Random inspection report
Care homes for adults (18-65 years)
Name: Address: The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG two star good service 15/09/2009 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: Gail Richardson Date: 0 1 0 6 2 0 1 0 Information about the care home
Name of care home: Address: The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG 01209218271 Telephone number: Fax number: Email address: Provider web address: mhinchliffe3@aol.com Name of registered provider(s): Name of registered manager (if applicable) Ms Cheryl Ann Dean Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Margaret Hinchliffe care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 3 1 5 0 9 2 0 0 9 The Peacocks provides care for three people with learning disabilities. The registered persons live on the premises with their son. The house is a terraced cottage, just outside the village of Four Lanes, between Helston and Redruth. Residents have access to the lounge and kitchen / diner. There is a bathroom / toilet upstairs, and each resident has their own bedroom. The front garden has a pond, and tables and chairs for people to use. The building and garden is not accessible to wheelchair users. The inspection report is not available at the home and it is suggested a copy is requested from management or via the CSCI website if required. The range of fees at the time of Care Homes for Adults (18-65 years) Page 2 of 16 Brief description of the care home the inspection is 302 pounds-322 poundsper week. Care Homes for Adults (18-65 years) Page 3 of 16 What we found:
This was an unannounced inspection, which took place over three hours on the 1st June 2010 by Compliance Inspectors Gail Richardson and Lynda Kirkland. For the purpose of this inspection the term We will be used when referring to the Care Quality Commission. The last key inspection took place on the 15th September 2009. We spoke with the registered manager by telephone on 22nd October 2010 when she confirmed that that they, the registered manager and provider, were working on all areas of the report. We visited the service to review how the home had managed the Statutory Requirements made at the key inspection. We toured the home and looked at all bedrooms and internal and external communal areas. There is currently one permanent person living at the home and one person who has been receiving regular respite care. There were no people living at the service available to speak with us. The registered provider and manager were on the premises and the registered manager spent time assisting us. We looked at care records for the two people and staff recruitment and training records. We found that none of the statutory requirements had not been addressed or met within the timescale stated. We made seven immediate requirements to ensure the urgent action of the Registered Manager to address shortfalls. The timescales for the immediate requirements vary in the body of the report to the timescales noted in the requirements listed at the end of the report. This is due to the processes that we use and the timescales to be used are the ones contained in the body of the report. What the care home does well: What they could do better:
We looked at the environment of the home. We found that the home was not clean and had a significant malodour of animals. The upper floor bathroom was particularly unhygienic with brown matter of identifiable origin noted to be on the wall. The walls showed evidence of mould growing and also on the ceiling. The sink and toilet were stained and dirty with brown matter. We ascertained that the bathroom had been cleaned four days previously by the registered manager, but the registered manager had not noticed the brown matter. All areas of the home must be cleaned and maintained to an acceptable hygiene standard which reduces any risk of cross infection for people using the service. The ground floor bathroom has a low standard of hygiene. This bathroom also has a
Care Homes for Adults (18-65 years) Page 4 of 16 radiator which does not have a low surface temperature restriction or guard. This may pose a risk of injury to people using the service. This radiator must be risk assessed and appropriate action taken to ensure that it does no pose a risk of burns to people using the service. The bedrooms were seen to be personalised. One bedroom was noted to not have any heating available should it be needed and the smoke detector was beeping to indicate that it was not fully functioning and required attention. We made an immediate requirement that the registered provider ensure that the smoke alarm system is checked and made safe by 01/06/10. We had made a previous requirement that the heaters and all portable appliances be tested to ensure that they were safe. We observed that these checks have not been undertaken. We made an immediate requirement that the registered provider undertake this safety check for all of the homes portable appliances and confirm to us, in writing, its completion. This must be completed by 07/06/10. Another bedroom was observed to have a fish tank with water but no cover and may place people at risk. Also noted within that room was the unrestricted window, this was also identified at the previous inspection and a statutory requirement made. This window had not been secured. The timescale for this to be completed was 30/10/09. This may pose a risk of falls injury to people using the service. We issued an immediate requirement that the upper floor window be risk assessed and appropriate window restrictor fitted. This must be completed by 03/06/10. We looked at the general environment both internally and externally and found that there was a high level of risk from the pet animals and also from the building work and debris in the front garden. We are advised that people using the service do not access the rear garden. However, with building work taking place means that the rear of the house may become a route of access for people using the service and as such will need a risk assessment and appropriate access provided. Many of the rooms at the home have locks on them which can only be locked and unlocked from the outside. This includes all of the bedrooms. The registered manager is recommended ensure that there is a clear policy for the use of these locks to ensure that they are not used inappropriately or restrict the access and liberty of people using the service. We noted that the registered manager has undertaken a risk assessment for the large dog who we are told, accesses the people using the service lounge. The registered manager found there to be no risk. However there are two other dogs and several animals who also reside at the home. No other risk assessments are in place. The front garden is part of an ongoing building project. The garden is cluttered with building equipment, animals and includes dog chains and childrens toys. This poses a risk of trip and fall hazard to people using the service. We made a previous requirement that all areas of the home be risk assessed and copies of these assessments be forwarded to the Commission. This was in 01/11/07. This was never undertaken. A further requirement was made at the recent key inspection 15/09/2009, that an environmental risk assessment be undertaken to ensure that the environment was safe for people using the service. This also has not been undertaken. An immediate requirement was made at this inspection that the registered provider is required to make sure that all areas are made free from risk/harm and risk assessments need to be put in place for all areas identified both internal and external to the home. This must be completed by 07/06/10.
Care Homes for Adults (18-65 years) Page 5 of 16 We looked at the care records for the people using the service. We had made a previous requirement on the 15/09/09 that the registered manager is required to ensure that all care plans are reviewed and updated regularly to accurately reflect changes in the persons needs. Care plans should be detailed and include all areas of identified need. This is required to ensure that there is a clear record of care needs and how staff are to meet those needs. The timescale was 30/10/09 and has not been met. The care records available have not been reviewed or updated to reflect current risks or care needs. The care plans are limited and lack sufficient detail to be person centered. The care plans do not reflect peoples personal aspirations, choices and preferences. Health care needs have not been monitored and recorded and there is no evidence that the people using the service are involved in planning their own care. We looked at the job descriptions for the volunteer staff at the home. These stated that they were expected to To carry out residents individual program plans. These plans were not available for staff to follow. We made an immediate requirement 01/06/10, that the registered provider is required to ensure that all people using the service have a detailed care plan in place which identifies all areas of assessed need and how those needs are to be met. This care plan should be in line with the National Minimum Standards and must also be regularly reviewed and updated. This must be completed by 07/06/10. Each person living at the home has a weekly record book. This books is a record and review of each week. These documents are limited, repetitive and do not review all areas of assessed need. Furthermore, we saw evidence that some books had been drawn on with colored pen and pages ripped out. These are legal documents and should not be accessible to people or children . To allow unrestricted access is in breach of peoples confidentiality and is also in breach of the Data Protection Act. The storage of personal documents must be reviewed and made secure. We also made a requirement on 15/09/09, that the registered manager must ensure that all risks identified have a clear assessment of that risk recorded in the persons care plan and a plan of care be in place to minimize and support the risk. This will ensure that the person is safe and the management of care supports independence. The timescale for this to be completed was 30/10/09. We saw that no risk assessments had been undertaken and the previous risk assessments were outdated and inaccurate. This may place people using the service at risk. We made an immediate requirement 01/06/10 that Risk assessments must be undertaken for all people using the service to identify areas of risk and actions to be taken to manage the risks safely. This must be completed by 07/06/10. We looked at medication records. The records provided for us were not current, we were told by the registered manager that current records could not be found. The registered manager must maintain current records for all medications administered which accurately reflect the name of the medication, dose, time given and must contain the administrators signature. A clear audit trail must be in place of all medications brought into the home and disposed of. Storage of medication is not secure and is currently stored in an unsecured and inappropriate place. Medication storage and all record keeping must be in line with the Royal Pharmaceutical guidelines. We looked at the job descriptions for both volunteer staff and found that they were expected to To maintain records eg medication. No volunteer staff have completed any medication training. Care Homes for Adults (18-65 years) Page 6 of 16 We looked at staff recruitment records for the volunteers who work at the home. We noted that the two people who provide voluntary care at the home did not have completed recruitment records. There were no current Criminal Record Bureau Checks or written references in place to support that appropriate checks had been undertaken. This means that people using the service may be placed at risk. The registered manager must ensure that appropriate records of recruitment checks are in place for all people who have unsupervised access to people using the service. We looked at training records for people who work at the home. This included the registered provider and registered manager. We had previously made a requirement at key inspection in 2006 and again in 2008. The registered person shall ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. This must include suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. (For example such training must include training as required by regulation such as fire training.) Accurate records of training must be kept including a certificate of completion of training courses attended. At the key inspection 15/09/09 this requirement was found not to have been met. We visited 01/06/2010 and found that whilst the registered manager has undertaken some training, the registered provider and the two volunteers have not undertaken any training. Not all areas of mandatory training have been completed by any staff member. No staff members have undertaken moving and handling training or updated first aid training. Training in food hygiene , protection of vulnerable adults and deprivation of liberty have not been undertaken by any staff. This lack of training may place people using the service at risk. All staff must receive mandatory training which also includes abuse awareness training by 10/06/10 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 Adults (18-65 years) Page 7 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 5 5 The registered manager is 30/10/2009 required to ensure that each person has a standard contract for the provision of services and facilities by the registered provider. This is needed to ensure that people using the service are clear about the service they are paying for. 2 6 15 The registered manager is 30/10/2009 required to ensure that all care plans are reviewed and updated regularly to accurately reflect changes in the persons needs. Care plans should be detailed and include all areas of identified need. This required to ensure that the person has a clear record of care needs and how to meet those needs. 3 9 12 The registered manager 30/10/2009 must ensure that all risks identified have a clear assessment of that risk and a plan of care to minimise and support the risk. This will ensure that the person is safe and the Care Homes for Adults (18-65 years) Page 8 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 management of care supports independance. 4 35 18 The registered manager 30/10/2009 must ensure that training is provided in all mandatory areas and is updated to reflect current good practice. This will ensure that the health and safety of people using the service is maintained. 5 35 18. 19 The registered person shall 01/02/2008 ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. This must include suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. (For example such training must include training as required by regulation such as fire training.) Accurate records of training must be kept including a certificate of completion of training courses attended. (Timescale of 01/12/2006 not met 2nd Notification) 6 42 13, 23 The registered person shall ensure that? (a) All parts of the home to which residents have access are so far as reasonably practicable free 01/11/2007 Care Homes for Adults (18-65 years) Page 9 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 from hazards to their safety; Unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. (c) The premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally; (d) Equipment provided at the care home for use by residents or persons who work at the care home is maintained in good working order; (For example there must be: Evidence that a satisfactory health and safety risk assessment system is in place. Evidence of risk assessments must be forwarded to the commission within the timescale set. Gas appliances should be tested at least annually. Evidence of this must be forwarded to the commission within the timescale set. 7 42 13 The registered manager 30/10/2009 must ensure that all portable appliances are tested as safe. This is required to ensure that all portable equipment used at the home is tested regularly to ensure its safety. 8 42 13 The registered manager must undertake an 30/10/2009 Care Homes for Adults (18-65 years) 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 environmental risk assessment of all areas of the home. This is needed to ensure that all areas of the home have as little risk as possible to peoples safety. Care Homes for Adults (18-65 years) Page 11 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 1 6 15 You are required to ensure 10/06/2010 that all people using the service have a detailed care plan in place which identifies all areas of assessed need and how those needs are to be met. This care plan should be in line with the National Minimum Standards and must also be regularly reviewed and updated This will ensur ethat peoples identified needs will be met. 2 9 12 Risk assessments must be 10/06/2010 undertaken for all people using the service to identify areas of risk and actions to be taken to manage the risks safely This will ensure that people are supported to manage risks safely. 3 26 12 The upper floor window must 10/06/2010 be risk assessed and appropriate window restrictor fitted. This will ensure that people using the service are free from the risks of injury from falls from these upper floor windows. 4 35 18 All staff must receive mandatory training which also includes abuse awareness training . 10/06/2010 Care Homes for Adults (18-65 years) Page 12 of 16 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 This is required to ensure that staff have the skills to meet the needs of people using the service. 5 42 13 You must ensure that the smoke alarm system is checked and made safe. This is required to ensure that people are safe. 6 42 13 You are required to 10/06/2010 undertake a safety check for all of the homes portable appliances and you confirm in writing its completion. This is required to ensure that the appliances at the home are safe for people to use. 7 42 18 You are required to make sure that all areas are made free from risk/harm and risk assessments need to be put in place for all areas identified both internal and external to the home. This is required to ensure that people using the service are safe from harm 8 42 13 We require that you complete a risk assessment for all areas of the home. This is required to establish any environmental risks and how any identified areas can be managed safely. 10/06/2010 14/06/2010 10/06/2010 Care Homes for Adults (18-65 years) Page 13 of 16 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 20 13 The registered manager must ensure that all medications administered at the home are recorded and the records maintained accurately. This will ensure that here is a clear audit trail of medications adminstered and promote safe practice. 11/06/2010 2 20 13 The registered person must 11/06/2010 ensure that all medications recieved into the home are stored safely in line with the Royal Pharmaecutical Society guidelines. This means that medication are stored safely and correctly and do not place people at the risk of accidental ingestion. 3 30 16 The registered manager must ensure that a satisfactory standard of environmental hygiene is maintained at all times. This will promote the safety of people using he service by minimising the risk of cross infection. 11/06/2010 4 34 12 The registered manager 18/06/2010 must ensure that appropriate recruitment checks are in place for all people who have unsupervised access to people using the service. This will promote the safety Care Homes for Adults (18-65 years) Page 14 of 16 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 of people using the service. 5 41 17 The registered manager must ensure that all records are well maintained and stored securly. This will ensure a good standard of record keeping and ensure that peoples confidentiality is maintained. 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 11/06/2010 1 24 The registered person is recommended to undertake a clear policy for the use of lockable internal doors to ensure that there is clear guidance on the homes restriction of access or liberty. The registered manager is recommended to risk assess all unguarded radiators and ensure that appropriate action is taken to ensure that there is no risk of injury from hot surfaces. 2 42 Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 16 of 16 - 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!
