Random inspection report
Care homes for older people
Name: Address: Laburnum Lodge 2a Victoria Street Littleport, Ely Cambridgeshire CB6 1LX one star adequate service 13/01/2009 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: Janie Buchanan Date: 1 6 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Laburnum Lodge 2a Victoria Street Littleport, Ely Cambridgeshire CB6 1LX 01353860490 01353860845 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) : Dr A Hassaan,Mrs S Hassaan care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 1 3 0 1 2 0 0 9 Laburnum Lodge is a two-storey house, that includes a single storey extension, to provide accommodation, personal care and support to 22 older people. The upper floor is accessed via stairs or a stair lift. A garden is available to the rear of the building. The home is situated in the centre of the village of Littleport and is close to shops, cafes, pubs and local amenities. A copy of the most recent inspection report is available in the entrance way to the home. The weekly charge is #340. Care Homes for Older People Page 2 of 9 What we found:
For this inspection we (The Care Quality Commission) visited the home and interviewed two members of staff, checked a sample of residents medication records, undertook a brief tour of the premises and checked risk assessments, staff files and staff training records. MEDICATION We checked a sample of residents medication records. These were generally satisfactory with a clear and accurate record kept of what was administered to residents by staff. All handwritten additions to the MAR sheets had been signed and dated and the number of tablets for variable dose medication such as paracetamol had been recorded. However the date on which liquid medication bottles had been open had not been recorded and the home is still to purchase a drugs register book in case any resident is prescribed a controlled drug. We raised the need for this register at our last inspection. More worryingly though, one resident had not received their analgesic tablet for a period of four days as the home had run out (reason stated on MAR sheet) of this medication. STAFF FILES We checked the personnel file of a member of staff who was about to start working at the home. The homes application form is poor and only requests that prospective employees give details of their current or last job. It does not ask for any information to help them decided if the person is suitable to be interviewed, such as what experience they have that makes them suitable for working with older people, what training and qualifications they hold, what they could bring to the post etc. The form does not request that the person gives two referees. The person was not sent a job description or person specification so that they knew what the job would entail. ENVIRONMENT The home is currently undergoing refurbishment work to improve its environment. Parts of the home have been redecorated; new carpets have been laid and bathrooms have been updated. The managers office has been enlarged making it a much more suitable and confidential space from which to manage the home and store necessary paperwork. At our last inspection we made a requirement that dangerous chemicals must be locked away securely. During this inspection we walked straight into the unlocked laundry and found a number of cleaning chemicals easily accessible to residents. The lock on the door was in fact broken and no attempt had been made to repair it. We saw the homes cat wander freely in and out the kitchen during our inspection. This is unhygienic as the cat could bring germs and dirt into areas where food is being prepared for residents. The menu in the residents lounge stated clearly in large letters that lunch would be roast pork with potatoes: in fact the lunch was Shepherds pie. This can only be confusing for residents.
Care Homes for Older People Page 3 of 9 RISK ASSESSMENTS The home has completed a number of risk assessments to identify risks and put in place control measures to prevent residents and staff being harmed. We read a sample of these assessments and found they were far too basic. For example a risk of electrocution was identified when using the homes stair lift. The control measure stated was visual check and testing before use. 6 monthly check by....(left blank). This does not tell the reader what they are to visually check ( the plug the operating mechanism the rail?); what would make it not safe to use; what to do if it is not safe, and who exactly is to check it every 6 months. Legionnaires disease is also another risk identified. The control measure stated is daily water flushing system. It is not clear what this means at all; who is to do it; what systems are to be flushed and gives no information about normal control measures for Legionella such as checking water is stored at a minimum temperature 60oC; checking the adequate insulation of pipes and tanks; checking water systems weekly; running of taps and showers in unused bedrooms etc. Without this detail these risk assessments are meaningless and do not provide the information needed to protect staff and residents. More worryingly staff were not aware of these assessments and there was no evidence to show that they had read and understood them and were putting the measures identified into place. MANAGEMENT We made a requirement at our last inspection that an application to register a manager must be made by 1 June 09. This requirement remains unmet and the home has been without a registered manager for over a year now. The deputy manager is currently acting up and although hardworking, committed and keen to improve the home she does not have sufficient knowledge of the national minimum standards and associated regulations to run the home effectively and within the law. . SUPERVISION We checked the supervision records for three members of staff which showed us they were not receiving supervision as frequently as recommended. One member of staff had never received any supervision or induction to her job despite having worked at the home since November 2009. What the care home does well: What they could do better:
There is still much this home needs to do to improve its service, protect residents living there and support its staff. The home must obtain an appropriate drug register book in case any residents are prescribed controlled drugs. Stock control must also improve so that residents have access to their medication when needed. Prospective employees should be provided with a job description and person specification
Care Homes for Older People Page 4 of 9 so that they know what their job entails, and the homes application form should request information about the person that is meaningful and relevant to the job concerned to ensure that only the right people are employed to work with vulnerable adults. Risk assessments must be much more detailed to ensure the safety and well being of residents and staff at the home. We made a requirement about this at our last inspection but there has been little improvement and we may take further enforcement action. The homes cat should not be allowed to wander in and out the kitchen area to reduce the risk of infection. Dangerous cleaning products need to be stored securely and safely away from residents so that they are protected. A requirement made at our previous inspection remains unmet and we may take further enforcement action. Staff must receive regular formal supervision so that their working practices can be discussed, their training needs identified and so they have the opportunity to raise their concerns. An application to register a manager with us must be made so that we can assess if the person has the right skills, experience and qualifications to run a home for older people. A requirement made at our previous inspection remains unmet and we take further enforcement action. 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 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 7 13 Residents risk assessments 02/03/2009 must be much more detailed to ensure that their well being and safety is maintained. 2 31 8 An application to register a manager of the home must be made so we can assess that they have right skills and experience to run a residential care home. 01/06/2009 3 38 13 All dangerous chemicals must be locked away securely so they are kept safe from residents. 31/01/2009 Care Homes for Older People Page 6 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 7 13 Residents risk assessments 27/07/2009 must be much more detailed. You must do this to ensure residents well being and safety is maintained and they are protected from possible harm. Previous timescale of 02/03/09 not met. 2 9 13 The home must obtain an appropriate controlled drug recording book. You must do this in case any resident is prescribed a control drug. 24/07/2009 3 29 7 Recruitment procedures must 21/08/2009 improve: application forms must be much more detailed and prospective employees must receive and job description and person specification You must do this to ensure that only the right people are employed to work with Care Homes for Older People Page 7 of 9 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 vulnerable adults. 4 31 8 An application to register a manager of the home must be made .You must do this so we can assess that the person has the right skills and experience to run a residential care home. Previous timescale of 01/06/09 not met. 5 36 18 Staff must receive formal supervision. You must to do this so their working practices can be monitored, their training needs identified and so they feel supported 6 38 13 All dangerous chemicals must be locked away securely. You must do this to ensure they are kept safely away from residents. Previous timescale of 31/01/09 not met 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 24/09/2009 24/08/2009 24/07/2009 Care Homes for Older People 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 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. 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 Older People Page 9 of 9 - 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!
