Inspection on 27/05/10 for Wear Court

This inspection was carried out on 27th May 2010.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 01/08/08

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 04/09/2010.

Random inspection report Care homes for older people Name: Address: Wear Court Rock Lodge Road Roker Sunderland SR6 9NX zero star poor 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: Irene Bowater Date: 2 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Wear Court Rock Lodge Road Roker Sunderland SR6 9NX 01915496441 01915485305 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Moorlands Care Homes (N.E.) Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 1 6 0 3 2 0 1 0 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 Care Homes for Older People Page 2 of 14 Brief description of the care home 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 405 pounds and 485 pounds per week to live at this home.The costs of newspapers, hairdressing, and toiletries are not included in the fees.Fees vary depending on peoples circumstances, further details can be found in the homes Service User Guide. Care Homes for Older People Page 3 of 14 What we found: This inspection was carried out by two inspectors on the 27 May 2010 and took seven and a half hours to complete. We undertook this inspection to follow up requirements made at a random inspection which was completed on the 16 March 2010. This was to tell the Provider what shortfalls we had found, what action was required to put these issues right and that we would take enforcement action should they continue to fail to address these. We also issued 3 Statutory Requirement Notices(SRN) after the previous inspection of the 16 March 2010. These are formal notices to tell the company what shortfalls we have found and that we may prosecute them if they fail to take the necessary steps to improve. We found significant progress in addressing most of the requirements made, for both those within the statutory requirement notices, and those made at the last inspection. During the visit we talked to the people who use the service, staff and the providers representative; looked at information about the people who use the service and how well their needs are being met; looked at other records which must be kept; checked that the staff had the knowledge,skills and training to meet the needs of the people they care for; looked around the building to make sure it was clean, safe and comfortable. We told the providers representative and the nurse in charge what we found. We have reviewed our practice when making requirements,to improve national consistency.Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations,but only when it is considered that people who use services are not being put at significant risk of harm. HEALTH AND PERSONAL CARE. We examined the care records of four service users in detail as we looked at specific aspects of individual care needs. We found that the care plans identified how each individual service users health and welfare needs were to be met and that the care plans had been reviewed at least monthly or sooner if the service users health or personal care needs had changed. Where assessments had been carried out by dieticians and speech and language therapists(SALT) their advice and instructions had been added to the relevant nutritional care plan. Specific care needs of service users who were at risk of weight loss, who required specialist diets were also detailed in care plans, along with evidence of weekly weight checks. The recording of care charts such as food and fluid intake and continence monitoring charts were being fully completed and could be cross referenced to care plans. Service users who were at risk of pressure damage had clear plans which identified Care Homes for Older People Page 4 of 14 wound care and use of pressure relieving mattresses, including ensuring that the mattress was set at the correct pressure for the service users weight. Service users who had poor mobility and needed assistance, had care plans in place which showed staff which hoist and sling to use and also how many staff would be needed for each activity, such as getting up, transferring to chair, bed, bath and toilet. Detailed risk assessments were in place for falls, nutrition (using the Malnutrition Universal Screening Tool,MUST), pressure ulcer risk,( using the Braden Scoring Tool), dependency, moving and handling, and continence care. This information was clear and updated on a monthly basis. There was evidence that service users are able to access all NHS services including GPs,opticians,dentists and specialist medical and nursing services. Care plans for short term health problems such as chest infections and urinary infections were completed along with care plans for related pain relief. The staff were caring and kind and made sure all care was carried out in private. We found that the requirements made in the SRN, that have fallen due, have therefore been complied with. DAILY LIFE AND SOCIAL ACTIVITIES. Social activities were not examined in detail during this visit. Service users did comment that they did go out and enjoyed a walk along the sea front and another service user confirmed that he still went out regularly on his own. Breakfast was served in the dining room at approximately 9:00 am. The dining tables were nicely set and service users were offered a selection of fruit juices as soon as they arrived for breakfast. There was a selection of cereals,porridge grapefruit,bread,toast and preserves along with a cooked breakfast of bacon,poached eggs and tomatoes.All of the meal including those for service users needing soft or pureed diet were well presented and cooked. Staff were available throughout the meal and they gave assistance in a sensitive manner. Mid morning drinks were available, as well as a large bowl of fresh fruit. There were choices for both the main course and dessert at lunch time and service users comments included, Its delicious, and the food is always good. A selection of hot and cold drinks including smoothies were served mid afternoon along with chocolate biscuits,fresh fruit and cake. When asked staff said the tea time meal was about 4:30 and then a supper trolley was available about 7:30 pm. ENVIRONMENT We looked around the building to make sure that the home was well maintained and kept Care Homes for Older People Page 5 of 14 clean. We saw that the home was safe, but that wear and tear was apparent, with floor coverings broken and worn in service areas such as the laundry, toilets and bathrooms. Many furnishings and fittings, including bed bases,bed linen and chairs, were worn. Also not all wardrobes have been fitted to the walls to minimise risk of toppling incidents. We also saw that many areas were in need of more thorough cleaning, such as easy chairs, occasional tables, door kicker plates, windows, carpets, bathrooms, toilets and sluices. The laundry assistant was off sick, was not replaced and the domestic only worked four hours.This meant most of the domestic work and all of the laundry was left for the care staff. They were too busy delivering direct care to very dependent service users which meant those necessary jobs were not done. The previously made requirement about the building has therefore not been addressed, and we will be writing a formal warning letter to the company on this matter. STAFFING. On the day of the visit there were nineteen service users living in the home with fifteen needing general nursing care. On duty was one qualified general nurse,three care assistants,one cook and an administrator from a sister home in Alnwick. The laundry assistant had telephoned in sick and was not replaced and the one domestic was due to work from 9am until 1pm. There is a maintenance person who works between the other homes in the group. The manager and activities person had recently left but we were told that the recruitment process was underway to replace them. We issued a Statutory Requirement Notice (SRN) following the inspection of 16 March 2010 as too few staff had receive the training needed to do their job properly. This included training on the following topics: 1st Aid training,(sufficient to ensure 1st Aid cover at all times.) Medications Administration for nursing staff . Safeguarding and whistle blowing for all staff. Moving and Handling for all staff. Health and Safety for all staff. Infection Control for all staff. Food Safety and Hygiene for all staff who handle food. Mental capacity Act and Deprivation of Liberty safeguards for all staff. We asked the company to ensure plans were in place for staff to receive this training by 31st July 2010. We found training on infection control has been arranged, and that the company had purchased a series of training DVDs on a broad range of topics, so training could be delivered in-house. These included most of those required in the SRN. We also saw plans were in place for some of the staff team to receive first aid training, and for all staff to attend a course on the Mental Capacity Act and Deprivation of Liberty Safeguards. The requirements made in the SRN, that have fallen due, have therefore been complied with. However we will still need to check that the training staff need is actually delivered. MANAGEMENT AND ADMINISTRATION. Care Homes for Older People Page 6 of 14 There has not been a registered manager in post since 2006. Managers have been appointed but none have completed an application to become registered with the Commission.The manager who was employed in November 2009 had recently left. The provider and his representative are in the home on a regular basis and complete audits and Regulation 26 reports. All staff have completed supervision,however qualified nurses have not had any formal clinical supervision. We have written separately to the provider about the need to appoint a manager as this is a legal requirement under the Care Standards Act 2000. Maintenance records were being completed for hot water, emergency call bells and emergency lighting. The Gas safety certificate has been provided and hoists and lifts have been regularly 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 14 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 To make arrangements to 12/04/2010 ensure that medication administration records are accurately maintained; that the reasons for nonadministration of medication are recorded by the timely entry of an appropriate code or entry on the medication record; that the meaning of any such codes are clearly explained on each record; and that the person administering the medication completes the Medication Administration Record in respect of each individual service user at the time of administration. To maintain an accurate record of medication administered. 2 9 13 To make arrangements to 12/04/2010 ensure that records are kept of all medicines received, administered and leaving the home, disposed of or carried forward from one month to the next. To maintain a full audit trail of medication in the home. 3 9 13 To make arrangements to 12/04/2010 Page 8 of 14 Care Homes for Older People 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 ensure that all medication is administered as directed by the prescriber to the service user it was prescribed, labelled and supplied for. To safeguard the health and welfare of people living in the home. 4 9 13 All medication must be stored at the correct temperature recommended by the manufacturer. Timescale of 01/10/09 not met To ensure that medication remains safe to use. 5 9 13 Regular audit of the 12/04/2010 medication system must be carried out and an action plan implemented when any discrepancies or concerns are identified. Timescale of 30/01/10 not met This helps identify any medication issues promptly, and helps confirm staff are following the homes medicines policy. 6 24 16,23 The registered person must continue to implement the action submitted to CQC to provide suitable furniture and fittings in all bedrooms. This will provide a comfortable environment for people to live in. 01/02/2010 12/04/2010 Care Homes for Older People Page 9 of 14 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 7 26 13 Staff in the home must be provided the facilities to adequately clean and disinfect equipment being used for personal care including the provision of adequate numbers of hot wash sterilisers. This will minimise the risk of cross infection. 01/02/2010 8 30 18 Ensure that sufficient 31/07/2010 numbers of staff receive first aid training in order that first aid assistance is always available in the home. Ensure that all members of staff with responsibility for administering medication are trained to do so. Provide all staff with training in adult safeguarding and whistle blowing. Ensure that all staff are provided with training in moving and handling which is appropriate to their work. Provide all staff with suitable training in health and safety. Provide all staff with suitable training in infection control. Provide all staff who prepare and handle food with suitable training in food safety and hygiene. Provide all staff with suitable training in the Mental Capacity Act and deprivation of liberties safeguarding. Care Homes for Older People Page 10 of 14 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 to ensure that people are cared for by staff who are competent and trained for the work they are to perform. 9 30 18 The registered person must 29/01/2010 ensure that staff are provided with appropriate training for the work they are to perform. This is so that people living in the home receive the care and support they need. 10 38 13 Ensure that free standing wardrobes in bedrooms are risk assessed and where necessary securely fixed. This is to prevent toppling incidents and prevent injury. 21/05/2010 Care Homes for Older People Page 11 of 14 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 23 Provide an action plan to show how the premises are to be kept in a good state of repair and make sure all areas are clean and reasonably decorated. This is to make sure service users have a safe, pleasant and clean place in which to live. 05/07/2010 2 26 13 There must be suitable arrangements in place tp prevent infection ,toxic conditions and the spread of infection at the home. This will make sure service users live in a clean infection free home. 02/08/2010 3 27 18 There must be sufficient domestic and laundry staff employed in the home. This is to make sure the home is maintained in a clean,hygienic state free from dirt and any odour. 31/08/2010 Care Homes for Older People Page 12 of 14 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 3 27 31 36 Agency or bank staff should be deployed when there is staff sickness. The provider should progress with the recruitment process for manager. Qualified nurses should be able to access appropriate clinical supervision for their professional development Care Homes for Older People Page 13 of 14 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. Care Homes for Older People Page 14 of 14 - 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!