Inspection on 01/08/08 for Wear Court

This inspection was carried out on 1st August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wear Court 27/05/10

Wear Court 17/05/10

Wear Court 16/03/10

Wear Court 18/02/10

Wear Court 11/12/09

Wear Court 30/07/09

Wear Court 08/11/07

Wear Court 01/12/06

Wear Court 25/01/06

Wear Court 13/09/05

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

CARE HOMES FOR OLDER PEOPLE Wear Court Rock Lodge Road Roker Sunderland SR6 9NX Lead Inspector Steve Tuck Key Unannounced Inspection 1st August 2008 9:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wear Court Address Rock Lodge Road Roker Sunderland SR6 9NX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 5496441 0191 5485305 Moorlands Care Homes (N.E.) Limited Manager post vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2007 Brief Description of the Service: Wear Court Nursing Home provides nursing and personal care for 30 older people. The home is situated in a residential area of Sunderland approximately 50 metres from the sea front and within easy reach of public transport facilities. The three-storey house was originally a residential dwelling and was converted to a care home in 1993. There is a passenger lift, which provides access to most areas of the home. A stair lift provides access to several bedrooms on the first floor that are inaccessible via the passenger lift. There are twenty-seven bedrooms, four of which are double and are currently used as single rooms. Eight single and two double rooms have en-suite toilet facilities however, some are not of a suitable size to allow access for wheelchair users or people with mobility difficulties. Corridors and door widths are wide enough to allow access for wheelchair users. The laundry, kitchen, dining room and lounge areas are all on the ground floor with the majority of bedrooms on the upper floors. There is a conservatory to the rear of the building, which overlooks the private and mature gardens. It costs between £399 and £492 per week to live at this home. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place over three days and was a scheduled unannounced inspection. Before the visit: We looked at: • Information we have received since the last Key Inspection on 8th November 08 and a Random Inspection on 20th May 08. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. The Visit: An unannounced visit was made on 1st August 2008. During the visit we: • Talked with the people who use the service, the staff and the acting manager. • Observed life in the home. • Looked at information about the people who use the service & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the acting manager what we had found. What the service does well: Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 6 People who move to the home have their needs assessed by social or healthcare workers and the acting manager so that everyone is sure that this is the right place for them to live. People living at the home benefit from well-trained staff who they know well. Staff turnover is low and they receive good levels of training with the majority having an NVQ level 2 or above. Both care practice and staff recruitment practices are governed by equal opportunity principles. People who live at the home are protected; they are safeguarded from abuse by staff who are trained to look after their best interests. If people have complaint then these are taken seriously and properly responded to by the home’s manager. Staff are very respectful and courteous to the people who live at the home. People living at the home described how their privacy is respected during their stay. Care is provided to people with a wide range of needs, with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the acting manager the opportunity to recruit staff from the same local background as the people living in the home. What has improved since the last inspection? What they could do better: People living at the home must have their needs and requirements met. They must be cared for in the way that has been agreed at an assessment or review and described in their care plan and there must be enough staff at the home so that their needs can be met. Plans of care must be written in enough detail to show the specific actions staff are to take to support peoples’ needs, preferences and lifestyle. And care plans must be written in enough detail so that they can be used to co-ordinate the work of staff and show if changes in peoples’ condition have taken place. There must be an accurate record of all medication held and administered at the home, accurate and verifiable records of controlled drugs must be kept and the process for monitoring and making sure that medication is accurately administered must be effective. This is so that people living at the home get the medication that they have been prescribed. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 7 The home is in a state of disrepair with urgent attention needed to the building. So that people living at the home can continue to live there in comfort and safety: • The premises must be kept in a good state of repair externally and internally; there must be plans of how urgent and routine maintenance, redecoration and refurbishment is carried out. • People’s rooms and communal areas must be clean and have no foul odours. And that proper materials and equipment must be in place to make sure that the home can be kept clean and odour free. • There must be equipment in bathrooms which prevents people using them from being scalded; • The heating system must be in good working order. • The laundry must be properly maintained so that it can be used to hygienically clean peoples’ clothes and bedding. • Safeguards must be in place so that when bedrails are used they do not put people living at the home at risk of injury. The owner must be able to demonstrate that the home is financially viable. This is so that the best interests of the people living there and their relatives can be reassured and the home can continue to support them. Where people have dementia type illness, the home must follow current best practice to make sure that peoples’ plan of care and staff support is relevant to their history and needs. There needs to be better-structured meaningful activities for people with these needs. There must be a manager at the home who is suitably trained, qualified, experienced and fit to run the home for the benefit of people living there. There must be a plan in place which demonstrates how the quality of the home is to be improved which is based on the views of the people who use the service. This is to make sure that people living at the home know that their service will be improved. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained staff from the home find out and understand the needs of people who wish to live there before they move in. This information helps to make sure that peoples needs can be met at the home and agree the ways in which staff are to support them. EVIDENCE: Information about the home for people who may be interested in moving there has been re written by the acting manager so they now have the information they need. Similarly the homes’ ‘Statement of Purpose’ which shows what the home intends to do for everyone has also been improved. People who live or intend to move to the home and staff working there can now see the aims, objectives, philosophy of care, services and facilities and terms and conditions of residency Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 10 so that everyone can be clear about what the home sets out to do for the people who live there. By looking at the records kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff, local authority social workers and the acting manager. This is so that the acting manager has a good understanding of peoples’ health and social care needs and can be sure that the home is going to be suitable for people who are going to live there. The acting manager also finds out what cultural and lifestyle needs people have to make sure that these can be met. The acting manager and senior staff have also had training which has given them the skills to find out what peoples needs are. As a result of these measures, all of the people living at the home since the last inspection have been properly placed and the home is able to meet their needs. One staff said, “As well as reports from social workers or nursing staff we spend time talking to relatives as often people cant tell us about their part lives and the things that they value; I think it’s the little things we find out about which helps people to settle in.” Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which should set out in detail their preferences and how their assessed needs will be met. But these are not always carried out nor do they fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples’ needs. EVIDENCE: All people who live at the home have a plan of care which gives a description of how their needs are to be met. There is a set structure for these records with pre-printed documents for nursing and care staff to fill in. Where people have clearly identified nursing care needs or treatments taking place these are written down and most of the time are regularly updated by nursing staff. Peoples physical condition is also monitored for example their weight is checked to make sure they are eating enough to stay healthy. Staff at the home judge how to support people who are at risk from falls and help them to Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 12 use equipment which maintains their fitness and independence around the home. And staff arrange for help from outside the home which can support people who are at risk of falling over. However records show that measures designed to make sure that people remained healthy were not always carried out for example: • Records showed that one person whose care plan said that they should have had their position changed every two hours to prevent them from getting pressure damage; did not have their position changed for over six hours. Records showed that one person whose care plan said that they needed assistance to have drinks every two hours was not offered them for over six hours. Records showed that one person whose care plan said that they needed support to eat at least every four hours was not supported for six hours. • • Records which describe how peoples social care needs are to be met did not match the actual support and actions which staff currently carry out. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not yet successfully combined in the care plans so that these can be used to consistently provide fully co-ordinated care. All of the staff interviewed could describe peoples’ needs, preferences and histories, however the potential areas of good practice were not generally shared with colleagues nor were these written down in care plans. For example: • The arrangements for someone who has a regular activity with friends outside of the home was not recorded in their care plan. • Some people are unable to communicate with speech but have other ways of letting staff know of their choices for example at mealtimes but these were not written in their care plans. The home provides care to people who have become frail and may also have dementia type illness. Care planning arrangements for these people do not yet reflect current best practice. For example, care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans, which place the person at the centre of a network of support for their needs and lifestyle requirements, are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of dementia increases. Due to their levels of need, people who live at the home are not able to organise their own medicines, and appointed staff therefore help in this area. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 13 Nursing staff who are trained in this area administer medication at the home. Medication is securely stored and records are kept which should help staff to make sure that people living at the home have the medication that they have been prescribed. But ten of the eleven records examined had mistakes. For example: • • • • • • Five controlled drug injections were being stored at the home but there was no record of this in the Controlled Drugs Register. One persons medication which was stored at the home was not recorded at all. Two people had received medication that had not been signed for. On nine occasions one person did not receive medication because they were sleeping but the record did not show this was the case. One person had one less medication in stock than they should have had but this could not be accounted for. Two people had not been given their medication when they should have on two occasions each; another person had not received their medication on one occasion. The relationships between staff, residents and relatives, were friendly and professional. Care was delivered in private and staff were seen to knock on doors and wait for permission before entering. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some people who live at the home are encouraged and supported by the staff to lead fulfilling lives. But this could be improved if staff had a better way of supporting the lifestyle needs of people who are more needy or have a dementia type illness. EVIDENCE: The acting manager and staff help people who live in the home to stay in contact with family members and friends. People who are able to get around the home or local community on their own and staff talked about what they do both inside and out of the home. For example visiting their local church. For some of the people who are unable or do not wish to leave the building there are some limited activities which take place. There is an activity coordinator and staff do spend time with people, talking to them and helping them to fill their time. However the activities co-ordinator is only employed on a part time basis and staff are busy meeting the care needs of people living at the home leaving them little time to provide all but basic opportunities. The Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 15 acting manager also acknowledged that it was difficult trying to get people to engage in any type of activity. The home provides for people who have dementia type illnesses. Although staff do spend time talking to people, which is good, there is also little for people to engage in. A programme of activities, specifically designed to support, interest and help to structure the lives of people with these needs is not yet in place. Staff at the home like to encourage relatives or friends to visit regularly and people living there said that they like it when people visit and make them feel welcome. Information about advocacy is available although no one has used an advocate. Many of the residents have brought small items with them making their rooms homely and reflective of their previous lifestyles, religious beliefs or cultural backgrounds. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal and size of portion to make sure that people got what they wanted. Comments from some of the people living at the home were, “The food is good.” “That was a good meal.” Staff are available during meals to offer support and assistance where needed. The cook has a good knowledge of the meals which people living at the home prefer. She understands the benefit of using fresh ingredients to help people to remain healthy. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. Where people need it food supplements are available to help people to maintain their health for example if they have diabetes or have difficulty maintaining their weight. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people who live at the home from being harmed which helps to promote their safety and security EVIDENCE: The acting manager has re written the complaints procedure so that it is clearer about what to do if they are not happy. This informs people about who they should make a complaint to and how much time that a complaint will take to look at. There is a record kept at the home of all complaints, which includes details of any investigation and the outcome. No one has approached the Commission for Social Care Inspection (CSCI) because they have been unhappy with the way that the home has managed their complaint. One person who lives at the home said, “They always seem to respond quickly if you say something isn’t right – I don’t have any problems.” Whilst there have been no instances where abuse has been shown to have taken place, the home has an adult protection procedure which can be used where necessary to protect people living at the home. Staff have guidance and training about what to do if they see or suspect abuse is taking place and all Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 17 staff spoken to showed that they knew what to do and what they expected to happen so that people remain protected. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,25 and 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People live in an environment which is poorly maintained and staff struggle to promote their safety, independence and comfort. EVIDENCE: Most of the home is in need of refurbishment and / or redecoration; although there has been some progress made since the last inspection this has not taken place within an acceptable timescale. Examples of areas which require urgent attention: • There were significant unpleasant odours in three rooms but the home has no carpet cleaning equipment so rooms cannot be hygienically cleaned. DS0000064820.V369614.R02.S.doc Version 5.2 Page 19 Wear Court • • • • • • • • • • • • The heating system is faulty and cannot be turned off even in hot weather making the home uncomfortably warm. The acting manager confirmed that hot water in bathrooms is not controlled by safety valves so water can be too hot and cause injury to the people who use them. The laundry flooring and walls are damaged. Laundry is being carried out in a room, which cannot be hygienically cleaned, and infections can not be effectively controlled. The conservatory roof is leaking leaving pools of water on the floor. There are over 20 tiles missing from the roof at the front of the building. One room has dangerous wiring. Several bedrooms rooms have broken furniture, drawers or wardrobes. There are pigeons nesting in the eaves and heavy droppings which obscure the views from some of the windows; and have odours. The bedding around the edges of the gardens are overgrown although the lawn has now been cut. Outside stonework is in poor condition. Outside paintwork is flaking off and in poor condition. The window panes in some rooms are broken – some of the Windows can not be opened because they are old or damaged. There have been improvements made since the last inspection. For example: • The kitchen has been cleaned decorated and repaired by the manager and staff. • Two rooms have been redecorated and refurbished, two more are being completed. The acting manager has been unable to persuade the owner to carry out a refurbishment / maintenance plan which she has drawn up which would demonstrate that the home is being kept at an acceptable standard. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. At times there are insufficient staff on duty to meet the needs of the people who are living at the home. This means that they may not get their needs met and could put them at risk of harm or neglect. EVIDENCE: An inspection on 20/05/08 showed that there had been insufficient staff employed at the home to meet the needs of the people who live there. The owner has reduced nursing staff from two to one during the day and reduced the kitchen and domestic staff; there is no laundry staff; These tasks are now carried out by care staff in addition to their role supporting people. The manager was unable to give any evidence of how she or the owner had made calculations about how many staff should be available at the home. There was no evidence that the specific nursing and care needs of the people living at the home had been accounted for; and the number of staff needed to support them had been considered. As well as this staff who are taking short term sickness absence or holidays were not replaced. This illustrates that staffing levels at the home were allowed to be arbitrary dependant on the good health of staff. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 21 At this inspection there were two care staff and one nurse to support nineteen people four of whom were described as being totally dependent and needing high levels of nursing care and support from staff. Records showed that two people did not get the care and support from staff so that over a period of time, they did not get sufficient fluids, nutrition or the changes in position to help prevent them from developing pressure damage. Comments from staff included, “Often the home is short of staff.” “ If one member of staff rings in sick, the workload is heavy on the staff on duty.” To improve…. “the home could employ more domestic staff and care staff.” “We have no laundry assistant at all or kitchen staff after 2pm so nurses / carers then have to do their job”. One person had been employed at the home since the last inspection and records showed that appropriate pre employment checks had been carried out before they were allowed to work which showed that they were suitable to work with vulnerable people. The majority of staff have worked at the home for a number of years, almost all have at least a National Vocational Qualification at level 2 or above. One person who lives at the home said, “All the staff are most helpful, kind and caring”. Another said, “ You could not get better care.” Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, the management and administration of the home does not fully support a service that is run in the best interests of people who live there. EVIDENCE: There is a new manager at the home who has been in post for five months before this inspection took place. She has been appointed by the owner but has not yet been assessed by the Commission for Social Care Inspection to make sure that she is suitable to be the manager of the home. The manager has a National Vocational Qualification in Management and in Care both at Level 4 and was the registered manager at her previous service. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 23 One staff said about the manager, “ I’m sure with help and support from the owner and the present staff we will once again be a home to be proud of”. Although the acting manager has done her best to improve services at the home, there is no system in place which measures the quality of the service or a plan which describes how this is to be improved. There is no management plan for the home which would describe how the quality of life for people is to be met. The overall management approach lacks clear vision. Some of the people who live at the home need assistance to manager their personal finances. A record is maintained for each person’s transactions. Entries were clear with signatures available. A random check of balances and cash were found to be correct. The home is run by Moorlands Care Home (NE) Limited. The Commission has been informed that H M Revenue and Customs has issued a petition to wind up a company of which Moorlands Care Home (NE) Limited is the majority shareholder. The owner has given assurances that the company continues to be a financially viable business. However at the time of this inspection the action by HM Revenue and Customs had not been finalised. Staff supervision does not yet take place at the home although the manager is planning how this is to be put in place. At present bedrails are used at the home to support people who live at the home. However guidance on their use has not been carried out; there is no plan of maintenance for this equipment, no risk assessment to show the actions to be taken to minimise risks to the people who use them and staff have not been trained how to use them safely. Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X 2 3 X 2 1 1 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 2 3 2 X 2 Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The owner must make sure that all care plans must have enough detail to show the specific actions staff are to take to support their needs preferences and lifestyle. Reviews must reflect the progress towards those goals. This is to make sure that staff plan and review how they work with people and that they write this down so that everyone in the home works in the same way. 2 OP7 12 This is a new Requirement. The owner must make sure that people living at the home are cared for in the way that is agreed and described in their care plan. This is to make sure that peoples health and personal care needs are met. 3 OP7 12 This is a new Requirement. The owner must make sure that all support for people with DS0000064820.V369614.R02.S.doc Timescale for action 01/11/08 01/09/08 01/11/08 Page 26 Wear Court Version 5.2 dementia type illness follows current best practice and this is recorded in each persons care plan. This is to make sure that people who have dementia type illness at the home are supported in ways that are most suitable for them. 4 OP9 13 This is a new Requirement. The owner must make sure that there is an accurate record of all medication held at the home. This is to make sure that people get the treatment they have been prescribed. 5 OP9 13 This is a new Requirement. The owner must make sure that Controlled Drugs are properly stored and accurate verifiable records are kept. This is to make sure that dangerous drugs are stored and administered safely. 6 OP9 13 This is a new Requirement. The owner must make sure that the process for monitoring and making sure that medication is accurately administered, is effective. This is to make sure that people get the treatment they have been prescribed. 7 OP12 16 This is a new Requirement. The owner must make sure that 01/10/08 there is a structured programme of activities which includes people with dementia and follows current best practice guidance. 01/09/08 01/09/08 01/09/08 Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 27 This is to make sure that people at the home have their lifestyle needs met. 8 OP19 23 This is a new Requirement. The owner must make sure that the premises are of a sound construction and kept in a good state of repair externally and internally. This is so that people who live in the home have an acceptable level of comfort, hygiene and safety. This is an outstanding requirement from 31/03/07. The owner must make sure that there is a plan of urgent and routine maintenance, redecoration and refurbishment which is developed and implemented. This is so the home can be brought up to acceptable standards of repair, safety, hygiene and comfort. 10 OP25 23 This is a new Requirement. The owner must make sure that there is equipment in bathrooms which prevents people using them from being scalded This is to make sure that people living at the home are not accidentally injured. 11 OP25 23 This is a new Requirement. The owner must make sure that the heating system is in good working order. This is to make sure that people live in an environment which is comfortable and they can Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 28 30/11/08 9 OP19 23 15/10/08 01/11/08 01/11/08 control. 12 OP26 16 This is a new Requirement. The owner must make sure that peoples rooms and communal areas are clean and have no foul odours. And that proper materials and equipment are in place to make sure that the home can be kept clean and odour free This is to make sure that people can live and work in pleasant and hygienic surroundings. 13 OP26 16 This is a new Requirement. The owner must make sure that the laundry is properly maintained so that it can be used to hygienically clean peoples’ clothes and bedding within a reasonable timescale. This is to make sure that peoples comfort, health and welfare is supported. 14 OP27 18 This is a new Requirement. The owner must maintain appropriate staffing levels to meet the needs of people living at the home. The registered person must ensure that there are sufficient kitchen and domestic staff employed so that the home is maintained in a clean and hygienic state, free from dirt and odours. This is an outstanding requirement from 08/11/07. The owner must make sure there 15/08/08 is a manager who is fit to be in charge of the home. 01/11/08 15/11/08 01/10/08 14 OP31 8 Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 29 This is so that people living at the home get a service which is expertly run. This is an outstanding requirement from 15/08/08 The owner must make sure that there is a plan in place which demonstrates how the quality of the home is to be improved which is based on the views of the people who use the service. This is to make sure that people living at the home know that their service will be improved. 17 OP34 7 This is a new Requirement. The owner must be able to demonstrate that the home is financially viable. This is to make sure that the home can continue to operate in the best interests of people living there. This is an outstanding Requirement from 01/08/08. The owner must make sure that staff have regular supervision. This is to make sure that staff get the direction and support that they require to meet the needs of the people who live at the home. This is a new Requirement 19 OP38 13 The owner must make sure that Department of Health guidance on the safe use of bedrails in care homes is undertaken. This is to make sure that people who live at the home are not at risk from poorly used or Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 30 16 OP33 24 01/10/08 01/10/08 18 OP35 18 01/11/08 15/09/08 maintained equipment. This is a new Requirement. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wear Court DS0000064820.V369614.R02.S.doc Version 5.2 Page 32 - 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!