Inspection on 26/01/09 for Maidment Court

This inspection was carried out on 26th January 2009.

CSCI 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

Maidment Court 24/06/08

Maidment Court 14/07/06

Maidment Court 28/02/06

Maidment Court 06/05/05

Maidment Court 06/10/04

Maidment Court 07/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Maidment Court 47 Parkstone Road Poole Dorset BH15 2NX Lead Inspector John Hurley Unannounced Inspection 26th January 2009 10:00 DS0000004051.V374965.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maidment Court Address 47 Parkstone Road Poole Dorset BH15 2NX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 674423 01202 676410 home.poo@mha.org.uk www.mha.org.uk Methodist Homes for the Aged Post vacant Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The twin suite, bedrooms 45 (a) and (b), is only to be let to a couple who have clearly expressed a desire to occupy such a room. 24th June 2008 Date of last inspection Brief Description of the Service: Maidment Court is a care home registered with the Commission to accommodate a maximum of 46 older people. The home is purpose-built and has a passenger lift to access the four floors of the home. Residents’ bedrooms are for single occupancy and have ensuite toilet facilities. The main communal rooms of two lounges and dining room are provided on the ground floor. There are five assisted bathrooms, one conventional bathroom and a walk-in shower room. The home offers one room for respite care. The home overlooks Poole Park and is in within a short walk from the town centre. Parking for staff and visitors is available at the back of the home. There are well-maintained gardens to the front and back of the home. The fee range is from £443 to £537 per person, the latter amount being for the twin suite of rooms. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is zero star. This means the people who use this service experience poor quality outcomes. The inspection process followed the Commission for Social Care Inspection Inspecting for Better Lives methodology. The views of the people who use the service and people important to them were sought; where appropriate their comments are included in this report. The inspectors also spoke briefly with a visiting health care professional. The inspection took 6 hours to complete carried out by two inspectors. At the time of the inspection that was no registered manager. We toured the building, spoke with the peripatetic manager, deputy manager, staff on duty and spoke privately with people who use the service on both an individual and group basis. We inspected a sample of the documentation relating to the individuals who reside at the home along with records relating to staff and other documents required by regulation. What the service does well: The people who live at the home are encouraged and supported to maintain links with families and friends. Staff interact positively with all that live at the home. The home serves a balanced and varied selection of food that meets individuals tastes and special dietary needs within pleasant surroundings. Alternatives are generally available, a choice of main meal was offered during the inspection, individuals informed the inspector that this was always the case. The home has a complaints procedure and people felt confident that complaints would be taken seriously with appropriate action taken. When employing staff the organisation ensures it considers equal opportunities issues well. What has improved since the last inspection? Whilst a number of aspects of the care planning process still require a lot of work there a signs of improvement. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 6 Similarly work has been started with regards redecoration of the communal areas but this requires to be project managed to ensure those areas that would benefit the well being of those who live at the home are targeted first. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not follow thorough pre-admission procedures in all areas of service provision. Initial care assessments are not clear or concise which may led to poor outcomes for those who use the service. EVIDENCE: We looked at a recent admission to the home to assess the quality of the information that had been sought at the time. The records showed that no information had been recorded regarding the person’s personal profile, life history, past medical history, current medical requirements. The pre admission assessment was incomplete and no subsequent reviews of the person’s well being had been recorded. Another person’s file was also assessed and found to lack similar information. One person’s file had a domiciliary care needs Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 9 assessment and little else to guide staff on how the persons needs should be met. The management of the home acknowledged our observations and shared our concerns with regards to this lack of assessment procedures and agreed to readdress this without delay. Staff informed us that intermediate care is not a feature of this service Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans do not illustrate peoples needs and so may put people at risk. Peoples cannot be assured that their health care needs can be fully met. Medication practices are poor and may put people at risk. EVIDENCE: At previous inspections it had been noted that care plans might detail specific tasks that need to be performed to met the needs of those who live at the home. For one individual this task was to be regularly moved whilst in bed to prevent pressure ulcers. We spoke with the district nurse responsible for this individual who informed us that they considered the persons needs were being met and that the staff had met this persons needs well. The recording relating to the actions taken had improved but had still to be kept in a consistent manner. Daily record entries refer to a sacral sore being dressed by the district Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 11 nurse but there is no associated wound care plan for care staff to promote healthy tissue and viability of the person’s skin between district nurses visits Food and fluid intake charts were not held on file but in the person’s bedroom. The charts we looked at relating the day of inspection and the preceding day. On the day of inspection at approx 2.30pm when examined, 40ml of orange juice had been recorded at breakfast with no other recording being noted. This would indicate that the person may not be having they’re needs met and was in danger of becoming dehydrated. This person is confined to bed, their moving and handling care plan, dated December 2007 referring to them walking with use of an aid is therefore out of date. The assessment made at the time refers to use of hoist with no reference to which equipment, sling to use. It was noted whilst looking around the building that slings were on the furniture with no reference to whom they were intended to assist. Management described the process of transferring the records held in the person’s room to the care files. If something significant occurs, an entry is made in the record on the care plan; these are also reviewed monthly. The record relating to this person’s care plan was written sporadically and out of sequence and so would not inform a systematic review and the planning of care. Files sampled did not contain any reference to the Mental Capacity Act nor were there any basics assessments relating to the persons capacity to make decisions, although it was evident from our observations that some people would struggle with some decision making. We looked at a communications book that was in use and found reference to one person who resides at the home leaving the home. It was recorded that staff considered this person was in the gardens but when they went to look for them it was found that they had left. The person’s file did not contain any reference to this issue. There was no risk assessment on file to assess any perceived risk that the person may have taken or subsequent staff concerns regarding this matter. Further more we had not been notified as required. The use of a communications book is poor practice as it fails to comply with the Data Protection Act requirements and undermines the persons privacy. Another persons file relating to health promotion refers to the use of creams for their hips, back and legs but does not go onto to reference to which creams to use or why they are to be used. The person has diabetes controlled by diet and medication. The care plan for nutrition refers to the person’s ability to record her own blood sugar levels, there is no associated care plan for staff to monitor these records. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 12 It was noted that relatives had concerns over the ability of their relative to effectively monitor their own blood sugar levels. Although there is some evidence of management consulting the district nurse there was still no instruction to staff with regards to monitoring the situation or information relating to the symptoms of diabetic’s such as hyper glycaemia. Daily records made by staff in relation to this person show irregular entries with lengthy gaps between recordings – for instance, the record indicates that they last ate in September 2007. Similarly we noted that this persons last moving and handling assessment was undertaken in December 2007. We sampled other people’s files and found similarly issues relating to recording peoples needs and aspirations as well as recording routine tasks. It was noted that in one local authority review dated the 18/12/08 one outcome was to monitor the person weight on a regular basis. At the time of the inspection this was still not happening and the last recorded entry on the weight-monitoring chart was 14/08/08. The persons moving and handling plan had remained unchanged since 13/07/07. Through discussion with staff it was established that this person required the assistance of a hoist, the manual-handling plan did not reflect this. Through discussions with people who live at the home we were informed that people who live at the home consider that they are treated well and with respect, discussions with visiting professionals also support these views. We looked at the Medication Administration Records (MAR) as previous inspections had identified concerns but improvements had been noted. We found that the improvements had not been sustained. Records sampled did not provide a clear and robust account of administration of medication for example; one person had been prescribed 60 tablets, 29 tablets were found to be in the box of medication meaning that 31 had been given to the person. On checking the signature sheets it was found that 43 tablets had been signed for. The management but this down as carryover but there was no evidence to support this such as a date of opening the recently dispensed box. There was further evidence of medication being signed for but not administered and poor accounting practices. When sampling the records it was noted that some people self medicate. We looked at the storage arrangements in two of the person’s rooms to examine if this was safe. Both had locked cabinets. It was found that one person had an out of date canister of Spirilon in the room the other had three bottles of medication in cabinet that she said she no longer took, all three bottles were sticky and dated between 2007 and 2008. Whilst touring the building it was noted that two bottles of a home remedy ‘cod liver oil’ were found in domestic refrigerator for peoples use – both bottles Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 13 were out of date and neither bore the name of the owner which could result in person becoming unwell. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and stimulation need to be provided based on peoples aspirations and needs. Visitors are welcomed and individuals are assisted with maintaining contact with relatives and friends The food is home cooked and appears to offer a balanced diet based on the needs and wishes of the individual. EVIDENCE: We spoke with one person who likes to keep as mobile as possible, using the middle floor for exercise. They informed us that they enjoyed the size of the home as it allowed them to exercise but in recent months access to the chairs, to rest on, at either end of her walk had been denied as staff regularly put hoists and other aids in the way using the sitting areas as storage. Despite this issue they enjoyed living a the home, the food was good and that their own room met their needs. One other concern they had related to the staff turnover, not knowing who was working and if the person knew their needs, Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 15 going on to say that it did not matter much to them as they could speak up but it did concern them that others may not be able to do so. Through discussions with people who live at the home we were informed that the main concern that people have is the high turnover of staff. One person stated that they enjoyed living at the home and could access the wider community with some assistance. The explained the impact that the lack of staff members, who they had formed a relationship with, was having on them giving the example that they found it difficult to get out and did not like to ask staff to shop for them for personal items such as slippers and underwear that they wanted to replace. Another person gave an example of asking a staff member for their sheets to be changed but never seeing the person who they had asked to change the sheets again, and having to ask again. The majority of those that we discussed issues with also raised concerns over the dependency of others who reside at the home. The major concerns here was that staff did not take time to talk and establish peoples needs and how to carry out care tasks such as assisting the person to the dinning room. Some people felt that staff’s time was taken up looking after those with higher dependency leaving little time for them. Whilst they understood the need for this some who had been resident for some time were able to inform us of outings and recreational activities they used to have and enjoy in the recent past. In order to ensure the inclusion of all of those who use the service it would be helpful if all activities were robustly monitored to ensure all who live at the home are having their social needs met. Visitors were observed entering or leaving the home. All visitors were warmly welcomed. We spoke with one relative who spoke highly of the home. People’s records and the visitor’s book in the entrance hall demonstrate contact with family and friends as well as visits by professionals. Several people are able to go out of the home alone and others with their families and friends. The staff informed the inspector that individuals are encouraged to retain contact with the wider community as much as possible. There was a good choice of main and sweet dishes, both for lunch and tea. Meals choices included special diets. Meals were served at nicely laid tables. The people who we spoke to confirmed that the food was generally of good quality and quantity and that a choice was offered. It was noted that those who remain in bed had to wait a very long time to receive their food and assistance, one person did not start their lunch until 2.30pm well all others had finished. The staff member told us this was not unusual. Although food and fluid charts were in place to monitor this person’s intake they were not completed, out of date and would not enable staff to Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 16 accurately determine whether the person had received sufficient nutrition for their needs. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service felt confident that any complaints or concerns would be listened to and taken seriously. The vulnerable adult procedure reflects the local authorities expectations in relation to multi agency working in order to protect the people who use the service. EVIDENCE: The people who we spoke with informed us that they felt able to complain and said they would have no concerns complaining to staff members who they knew, should they have need to. They were unsure of who was managing the home but those that were able stated that they would raise issues for those that were not able, such as having meals served that were cool or without gravy etc. The home keeps a record of any complaints made. There have been no issues recorded at the home since the last inspection. We looked at the policies and procedures manual at the home during the inspection. It was noted that the home has an adult protection policy to reflect the local authorities expectations in relation to multi agency working. We looked at the staff training records that demonstrated that most staff had received training in the Protection of Vulnerable Adults (POVA). Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 18 The staff that we spoke to were able to inform us of the correct procedures to follow should they be concerned of a adult protection issue. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment needs to be updated to meet the needs of those who live in it. The management need to ensure that infection control procedures are established, maintained and monitored to protect those who live and work at the home. EVIDENCE: We toured the building soon after we arrived for the inspection. At the previous unannounced inspection we raised concerns over the general state of repair of the home and a number of infection control issues. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 20 It was noted that a programme of redecoration had started but there was no clear rationale for why some areas were receiving attention and not others for example, some of the upstairs corridors had been painted but some communal toilets and bathing facilities remained in poor condition. The work that had been done had undermined some of the previous risk assessments as some fixtures such as radiator covers had not been re-fixed and window restricted removed and not replaced or re risk assessed. The inspectors were informed by staff that due to the height of the windows above the floor that window restrictors were not required as this conformed to building regulations, the files relating to those who use the service did not contain evidence of risk assessments relating to them climbing out of windows. Within the home there are several small kitchenettes that allow a degree of choice and independence for some who reside at the home by way of keeping some drinks, sauces etc in the fridges. At the last inspection it was pointed out that these areas were not being sufficiently monitored to ensure that good food hygiene practices were being observed. At this inspection it was again noted that there was out of date food in the fridges and the crockery and other utensils were dirty. There was no useful or comprehensive record of the fridge temperatures being monitored. The home has a two small high-level (third storey) terraces, which are enjoyed by those who can access them. However there was no associated risk assessments relating to either the terrace or the individuals who used them. It was however noted that some parts of these areas had been risk assessed on the 28/08/07 relating to “edge protectors” and the need to fit them, this had not been achieved at the time of the inspection. At the beginning of 2009 there had been an outbreak of Sickness and Diarrhoea at the home. Whilst the management had consulted with the Health Protection agencies and had acted on their guidance it was concerning to note that no action had been taken with regards to some basic infection control measures. At the previous inspection it was pointed out to the management that the bins in the toilet areas were uncovered, there were dirty urine bottles in these areas and the floor in the sluice was in poor condition. At the time of the last inspection the management agreed to provide bins that were foot operated so as to ensure good infection control practices but at this inspection there was no evidence that these had been purchased or ordered. Floor coverings in key areas were still in poor condition and dirty urine bottles were still evident. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are a core group of long serving staff that are knowledgeable with regards to the needs of those people who use the service. There are sufficient staff on the rota to meet the current needs of the people who live there. Recruitment practices could be improved to better protect residents. EVIDENCE: We looked at a number of the recruitment records and found must of them to be in order but not all. One person’s file demonstrated did not hold verified references. The two references obtained were not from the applicant’s last employer. This person started work at the home with no evidence of a work permit held for this person. We also found another staff member who had started employment without all the necessary references. We noted that part of the pre employment checks relating to equal opportunities asked for all the relevant information. All of the staff files sampled had a relevant Criminal Records Bureau check most had evidence of the person’s identity Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 22 We looked at the induction training files for seven new members of staff, the programme was held in accordance with Skills for Care training standards, each member of staff started at Maidment Court on 21st January and had completed the first day of induction. The management stated that they would work through the remaining standards within their first 6 weeks. The rota demonstrates that there are 1 or 2 seniors on duty daily, 6 care staff each morning, 5 each afternoon and three each night. Additionally there is a cook, kitchen assistant, 3 housekeepers and laundry assistant. We spoke with the management about the concerns raised by those who live at the home regarding staff turnover and agency staff. It was acknowledged there had been a period of instability but it was hoped that this was coming to an end with the recent recruitment. At the time of the inspection the management were in the process of developing a full staff training matrix to ensure that all staff had received the necessary statutory training. Through discussion with the staff group and by observing the people who use the service it is reasonably clear that the staff team have empathy for the people who live at the home. There were many good examples observed of staff interacting positively with the people who use the service. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management structures are in place but action needs to be taken to address pre admission assessments, care planning and medication administration in order to achieve good outcomes for residents. Risk assessment need to be completed in order to protect those who use and work at the home. There needs to be a managed approach to the refurbishment of the building in order to provide a safe environment for those who live at the home. EVIDENCE: Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 24 At the time of the inspection there was no registered manager, they had recently left with little notice. A peripatetic manger from the oganisation was carrying out the management of the home. They acknowledged that there was a lot of work to do to re-establish the National Minimum Standards and had already taken some steps towards this goal. The home continues to report notifiable incidents to the Commission as required under Regulation 37. As was discussed under the Environment section many areas of the home were ‘tired’ and in need of redecoration or refurbishment. The risks caused by this were of concern. There did not appear to be any cohesive plan to address these issues. Issues such as several doors throughout the home labelled ‘fire door, keep locked when not in use’, were unlocked, one of these containing products that come under COSHH regulations. These type of issues together with the lack of up to date risk assessments put people at unnecessary risk. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 2 2 2 2 2 1 1 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x x x x 1 Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 & 12 Requirement Assessments and care plans must provide sufficient information as to how care is to be delivered to meet the social, health and personal care needs of residents and these must be reviewed monthly. Moving and handling plans must be kept up to date and systems in place to ensure that staff abide by these. This requirement is repeated from the inspection of 24 June 2008 Timescale for action 28/04/09 2. OP8 12 (1) (a) You are required to ensure that health needs of residents, with particular reference to those being cared for in bed, are met. This requirement is repeated from the last key inspection of 24 June 2008 28/04/09 Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 27 3. OP9 13(2) Accurate records must be kept of 28/04/09 all medicines given to people, signed for by staff at the time of giving. This is to ensure that the records are complete and accurate, and help to show that people receive their medicines as their doctor has prescribed. You are required to ensure that all requirements of Schedule 2 are complied with when recruiting new members of staff. This requirement is repeated from the last key inspection of 24 June 2008 28/04/09 4. OP29 Schedule 2 5. OP30 18 (c) You are required to ensure that staff receive mandatory training and that their training is kept up to date in order to ensure those who live at the home needs are met. This requirement is repeated from the last key inspection of 24 June 2008 28/04/09 6. OP19 23 7. OP3 14 8 Maidment Court 13(4)(a) The home needs to have a comprehensive and coherent plan in relation to the refurbishment of the home in order to provide those who live in it a safe and comfortable environment The home should not admit any person without their needs being robustly assessed and a statement made stating how their needs will be met. The home must ensure that DS0000004051.V374965.R01.S.doc 28/04/09 28/04/09 28/04/09 Page 28 Version 5.2 OP19 9 OP7 13(4)(c) environmental risk assessments are routinely carried out and action taken to reduce any perceived risk The home needs to ensure that all persons living at the home have an up to date risk assessment that details the action to be taken to reduce any perceived risk. 28/04/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations It is recommended that pre-admissions assessments are signed and dated at the time they are completed. Maidment Court DS0000004051.V374965.R01.S.doc Version 5.2 Page 29 Care Quality Commission South West Region PO Box 1251 Newcastle upon Tyne NE99 5AN National Enquiry Line: 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. 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