Inspection on 19/10/09 for Sweetcroft Residential Care Home

This inspection was carried out on 19th October 2009.

CQC found this care home to be providing an Poor 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sweetcroft Residential Care Home 06/08/09

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Random inspection report Care homes for older people Name: Address: Sweetcroft Residential Care Home 53 Sweetcroft Lane Uxbridge Middx UB109LE 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: Jane Collisson Date: 1 9 1 0 2 0 0 9 Information about the care home Name of care home: Address: Sweetcroft Residential Care Home 53 Sweetcroft Lane Uxbridge Middx UB109LE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ilford Homes Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 20 Number of places (if applicable): Under 65 Over 65 20 20 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is:- 20 The registered person may provide the following categories of service only Care home only - Code PC to service users of the following gender Either whose primary care needs on admission to the home are within the following categories: old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Sweetcroft is a residential home for twenty older people. It is located in a large detached house on a quiet residential road. It is within a mile of the local shops and Care Homes for Older People Page 2 of 16 Brief description of the care home Hillingdon underground station. The A40 and public transport links are close by. Sweetcroft was an existing home, taken over by new providers in February 2009. There had been an Acting Manager in post and a new Manager Designate had been appointed in August 2009. There are twenty single rooms, on two floors, of which thirteen have an en-suite toilet and two have en suite bathrooms. There are two additional bathrooms and a number of toilets. There is a passenger lift to the first floor. The lounge and separate dining room are on the ground floor. There are pleasant gardens, including a patio to the rear of the building, and parking to the front. There is a kitchen, laundry room and a small office. In the entrance hall, there are CCTV cameras for security. The fees range from £409 to £550 per week. The respite fee is £575. Care Homes for Older People Page 3 of 16 What we found: We visited the home on Monday 19th October 2009 from 10.15am to 3pm to check on the progress of the Statutory Requirements Notices made to the home after the inspection in August 2009. These were in relation to the medication administration and the recruitment procedures. The Manager Designate was present. The medication Statutory Requirement Notice issued on 4th September 2009 required the home to Make arrangements for the recording, safekeeping, safe administration and disposal of medicines received into the care home by October 5th. We looked at the storage of medication, the recording of medication, and audited several samples to see if medicines were being given as prescribed. The home was using a new supplier and we noticed that the MAR Medication administration records were well completed with records of receipts and administration. We noticed that when tablets were left in the monitored dosage system they could be reconciled with the code for the reason of not giving. We counted 12 samples of medicines in their original packs and all could be reconciled with signatures for administration on the MAR. We checked the recording of Warfarin and we noticed that records tallied with the INR and dosage from the hospital and audits of the tablets indicated accurate administration. We noticed that an incorrect dose of Warfarin had been printed on the MAR but staff were giving it correctly. The Manager altered the MAR at the time of the inspection and contacted the pharmacist after the inspection. We noticed that when residents had an allergy that this was written on the MAR. However, no known allergy was not stated when the allergy status was not known. We noticed that blood glucose was measured when a resident had diabetes. The lancing device in use was designed for self testing, though, and not for professional use to prevent the risk of infection. We noticed that for one resident, who kept her medicines locked in her room, that it was difficult to audit medicines and we also noticed one gap on her MAR. Storage generally was good and the home had a new fridge for storing those medicines that required cold storage to maintain their potency. Balances of controlled drugs were accurate and they too were stored securely. Overall, we were satisfied that the home had complied with the Statutory Requirement Notice and that medicines were being administered as prescribed to maintain the health of the residents. The improvement needs to be maintained by regular auditing so that any issues can be identified and addressed. On the recruitment Statutory Requirement Notice, which issued on the 10 September 2009, and due to be completed on the 16 October 2009, we found that the majority of the requirements had been met. There had been some difficulty in getting all of the references again, together with the dates of employment, but there was evidence that Care Homes for Older People Page 4 of 16 the Manager had tried to do so and the referees had not all responded. She is aware that she needs to continue to try and obtain the missing information. In one case, a reference was received and, after investigation, the home had made the decision not to continue to employ the staff member. On the remaining files, we found that the Manager had asked staff to fill in the gaps on their employment histories or they had provided a CV with the dates of employment. We found that the Manager had been provided with a new reference form from the Registered Providers but part of this was missing. She took action to ensure that she now has the full reference form for future use. The information in the Managers file had been completed and one of the references, which had been applied for again, had been returned. We confirmed with the Registered Providers that the second reference had been received for the Manager. All of the staff employed, including the Manager, has a Criminal Records Bureau disclosure. Overall, we found that the files were being kept in better order, allowing us to find the information we required. 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 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 1 4 The Registered Providers must ensure that the Statement of Purpose is completed to reflect the needs of the people the home is able to accommodate. The home can demonstrate that the needs of people with dementia can be met by the homes staffing, environment and activities. 31/10/2009 2 1 5 The Registered Providers must ensure that an up-todate version of the Service Users Guide is completed and distributed. To ensure that people living in the home and their representatives have current information. 31/10/2009 3 2 5 The Registered Providers 31/10/2009 must ensure that an up-todate terms and conditions or a contract are supplied to the people living in the home. To ensure that people have the information on fees and facilities. 4 3 14 The Registered Providers must ensure that a 31/10/2009 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 procedure is in place which demonstates that all of the needs of the people considered for admission have been assessed for all areas of support, including dementia. To ensure that the needs of the person being admitted are fully assessed and there is evidence to show that their needs can be met. 5 4 18 The Registered Providers 31/10/2009 must ensure that staff have the required training and expertise to meet the needs of the people being admitted. To ensure that staff are able to support people with dementia and any other specialist needs. 6 7 13 The Registered Providers 30/09/2009 must ensure that all potential risks are assessed and action taken to minimise any risks to the person or to the staff. These must be updated as and when the persons support needs change. To ensure that people and staff are protected and risks to their health and safety are reduced. 7 7 15 The Registered Providers must ensure that a care planning system is in place which contains up-to-date plans for each person, 31/10/2009 Care Homes for Older People Page 7 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 showing how their needs will be met. These must be seen to have been produced in conjunction with the person or their representative. To ensure that peoples needs are known and appropriate action is in place to meet their needs. 8 8 12 The Registered Providers must ensure that the heath needs of the people living in the home are assessed and recorded, together with the action taken to meet those needs. To ensure that people have their health needs met appropriately. 9 10 12 The Registered Providers must ensure that staff are aware, through training and supervision, that peoples dignity is to be respected at all times. To ensure that people are treated appropriately and their privacy and dignity are maintained. 10 12 16 The Registered Provider must 31/10/2009 ensure that, in consultation with the residents and their representatives, a range of activities is provided which meet the needs of people living in the home. To ensure that people have Care Homes for Older People Page 8 of 16 30/09/2009 30/09/2009 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 the opportunity for a range of activities. 11 13 16 The Registered Providers must ensure that people have the opportunity for outings and to remain in contact with the local community. To ensure that all of the residents have the opportunity to go outside of the home, particularly those without families or visitors. 12 18 13 The Registered Providers 30/09/2009 must ensure that there is information available for staff on safeguarding policies and procedures. To ensure that staff are aware of the processes for reporting safeguarding incidents. 13 18 13 The Registered Providers must ensure that new staff have the training in safeguarding people to help them support and protect people. To ensure that all staff have the awareness of safeguarding and understand the procedures for reporting. 14 19 13 The Registered Providers 30/09/2009 must ensure that all areas of the home are safe and that risk assessments have been completed to minimise any Page 9 of 16 31/10/2009 30/09/2009 Care Homes for Older People 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 risk to people living in the home and to staff. To ensure that all areas are maintained to a safe standard and any risks are minimised. 15 30 18 The Registered Providers must ensure that all staff have the required induction and training to perform the work they are employed to carry out. To ensure that staff have the skills they need to carry out their work to a good standard. 16 31 9 The Registered Providers 31/10/2009 must ensure that the home is managed by qualified, competent and experienced staff. To ensure that the Care Home Regulations are understood and are being met, to protect and support the residents. 17 33 24 The Registered Providers 31/10/2009 must ensure that the home has a system for quality assurance and monitoring that reflects the views of the people living in the home and their representatives. To ensure that people have input into the way in which the home is run. 31/10/2009 Care Homes for Older People Page 10 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 18 33 26 The Registered Providers must ensure that the monthly visits to the home are carried out and are available for inspection. To demonstrate that the Registered Providers have satisfied themselves that the home is being run to a good standard, records are in order and the residents and staff views are sought. 30/09/2009 19 35 13 The Registered Providers 30/09/2009 must ensure that the systems in place for holding peoples money are known to those concerned and regular audits are carried out. To ensure that people are aware of the systems for keeping their money and that it is checked on a regular basis. 20 36 18 The Registered Providers must ensure that staff receive regular supervision from management staff. A programme must be commenced to ensure that all staff commence regular supervision within the timescale. To ensure that staff receive support and guidance in carrying out their work. 31/10/2009 21 37 17 The Registered Providers 31/10/2009 must ensure that the records kept in the care home are Page 11 of 16 Care Homes for Older People 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 maintained in good order, and are up-to-date and available for inspection. To demonstrate that the home is well managed, with good systems and monitoring procedures in place. 22 38 13 The Registered Providers 30/09/2009 must ensure that the outstanding work identified in the fire risk assessment is carried out. To protect people living in the home, staff and visitors. 23 38 37 The Registered Providers 18/09/2009 must ensure that staff are aware of the circumstances under which a notice must be made to the Care Quality Commission under Regulation 37 and must monitor to ensure this is done. To ensure that the home reports appropriately under the Care Home Regulations 2002. 24 38 13 The Registered Providers 31/10/2009 must ensure that there is a schedule of planned maintance and servicing, and staff are aware of the checks that are required to maintain good health annd safety in the home. To support safety in the home and protect peoples Care Homes for Older People Page 12 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 health and safety. 25 38 13 The Registered Providers 30/09/2009 must ensure that risk assessments on the environment are carried out and action taken to minimise risks to staff and residents. To ensure that any risks to staff and people living in the home are reduced and eliminated wherever possible. Care Homes for Older People Page 13 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 9 13 The Manager must ensure that regular audits of the medication continue and are available for inspection. Audits must record what issues are identified and what action has been taken so that they do not happen again. This is to maintain good practice and provide evidence of accurate administration. The Manager must ensure that all of the information required for the recruitment records is obtained. To support the protection of the people using the service. 14/11/2009 2 19 29 30/11/2009 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 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. 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