Random inspection report
Care homes for older people
Name: Address: Tregothnan Retirement Home 112 Balmoral Road Morecambe Lancashire LA3 1ST two star good service 29/12/2008 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: Denise Upton Date: 0 5 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Tregothnan Retirement Home 112 Balmoral Road Morecambe Lancashire LA3 1ST 01524412259 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) : Thackray Care Services Ltd care home 13 Number of places (if applicable): Under 65 Over 65 13 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category 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 The maximum number of service users who can be accommodated is: 13 Date of last inspection Brief description of the care home Tregothnan Residential Home is situated on one of the main roads leading into the West End of Morecambe, in a fairly quiet residential area, close to local shops and amenities. There is a ramp leading up to the side of the front door for use by wheelchair users, but there is still a small step to enter the front door. The home is a Victorian terrace built over three floors, accessible by a passenger lift. Four of the bedrooms have an ensuite facility and, for the remainder, there is a bathroom/toilet within easy reach. There are communal areas including a small roof terrace, a dining
Care Homes for Older People Page 2 of 9 2 9 1 2 2 0 0 8 Brief description of the care home room and lounge. There are toilets on all floors which are accessible to residents. On admission to the home, residents are provided with an individual copy of the Service User Guide. The homes Statement of Purpose is also made available to newly admitted residents and other interested people. These two importent booklets tell people about the home and the services and facilities provided. Residential care fees at the Tregothnan Care Home currently range from three hundred and eighty six pounds fifty pence a week to four hundred and fourteen pounds a week. Care Homes for Older People Page 3 of 9 What we found:
We conducted an unannounced site visit to Tregothnan Residential Care Home during the late morning and early afternoon period of a mid week day. We spoke with the registered manager, two members of the care staff team and three individual residents. Discussion also took place later in the visit, with the registered provider. We had received an anonymous concern related to the physical environment at the home. One of the concerns raised was that rain water was causing leaks, affecting areas of resident accommodation. At the time of the site visit we observed the majority of bedroom accommodation and all communal areas of the home. We were told that about four years ago the roof was completely replaced. Since that time there had been occasions when a water leak has occurred in a number of bedrooms. However this was infrequent and seemed to be dependent on the weather conditions at that time. When there was just very heavy rain, there was no evidence of a water leak. However when there was heavy rain accompanied by strong winds, a water leak sometimes appeared although this was rarely in the same place. On each occasion when a rain water leak occurred, this had been repaired by external contractors. However the root cause of the problem remains undetected even though the external roofing contractors had used various methods to try and establish the cause, including using dye to try and detect the source of the water leak. Observation of the internal environment confirmed some evidence of old water damage, however at the time of the visit these areas were dry and unaffected by the recent heavy rain. In two areas of the home however a water leak was observed. One area was on the upper floor corridor just above a fire door where a very slow but persistent small drip was observed. There was evidence of another water drip in a residents bedroom. There was a bowl lined with a towel placed on the floor in this bedroom to catch the drips. At the time of the site visit no water was seen to be dripping from the ceiling in this room but the resident that occupied this bedroom did confirm that this had recently occurred. The resident also said that he had been offered another bedroom until the drip was repaired and although he had moved to an alternative bedroom for two nights, he wanted his original bedroom back and made a positive decision to return there even though he was aware of the water leak. The immediate concern was that the anonymous alerter stated that rain water sometimes travelled down the light fitting in this bedroom. At the time of the site visit an electrical contractor was in the home undertaking some work. The registered manager confirmed that once the contracted work had been completed, he would ask the electrical contractor to check the safety of the electrical installation system, particularly with regard to the alleged water leak travelling down the light fitting. We have asked the registered manager to let us know the outcome of this safety check and keep us informed with regard to the repairs to the roof. The registered manager is keen to eliminate the problem with rain water occasionally leaking into the building and confirmed that another roofing contractor would be commissioned to undertake the required work and hopefully find the root cause of the problem. Care Homes for Older People Page 4 of 9 Staff and residents spoken with all confirmed that the registered manager had arranged for various roofing contractors to visit the home and repair the roof on several occasions, however the problem periodically, kept reoccurring. Another area of concern was that fire doors are sometimes wedged open. The registered manager stated that this sometimes occurred if staff were assisting a resident that used a wheelchair in order to ensure the safe transfer of that person through the door. Whilst it is acknowledged that on occasions a door wedge may be necessary to make sure residents are kept safe and that their movements are not restricted, this should be done with the minimum of risk in respect of maintaining fire safety precautions. It is recommended that the Fire Service are approached for advice and guidance on the best way to maintain fire safety whilst ensuring the safe transfer and independent movement of residents. We again asked the registered manager to inform us of what the fire officer had advised. There was also an allegation that an upper floor bathroom had no heating. At the time of the site visit there was some heat emitting from this radiator although the radiator was not as hot as some of the other radiators. The room however felt warm enough. A member of staff spoken with said that this bathroom was always warm enough when she was assisting residents to either wash or have a bath. The member of staff also said that all radiators had very recently been bled including the radiator in that particular bathroom. It was noted that the radiator in another second floor bathroom was not fitted with a radiator guard. This would help prevent the risk of accidental scalding. We were told that this radiator had been fitted with a radiator guard, there was no explanation of why the radiator guard had been removed. The registered manager told us that the original radiator guard would be replaced or alternatively a new radiator guard would be fitted. Again we asked the registered manager to let us know when this had been done. During the course of the visit, residents were observed being assisted from the lounge to the dining room for their mid-day lunch. Three of these residents were assisted using a wheelchair. It was noted however that there was no foot rest on the wheelchair, with residents required to hold their feet up when the wheelchair was moved, otherwise their feet would have dragged on the floor. This could compromise resident safety. The covering to the cushion on the wheelchair was also in need of repair or replacement. Consideration should be given to repairing these two items or alternatively seeking medical professional input to ensure that the wheelchairs in use remain appropriate. What the care home does well: What they could do better:
In order to ensure that residents, staff and visitors are kept safe, the electrical installation system should be checked as a matter of priority to make sure that it has not been affected by rain water, advice should be sought from the Fire Service with regard to
Care Homes for Older People Page 5 of 9 fire doors being wedged open, the radiator guard in the upper floor bathroom should be replaced and the roof repairs and further investigation into the root cause of the problem should take place as soon as possible. It is also recommended that the wheelchairs in use be fitted with a foot rest and consideration could be given to seeking professional medical advice to make sure that the wheelchairs in use continue to be appropriate for the people that use them. 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 6 of 9 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 3 14 Following the pre admission 28/02/2009 assessment, the prospective resident must be informed in writing the outcome of the assessment. (Not assessed at this random inspection) This would confirm to the prospective resident that their current needs and requirements could be met at the home. 2 9 13 The storage of controlled 31/03/2009 drugs must be in line with the recently amended Regulation. (Not re-assessed at this Random Inspection) This would make sure that controlled drugs maintained at the home are stored as safely as possible. 3 38 13 All staff that have not done so must be provided with with manual handling training and basic first aid training. ( Not assessed at this Random Inspection) This is for the protection of residents and staff. 30/04/2009 Care Homes for Older People Page 7 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 19 13 The electrical installation 30/11/2009 system in the home must be checked to ensure safety. This would make sure that the electrical system has not been affected by water damage. 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 2 19 22 Attention should be given to the roof to prevent deterioration and to ensure the property remains dry. Wheelchairs used by residents should be fitted with an appropriate foot rest and wheelchair cushion cover(s) repaired or replaced. The radiator guard missing from a second floor radiator should be replaced. The Fire Service should be approached for advice regarding the best way to maintain fire safety whilst ensuring the safe transfer of residents that require the use of a wheelchair and to maintain independent movement for residents.
Page 8 of 9 3 4 25 38 Care Homes for Older People 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!
