Random inspection report
Care homes for older people
Name: Address: Sandhurst Lodge 58 Ampthill Road Bedford Bedfordshire MK42 9HL one star adequate service 22/04/2009 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: Sally Snelson Date: 0 5 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Sandhurst Lodge 58 Ampthill Road Bedford Bedfordshire MK42 9HL 01234352051 F/P01234352051 sandhurst_lodge@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Dr Surinder Kumar Gulati Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 10 10 10 dementia mental disorder, excluding learning disability or dementia physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 0 2 1 0 2 0 0 9 Sandhurst Lodge is a care home registered to accomodate up to 10 people whose primary care needs on admission fall within one of the following categories: old age, dementia, mental disorder (excluding learning disabilities) and physical disabilities. The home is located on a busy main road in the heart of Bedford town within close proximity to the local hospital, amenities including transport links. The accommodation
Care Homes for Older People Page 2 of 8 Brief description of the care home is set out over three floors - accessible via a staircase and a shaft lift. All bedrooms are single occupancy and communal facilities include a small lounge and dining room on the ground floor. There is one assisted bath and one shower, which would not be accessible for people with a physical disability. There are no ensuite facilties and there is limited outside space. At the time of this visit, work was in progress to extend the home to create a further 7 bedrooms. Information about the home is available within the Statement of Purpose (SoP) and Service User Guide (SUG). Both are available within the home along with a copy of the most recent inspection report for this service. The SoP states that the fees for the home at the current time are £457.06 per week upwards. Care Homes for Older People Page 3 of 8 What we found:
This random inspection of Sandhurst Lodge was undertaken on the morning of 5th November 2009. The focus of the inspection was to look at record keeping in the home, including medication records. At the start of the inspection there were three care staff on duty supporting the seven residents. One resident had moved to a nursing provision the previous day. One carer was identified as being in charge of the shift. She told us she was not currently employed as a senior carer, but had worked in this capacity in the past in another home. She conducted herself appropriately and aided the inspection process. We were told that there was currently no manager employed. The carer tried to contact Mrs Gulati and Mr Gulati junior, the son of the providers. Neither were immediately available, but we were able to speak to Mr Gulati junior on the telephone. Both arrived at the home before the end of the inspection and received the feed-back. We were told that the most recent manager had not been given a contract at the end of her probation period. We were told that the post had been advertised and interviews had taken place, a final decision was being made that day. We were given the name of the person considered appropriate for the role. We looked at the medication systems in place. The Medication Administration Records (MAR) were neatly kept. We noted that omission codes were used when a medication was not given for any reason and that staff always signed when they gave medications. There were no gaps in the recordings. We looked at the NOMAD packs (the blister packaging that most of the medications are packed in by the pharmacy). People had received all the medications they were due. However where medications were given as required (PRN), because any unused medication carried over from the previous month were not recorded and added to the total, we were unable to reconcile these medications. For example, one resident ha received a 100 paracetamol on 31/10/09 and this was recorded. It was also clearly recorded that 12 tablets, in divided doses, had been given However when we counted the tablets held by the home there were 96 rather than the 88 we expected to find. The member of staff who had administered the medication that morning had been trained to do so and had a certificate to support the training. We reminded Mr Gulati that the signature list at the front of the MAR file needed to be updated to remove a number of names and add a new member of staff. We looked at the care records for one resident who we had been told had absconded recently. We were aware that a report had not been received by us or the safeguarding team. Mrs Gulati and Mr Gulati junior stated that this had occurred on the 16th July 2009 and that the documents relating to this were with the solicitor, as they were required by Bedford Borough. We had been advised of this incident. There was nothing in the daily notes or from talking to staff that suggested a similar incident had occurred more recently, as we had been advised. A care file identified that a resident had some periods of aggression. A risk assessment had been written, but needed more detail to guide staff in managing behaviours. There was an incident report relating to an incident 01/10/09 that recorded one resident had slapped another. It was signed by a carer who was on duty. We were told it was a lash out and that no mark or injury had occurred so it was not reported to us or to SOVA.
Care Homes for Older People Page 4 of 8 There were two sets of care plans in the file we sampled. The Care plans detailed how and why most aspects of care were to be provided, but we did not see how the plans had been reviewed. We did see some hand written notes of changes to the original plans (written on 16/04/09), but these changes were not dated. There was a signature confirming that plans had been reviewed in October 2009. Mrs Gulati told us that the reviews were recorded on the computer system, but as the system was not running because of the recent office move we could not confirm this. people using the service had been weighed in August, September and October 2009. We looked at the financial arrangements for money held by the home on behalf of residents. Each resident for whom money was held had a cash box and a record was kept of any money received into the home, or used for expenses. Receipts as proof of purchase were kept. One of the balances was out by 4p, and while we appreciate that the money had been rounded up, rather than having odd pence in the box, and that the discrepancy was to the advantage of the resident this did not indicate that accurate records were being kept. Where involved family members were also checking financial records. The provider was not available to ascertain if any additional regulation 26 visits had been carried out. To date we were only in receipt of the report of one visit. 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 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 12 16 Activities provided by the 23/06/2009 home should suit the needs, preferences and capacities of the people living there. To ensure that people, particularly those with dementia, are given meaningful opportunities for stimulation. 2 31 9 The manager must apply for registration with the CQC. To ensure that she meets the fitness criteria for managing a registered care home. 05/06/2009 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, 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 Older People Page 7 of 8 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 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!
