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: 2 6 0 7 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 10 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 10 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. This random visit was undertaken by two inspectors over six hours. Our Regional Director accompanied the inspectors for some of the visit to observe fieldwork in practice. There were 13 people living at the home. The home did not know that we would be visiting. Following our unannounced key inspection of the home in June, we shared our concerns with the local authority and the Primary Care Trust. Birmingham City Council placed a suspension upon the home which means that they will not pay for anyone new to go and live at the home until improvements are made. The reason for this visit was to review the homes progress at meeting the Statutory Requirement Notice that we had issued following the key inspection in June 2010. This was in relation to peoples health and welfare needs. During this visit we looked around some areas of the home and spent some time sitting in the lounge area with the people who live there. We looked at records for water temperatures and audits of care files. We looked at five peoples care files, spoke to three staff and two people who live at the home. We spoke to the manager and one of the owners of the home. These are our findings: There had been further decoration of some peoples bedrooms to enhance the environment in which they lived. The offensive odours noted on the previous visit had been resolved, with the exception of one persons bedroom. The basement had been cleared of clutter, a new floor had been laid and it had been repainted. Cupboards had been installed to make storage space. During the morning we sat in the lounge and observed staff interacting with people. Staff were playing card games with people, reading newspapers to them and helping them to play musical instruments. During the afternoon we saw that some people went out of the home with staff for a walk. One person had been moved into a position in the lounge which enabled them to watch the television more comfortably. One person was sitting in the sensory room. Within this room there were some fibre optic lights which were hanging down in front of the person and could place people at risk from harm. We asked the manager if there was a risk assessment completed for the use of this room, to ensure that risks to people were minimised. The manager told us that there was not a risk assessment but one would be written. This means that the home had not been proactive in identifying and reducing risks to people. We checked some of the water temperature records and found that these had been
Care Homes for Adults (18-65 years) Page 4 of 10 checked weekly and were within an acceptable range to reduce any risks to people in the home. We looked at five peoples care files. At our last visit we identified concerns with two peoples care files and the care being given by staff. We looked at these two files and found that some of the information had been updated. The amount of thickener that people needed in their drinks was now clearly recorded. Staff spoken to were able to tell us how much thickener they should add to peoples drinks to minimise the risks of them choking. Insulin protocols had been written however the care plans did not give staff guidance of signs or symptoms of hypo or hyperglycemia (low or high blood sugar levels). The manager added this information at the time of our visit. One person had a history of malnutrition. They had been taken into hospital on many occasions as their diet and fluid intake was poor. Their care plans said that they should be weighed weekly and it was of concern that this had not been carried out. This person had not been weighed for two weeks and the previous month had only been weighed twice. This was despite a dietitian recommending that weight was continued to be monitored when they reviewed the person in June 2010. The Primary Care Trust had also identified weekly weights were required in April when they completed an audit of the file. Staff gave us conflicting information about this persons weight recordings. We looked at the care file for one person who was sitting in the sensory room when we arrived at the home. It was concerning that their records showed that they had not had their position altered for almost five and a half hours on the day of our visit. Daily records on the 12th July showed that there was some redness to the persons buttocks noted. The GP had prescribed some ointment the following day for the skin which was to be applied for five to seven days. We looked at the Medication Administration Records and found that the ointment was still being applied after 13 days. Staff had not sought further medical advice but had continued to apply the ointment. Care plans had not been updated to reflect the redness of the persons skin and there were no further entries in the daily records regarding this after the 14th July. We spoke to three members of staff who were unable to tell us if the person still had redness or if this was now resolved. One staff member told us If we smell anything then we change X but if not we do not move X another member of staff said we do not bring X out until they go back to bed, normally there all day until after 3pm. This does not ensure that the risks of people developing sore skin are minimised. Following the visit the manager told us that actions had been taken to address this; however this is a reactive approach. We looked at the care plans regarding an infection that one person had. The care plans had not been updated and still included details of body washes and nasal ointments that were no longer in use. The Statutory Requirement Notice regarding peoples health and welfare needs had not been met and requirements regarding updating care plans were not met. We still have concerns in relation to care planning, risk assessments for individuals and peoples health care needs not being met. We are considering what further action to take in order to bring about improvements in the home for the people who live there. We will continue to monitor the homes progress. Care Homes for Adults (18-65 years) Page 5 of 10 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 6 of 10 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 10 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 23 13 Staff must have the 07/07/2010 competence to recognise and respond to potential safeguarding concerns. To protect people from harm. 7 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. 8 34 19 Robust recruitment systems must in place. To ensure that people are safe from harm. 9 39 12 Systems must be in place to 30/07/2010 identify areas of concern and action taken in a proactive way. To ensure that the home is run in the best interests of the people who live there. 28/07/2010 07/07/2010 Care Homes for Adults (18-65 years) Page 8 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 Ointments must be administered only for the prescribed amount of time. To ensure that people receive their medications as prescribed by their doctor. 31/08/2010 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 People should be weighed as individually assessed so that staff can monitor any changes in their weight. People should have their position altered as their needs identify so that the risks of sore skin developing are minimised. 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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!
