Random inspection report
Care homes for older people
Name: Address: Urmston Cottage Greenfield Avenue Urmston Manchester M41 0XN two star good 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: Val Bell Date: 2 0 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Urmston Cottage Greenfield Avenue Urmston Manchester M41 0XN 01617473738 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) : Urmston Cottage (Mcr) Ltd care home 45 Number of places (if applicable): Under 65 Over 65 45 0 old age, not falling within any other category physical disability Conditions of registration: 0 45 The registered person may provide the following category of service only: Care home with nursing - Code N 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 anyother category - Code OP Physical disability - Code PD The maximum number of service users who can be accommodated is: 45 Date of last inspection Brief description of the care home Urmston Cottage is an extended Victorian property offering care and accommodation with nursing support to 45 service users. There are several lounges and a dining area for service users communal use. Bedroom accommodation is on two floors and is for single and double occupancy. Some bedrooms have en-suite facilities. A passenger lift supports service users to reach all parts of the home. There are gardens to the rear of
Care Homes for Older People Page 2 of 10 Brief description of the care home the property, which are well used in fine weather and parking space is available to the side of the home. The home is near the centre of Urmston, close to a number of shops and market place. It is close to local bus routes and the Metrolink. Fees are dependant on assessed care needs and individual funding arrangements and details of these can be obtained by contacting the manager at the home. Care Homes for Older People Page 3 of 10 What we found:
We last inspected this service on 7th May 2009. This was an unannounced random inspection conducted over two days, 19th and 20th January. This means that the manager was not told beforehand that we were coming to visit. We received an anonymous complaint about Urmston Cottage in November 2009. Several concerns were expressed about the care being received by some people using the service and these were referred to Trafford local authority for investigation under their safeguarding adults procedures. The remaining concerns related to the way the home was being managed and we looked at these issues during this visit. The complaint we received alleged that people living in the home were being put to bed early because there were not enough staff to meet their needs after 20:00. We arrived at the home at 20:30 on 19th January. There were 42 people receiving care in the home and eight people were watching television in a lounge. The remaining people were either in bed or watching television in their rooms. A nurse and three care assistants were on duty and the nurse who worked the daytime shift was just about to go home. She stayed back to talk to us. Both nurses felt that the home had been suitably staffed that evening and rotas confirmed that this level of staffing had been maintained. We were told that it was sometimes difficult to meet peoples nursing care needs during the mornings because people requiring this care were accommodated in various parts of the building. An extra nurse had now been deployed in the mornings to help administer medication, which meant that the second nurse could concentrate on providing the nursing care. We asked the nurses why so many people were in bed. They said that this was their choice and they were always asked if they wanted to go to bed. One nurse told us that some people ask to go to their bedrooms after tea. The times that people choose to go to bed had not been clearly recorded in the care plans we looked at. The staff we spoke to confirmed that they had received training in recognising abuse and what action they must take if they suspected a person was at risk of abuse. We walked round the home to assess cleanliness and health and safety. Contractors were currently working on the installation of a new heating system. We were concerned to find exposed hot water pipes along the skirting boards in two bedrooms. These were very hot to touch and potentially placed people at risk of accidental injury from burns. Both sets of water pipes had been boxed in by the time we returned the next day. We found all parts of the home to be suitably heated and clean. We were told that additional domestic staff had been provided to ensure that the home was thoroughly cleaned after the contractors left each day. The seat from one of the toilets had sheared off its fixings and had been left propped up against the wall in the toilet area. We found food stocks in the home to be low, with little variety and no evidence of fresh fruit and vegetables. The manager told us that they were awaiting deliveries and that fruit and vegetables are ordered three times per week. We were also concerned to find three bedroom doors propped open with stools and the
Care Homes for Older People Page 4 of 10 doors to bedrooms where people were asleep had been left ajar. We were told that this was done so that people were not disturbed when night staff did their hourly checks. We saw a risk assessment for one of the people whose bedroom door was propped open. It told us that this was the persons choice and that they understood the risks involved in doing this. A care plan we examined stated that the person wanted baths on two days per week and that these days should be the same each week. There was no written evidence of which days the person wanted to have a bath and progress notes did not provide evidence that this persons care was being met according to the care plan. The care plan told us that the person needed positional changes for pressure relief. The night care plan did not inform the reader of the frequency of the positional turns, although it was clear from the turning charts that this was being provided every hour. We saw an assessment for pressure relief that stated the person was to use a pressure relieving mattress and cushion. It stated that she had refused use of a pressure mattress. We did not see any written evidence that advice had been obtained from the tissue viability nurse about the risks of this person not using a pressure relieving mattress. We were introduced to a person who was in bed at the time of our visit. She was not able to take food or fluids by mouth. We were concerned that her mouth looked dry, cracked and sore. The nurse showed us a pot of Vaseline that was in the bedside table, although she was not able to explain why the person had not received oral health care that night. We looked in the persons care plan and found that there was no oral health care plan in place. During our second visit we brought this to the attention of the manager. She confirmed that none of the people accommodated had oral health care plans. At our last visit we were told that the manager was in the process of submitting an application for registration with the Care Quality Commission, although this had not been received. The manager told us that she was awaiting an enhanced disclosure from the Criminal Record Bureau. Once this had been received she would be submitting her application to us. What the care home does well: What they could do better:
Care plans must contain sufficient detail to demonstrate how peoples needs and preferences will be met in relation to oral health care, pressure area care, bathing and individuals stated preferences relating to bedtime. There must be adequate quantities of food held in the home at all times to provide people living in the home with varied choices of nutritious and wholesome diets. Bedroom doors are fire doors and these must be kept closed at all times to keep people safe from harm in the event of a fire. People who choose to keep their bedroom doors open must have suitable equipment fitted to the doors for automatic closure when the fire alarm is activated. Care Homes for Older People Page 5 of 10 The manager must submit an application for registration with the Care Quality Commission. 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 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 7 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 1 8 12 Care plans must contain sufficient detail to demonstrate that peoples needs are being met appropriately and in accordance with their stated preferences. To ensure that people are receiving care and support that promotes their wellbeing. 19/02/2010 2 15 16 Sufficient amounts of suitable, nutritious and wholesome food must be available in the home. To ensure that people using the service have a choice of suitable diets at all times. 19/02/2010 3 19 23 Fire doors in the home must be kept closed at all times. To safeguard people from the harmful effects of smoke inhalation in the event of a fire. 19/02/2010 4 31 9 The manager of Urmston 05/03/2010
Page 8 of 10 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 Cottage must apply for registration with the Care Quality Commission. To ensure that the manager is a fit person to manage a home for older people. 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 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!
