Random inspection report
Care homes for older people
Name: Address: Marray House 12-14 Essa Road Saltash Cornwall PL12 4ED zero star poor service 26/04/2010 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: Gail Richardson Date: 0 3 0 8 2 0 1 0 Information about the care home
Name of care home: Address: Marray House 12-14 Essa Road Saltash Cornwall PL12 4ED 01752844488 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Enid Robertson Crofts,Mr Peter William Crofts Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 2 6 0 4 2 0 1 0 Marray House is registered to provide personal care and accommodation for up to 23 older persons. It is a detached house situated near the centre of Saltash, close to the shops, public transport and community facilities. Peoples bedroom accommodation is provided on the ground and first floors. Stair lifts are provided to assist peoples mobility. Two Communal lounge/dining rooms , kitchen and laundry areas are provided on the ground floor. Mrs Crofts has been registered as a care provider for 28 years. The fees range from 314.25 to 325 pounds per week and the fees do not include hairdressing, chiropody and newspapers. A brochure is provided for those wanting
Care Homes for Older People Page 2 of 12 Brief description of the care home more information about the home and its facilities. Care Homes for Older People Page 3 of 12 What we found:
This was an unannounced inspection, which took place over three hours on the 3rd August 2010 by Compliance Inspectors Gail Richardson and Mandy Norton. For the purpose of this inspection the term We will be used when referring to the Care Quality Commission. The last key inspection took place on the 15th and 26th April 2010. A further random inspection took place on the 2nd July 2010. At that time we looked at areas relating to risk assessment, care planning and medication practice. We found that none of the statutory requirements relating to these areas had not been addressed or met within the timescale stated. This inspection is to follow up on the same requirements made relating to risk assessment, care planning and medication management to establish the actions the home has taken to meet the outstanding requirements. We looked at care records for four people using the service and Medication Administration Records. We also took this opportunity to review recruitment records fro prospective staff to be employed at the home. We found that none of the statutory requirements relating to the areas assessed had been fully addressed or met within the timescale stated. What the care home does well: What they could do better:
We visited the home previously on the 2nd July 2010 as part of a random inspection to follow up requirements made at the key inspection on 26/04/2010. We identified that four care plans did not reflect changes in need, treatment and equipment and did not supply staff with an updated plan of care to ensure that for some people using the service, their current needs could be met. The timescale for action was 20/05/2010. We stated at that time that care plans must be updated to reflect all areas of assessed need and all changes must be updated to provide staff with a clear plan of care to follow for each person. We visited the service again on the 3rd August 2010 and reviewed the same four care plans and no updates or reviews have taken place. The care plans and risk assessments did not reflect all current assessed needs and this may place people at risk. An immediate requirement was made that the management of the home are required to update and review all care plans, risk assessments and documentation for each person to ensure that staff have clear plans of care to follow to enable the needs of people using the service to be met. Timescale for the Immediate Requirement is 3rd September 2010. As stated above, we visited the home on 02/07/2010 as part of a random inspection to follow up six requirements made at the key inspection on 26/04/2010 relating to medication practice. On both of those inspections we identified that medication storage and recording is not in line with guidance and current best practice and may place people at risk. Timescale for action was 21/05/2010. We visited the home again on the 3rd August 2010 to undertake a random inspection and reviewed the areas identified. We found that the six statutory requirements had still not been met. We made an immediate
Care Homes for Older People Page 4 of 12 requirement that the management of the home are required to update all medication practices identified to ensure that storage, administration and recording of medications are safe and accurate. Timescale for Immediate Requirement is 10th August 2010. We requested the recruitment files of three staff planned to start work week commencing 9th August 2010. These recruitment files were not available and we could not establish if all recruitment checks had been undertaken. At the key inspection 26/04/2010 we required that all recruitment checks for new staff must be in place prior to staff starting work at the home. The timescale for action was 20/05/2010. We made an immediate requirement that management of the home are required to ensure that recruitment practices are in line with Care Homes Regulations 2001 to ensure that people remain safe. Timescale for Immediate Requirement is 10th August 2010. 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 12 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 15 Risk assessments must be 20/05/2010 undertaken for each person in relation to diabetes, self administration of medication and moving and handling (where appropriate). Following those assessments appropriate action must be taken to ensure that people are kept safe 2 7 15 The registered person must ensure that all areas of identified need have an appropriate plan of care for staff to follow . This will ensure that staff are aware of all care to be provided. This will also provide a clear audit of all care given. 20/05/2010 3 9 13 The home does not have 21/05/2010 suitable storage for controlled medications and is advised to address this with secure and appropriate storage This will mean that should the storage be required at short notice the facility is readily available. Care Homes for Older People Page 6 of 12 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 4 9 13 All prescribed creams must be stored correctly at the right temperature and for their shelf life only. Medications prescribed for one person must not be re appropriated to another person. To remove labels and write names on boxes, may place people at risk of harm 21/05/2010 5 9 13 The registered manager must ensure that all medications which are given to epople for self administration are recorded. This is required to ensure that there are records of medications provided and will provide a clear audit trail of medications taken. 21/05/2010 6 9 13 The registered person must ensure that medications are signed for correctly. This will mean that procedures are correctly folowed and medication adminstered safely 20/05/2010 7 9 13 When staff are required to hand transcribe medications onto the administration record, that two staff sign the record. This will ensure that there is no risk of error in transcribing. 20/05/2010 Care Homes for Older People Page 7 of 12 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 8 12 16 The registered person is required to ensure that a programme of activities is planned for the recreation and enjoyment of people using the service. The programme is required to include social interaction for all people using the service at a level of their participation and enjoyment. 17/09/2009 9 19 12 The registered person is 20/11/2009 required to implement a repair / refurbishment programme to all areas of the home needed repair. This is with particular reference to all of the bathrooms / shower room which pose the risk of cross infection. This is required to ensure the maintenance of an environment which is safe for use by people using the service. 10 29 18 The registered person must 20/05/2010 ensure that all recruitment checks are in place prior to staff starting work at the home. This would include and recent photograph, that all documents are signed and dated when received. That a full and detailed employment history is obtained with reasons for leaving the last employer and that Protection of vulnerable adults checks are received prior to the staff member starting work.
Page 8 of 12 Care Homes for Older People 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 This s required to ensure that people using the service are kept safe from harm 11 30 18 The registered person must ensure that staff training is provided for all staff to ensure that they remain updated on current good practice. This is needed to ensure that people using the service receive a good standard of care which promotes their safety and wellbeing. 12 31 12 The provider/manager is 21/05/2010 required to undertake audits of the home with relation to risk assessment, care planning, medications and recruitment. This is required to ensure that the quality of service is safe. 13 33 26 The registered person is required to undertake a visit to the home at least once a month and produce a report to be forwarded to the Care Quality Commission reviewing the areas outlined in this regulation. This is required to enable the registered person to have an overall view of the quality of the care provided. 14 38 12 The registered person must 21/05/2010
Page 9 of 12 22/10/2009 21/05/2010 Care Homes for Older People 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 ensure that hot water outlets are monitored and that they do not exceeded the health and safetys guidance on upper limits. This is required to ensur ethat people using the service are not at risk of burns and scalds. 15 38 12 The registered person is required to ensure that all substances hazardous to health are stored securely. This is required to ensure that there is no risk of accidental ingestion. 21/05/2010 Care Homes for Older People Page 10 of 12 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 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 Care Homes for Older People Page 11 of 12 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. © 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 Older People Page 12 of 12 - 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!
