This inspection was carried out on 10th October 2008.
CSCI found this care home to be providing an Adequate service.
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.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Quarry Mount Residential Care Home 83 Bath Road Swindon Wiltshire SN1 4AX The quality rating for this care home is: The rating was made on: one star adequate 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Sally Walker Date: 1 0 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Quarry Mount Residential Care Home 83 Bath Road Swindon Wiltshire SN1 4AX 01793527715 01793616130 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Quarry Mount Care Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 0 0 0 Over 65 25 32 4 Conditions of registration: The maximum number of service users who may be accommodated in the home at any one time is 32 No more than 25 service users aged 65 years and over with dementia may be accommodated at any one time No more than 4 service users aged 65 years and over with a physical disability may be accommodated at any one time Date of last inspection Brief description of the care home Quarry Mount is a large detached house in the Old Town area of Swindon offering accommodation and care to 32 older people, some of whom have dementia. The home is a short walk from local shops, post offices, bus stops and churches. The home is Care Homes for Older People
Page 2 of 8 arranged on three floors. There is bedroom accommodation on all three floors. The communal space is arranged on the ground floor and consists of a large lounge, a dining room and a further lounge and dining room. A conservatory was added in 2007. There is also some seating accommodation in the hallway. There are two semidetached bungalows in the rear garden accommodating four residents. There is a large garden at the rear. Seats and tables are provided in the summer so that residents can sit outside. The staffing rota provides for a minimum of 4 and a maximum of 8 care staff during the waking day. There are 3 waking night staff. Details about the weekly fees can be obtained directly from the home. The last Key inspection was on 12th December 2007. Care Homes for Older People Page 3 of 8 What we found:
We looked at the care records of those people who had fallen. We saw that peoples risk of falling had been identified during the pre-admission process. We saw that one person whos mobility was described as poor, had had a period of rehabilitation at another care home. People who had fallen had had their risk assessments reviewed and revised following these falls. The layout of their bedrooms had also been taken into account in the review. The assessments had clear details about what must be in place to minimize the risk of falls. One person had attended the falls clinic following the fall and hip protectors were being used. Another person used arm protectors. We saw that listening devices were in use in these peoples bedrooms and on the top corridor. There was a clear procedure on the use of these devices to protect peoples privacy. Mrs Meadowcroft told us that the three waking night staff were also very vigilant in monitoring those people who were assessed as at risk of falling. Listening devices were not used in any of the other bedrooms. We saw that the daily reports were very detailed. At the last inspection of 12th December 2007 we made a requirement that care plans must identify how assessed needs are to be met. At this random inspection we saw that care plans were varied in the amount of detail recorded. We said that the care plans were very detailed in describing each persons assessed needs. In order that this requirement is fully met, all the care plans must identify guidance to staff on how to meet the assessed need. We said that the care plans must be reviewed and revised when any change of need was identified in the daily report. These entries must prompt a review of the persons care plan. We saw in one risk assessment that the person was described as very violent and aggressive towards staff. The guidance was for staff to reassure the person when this happened. We advised that judgemental or unclear terms should be avoided. Records must state what is observed or said and there must be more detail on what is meant by reassurance. We saw that peoples social and family history was well documented in their care plans. Mrs Meadowcroft showed us a care planning format that had been purchased. This was to be implemented by the end of October 2008. Mrs Meadowcroft told us that senior staff write and review the care plans. Mrs Meadowcroft agreed to undertake a review of all the care plans by the end of January 2009. Mrs Meadowcroft regularly monitored the accident records to determine causes and any patterns. Falls occurred at different times of the day and night. Some people were able to tell staff how they had fallen. Other people had difficulty in expressing what had happened. Mrs Meadowcroft had reviewed and revised peoples falls risk assessments as a result of the falls. Some people were prescribed medication with drowsiness indicated as a possible side effect. A new GP was to review all medication as a matter of priority. Mrs Meadowcroft told us that some peoples medical conditions would cause drop in blood pressure which could affect their balance. Mrs Meadowcroft attends the Primary Care Trust falls steering group every four Care Homes for Older People Page 4 of 8 months. She had an assessment which she was due to take to the next meeting. Mrs Meadowcroft was also due to attend the care homes meeting with Swindon Environmental Health Officers. We saw that consideration had been taken so that people who use the service who may have dementia could make better sense of their environment. Toilet doors were painted yellow and had pictorial signs on them. There were also signs with arrows at different points so that the toilets could be found more easily. All the signs were at eye level. We saw that staff had made efforts to ensure that peoples clocks in their bedrooms showed the right time. All commodes in the bedrooms that we looked in were clean and fresh. There were no unpleasant smells noted during the visit. Peoples bedrooms were furnished and decorated to make them homely. 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 8 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15(1) The person registered must 01/02/2008 ensure that care plans identify how assessed needs are to be met and monitored. This must include how behaviours are monitored, outcomes of pressure damage assessments, nutrition, use of any equipment and any interventions by district nurses. The person registered must 12/12/2007 ensure that residents freedom of movement is not restricted by any safety or comfort equipment. Risk assessments must be carried out on any reclining chairs purchased by family to ensure residents safety. Care plans must identify the arrangements following risk assessments carried out by district nurses for the safe use of any bed rails. 2 18 13(4)(c)&(7) Care Homes for Older People Page 6 of 8 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 15 Care plans must record full 31/01/2009 details of how current needs are to be met and monitored. For continuity of care for the people who use the service 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 pressure damage risk assessment should indicate which outcome score prompts a referral to the district nurse. Consideration should be given to providing refresher training in care planning. 2 30 Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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!
