Inspection on 07/09/09 for Sycamore Rise Residential Care Home

This inspection was carried out on 7th September 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sycamore Rise Residential Care... 15/06/09

Sycamore Rise Residential Care... 02/04/09

Sycamore Rise Residential Care... 17/04/08

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Random inspection report Care homes for older people Name: Address: Sycamore Rise Residential Care Home Hill Lane Colne Lancashire BB8 7EF zero star poor service 02/04/2009 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: Christopher Bond Date: 0 7 0 9 2 0 0 9 Information about the care home Name of care home: Address: Sycamore Rise Residential Care Home Hill Lane Colne Lancashire BB8 7EF 01282864209 01282870897 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Crystal Care Homes Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 23 Number of places (if applicable): Under 65 Over 65 0 0 23 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 23 23 0 The registered person may provide the following categories of service only. Care home only - code PC, to people 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. Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD The maximum number of people who can be accommodated is: 23 Date of last inspection 1 5 0 6 2 0 0 9 Care Homes for Older People Page 2 of 10 Brief description of the care home Sycamore Rise is a care home that accommodates 23 residents including people who have dementia. The bedrooms are mainly single rooms and most of them have ensuite facilities. There are two shared double rooms. There are two lounges, one that doubles up as a dining area. There is a lift available that serves all floors. The home is situated in a rural setting on the outskirts of Colne, Lancashire. There are good views of the surrounding countryside and some of the rooms overlook the hills around the home. There are no services in the immediate vicinity of the home. There are, however, shops and other services in the local town. Bus services into the town are limited and the home does not have its own transport at present. Information relating to the homes Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit the information given to the Commission showed that the fees for care at the home are from GBP 366.00 to GBP 413.00 per week, with added expenses for hairdressing and chiropody. Care Homes for Older People Page 3 of 10 What we found: This was a random inspection which took place on the 7th September 2009. The purpose of this inspection was to monitor the service after a key inspection in April found that outcomes for residents were poor ( 0* quality rating). We asked the owner of the home to complete an improvement plan, and this was submitted to us in May 2009. We undertook a further random inspection of this service on the 15th of June 2009 and found that there were still areas of the service that needed to improve. A Statutory Requirement Notice was issued to the owner of the home in July 2009. This notice required the company operating the home to improve the control of medicines at Sycamore Rise. We looked at how the acting manager of the service and the owner had addressed the requirements made of the service by the Commission. We looked at care documentation within the home and the medication systems that were in place. We spoke to three of the care staff, and a senior carer. We also spoke to five people who used the service about their experiences and care whilst living at the home. We also spoke to the visiting District Nurse about how she found the arrangements for delivering care within the home. Serious concerns about the safe handling of medicines were identified at our previous visits. This visit was made to look at any action taken to improve the handling of medicines at the home in order to meet with current requirements. Overall, we found that the arrangements for handling peoples medicines had improved and that action had been taken to address the requirements of Statutory Requirement Notice served in July 2009. All staff handling medicines had completed refresher certificated medicines training, and where people were new to medicines administration at the home the manager planned to carry out observations (checks) before they were allowed to handle peoples medicines. This helps to ensure that staff know what to do and that the homes procedures are followed. We saw that the medicines administration records were now referred to and completed at the time medicines were administered to each person. And that records were kept where district nurses administer peoples injections, showing when the next dose was due. Clear and accurate record keeping helps to support the safe administration of medication, reducing the risk of mistakes. A review had been carried out with someone who managed their own medicines and more support put in place to help ensure their medicines were managed safely. We found that GP and other health care professional advice was mostly clearly recorded helping to ensure that changes to peoples medicines were properly and promptly made. Concerns about the handling of medicines on admission to the home continued throughout July but we found that where people had more recently come to live at the home checks were made with their doctors to help ensure they had all the medicines that were needed. But, it is recommended that where possible more information is gathered about peoples medication needs before they come to the home, for example discussing whether the person normally self-administers medicines. Where medicines were prescribed when required there was usually (but not always) some written guidance for care staff about when these medicines may be needed. This should be Care Homes for Older People Page 4 of 10 extended where appropriate to ensure when required medicines guidance is always included in relevant care plans, helping to ensure medicines are consistently used when needed. We saw examples where clear records were made in peoples daily notes when these medicines were used, helping to ensure all staff were aware of any support that person may need. The manager was working with the doctors surgery and pharmacy to help improve the ordering of medicines and to reduce the risk that medicines will run out. We checked a sample of current medicines records and stocks and found sufficient medicines were available to allow continuity of treatment. It was of concern that we saw two examples where creams prescribed when required were not included on peoples current medicines records. These creams were available in the home but were not currently needed. The manager was aware of this concern and was working with the pharmacy to look at procedures for ensuring all current medicines were listed. It is recommended that monthend procedures are reviewed to help ensure that when the new monthly delivery of medicines is checked in any when required medicines that have not been stopped are included on the new record. We also looked at the general care records for the people who lived in this home. We found when we last visited the home that care planning was a concern because information wasnt being entered properly and the information within each plan wasnt being regularly reviewed. Reviews are important because current care needs can be assessed and information within the plan can be altered if there is any change. The care that the service offers can then be altered and information updated so that it is current and consistent. We found on this occasion that a new care planning document was being used. Reviews were built into the plan and the manager helped to ensure that everyones care was properly reviewed and changes noted. We looked at a number of care plans and each area of care was properly reviewed. We saw that notes within the plan had been updated and, on talking to the care staff, they had a better knowledge of peoples current care. Any dangers that were evident, particularly when people were at risk of falling, were properly risk assessed to minimise any instances, and to ensure that care staff were more aware of areas of risk. We also saw that pressure area care was being properly recorded and there were good notes within the plans. A District Nurse was visiting the service whilst we were there. She told us that the care staff were involved in pressure area care and had a better knowledge of tissue breakdown. Peoples care had improved because of this: regular notes were found within the care plans about pressure area care and the District Nurses notes complemented these. On our last visit to the home we saw that continence care was not being addressed properly. There was a bad smell in the main lounge and people were not being taken to use the toilet regularly enough. The current acting manger has rectified this by having each person assessed by the continence nurse. Better pads have been purchased and we saw that the people who used the service were being given continence care, and changed, regularly. A new carpet had been fitted to the main lounge and there were new chairs. There were no offensive smells. The acting manager also told us that the domestic staff were proactive in cleaning things up as soon as possible. Consequently those who lived at Sycamore Rise were having their dignity protected properly and were able to live Care Homes for Older People Page 5 of 10 in much nicer surroundings. The care staff that we spoke to had a better knowledge of individual care issues and the manager promoted this. The owner of the home had arranged for a small room to be converted to an office on the ground floor. The manager told us that this helped her to be alert to the care needs of the residents and be available for advice and support for the care staff. Previously the main office was in the basement of the building. An area had been created in the hallway of the home where the care staff could contribute to care plans and update records. This helped to ensure that the dining area wasnt being used by staff to do this. This area was quieter and afforded more privacy. The acting manager of the service had applied to become registered with the Care Quality Commission and has shown during this random inspection that she had the organisational skills and managerial knowledge to oversee the service properly. There were enough care staff on duty to help ensure that the people who used the service were having their needs addressed adequately. Staff breaks were properly organised to ensure that enough carers were available at all times. One of the residents told us There seems to be a lot more girls around now, its much better. No new care staff had joined the staff team since our last inspection. We found, however, that a good induction programme had been planned to ensure that everyone had a good basic knowledge of how the service ran, before starting work. New bedroom furniture and beds had been bought for every room and areas of the home had been re-carpeted and redecorated. Overall, the home was a much nicer place to live. We spoke to five of the people who lived at this home. There were some complimentary comments, such as, Its much nicer now. One person also told us that my rooms much better, a new comfortable bed, and plenty of room for clothes. The manager of the home told us that she was pro-active in communicating what was needed to the owner of the service. There was still work that needed to be done, however, and the acting manage had a list of things that needed to be replaced and renewed. The exterior of the building still needed attention and some of the double glazing units had failed, making the glass hard to see though due to condensation. There were some records within the care plans that showed that important information was being gathered about the history and interests of the residents. Interests and hobbies were being recorded along with information about family support and employment history. care staff would be able to use this information to formulate appropriate activities that people would enjoy, and to initiate conversation whilst stimulating memories. This is essential, particularly when caring for people who have dementia. It would have been nice to see a list of planned activities for the day so that the people who used the service could see what was being planned and make a decision about whether or not they would like to be involved. There wasnt a designated activities co-ordinator, although the acting manager would like to introduce this post so that daily activities could be better planned to suit the needs of those who live a the home. What the care home does well: Care Homes for Older People Page 6 of 10 A lot of work had been done to help ensure that the environment was nicer for the people who used the service. The service was homely and pleasant and people told us that it was a nicer place to live. Training had taken place for the care staff to help improve their knowledge and skills, and enhance their safety awareness. Peoples care was being planned, delivered and reviewed in an appropriate manner. 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 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 8 of 10 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 1 9 The month-end medicines procedures should be reviewed to reduce the risk of when required medicines being missed off the new medicines record. Where possible more information should be sought about peoples medicines needs and choices before they come to stay at the home. 2 19 The owner of the home should continue to with the renewal and refurbishment of the home. This is to help ensure that people live in a pleasant environment with good quality fixtures and fittings around them. 3 19 The owner of the home should consider replacing the double-glazed window units within the home that have failed, and replacing the single-glazed units. This is to help ensure that the home is warmer in the winter months and is draught free. Care Homes for Older People Page 9 of 10 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 10 of 10 - 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!