Random inspection report
Care homes for older people
Name: Address: The Malthouse Bay Road Gillingham Dorset SP8 4EW three star excellent 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: John Hurley Date: Information about the care home
Name of care home: Address: The Malthouse Bay Road Gillingham Dorset SP8 4EW 01747822667 01747821270 malthouse@affinitycarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Malthouse Healthcare Ltd care home 33 Number of places (if applicable): Under 65 Over 65 33 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 33. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home The Malthouse is a 17th Century building with attractive gardens situated on the outskirts of Gillingham, which has been considerably extended to provide residential care for 33 older people. The home is located approximately half a mile from Gillingham town centre in a quiet lane. The home has recently come under new ownership and the Registered Providers are Malthouse Healthcare Ltd. The Registered Manager is Mrs Sue Bracher.
Care Homes for Older People Page 2 of 9 Brief description of the care home The accommodation is arranged over three floors with a passenger lift serving the first floor and a stair lift providing access to the three second floor rooms. There are 31 bedrooms, 4 of which are suitable for a couple, friends or relatives wishing to share. Bedrooms are of good size and all but one has en-suite facilities. In addition to personal care and support, the service provided includes all meals, laundering of clothes etc., and all housekeeping; a range of social and leisure activities are also provided, and the manager and staff provide help to make and attend healthcare appointments, where this is necessary. In the grounds of the home five lodges have been built offering an independent lifestyle. On the ground floor there are three apartments also offering an independent lifestyle. The lodges and apartments do not form part of the registered premises. The home has achieved the Investors in People Award. At the time of this inspection the weekly fees range from #625 to #715. Additional charges are made for hairdressing, chiropody, newspapers and personal shopping. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Care Homes for Older People Page 3 of 9 What we found:
We carried out the random inspection to establish if the staffing levels of the home. We looked at the rotas and staff files to establish if the National minimum Standards were being maintained. We found that whilst there was adequate numbers of staff on duty they did not appear to have had the necessary training with which to carry out their roles. Their fitness to work with vulnerable people had not been robustly established. We found that some staff had started work without a Protection of Vulnerable Adults check and suitable references. Employment histories were not always completed and gaps in employment had not been evaluated. This lack of a robust approach to recruitment puts people at risk. With regards to training a number of new staff that had been employed since the last inspection but they did not have an induction into the work they were going to do. The staff group did not have all of the necessary statutory training required. The shifts appeared to be covered based on the availability of staff rather than the skills they possess matching the needs of those who live at the home. For example on one night shift was one person who did not have the full statutory training required supported by a fairly new member of staff who had not received an induction with a third member of staff whos first shift was that night. No one on that shift had any manual handling training. We looked at the medication administration records in particular the Controlled Drugs register. We noted that in the controlled drugs register one preparation was to be given as a diminishing dose. The records seen evidenced that the medication was given one at night, every night. The directions for administration was to give one at night for a period of time and then reduce it to one every other night. This evidences that the instructions for giving the medication had not been followed and so may have but the person receiving the medication at risk. The controlled drugs register had been audited by the home where this issue had not been picked up. Through examination of the medication records it was established that the administration of medication could be more robust with the introduction of a clear rationale for the dispensing of medication via the Per Required Needs (PRN) route for example if a person has been prescribed pain relief for problems with a hip staff should not give it for pain in the shoulder as this may be an emerging health care need. Therefore, staff need to have clear guidelines and boundaries around given medication via this route to ensure that peoples needs are met in a consistent and safe manner. Whilst at the home we had a very brief tour of the premises. The communal areas were found to be well decorated and comfortable. The home was clean through out. Rooms occupied by those who live at the home were furnished to reflect individuals tastes. The communal bathrooms were clean and pleasantly furnished. In these areas we observed several hand towels and flannels. Whilst they all appeared to be clean this undermines infection control practices and may put people at risk of cross infection. What the care home does well:
Care Homes for Older People Page 4 of 9 The home provides pleasant surroundings for the People to live in. The home is well decorated and furnished to a good standard. 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 9 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 6 of 9 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 You must ensure that the 24/07/2009 receiving, administration, recording of and returning of medication is carried out in accordance with the National Pharmaceutical requirements To ensure that medication practices do not put people at risk of harm. 2 26 13 You must ensure that infection control policies are adhered too . To promote the well being of those at the home 31/07/2009 3 29 19 You must not allow any 17/07/2009 member of staff, or prospective member of staff, to work at the home until such time as you have all the information required with which to establish their fitness to work at the home. This is in order to protect those who live at the home 4 30 18 You must ensure that all staff 31/07/2009
Page 7 of 9 Care Homes for Older People 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 undergo a formal recorded induction into the work they are going to perform. This is to ensure people are not put at risk from poor practice 5 30 18 You must ensure that all staff 14/08/2009 have the necessary statutory training. This is to ensure that peoples needs can be met in a safe manner 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 8 of 9 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 9 of 9 - 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!
