Inspection on 26/01/10 for Purbeck Care

This inspection was carried out on 26th January 2010.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Purbeck Care 13/10/09

Purbeck Care 11/05/09

Purbeck Care 22/10/07

Purbeck Care 20/02/07

Purbeck Care 08/05/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 11/04/2010.

Random inspection report Care homes for adults (18-65 years) Name: Address: Purbeck Care Binnegar Hall East Stoke Wareham Dorset BH20 6AT zero star poor service 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: Jo Johnson Date: 2 6 0 1 2 0 1 0 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 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Purbeck Care Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 52 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 people in the category of LD(E) Date of last inspection Brief description of the care home 52 1 1 0 5 2 0 0 9 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 may be both complex and challenging to the services. Care Homes for Adults (18-65 years) Page 2 of 14 Brief description of the care home 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. Care Homes for Adults (18-65 years) Page 3 of 14 What we found: Since the key inspection the registered provider has met with us and provided us with two progress updates of the action they have taken following the inspection. Each living unit or house now has a manager and a specific staff team. A general manager has been appointed to manage the whole service. He had been in post for two weeks at the time of the inspection. Staff commented positively on the new general manager and their open style of management. They also told us that overall that having dedicated teams and managers in each living unit was having a positive impact on people living at the home and the staff. As part of this inspection we assessed the suitability of the four new two bedroomed bungalows. We found that they were suitable to be used once the buildings have been signed off by the builders and building control. The general manager and director told us that three people who already live at the home have been assessed for three of the bungalows. They have been involved in choosing the decor and household items for their new homes. We looked at the care records, plan and risk assessments for one person that we case tracked at the key inspection. Their plan and risk assessment had been updated since the key inspection. We spoke with the individuals key worker who told us that there has been some positive progress with supporting and encouraging this individual in managing their diet and diabetes. The general manager showed us the person centred planning tracker that he is introducing. It is very user friendly and the people living in Garden cottage have started to use it with staff support. The person centred planning tracker includes goal setting and monitoring. The people in Garden cottage are now keeping their plans and care records in their bedrooms. Everyones medication is now securely stored in their bedrooms and is now administered by Garden cottage staff. There are new easy to read and complete monthly reviews that are being implemented. this means that some people will be able to participate in their reviews and record keeping. We will fully assess the requirements relating to care planning, risk management, medication and health care at the next key inspection. Since the key inspection new crockery and cutlery has been purchased for East Wing and some of the plastic crockery has been replaced in Stable cottage. A dishwasher, washing machine and tumble dryer has been fitted in East wing. People who live at the home and staff told us that they liked being able to do these daily living tasks themselves. The people who live in East and West wing are in the process of choosing new names for their houses. They will vote on the new names at the next house meeting. People enthusiastically told us their choices of names for their houses. All of the houses were clean and free from any offensive odours during the inspection. Care Homes for Adults (18-65 years) Page 4 of 14 There is now a new cleaning schedule in place that includes daily monitoring. The sashs and weights in East and West wing have been replaced so that the windows now open and close safely. There is a replacement and refurbishment plan in place for each of the houses. This includes the replacement of Stable cottage kitchen, a specialist toilet for one person, new lounge furniture for East wing and a kitchenette for East wing. The requirements relating to the environment will be fully assessed at the key inspection. Overall the staffing levels at the home have increased since the key inspection. The general manager and director told us that there is an ongoing recruitment drive. From discussion with staff and managers there are still more staff that need to be specifically recruited to support the one woman who lives in Stable cottage. This is to ensure that their preference of gender of carer in relation to personal and intimate care is respected. Since the key inspection a comprehensive staff training programme has been implemented. Staff spoke positively of the training and support they had been provided with so far. The training programme includes; safeguarding adults, medication, epilepsy, mental health, record keeping, equality and diversity, fire safety, moving and handling, autism, care of older people, managing risks, first aid and the Mental Capacity Act and Deprivation of Liberties. Since the key inspection the management team at the home has notified us of events under regulation 37 and made safeguarding referrals to the local authority as appropriate. The requirement relating to staffing will be fully assessed at the key inspection. What the care home does well: What they could do better: Requirements that show as outstanding may not have been fully assessed and may have Care Homes for Adults (18-65 years) Page 5 of 14 been met. All outstanding requirements will be fully assessed at the key inspection. Other requirements were not assessed as they are within timescales. There are no new requirements from this random inspection. 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 14 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 2 14 People must only be 01/01/2010 admitted to the home following an accurate full assessment that demonstrates that staff have the skills and knowledge to meet their needs. This is to make sure that people are placed at the right home, and that their needs can be met. 2 2 14 People must be consulted and be involved in their own assessments and any decisions as to where and with whom they live. This is to make sure that people are involved about where and who lives with them. 01/01/2010 3 6 15 Peoples care plans must be 01/01/2010 reviewed, kept up to date, and include all the individuals needs identified in their assessments and their wishes and aspirations. This is so staff know what care and support people require to make sure that all their needs are met and they are well cared for. Care Homes for Adults (18-65 years) Page 7 of 14 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 4 6 12 People must be provided with 05/02/2010 suitable communication support to make their views and wishes known in their care plans. This is so people can contribute to their plans and their views are recorded. 5 7 12 Where people have 01/01/2010 restrictions or limitations placed on them this must be based and evidenced in their best interests by their own agreement or under the Mental Capacity Act or where necessary by a Deprivation of Liberty application. This so people are protected and any restrictions are made in their best interests. 6 9 13 Any areas of risk identified for an individual must be assessed and these assessments must include individual behaviours, self harm or harm to other people, medical conditions such as epilepsy. They must include descriptions of how staff are to support them. This is is that any risks are minimised and staff know what action to take to keep people safe. 27/11/2009 7 11 12 People must be provided with 01/03/2010 opportunities to develop their social, emotional, educational, communication Page 8 of 14 Care Homes for Adults (18-65 years) 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 independent living skills. This is to ensure that people have a good quality of life and well being. 8 17 12 People must be given a choice of food that is in an accessible format. This is so people can choose their food each day. 9 18 12 Peoples privacy and dignity 27/11/2009 must be maintained at all times. Care plans must detail how staff are to support people in situations where their privacy and dignity may be compromised. This is to ensure the safety, privacy and dignity of people living at the home. 10 18 12 Care plans, risk and 01/01/2010 behaviour management plans must be followed for all individuals. This is to make sure that people are supported and cared for in line with their assessed needs and care plans. 11 19 13 Where an individual is prescribed medication that can be administered by staff at the home. The staff must be trained to do so. This is to make sure that people receive prescribed Care Homes for Adults (18-65 years) Page 9 of 14 01/01/2010 01/01/2010 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 medication. 12 20 13 Staff must be trained in the 01/03/2010 administration of medication. This is is staff know how to safely administer medication. 13 22 22 There must be a record of any complaints, the investigation, the action taken and the response to the complaint. This is to make sure that complaints are investigated and acted on. 14 23 13 All staff must be provided with adult protection training. This is to make sure that staff recognise and know how to report any allegations of abuse. 15 23 13 There must be records of 04/12/2009 restraints or physical interventions. Physical intervention plans must be in place for people and these must be agreed by a multidisciplinary team and to be in their best interests. Any physical interventions must be reported under regulation 37. This is to make sure that accurate records are kept and that physical interventions are only used in exceptional circumstances Care Homes for Adults (18-65 years) Page 10 of 14 01/01/2010 05/03/2010 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 safeguard the individual and others. 16 24 13 The kitchen in Stable Cottage 05/03/2010 must be replaced. This is because it is an infection control risk. 17 30 16 (2) (k) The registered provider must 04/12/2009 ensure all parts of the home are kept clean, hygienic and free from offensive odours. This is an outstanding requirement from the last two key inspections. 18 33 18 Staffing levels provided at the home must be based upon the individual needs of the people who live there. This is to make sure that there is sufficient staff to meet the personal, physical, social and psychological care and support needs of the people at the home. 01/01/2010 19 34 19 Staff waiting for CRB clearance must be supervised by a named member of staff. Any declarations of convictions must be risk assessed. This is to make sure that whilst the suitability of staff is verified they do not work unsupervised. 16/11/2009 20 35 18 All staff must be trained in all 03/05/2010 of the mandatory areas and Page 11 of 14 Care Homes for Adults (18-65 years) 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 specialist training such as medication, epilepsy, care of older people, mental health conditions, working with people with forensic histories, BSL, adult protection and assessing and understanding risks. This is to make sure that staff have the skills and knowledge to be able to meet peoples needs. 21 36 18 Staff must be appropriately supervised. This is to make sure that staff have the right support and guidance and their performance is managed. 22 39 24 The overall management of 01/02/2010 the home must improve, and develop effective ways of assessing and monitoring the quality of the service. This is so that shortfalls are identified, are improved on and the quality of the service is kept under constant review. 23 39 24 The management at the 01/01/2010 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. 01/02/2010 Care Homes for Adults (18-65 years) Page 12 of 14 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 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 Adults (18-65 years) Page 13 of 14 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. 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