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Inspection on 12/11/09 for Karistos

Also see our care home review for Karistos for more information

This inspection was carried out on 12th November 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This is a random inspection to check that a specific requirement had been met and therefore not all the core standards were assessed. All of the standards will be assessed at the next key inspection of the home.

What the care home could do better:

This is a random inspection to check that a specific requirement had been met and therefore not all the core standards were assessed. There are a number of outstanding requirements and these will be assessed at the next key inspection of the home. The manager and owners have a reactive approach to managing the home. Systems need to be implemented so that concerns and trends are identified and acted upon proactively.

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 07/07/2009 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: Lisa Evitts Date: 1 2 1 1 2 0 0 9 Information about the care home Name of care home: Address: Karistos 29 Chantry Road Moseley Birmingham West Midlands B13 8DL 01214424794 01214424794 karistosnursinghome@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 care home 17 Type of registration: Number of places registered: Conditions of registration: Category(ies) : 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 walking distance of shops and bus routes. There are no parking facilities at the home and cars would need to be parked on the main road at the front of the building. Care Homes for Adults (18-65 years) Page 2 of 9 0 7 0 7 2 0 0 9 Brief description of the care home 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 £400 - £600 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 9 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. A random inspection was undertaken at the home on the 9th November 2009. This random visit was undertaken by two inspectors over one hour. There were 15 people living at the home and they did not know that we would be visiting. The reason for this visit was to review the homes progress in meeting the immediate requirement made at the visit on the 9th November. This was in relation to bedroom doors needing adjustment so that they closed fully to protect people from harm. We looked at the bedroom doors, reviewed fire drill records and reviewed one care plan that we had seen at the previous visit. These are our findings: We reviewed the bedroom doors on the top floor of the home and found that they had been adjusted and were now closing fully to protect people from harm. This means that the home had met the immediate requirement. The manager had completed fire drills with staff on duty both during the day and at night to ensure that they knew what to do in the event of a fire. These drills had been completed each day since we met with the manager and owners to discuss our concerns after the last visit. We looked at one file to check that the care plan had been updated, following our visit on the 9th November 2009. We found that there were now instructions for the person to be sat up whilst they were receiving their PEG feed (feed through tube in stomach) to minimise any potential risks to the person. The manager told us that the nurse was going to see the GP the following morning to get specific details of when they should give as required medication for one person who had seizures. The manager confirmed the following day that this had been done and told us that the care plan would be updated with this information. We saw that the person had had a seizure on the day of our visit which had been recorded in the daily records but had not been entered onto the seizure record. As stated at the previous visit to the home, these records should be completed so that staff can easily monitor any changes with the condition. One of the owners was present for our visit and showed us a new tool they were planning to use in the home to monitor the quality of the service. The outcome of this will be reviewed at our next visit. No requirements were made as a result of this visit. Please note that statutory requirements number one and two were made at previous visits. Due to the visits being Care Homes for Adults (18-65 years) Page 4 of 9 completed close together our computer system does not generate the requirements and therefore has been added manually so that the complete list of requirements is shown. 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 Adults (18-65 years) Page 5 of 9 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 9 13 Risk assessments must be reviewed. To ensure that they are current and give guidance about how to manage potential risks. 14/08/2009 2 14 16 Arrangements for activities must be reviewed. So that people are stimulated and their needs are met. 01/09/2009 3 17 16 People must be offered a 21/08/2009 diet, that meets their needs. So that personal preferences, health and religious needs are met. 4 18 12 People should be suppported 28/08/2009 to meet their needs. So that their dignity is maintained. 5 19 12 Care plans must provide information that is current. So that health care needs can be monitored and staff have guidance to follow. 28/08/2009 6 32 18 Staff must have the skills and knowledge. 18/09/2009 Care Homes for Adults (18-65 years) Page 6 of 9 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 meet peoples individual needs. 7 39 26 Arrangements must be in place so that the provider visits the home and writes a report about the conduct. To ensure that peoples views are listened to and acted upon. 31/08/2009 Care Homes for Adults (18-65 years) 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 20 13 Staff must have protocols to 04/12/2009 follow so they know when to give as required medication. So that people receive medication as prescribed. 2 23 13 Systems must be in place to report allegations. To ensure that people are protected from harm. 04/12/2009 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 19 19 Records of seizures should be maintained so that staff can monitor changes in peoples condition. People should be sitting up to a thirty degree angle when receiving PEG feeds. (Feeds through tubes in their stomach) Care Homes for Adults (18-65 years) Page 8 of 9 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). 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