Random inspection report
Care homes for older people
Name: Address: Melrose House 95 Alexandra Road Southend-on-Sea Essex SS1 1HD one star adequate service 28/09/2009 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: Vicky Dutton Date: 1 0 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Melrose House 95 Alexandra Road Southend-on-Sea Essex SS1 1HD 01702340682 01702436551 melrosehouse@btclick.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sonia Matilda Leggett Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Masood Rashid care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Conditions of registration: 34 0 The registered person may provide the following categories of service: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 34 Date of last inspection Brief description of the care home Melrose House is a detached property which is registered to provide care and accommodation to up to 34 older people. The home may also provide care for people living with dementia. Bedrooms are situated on the ground, first and second floors.
Care Homes for Older People Page 2 of 10 2 8 0 9 2 0 0 9 Brief description of the care home Some bedrooms have an en suite facility. Bathroom and toilet facilities are provided throughout the building. A passenger lift provides access to all areas. On the ground floor there are three pleasant communal lounges and a dining room. Melrose House has a garden and patio area at the rear of the house. The home is situated in a residential area within a conservation area. It is within a short walking distance of Southend shopping centre and seafront. The home is also close to mainline railway stations and numerous bus routes. There is limited parking at the front of the property. On street parking may be available depending on the day/time. The current rate of fees is between £520.00 and £550.00 Additional charges are made for hairdressing, chiropody, clothing, papers, magazines and transport. Information about the home is made available to people in the Statement of Purpose and Service Users Guide. Care Homes for Older People Page 3 of 10 What we found:
A recent safeguarding alert was raised with the local authority and is currently being investigated by the police. The alert indicated that the home might potentially not be meeting all of their regulatory responsibilities. Following a management review to look at the information received we undertook this random inspection to look at: Safeguarding awareness and practice, care planning, risk assessments, environment and staff training, qualifications and support. When we visited we spent five and a half hours at the service. We looked at care records, medication records and staffing records. We spoke to some residents, and looked around the building. Surveys for residents and staff were sent out by us in February this year. In March We received responses back from five people living at the home and four staff. Although people made positive comments, (see below,) answers to our questions indicated some room for improvement. For example only one person felt that they always received the care and support that they needed. People said that staff were usually available and usually listened and acted on what they said. Everyone however said that they always received the medical care that they needed, and everyone was aware of how to raise any concerns or make a complaint. Management and staff at the home were friendly and helpful. They assisted us fully when we visited. People said that they found the building comfortable and liked their rooms. They were however disappointed that the gardens were not kept nicely. We saw that the garden was extremely overgrown. One person told us, Its disgusting, even the washing cant hang properly. The manager told us that the lawn mower had been broken. While we were there a member of staff addressed the situation and cut the grass with a strimmer. Also when we looked round we saw that televisions in the homes three lounges were quite small for the size of the rooms and that the picture quality was not good for people whose sight might not be perfect. This visit identified that there were many examples where record keeping is poor or not consistent. When people moved into the home their needs were not being assessed or proper care plans being put in place in a timely manner. This has the potential to place people at risk through their health and care needs not being properly assessed, addressed and monitored. Good records were not being kept relating to peoples ongoing daily life and care. For example daily notes mostly gave no feel for how the person had sent their day or how they had been. Poor recording also made it look as though some people were offered limited opportunities for regular baths. It was however positive to note that in relation to care planning the manager had already commenced an audit process to address some of the issues highlighted by our visit. This lack of a robust and proactive approach also affected how peoples medicines were being managed. Generally good records were maintained, and the management of
Care Homes for Older People Page 4 of 10 creams and topical applications had improved since our previous visit. However where people were refusing their medicines, or taking them in a way other than initially prescribed, this had not been followed up with their doctor. There were no protocols in place for medicines that were to be taken on an as and when required basis. A good audit trail was not always maintained when booking in medicines. Again a lack of consistent record keeping did not allow us to feel sure that staff were being properly supervised and supported in their role. Supervision records were inadequate and did not show that staff received regular one to one support. What the care home does well: What they could do better:
When people move into the home they should expect that they will be consulted about their care and other needs. They should know that care plans will be put in place in a timely manner to assist staff in offering appropriate support. The home urgently need to review all their care documentation to make sure that it is accurate, consistent, well maintained and focused on the person. People should feel confident that the home will be alert to all of their health and personal care needs and meet them in a safe and consistent way. The home need to keep staffing levels under review and ensure that as far as possible people have a choice of male or female carers to deliver their care. Staff need to receive proper supervision and support that is well documented. This will help them to have space to discuss any practice issues and continue their development. People should feel confident that issues relating to the medicines are managed effectively. Medication needs better management to ensure that any administration issues are dealt with in a proactive manner rather than being allowed to carry on. Although the staff team have a good awareness of safeguarding and information is
Care Homes for Older People Page 5 of 10 available, this is not always sufficient to protect residents. Poor record keeping and management has led to a further safeguarding alert being raised as a result of an unexplained injury. The homes grounds should be kept in a suitable condition so that residents can enjoy them. 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 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 7 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 1 10 15 People should be consulted 13/06/2010 with and their needs must be properly assessed. Care and support plans must be put in place in a timely manner. So that people receive the care and support they need from the start of their stay at the home. 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 15 All care plans and care 30/06/2010 documentation must be fully reviewed to ensure that they provide a sufficiently robust basis for providing good support and and a person centered and joined up approach to care. So that people can feel confident that the service will meet their needs in a safe and effective manner. 2 9 13 Peoples health and welfare must be properly supported through the robust management of their medicines. So people can feel confident that any issues they have 30/06/2010 Care Homes for Older People Page 8 of 10 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 with their medication will be properly managed. 3 36 18 Staff must receive proper supervision and support to undertake their role. So that staff feel confident and well supported in their work with residents and have the opportunity to discuss any concerns or practice issues. 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 30/07/2010 1 9 To assist in the safe management and delivery of care and medicines photographs should be available on care files and medication records. As far as possible residents should have a choice of if their support is provided by a male or female carer. Staff should receive training in managing challenging behaviour. Staff should receive formal supervision at least six times a year. 2 3 4 27 30 36 Care Homes for Older People 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 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 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!
