Inspection on 25/08/09 for The Queen Charlotte

This inspection was carried out on 25th August 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Queen Charlotte 03/11/09

The Queen Charlotte 05/08/09

The Queen Charlotte 29/07/09

The Queen Charlotte 24/07/09

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 14/03/2010.

Random inspection report Care homes for older people Name: Address: Montevideo House 432 Chickerell Road Chickerell Weymouth Dorset DT3 4DQ new service which has yet to be given a quality rating 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: Amanda Bell Date: 2 5 0 8 2 0 0 9 Information about the care home Name of care home: Address: Montevideo House 432 Chickerell Road Chickerell Weymouth Dorset DT3 4DQ 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Althea Health Care Properties Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 51 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 51 51 The maximum number of service users who can be accommodated is 51. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Mental disorder (Code MD) Dementia (Code DE) Date of last inspection Care Homes for Older People Page 2 of 13 Brief description of the care home Montevideo House is a mostly purpose built care home with nursing, located on a main road on the western edge of Weymouth. There is a bus stop close to the home, providing a service to and from Weymouth town centre. Montevideo House is registered to provide care with nursing to elderly people with a mental disorder, including dementia. The home comprises a ground, first and second floor providing accommodation for a maximum of 51 people; all are accommodated in single bedrooms with en-suite hygiene facilities. There are assisted bathrooms and communal rooms on each of the three floors. All registered parts of the home can be accessed without the necessity to negotiate steps or stairs; there is a passenger lift. In the basement are the laundry, food storage facilities, and the heating establishment; the basement is not accessible to residents and their visitors. Laundering of clothing and household linen is carried out in the home at no additional cost to residents; items requiring dry cleaning are charged extra because it is necessary to send them out of the home for this service. There is a large attractively maintained garden to one side and rear of the Montevideo House building and car parking spaces at the other side. A hairdresser visits the home each week; there is an additional charge for this service. The home is owned by Althea Health Care Properties Ltd and was registered in their name in June 2009. They have managed the service since February 2009 prior to purchasing the service. At the time of inspection there was no registered manager in place. Fees are charged weekly; at present they range between £650 and £900 per person. Care Homes for Older People Page 3 of 13 What we found: This focused inspection was carried out on the 25th August 2009 by two inspectors. The purpose of the inspection was to establish whether the home had complied with a statutory requirement notice with regard to the safe use of bedrails and requirements made in relation to the safe storage, recording and administration of medication had been complied within the timescales that we set at the key inspection on the 28th and 29th July 2009. We arrived at 11am and left at 12:30pm. We toured the premises and found that the bedrails we identified as being unsafe at our key inspection on the 28th July and our random inspection on the 5th August 2009 had been replaced. We saw that people living in the home who needed bedrails in place were now sleeping in profiling beds, which had the appropriate, safe bedrails attached. We spoke to nursing staff about the progress that had been made with the requirements relating to medicines and looked at relevant medicine records. Arrangements have been made to record when medicines administered infrequently are next to be administered. This is to ensure that people receive their medicines at the intervals prescribed to have the most beneficial health effect for them. Arrangements have been made to ensure that all medicine stock is suitable for use. This is to ensure that out of date stock is removed so reducing the risk of inappappropriate use. Staff told us that out of date stock had been sent for disposal, however no record had been made of this disposal. Guidance is available for medicines prescribed to be administered when required however we found that this was not always detailed enough for people to be assured that they will receive their medicines in a consistent manner in response to their symptoms. We saw that one person had been prescribed a medicine with a variable dose to be given when required. The reason for giving the medicine was not clear and there was no information to help staff decide how much should be given. Staff told us the they are taking action to improve their pharmacy service and ensure that medicines are available to be administered in accordance with the directions of the professional prescribing them. However at the time of this inspection we saw that some medicines had been unavailable for administration during the present month due to gaps in the supply. The requirement relating to obtaining blood samples and administering injections could not be checked because at the time of the inspection no-one living in the home was having blood samples taken or having injections. We saw no equipment for taking blood sample in the home. Staff showed us sheets which they use for recording that creams and ointments have been used as prescribed. These included a body map to show where they need to be applied and a recording sheet for carers to sign when they have applied them. This is good practice to ensure that these medicines are used correctly. Care Homes for Older People Page 4 of 13 Records had not been made of some medicines disposed of from the home, including those taken with a person moving from the home. Records had not been made of some of the medicines received into the home for the current month. This means that there is no audit trail to show that medicines have been received into the home, used and disposed of safely and appropriately. 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 Older People Page 5 of 13 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 3 14 The registered person shall not provide accommodation to a service user at the care home unless their needs have been assessed by a suitably qualified or suitably trained person. To ensure the home will be able to meet the persons needs when they arrive in the home. 28/08/2009 2 4 18 The registered person must 28/10/2009 ensure that the persons employed by them to work at the care home receive training appropriate to the work they are to perform. This must include training in dementia care. This will ensure that those people living at the home who suffer with dementia will receive the appropriate care. 3 7 14 The registered person must ensure that a written plan is drawn up in sufficient detail to meet the health and welfare needs of service users. To ensure that staff have accurate and detailed 27/08/2009 Care Homes for Older People Page 6 of 13 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 information to meet each persons health needs. 4 8 12 The registered person must make proper provisison for the health and welfare of service users. To ensure that people receive adequate nutrition and hydration and monitoring charts are completed and used effectively. 5 9 13 (2) Arrangements must be 19/08/2009 made to ensure that safe practices are followed when obtaining blood samples and administering injections. This is to prevent the risk of needlestick injury occuring and the risk of cross infection. 6 9 13 (2) The provider must ensure 19/08/2009 that there are clear protocols and guidance available for those medicines prescribed to be administered when required. This is so that people can be assured that they will receive their medicines in a consistent manner in response to their individual symptoms. 7 12 12 The registered person must consult with service users and make provision for recreational and social 28/10/2009 27/08/2009 Care Homes for Older People Page 7 of 13 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 opportunities based on their needs and preferences. To minimise risks of boredom and associated distress. 8 15 16 The registered person shall 28/09/2009 ensure that food is provided to meet the needs of service users, at appropriate times and of a sufficiently appetising standard, to encourage residents to accept adequate nutrition. This will enhance their quality of life by enjoyment of food and promote physical wellbeing. 9 16 22 The registered person shall establish a procedure for considering complaints, which is appropriate to the needs of service users and ensure that all complaints are investigated. So that the people who use the service are listened to and action is taken accordingly. 10 18 13 The registered person must 24/08/2009 make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm of abuse. To ensure that staff are aware of safeguarding Care Homes for Older People Page 8 of 13 28/09/2009 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 guidance and report any suspicions or actual abuse to the appropriate agencies. This must include any reports of bruising of unknown origin. 11 19 23 The registered person shall 28/10/2009 ensure that the physical design and layout of the premises meets the needs of service users, that it is kept in a good state of repair externally and internally, that there is available the necessary moving and handling equipment. this must include the replacement of worn carpets and the provision of slide sheets. To promote and protect the comfort and safety of people living in the home 12 26 13 The registered person must ensure that all staff have undertaken training in infection control. To minimise the risk of cross infection. 13 26 16 The registered person must 24/08/2009 ensure that the home is kept clean and make suitable arrangements for maintaining satisfactory standards of hygiene in the care home. To ensure that the risk of cross infection is minimised Care Homes for Older People Page 9 of 13 28/10/2009 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 and the home is a more pleasant place to live. 14 29 19 The registered person shall 14/08/2009 not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in Schedule 2. To protect vulnerable people from risks of harm and abuse 15 30 18 The registered person shall 28/10/2009 ensure that all staff have undergone induction training in line with the standard of Skills for Care. This must be done retrospectively if staff have not had induction training to this standard. This is to ensure that staff have the necessary skills and competencies to meet the needs of the resident group. 16 31 8 The registered person must appoint an individual to manage the care home where there is no registered manager in respect of the care home. To provide leadership to staff and ensure that residents have good care. 17 33 24 The registered person must establish and maintain a system for evaluating the quality of the services provided at the care home. 28/10/2009 28/10/2009 Care Homes for Older People Page 10 of 13 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 To identify any shortfalls in the service so that action can be taken to improve. 18 36 18 All nursing and care staff must be appropriately supervised To recognise training needs and personal development of staff. 19 37 17 The registered person must maintain in the care home records specified in Schedules 3 & 4 of the Care Homes Regulations 2001. This will ensure that up to date and accurate information with regard to the care home is available. 28/10/2009 28/10/2009 Care Homes for Older People Page 11 of 13 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 9 13 Records must be kept of the 30/10/2009 receipt of all medicines into the home and of the disposal of all unwanted medicines. This is to ensure that medicines have been used safely and that peoples health is protected. 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 12 of 13 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). 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