on a blank piece of paper, there was no date or signature to say who had completed this check. We looked at staff rotas and as we had found at the last visit to the home, there were various versions of the staff rota. The rota did not give an accurate reflection of the staff who were on duty on the day of our visit. We did confirm that there were three care assistants and one nurse on duty for the afternoon, to meet the needs of the people who live there. One immediate requirement was made as a result of this visit in relation to bed rails and this has now been met. Two recommendations have been made. Due to visits being so close together our computer system does not generate a full list of requirements and therefore they have been added manually to ensure that the complete list of requirements is shown. Requirement number one was made at the last visit to the home. What the care home does well: What they could do better: As identified at previous visits to the home, the home responds well when they are told to Care Homes for Adults (18-65 years) Page 5 of 11 put something right. However this still remains a reactive approach which may put the health and well being of the people living there at risk. Audits of boxed medications should be completed to ensure that medication is given as prescribed. References must be obtained from peoples most recent employer to minimise the risk of harm. Staffing rotas should be an accurate reflection of the actual staff on duty. 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 11 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 6 14 Care plans must be updated 07/07/2010 when peoples needs change. So that staff know how to support people. 2 9 13 Risk assessments must contain enough information about how to minimise the risks. So that risks are minimised and people are safe. 07/07/2010 3 16 12 Staff must interact with people who live at the home including people who are unable to verbally communicate. So that people lead an interesting and stimulating lifestyle. 05/07/2010 4 19 12 Ensure that systems are in place. To promote and make proper provision for the health and welfare of service users. 25/06/2010 5 19 12 Make arrangements to 25/06/2010 ensure that staff comply with peoples identified healthcare needs. So that peoples needs are Care Homes for Adults (18-65 years) Page 7 of 11 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 met and people are safe. 6 20 13 Ointments must be administered only for the prescribed amount of time. To ensure that people receive their medications as prescribed by their doctor. 7 20 13 Ointments must be administered only for the prescribed amount of time. To ensure that people receive their medications as prescribed by their doctor. (Previous requirement) 8 23 13 Staff must have the 07/07/2010 competence to recognise and respond to potential safeguarding concerns. To protect people from harm. 9 32 18 Staff must have the knowledge and skills to interact with people and know their needs. So that peoples needs are met in a way they prefer that is meaningful. 10 34 19 Robust recruitment systems must in place. To ensure that people are safe from harm. 11 39 12 Systems must be in place to 30/07/2010 identify areas of concern and action taken in a proactive way. Page 8 of 11 31/08/2010 31/08/2010 07/07/2010 28/07/2010 Care Homes for Adults (18-65 years) 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 ensure that the home is run in the best interests of the people who live there. 12 42 37 Appropriate authorities must 03/09/2010 be informed of any incidents that may affect peoples health and welfare. So that people are safe from harm. Care Homes for Adults (18-65 years) 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 1 42 37 Appropriate authorities must 03/09/2010 be informed of any incidents that may affect peoples health and welfare. So that people are safe from harm. (made at previous inspection) 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 2 20 33 Audits of boxed medications should be completed to ensure that all medications are given as prescribed. Staff rotas should be an accurate reflection of the staff on duty. Care Homes for Adults (18-65 years) 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 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. 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