Random inspection report
Care homes for adults (18-65 years)
Name: Address: Purbeck Care Binnegar Hall East Stoke Wareham Dorset BH20 6AT The quality rating for this care home is: The rating was made on: two star good service 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. Care Homes for Adults (18 – 65 years) Page 1 of 11 Lead Inspector: Jo Johnson Date: 1 1 0 5 2 0 0 9 Care Homes for Adults (18 – 65 years) Page 2 of 11 Information about the care home
Name of care home: Address: Purbeck Care Binnegar Hall East Stoke Wareham Dorset BH20 6AT 01929552201 01929556441 Purbeck@bmlhealthcare.co.uk www.purbeckcare.com Purbeck Care Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : learning disability Number of places (if applicable): Under 65 52 Over 65 0 care home 52 Additional conditions: 5 people in the category of LD(E) Date of last inspection: Brief description of the care home: Purbeck Care Ltd is registered to provide a residential service for up to 52 people with Learning Disabilities. The accommodation is provided in four separate units and each unit offers a different type and level of support. The main house is divided into two separate wings, West Wing provides care and support to both older and younger residents and has 15 bedrooms, 4 of which are on the ground floor. The East Wing provides support and care in a structured environment for people whose behaviour
Care Homes for Adults (18 – 65 years) Page 3 of 11 D D M M Y Y Y Y may be both complex and challenging to the services. There are 9 bedrooms available. Garden Cottage provides a more independent environment for residents who have a higher level of self-determination and independence. There are 5 bedrooms each with en suite facilities. Stable Cottage provides care and support to residents whose behaviour has been identified as falling within an autistic spectrum. All 7 bedrooms have en suite facilities. Each unit has ample communal rooms: - lounge, dining room, and sufficient toilet and bathroom facilities appropriately sited. The two cottages have separate kitchen areas. The accommodation is set in approximately twenty acres of land. There is a productive walled garden providing fruit and vegetables, which are regularly used in the catering for the residents and in addition an area of the grounds has been set aside for animal husbandry. Entrance to the home and grounds, which are just off the main Wool to Wareham Road, is via large electronic gates, which provide extra safety for residents. There is ample parking for both staff and visitors. There is a separate Day Centre, which provides space for a range of different activities as well as having its own kitchen and dining areas. At the time of the inspection 34 people were accommodated. Care Homes for Adults (18 – 65 years) Page 4 of 11 What we found:
This random inspection was undertaken following concerns we had following a fire at the home and a safeguarding referral made to us and the local authority. We had concerns that staff had not followed guidelines and procedures in place at the home. We looked at two peoples care records. Both people had clear plans and guidelines in place on how staff are to support them in their day to day lives. There were risk assessments in place for any behaviours that may challenge. One persons risk assessment and should be updated to reflect what staff need to do when the person is wanting to leave the home at night. One persons risk assessment and plan had been updated following the fire. Actions have been taken to minimise the risks both in the environment and from the individual. There is now also a plan in place for when this individual refuses their prescribed medication for more than three days. This person had previously been subject to a Guardianship under the Mental Health Act. However, it was not clear from the care records or from discussion with the manager as to the current status of this individuals residence at the home or under the Mental Health Act. One of the people has made an allegation about a member of staff. We looked at all of the care records relating to this person. There was no record of the incident that was witnessed by another person living at the home. A body map had not been completed until at least two days after the incident. Staff had not followed the care plan for this individual, recorded the incident or completed a body map. Requirements relating to record keeping and following care plans have been made as a result of this inspection. Staff at the home undertake monthly reviews by following a check list. There are a number of different records and files kept about each individual and the reviews may not consider all of the information available. It is recommended that the monthly reviews collate all of the information recorded about individuals. This is so there is a clear monthly summary that gives a picture of how people have been and how they have spent their time. People should be involved in their monthly reviews where possible. This is so they can contribute to their reviews and care records. We found records for another person in one individuals care records. We looked at the staff file for one member of staff. There was not a clear record of the previous disciplinary action taken, hearings or outcomes of disciplinaries relating to this staff member. The manager was aware of an incident within the last year that was not recorded in the personnel file. The history of disciplinary actions and allegations should be collated and detailed in the individuals staff file. One member of staff lives on site at the home. There was not any record of a tenancy agreement and how and if this relates to the employment of the individual. The organisation must be able to demonstrate how they safeguard people living at the home from people who may also live on site who are subject to suspension and or Care Homes for Adults (18-65 years) Page 5 of 11 disciplinary action. Care Homes for Adults (18 – 65 years) Page 5 of 11 We discussed with the manager the fire in one persons bedroom. We raised serious concerns that the staff did not follow fire procedures, the fire brigade were not immediately called and the people living at the home were not evacuated. The manager told us that he has met with all of the staff who were involved in the incident and reiterated that they must follow procedures. All staff have now been retrained in fire procedures. The fire officer has visited the home and made further recommendations to reduce the risks in the bedroom of the individual. These recommendations have all been implemented. 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 Adults (18 – 65 years) Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes Outstanding Statutory Requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action No 1 30 16 The registered provider must 01/10/09 ensure all parts of the home are kept clean, hygienic and free from offensive odours. The registered provider must 01/10/09 ensure all staff receives regular fire training. 2 42 23 Care Homes for Adults (18 – 65 years) Page 7 of 11 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, Care Homes 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 12 The current status of one individuals residence at the home under the Mental Health Act must be clarified. This is so the individual is clear about their status at the home and their rights under the Mental Health Act. 03/08/2009 2 10 17 Accurate records must be 01/07/2009 maintained for people. This must include incident records and body maps following any injury or allegations. This is to demonstrate that people are receiving the care and support they are assessed as needing and that accurate records are kept. 3 18 12 Care plans, risk and 01/07/2009 behaviour management plans must be followed for all individuals. This is to make sure that people are supported and Care Homes for Adults (18 – 65 years) Page 8 of 11 cared for in line with their assessed needs and care plans 4 23 13 The organisation and 01/07/2009 manager must be able to demonstrate how they safeguard people living at the home from people who may also live on site who are subject to suspension and or disciplinary action. This is to safeguard the people living at the home. The management at the 01/09/2009 home must develop ways of monitoring and observing the practices of staff working directly with individuals. This is to ensure that that staff are following procedures and guidelines. Staff must follow the fire 03/06/2009 procedures at all times. This is to ensure the safety of all persons at the care home. 5 38 24 6 42 23 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 6 It is recommended that the monthly reviews collate all of the information recorded about individuals. This is so there is a clear monthly summary that gives a picture of how people have been and how they have spent their time. People should be involved in their monthly reviews where possible. This is so they can contribute to their reviews and care records One persons risk assessment and should be updated to reflect what staff need to do when the person is wanting to leave the home at night. A tenancy agreement should be in place for the member of
Page 9 of 11 2 7 3 9 4 23 Care Homes for Adults (18 – 65 years) 5 34 staff who lives on site. This agreement should specify how and if this relates to the employment of the individual. The history of disciplinary actions and allegations against staff should be collated and detailed in the individuals staff file. Care Homes for Adults (18 – 65 years) Page 10 of 11 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 Adults (18-65 years) 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
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