Inspection on 05/08/09 for The Wight House Care Home

This inspection was carried out on 5th August 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

The Wight House Care Home 24/02/09

The Wight House Care Home 25/09/08

The Wight House Care Home 01/04/08

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Random inspection report Care homes for older people Name: Address: The Wight House Care Home 138 Portsmouth Road Lee on the Solent Hampshire PO13 9AE zero star poor service 26/02/2009 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: Patricia Trim Date: 0 5 0 8 2 0 0 9 Information about the care home Name of care home: Address: The Wight House Care Home 138 Portsmouth Road Lee on the Solent Hampshire PO13 9AE 02392552291 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) : Wight House Care Ltd care home 12 Number of places (if applicable): Under 65 Over 65 0 0 12 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 12 12 0 The maximum number of service users to be accommodated is 12. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home The Wight House provides care and accommodation to 12 older persons who may have dementia or mental health needs. Care Homes for Older People Page 2 of 13 2 6 0 2 2 0 0 9 Brief description of the care home Accommodation comprises 10 bedrooms on two floors. Two rooms are capable of accommodating 2 people who use services, but these are predominantly used as single rooms unless people express a wish to share. There is a stair lift to help people reach the first floor but there are a number of areas that need people to be able to walk up a few steps. Three bedrooms are located on the ground floor. There is a communal lounge and dining room on the ground floor and a small quiet room on the first floor. There is a small garden and patio area. The home is situated very near the seafront, with views of the sea. Local shops and amenities are a short walk away. Care Homes for Older People Page 3 of 13 What we found: The last key inspection of this service was on 26th February 2009. The rating following that inspection was zero stars, meaning outcomes for people who live there are poor. The report from that inspection is now in the public domain and available on our website. Since the last key inspection The responsible individual has voluntarily agreed not to admit anyone new to the service. Adult Services have been monitoring the service under the Safeguarding protocol. This has comprised regular review meetings and weekly visits to the home. They have also completed assessments on all but one of the 8 people currently living in the home. The purpose of this visit was to monitor compliance with the 1 outstanding and 13 new requirements made following the last inspection. It was also to ensure the health and safety of people who use the service had not been compromised by the Wight House Care Ltd. going into administration in July 2009. Two inspectors, Pat Trim, lead inspector, and Joy Bingham visited the service on 6th August 2009 from 10 a.m. till 13.30 p.m. The manager was present during the visit and there was an opportunity to speak with most of the people who use the service and two staff. Time was also spent observing how and where people were spending their time in the home and looking at the environment. We also viewed a number of documents, including looking at the records kept for two people who use the service. During the visit we found that 7 of the requirements made following the last inspection had been complied with. However 6 requirements remained outstanding. Action has not been taken so that people who use the service may live in a safe, comfortable environment where their needs are met. Two further requirements were made as a result of this visit. A requirement was made at the last inspection that people who use the service should have their mental health needs assessed and, where a need was identified, a plan of care be put in place to give staff the guidance they needed to support the person. A mental health assessment had been introduced that could identify whether the person had high, medium or low mental health needs. Two of these completed assessments were seen. The assessments identified the degree of peoples needs but the information about the level of risk was not used to inform a plan of action and support. One risk assessment actually contradicted the information completed on the initial assessment. The manager explained the initial assessment no longer reflected the persons needs, but this information was not recorded anywhere. The two conflicting pieces of information would make it difficult for anyone trying to support the person concerned and might mean their needs were not met appropriately. The assessment was completed in May 2009, but had not been reviewed and had not generated a plan of care to meet the persons identified needs. A second mental health assessment, completed 07/05/2009 identified a person as having medium mental health needs because they sometimes suffered from depression. There Care Homes for Older People Page 4 of 13 was a care plan for the mental health needs of this person, which stated staff were to monitor and to spend time talking with the person if they said they felt unhappy. There was no further guidance about when to report this or to refer to health care professionals so that the persons health care needs were responded to. A requirement was also made that risk assessments should be completed in respect of peoples health care needs and that where a risk was identified an action plan be put into place. The two files seen showed a risk assessment tool had been added to each file, but these did not accurately reflect the level of risk, or consistently identify how to minimise it. For example, one person had a nutritional risk assessment completed that showed them as low risk with no need for a risk assessment. However, in the care plan this person was identified as high risk because they had poor compliance in respect of their diabetes. This means that risks are not being assessed and managed. The care plan relating to eating and drinking required staff to record food choices and to monitor blood sugar levels. However, there was no information for staff so that they knew when the levels were becoming unstable and when they needed to take action by contacting a health care professional. The failure to have clear guidance meant the risks were not being assessed and managed effectively. Another risk assessment identified that there was no risk relating to someone smoking because they were not allowed to in the house or grounds. The manager explained that at the time of admission the hospital assessment had stated the person should not smoke because they had caused a fire in their previous home. The person still liked to smoke and did so when out with their family. There was no record of a multi-agency agreement that it was in the persons best interests not to be able to smoke or any information about the risks involved. There was no evidence it had ever been discussed with the person concerned, or kept under review. There was no risk assessment to see if the risks could be minimised so the person could continue to smoke if they wished to. The medication cupboard, purchased following a requirement made at the inspection of 1st April 2008, had been fitted and medication was now being stored safely. The manager was making arrangements for a medication trolley to be supplied to give further storage and to make it easier to take medication to people throughout the day. The majority of people said they liked the meals offered. People were seen choosing an alternative to the main meal and confirmed they could have drinks and snacks throughout the day and night. At lunchtime, someone was seen choosing to have an alternative to the main meal. The manager stated that she had sufficient money to buy food for people who used the service. The home was well stocked with food supplies. The environment continues to look shabby and worn and does not provide pleasant surroundings for people to live in. The hall, stairs and landing carpets are very stained. The paint on the hand rail on the stairs is worn so the handrail feels sticky to the touch and is not easily cleaned. The carpets in two bedrooms are very stained and there is a strong smell of urine in each room. Care Homes for Older People Page 5 of 13 The toilet in the downstairs bathroom has been repaired, but the hoist is showing signs of wear and tear, with paint flaking off and the underside of the seat is stained. This shows it is not clean and when lowered into bath water puts people at risk of cross infection. One person chooses not to have a bath and gave as a reason the hoist is uncomfortable and the bath too low. All communal bathrooms have handtowels instead of paper towels. This puts people at risk of infection. The manager said a development plan for the environment was being completed. However people continue to live in surroundings that do not provide satisfactory living conditions. A requirement was made following the last inspection that the cleanliness of the home be monitored. The manager said two new cleaners had been employed who were working in the home for 4.5 hours five days a week. She also said a cleaning schedule was being drawn up to ensure all areas of the home were deep cleaned on a regular basis. The areas referred to in the previous report had now been cleaned. However, there continues to be unpleasant odours in the home and stains which show that the service is not throroughly cleaned to a hygienic standard for people to live in. Information received from Hampshire Fire and Rescue Service evidenced the home had complied with the requirements relating to fire safety made by them. Comments were also received from the Environmental Heath officer that the requirements made in respect of health and safety had been met. The manager said a number of new staff had been employed since the last inspection, bringing the total number of staff employed to 18. She felt this gave her more opportunity to carry out the management role, but she was covering 2 waking nights during the week of the visit. This meant she was not on duty at the time of the visit and came in specifically to assist us. She felt she was able to use her time working waking nights to carry out some of the management function. The files of two new staff were viewed to assess the recruitment process. Both files contained the required information such as Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, completed before the person began working in the home. The service does not have a registered manager who is in charge and accountable for the service and who has been deemed fit to manage the home by going through the registration process. The manager stated she had completed her application but she had been waiting for Wight House Care Ltd. to provide the fee. She is currently being supported in her management role by a representative of the administrators. Copies of Regulation 26 reports were seen which showed they had been completed on a monthly basis from the last inspection until May 2009. However, the service has failed to carry out Regulation 26 visits since May 2009 when the home has clearly been failing to provide satisfactory outcomes for people living there and when monitoring may have meant that this could have been improved. The manager said people who use the service had been kept informed of the recent Care Homes for Older People Page 6 of 13 changes in the home. Letters were being sent to relatives to give them up to date information and they had been invited to attend a meeting in July 2009. Five of the eight families attended. People who use the service are being invited to give their views about the service they receive and are currently completing survey forms. The manager said this information would be used to identify any areas of concern and to make changes. The manager had completed an environmental risk assessment. This included the use of the freestanding heaters currently in use at the time of the last inspection. She stated the thermostatic control valves used to control the temperature of hot water delivery at outlets had been serviced but had not yet received the certificate. Two valves were faulty and required replacing, but neither of these were on baths so did not constitute a high risk to people who use the service. She had been monitoring the temperature of hot water outlets since the last inspection, but said she had not completed the record for the last few weeks. She was aware that this was part of monitoring the safety of the environment and agreed to start recording the temperatures again immediately. However the failure to continue to monitor the service without being directed to demonstrates a lack of understanding about the need to ensure people who use the service are protected against the risk of accidental injury. The manager said arrangements had been made to make regular payments to creditors and this meant she was now able to arrange to have equipment serviced. The servicing for the hoist and stairlift was due to be carried out in July 2009 and the failure to have this done put people who use the service at the risk of harm. The manager was aware this was overdue and was making arrangements for an engineer to visit. Other visits had been made and equipment serviced. 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 7 of 13 Care Homes for Older People Page 8 of 13 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 8 13 The registered person must ensure that where a risk to the persons health care needs is identified an assessment is completed that identifies the risk and gives clear guidance on how it should be minimised. The risk assessment must be kept under review. This is so all staff know what the risk is and how it needs to be managed to minise it. 30/06/2009 2 8 12 The registered person must 30/06/2009 ensure a care plan, completed from information obtained in the assessment, is put in place for the mental health needs of people who use the service so that staff have the guidance they need to manage and support the individuals mental health needs. 3 19 23 The registered person must introduce a system to monitor the environment, together with an action plan to renovate and redecorate the home. 30/06/2009 Care Homes for Older People Page 9 of 13 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 This is so people who use the service may live in a safe, comfortable environment that meets their needs. 4 26 23 The registered person must ensure that all parts of the home are regularly cleaned. This is to ensure people who use the service live in a clean environment where the risk of infection is minimised. 5 31 8 The provider must make 30/06/2009 arrangements for an application to be submitted to the Commission for Social Care Inspection for the registration of a manager so the day to day running of the home can be managed. 6 38 24 The registered person must 30/06/2009 establish and maintain a system to review the quality of care at the home in consultation with people who use the service and their representatives This is to ensure the home is well run for the benefit of people who use the service. 30/06/2009 Care Homes for Older People Page 10 of 13 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 14 12 Any limitation imposed on a 06/09/2009 person who use the service must be agreed to be in the persons best interests, must be explained to the person and must be kept under review so that peoples rights to choose what they do is only restricted because there is a high risk to their personal safety or the safety of others. 2 38 13 The registered person must 06/09/2009 ensure the temperature of hot water outlets on all baths is consistently monitored so that people who use the service ar protected from the risk of scalding. Care Homes for Older People Page 11 of 13 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 12 of 13 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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