This inspection was carried out on 3rd November 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 but made no statutory requirements on the home.
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: 0 3 1 1 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 2 6 0 7 2 0 0 9 Care Homes for Older People Page 2 of 12 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 12 What we found:
This focused inspection was carried out on the 3rd November 2009 by two inspectors and took approximately four hours. The purpose of the inspection was to review the environment in which people were living; the nutritional status of residents; procedures around the storage, recording and administration of medicines and recruitment of staff. We toured the premises and found that the home was much brighter than on the previous inspection. There was a programme of ongoing maintenance and refurbishment. We saw that the lounges and dining room had been reorganised to make it more comfortable for the people living at Montevideo. However most of the residents had been encouraged to come to the lounge, which meant the environment was very noisy and this may be overwhelming for those people with dementia. People told us that staff received training in infection control. We saw that generally the home was clean and fresh, although some individual rooms were still malodorous. The manager told us that further refurbishment is planned and a number of carpets will be replaced. We saw that people were offered frequent drinks and snacks during our visit. We reviewed records for diet and nutrition, which recorded that people were receiving adequate amounts of diet and fluids. We spoke to nursing staff about the progress that had been made with the requirements relating to medicines and looked at relevant medicine records. Improvements have been made in record keeping. However where a resident was receiving medication covertly and a risk assessment had been put in place there was insufficient information as to how these medicines were to be given. If given in the wrong way the efficacy of the medication may be altered. We recommended that more information be available to staff. At the last key inspection in July 2009 we found that the recruitment processes were not robust and we found the same at this inspection. We reviewed the personnel files for three members of staff. A variety of information was held on file but where we saw adverse CRBs and references there were no risk assessments in place to establish whether their employment was suitable. We saw no evidence of interview records. For people attending the home who have direct contact with residents, other than personal visitors, the management team must satisfy itself that these people are suitable, thus protecting the people living there. The home was unable to provide such information. What the care home does well: What they could do better:
As a result of poor recruitment practices we issued an immediate requirement that essential information be obtained so that only suitable people are employed and attend
Care Homes for Older People Page 4 of 12 the home. Althea Care have given us assurances that this work is being carried out. The home should consider the noise level in the main lounges, which may upset some people. They should be able to reside in a quieter environment if they so wish. Bedrooms should be kept clean and malodours dealt with quickly. Where medication is given covertly the risk assessment should give sufficient information as to exactly how the medicine is given. 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 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. Not assessed at this inspection. 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. Not assessed at this inspection. This will ensure that those people living at the home who suffer with dementia will receive the appropriate care. 3 12 12 The registered person must consult with service users and make provision for 28/10/2009 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 recreational and social opportunities based on their needs and preferences. Not assessed at this inspection. To minimise risks of boredom and associated distress. 4 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 5 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. Not assessed at this inspection. This is to ensure that staff have the necessary skills and competencies to meet the needs of the resident group. 6 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. 28/10/2009 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 Appointment made. Application to register with CQC not yet made. To provide leadership to staff and ensure that residents have good care. 7 33 24 The registered person must establish and maintain a system for evaluating the quality of the services provided at the care home. Not assessed at this inspection. To identify any shortfalls in the service so that action can be taken to improve. 8 36 18 All nursing and care staff must be appropriately supervised. Not fully assessed at this inspection. To recognise training needs and personal development of staff. 9 37 17 The registered person must maintain in the care home records specified in Schedules 3 & 4 of the Care Homes Regulations 2001. Not fully assessed at this inspection. This will ensure that up to date and accurate
Care Homes for Older People Page 8 of 12 28/10/2009 28/10/2009 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 information with regard to the care home is available. Care Homes for Older People Page 9 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 1 29 19 The home must make arrangements to safeguard vulnerable peole from the risks associated with potentially unsuitable staff. In advance of any person who is not a private visitor attending the home and likely to have contact with residents, the home must obtain and keep essential information including references and CRBs to provide evidence of their suitability. To protect the vulnerable people living at the home. 26/11/2009 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 1 9 Where covert medication is given the risk assessment should provide clear information as to how the medicine is to be given. The environment should be comfortable for those living
Page 10 of 12 2 19 Care Homes for Older People 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 there. Quiet areas should be available for those people not wishing to sit in the main lounges. 3 26 Malodorous rooms should be cleaned promptly. 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. 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 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!
