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Inspection on 09/06/10 for Victoria House Care Centre

Also see our care home review for Victoria House Care Centre for more information

This inspection was carried out on 9th June 2010.

CQC found this care home to be providing an Adequate 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere at the home was relaxed and welcoming. The home now has a new manager who has been in post for approximately six weeks. On the day of the inspection a qualified nurse had failed to turn in for duty. The manager who is a registered nurse, had stayed back to cover the shift. The management team are in the process of trying to recruit additional nurses. Prior to the inspection we were told that people were being dressed in nightclothes from early in the afternoon. There was no evidence to suggest this during our visit. We were also told that people were left in wheelchairs all day and that people were left in dining rooms after tea. Again this practice was not observed during the inspection. People were sat in comfy chairs in lounges and there were lots of interactions between the staff on duty and people living at the home, this was particularly evident on the nursing units. Bath recording temperatures are now being completed on a weekly basis, this helps to minimise the risk of someone being scalded or burned. Risk assessments on hand sanitizer are now available in the home so that staff know what to do if someone ingests it. Some staff have received training on bed rails and regular maintenance checks are now recorded to ensure that any bed rails fitted to beds are fitted correctly. Bolt locks have been removed from doors on the dementia unit. Fire doors to external corridors are no longer being being wedged open. Maintenance records viewed were well recorded and up to date. We were also told that staff were not carrying out appropriate manual handling practices. The staff spoken to during the inspection were aware of legislation and no poor practice was observed. This is something that needs to continue to be monitored by all senior staff working in the home.

What the care home could do better:

We looked at some care plans. These records are still in need of some work to ensure that any identified needs and risks are properly evaluated and drawn up into a plan of care.We asked to look at the complaints procedure, the one we were shown had not been updated as it still made reference to registration and inspection and had no contact information for the local authority, PCT or ombudsman. We asked to look at the safeguarding adults procedure, this had also not been updated to reflect who to report any safeguarding concerns to. We had a look around the residential unit. There were some unpleasant odours on this unit and some of the carpet was stained. The home would benefit from a planned programme of carpet replacement in this unit. We looked around the upper nursing unit. The bathroom on this unit had an unattended trolley with a razor and some unlabeled disinfectant on it. The staff member said that the trolley was ready to take round when people wanted to start getting ready for bed. Items such as razors and disinfectant should not be left unattended on trolleys. We asked if the razor was used for communal use but were told `no`. The bath on this unit was dirty and had not been cleaned out after use, the staff member did try to clean the bath but it was not draining properly. This requires attention. We were told that the washing machine was not working in the laundry upstairs. This needs to be fixed. Some concerns had been raised prior to the inspection about RGN cover and how one nurse is able to work between two nursing units. The home need to demonstrate to CQC how the current staffing levels meet the needs of the people living at the home. Epilepsy training has not yet commenced for staff. Bed rail assessments are still not being completed for all residents. Those that are complete are not always completed in sufficient detail. The handyman identified issues where overlay mattress are to high. Although concerns are raised with the manager there is not always sufficient evidence to show what action is being taken as a result. There is now a risk assessment for the lift. It states "new interior and key pad to be fitted". A key pad has been fitted to the doors on the corridor and not to the lift, the risk assessment should reflect this. We discussed supervision with the manager, she said that not all staff were receiving regular supervision but that was something which was due to be implemented.

Random inspection report Care homes for older people Name: Address: Victoria House Care Centre Middlesbrough Park Road North TS1 3LD one star adequate 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: Tanya Newton Date: 0 9 0 6 2 0 1 0 Information about the care home Name of care home: Address: Victoria House Care Centre Middlesbrough Park Road North TS1 3LD 01642242975 Telephone number: Fax number: Email address: Provider web address: vh@keyhealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Deborah McKinley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Key Healthcare (Operations) Limited care home 68 Number of places (if applicable): Under 65 Over 65 0 10 0 dementia old age, not falling within any other category physical disability Conditions of registration: 58 0 12 The maximum number of service users who can be accommodated is: 68 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 any other category - Code OP, maximum number of places 10, Dementia - Code DE, maximum number of places 58, Physical Disability - Code PD, maximum number of places 12 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Victoria House Care Centre is a large converted Victorian property with a modern extension that has been in place for a number of years. The home is close to the centre of Middlesbrough and is opposite Albert Park. It is close to public transport and shops are nearby. Victoria House Care Centre offers spacious accommodation both communal and bedrooms. Some of the bedrooms have ensuite facilities, whilst others have wash-hand basins. There are a number of units within Victoria House Care Centre, a unit for younger adults with physical disabilities on the ground floor, a unit for older people with dementia, set across two floors and two units for older people with dementia who have nursing needs set across two floors. Care Homes for Older People Page 3 of 9 What we found: Two inspectors carried out an unannounced visit to the service between the hours of 4.45pm and 7.45pm. We looked around the home, looked at some records and spoke to the manager and some of the staff on duty. The visit also focused on previous requirements and recommendations which were made during the last inspection of the home which took place on the 13th October and the 16th of November 2010. Prior to the inspection we had received some information raising some concerns about the home, we looked at these concerns as part of the inspection. The requirements in relation to medication were not looked at during this inspection, these will be followed up in a later inspection and will be reflected in this report as outstanding. What the care home does well: What they could do better: We looked at some care plans. These records are still in need of some work to ensure that any identified needs and risks are properly evaluated and drawn up into a plan of care. Care Homes for Older People Page 4 of 9 We asked to look at the complaints procedure, the one we were shown had not been updated as it still made reference to registration and inspection and had no contact information for the local authority, PCT or ombudsman. We asked to look at the safeguarding adults procedure, this had also not been updated to reflect who to report any safeguarding concerns to. We had a look around the residential unit. There were some unpleasant odours on this unit and some of the carpet was stained. The home would benefit from a planned programme of carpet replacement in this unit. We looked around the upper nursing unit. The bathroom on this unit had an unattended trolley with a razor and some unlabeled disinfectant on it. The staff member said that the trolley was ready to take round when people wanted to start getting ready for bed. Items such as razors and disinfectant should not be left unattended on trolleys. We asked if the razor was used for communal use but were told no. The bath on this unit was dirty and had not been cleaned out after use, the staff member did try to clean the bath but it was not draining properly. This requires attention. We were told that the washing machine was not working in the laundry upstairs. This needs to be fixed. Some concerns had been raised prior to the inspection about RGN cover and how one nurse is able to work between two nursing units. The home need to demonstrate to CQC how the current staffing levels meet the needs of the people living at the home. Epilepsy training has not yet commenced for staff. Bed rail assessments are still not being completed for all residents. Those that are complete are not always completed in sufficient detail. The handyman identified issues where overlay mattress are to high. Although concerns are raised with the manager there is not always sufficient evidence to show what action is being taken as a result. There is now a risk assessment for the lift. It states new interior and key pad to be fitted. A key pad has been fitted to the doors on the corridor and not to the lift, the risk assessment should reflect this. We discussed supervision with the manager, she said that not all staff were receiving regular supervision but that was something which was due to be implemented. 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 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 9 13(2) Medication must be stored securely and safely. A system must be in place to check expiry dates of medicines and add the date of opening when necessary. This makes sure medication is safe to administer. 31/01/2010 2 9 13(2) Medication must be given as 31/01/2010 prescribed and a record must be made at the time that it is given. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected. 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 38 23 Risk assessments on the safe 15/07/2010 use of bed rails must be in place in all cases where bed rails are in situ. To ensure the safety and welfare of people living at the home. 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 7 The work that has commenced on updating care plans should continue. care plans should be developed further to ensure that they contain the finer detail required for staff to appropriately meet peoples needs. They should include any areas identified within the assessment. The complaints procedure should be updated to reflect the move from CSCI to CQC. The adult protection procedure should be updated so that it links with the local authority procedure on safeguarding vulnerable adults. The carpets in the residential unit would benefit from replacement as some were badly stained and smelly. 2 3 16 18 4 19 Care Homes for Older People Page 7 of 9 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 The washing machine on the upper nursing unit needs to be fixed and the bath which is not draining appropriately also needs attention. 5 27 The home should demonstrate to CQC how the current RGN staffing numbers meet the needs of people living at the home. Staff should receive training in epilepsy, so that they can meet the needs of people living at the home. All staff should receive a minimum of six supervision sessions each year. Items such as razors and disinfectant should not be left unattended as this could pose a risk to people living at the home. 6 7 8 30 36 38 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. © 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. 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