Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 05/08/09 for The Queen Charlotte

Also see our care home review for The Queen Charlotte for more information

This inspection was carried out on 5th 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 23 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All staff were courteous and helpful throughout our inspection.

What the care home could do better:

We toured the premises and in six rooms we found bedrails to be unsafe. We saw gaps between the bedrail and mattress large enough for the occupant to trap themselves, which could have caused serious injury to that person. This is of serious concern to us because the home had failed to take action following the immediate requirement made on the 28th July 2009 and people were put at risk. Records were seized and we may take enforcement action to ensure that the Registered Provider complies with associated regulations. We saw that a lock had been fitted to the kitchen door so that it could remain locked when no member of staff was present. This meant risks of injury to residents who entered this area were minimised. We found a number of people who were fully dressed in day clothing asleep in their beds. We were told by staff that some residents were washed and dressed early and then put back to bed. We could find no evidence in care files that this was the choice of the individual. We fed back our concerns to the acting manager and a director of Althea Healthcare Properties Ltd, who were unaware of this poor practice. We were given assurances that people`s personal preferences about the time they would like to get up would be respected.

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 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 16 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 16 What we found: This focused inspection was carried out following the concerns raised at our key inspection which took place on the 5th August 2009, when we found the outcomes for people using this service to be poor. At this random inspection a visit was also conducted by a social worker investigating safeguarding concerns. We arrived at 06:10 hours and left at 11:15 hours. The outcome areas reviewed at this inspection were those relating to the delivery of care and the health and safety of residents. We had made an immediate requirement in relation to unsafe bedrails at the key inspection on the 28th July 2009. We required that all bedrooms must be checked and made safe. Where the home was unable to make the room safe a risk assessment must be undertaken and suitable arrangements put in place. This was to maintain the health and safety of the residents. At this inspection we found bedrails attached to a number of beds which were still unsafe. They were unstable, ill fitting and posed a risk of entrapment to the individuals using these beds. We may take enforcement action to ensure that the health and safety of residents is improved and maintained and evidence has been submitted to our Regional Enforcement Team for consideration. 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 4 of 16 Care Homes for Older People Page 5 of 16 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 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 information to meet each person health needs. this must include all aspects of their health and welfare including wound care. 27/08/2009 2 8 12 The registered person must 29/07/2009 promote and make proper provision for the health and welfare of the service users. This must include the correct use of pressure relieving devices. To reduce the risk of people developing pressure sores. 3 8 12 The registered person must make proper provision for the health and welfare of service users. To ensure that people receive adequate nutrition and hydration and monitoring charts are completed and used 27/08/2009 Care Homes for Older People Page 6 of 16 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 effectively. 4 9 13 The registered person must 29/07/2009 make fobust arrangements for the recording, handling, safe keeping, safe administration and disposal of all medicines in the home. To protect residents from ingesting medicines which are not prescribed for them 5 17 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 place at risk of harm or abuse. To ensure that staff are aware of safeguarding guidance and report any suspicions or actual abuse to the appropriate agencies. This must include any reports of bruising of unknown origin. 6 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 and the home is a more pleasant place to live. Care Homes for Older People Page 7 of 16 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 2 14 The registered person shall not provide accomodation 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 27/08/2009 Care Homes for Older People Page 8 of 16 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 to meet the health and welfare needs of service users. To ensure that staff have accurate and detailed 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 The provider must 19/08/2009 ensure 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. 6 9 12 The provider must ensure 19/08/2009 that there is a safe system in place, to have medicines available to administer them in accordance with the directions of the professional prescribing them. 27/08/2009 Care Homes for Older People Page 9 of 16 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 This is so that people receive their medicines as prescribed. 7 9 13 Arrangements must be made 19/08/2009 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 benficial health effect for them. 8 9 13 Arrangements must be made 19/08/2009 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. 9 9 13 Arrangements must be made 19/08/2009 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 inappropriate use. 10 12 12 The registered person must consult with service users and make provisison for recreational and social opportunities based on their needs and preferences. 28/10/2009 Care Homes for Older People Page 10 of 16 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 To minimise risks of boredom and associated distress. 11 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 willl enhance their quality of life by enjoyment of food and promote physical wellbeing. 12 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. 13 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 guidance and report any Care Homes for Older People Page 11 of 16 28/09/2009 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 suspicions or actual abuse to the appropriate agencies. this must include any reports of bruisng of unknown origin. 14 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. 15 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 and the home is a more pleasant place to live. 16 26 13 The registered person must ensure that all staff have undertaken training in infection control. To minimise the risk of cross infection. Care Homes for Older People Page 12 of 16 28/10/2009 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 17 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. 18 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. 19 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. 28/10/2009 20 33 24 The registered person must establish and maintain a system for evaluating the quality of the services provided at the care home. To identify any shortalls in 28/10/2009 Care Homes for Older People Page 13 of 16 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 the service so that action can be taken to improve. 21 36 18 All nursing and care staff must be appropriately supervised. To recognise training needs and personal development of staff. 22 37 17 The registered person must 28/10/2009 maintain in the care home records speified 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. 23 38 13 All bedrooms must be checked and made safe. Where you are unable to make the room safe a risk assessment must be undertaken and suitable arrangements put in place. All bedrooms must be checked and made safe. Where you are unable to make the room safe a risk assessment must be undertaken and suitable arrangements put in place. 24/08/2009 28/10/2009 Care Homes for Older People Page 14 of 16 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 8 The home should provide a sufficient number of slide sheets to aid the comfort of service users when moving them in bed. It is recommended that the audits currently in use are reviewed and made more robust to prevent shortfalls in the future. It is recommended that when people have medicines prescribed to be applied to the affected part that this is reflected in the care plan. It is recommended that when the application of external medicines is delegated to carers that there is a clear record of the training these carers have received and also for the delegation process. The home should consider the provision of one to one activity sessions for those people unable or unwilling to participate in group activities. Broken waste bins should be replaced with foot operated ones. Soiled linen should not be hand sluiced. Where known risks, such as the ingestion or suffocation from plastic aprons and vinyl gloves, are present they should be assessed and action taken to minimise the risk. Personal protective clothing should be accessible to staff for their use and not to residents with dementia. All staff should have access to the sluice rooms. It is recommended that nursing and care staff receive formal supervision at least six times a year. 2 9 3 9 4 9 5 12 6 7 8 19 26 26 9 10 26 36 Care Homes for Older People Page 15 of 16 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 16 of 16 - 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!