Random inspection report
Care homes for older people
Name: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP one star adequate service 30/06/2009 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: Janie Buchanan Date: 2 3 1 2 2 0 0 9 Information about the care home
Name of care home: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP 01487841404 F/P01487841404 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) : Farrington Care Homes Ltd care home 24 Number of places (if applicable): Under 65 Over 65 24 24 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 3 0 0 6 2 0 0 9 Woodlands provides care, accommodation and support for up to 24 older people, some who have a degree of confusion or a form of dementia. The home is situated in the village of Earith, which is approximately 6 miles from the market town of St. Ives; from the rear of the home are good views across the River Great Ouse. Residents accommodation is on two floors, the upper floor being accessed via a shaft lift. The home has 18 single and 3 double rooms, but would only be used to accommodate a couple if the need arises. Sixteen of the single rooms have en-suite toilets, and 4 rooms also have baths. There are 4 toilets, one specialist bath, and a level access shower. Communal areas include 2 lounges, a dining area, and a large conservatory, all of which are available for residents use. A pleasant garden area leading down to
Care Homes for Older People Page 2 of 12 Brief description of the care home the river is provided outside. Residents are supported by a team of care staff; the premises are looked after by domiciliary staff and a maintenance person. A copy of the latest CQC inspection report can be requested from the home or downloaded from www.cqc.org.uk Charges vary between £363 and £563 per week. Care Homes for Older People Page 3 of 12 What we found:
The reason for this visit was to check on compliance with the requirements and recommendations made at our previous inspection of 30/06/2009. We visited the home and spoke with residents, staff and the manager. We checked medication storage and a sample of medication administration records. We undertook a tour of the building and viewed a range of the homes policies and documents. MEDICATION We checked a sample of residents MAR sheets and noted that a signature tally was now in place, that a controlled drugs book had been purchased and that date on which liquid medication bottles were opened was now being kept. However, we found the following serious shortfalls: staff were signing for medication that they themselves had not actually administered to residents; the amount of medication in stock did not tally with the amount of medication actually recorded; the date on which the prescribers instructions for Warfarin tablets had changed had not been recorded resulting in one resident receiving the wrong amount and staff were not recording the amount of variable dose medication they give to residents, making it impossible to account for how much they had actually received. CARE PLANS At our last inspection of 30/06/2009 we made a requirement that residents must have their nutrition assessed and be weighed regularly. During this inspection we checked the care plans for 2 residents and noted that residents weights were being checked and their nutrition was assessed. At our last inspection of 30/06/09 we made a requirement that residents must be involved in panning and reviewing their care. We checked the care plans for two residents and neither contained evidence that residents had been actively involved in reviewing their care despite being very able to do so. The deputy manager also told us that staff do not sit with residents and go through their plans with them when they are reviewed monthly. At our last inspection of 30/06/09 we recommended that residents be given the opportunity to express their wishes about what they want to happen when death approaches and to give instructions about the formalities they want observed after their death. None of the care plans we checked during this inspection showed that residents had been given this opportunity or had their preferences recorded. One staff member we interviewed told us: we dont really discuss end of life issues with residents. ENVIRONMENT At our last inspection of 30/06/09 we recommended that better signage and orientation aids should be provided around the home to help residents and relatives find their way about more easily. We also recommended that residents names be placed on their doors so they could identify them. We undertook a tour of the building and none of these recommendations had been acted upon. We also recommended that screening be
Care Homes for Older People Page 4 of 12 provided in shared bedrooms to maintain residents dignity and privacy. We checked three shared bedrooms and no screening had been made available. During this inspection we noted that many of the bedrooms could not be locked by residents, denying them privacy and security and there were also no lockable facility in some bedrooms for residents to store money valuables or medication should they wish. STAFF TRAINING We checked the training files for four members of staff and it was of concern to note that training for two domestic staff was inadequate: neither had received training in moving and handling, infection control, COSHH health and safety, and safeguarding vulnerable adults. STAFF SUPERVISION We looked at the supervision records for four staff. One of these staff had only received one supervision since she started working at the home and two had not received any supervision of their working practices at all. SAFEGUARDING At our inspection of 30/06/2009 we recommended that information about how to raise complaints and also how to report any adult protection issues should be made available around the home so that residents their visitors and staff know who to contact should they wish to raise concerns. We toured the premises and found no evidence that this had been done. We asked for a copy of the homes safeguarding policy but the manager was unable to find it. RECRUITMENT We checked the personnel files for three recently recruited members of staff. Two of these staff had been employed before a full CRB disclosure had been received, thereby putting residents at unnecessary risk. The manager stated that all prospective employees had been interviewed but there were no interview notes available to evidence this or to show that the interview process was fair and done in line with employment legislation. MANAGEMENT The current manager dos not have the registered managers award or any qualification comparable to an NVQ level 4 in care or management. She also showed a poor knowledge of the national minimum standards and the legal framework within which she operates. What the care home does well: What they could do better:
Residents who are able must be actively involved in planning and reviewing their care so
Care Homes for Older People Page 5 of 12 they have a say in how they are to be helped and can agree to any changes in their plan of care. We raised this at our last inspection but there has been no improvement. Residents need to be given opportunities to discuss their preferences about end of life issues and to record these to ensure their wishes are respected. We raised this at our last inspection but there has been no improvement. We noted serious shortfalls in the administration of residents medication and these must be addressed so that residents receive their medication as prescribed and that an accurate record is kept when medication is given to them. Better signage and orientation aids should be provided around the home to help residents find their way about. In particular bedroom doors should have peoples names on them so they are easier to find. We raised this at our last inspection but there has been no improvement. Residents must be able to lock their bedroom doors for their privacy and security. Each room should also contain a lockable storage facility so they can keep money valuables or medication safely. Screening must be provided in all shared rooms so that residents living there can have their privacy and dignity maintained. We raised this at our last inspection but there has been no improvement. All staff (including domestic staff) must receive training in safeguarding vulnerable adults so that they have a good understanding of the adult protection system in their local area and the part they play should the need arise. Staff should not commence working at the home until a full CRB check has been received (unless there are very exceptional circumstances) so that residents are protected. Information about how to raise complaints and concerns and also how to report any adult protection issues should be made easily available around the home so that residents their visitors and staff know who to contact should they wish to raise concerns. We raised this at our last inspection but there has been no improvement. Domestic staff must receive training in infection control, health and safety, moving and handling, and COSHH so they have the knowledge and skills to do their job safely. Notes from interviews with prospective employees should be kept to demonstrate that their recruitment was fair and conducted in line with good employment practices. Staff must receive regular supervision so that their working practices can be discussed, their training needs identified and so they can raise any concerns they may have. We raised this at our last inspection but there has been no improvement. Many of the requirements and recommendations we made at our last inspection have not been met. This shows a poor regard for the national minimum standards and the manager must demonstrate that she takes legal requirements and recommendations we make seriously and meet them within the timescales set or we may consider enforcement action.
Care Homes for Older People Page 6 of 12 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 12 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 7 15 Residents must be involved in planning and reviewing their care. You must do this to ensure they have an active say in how they are to be helped by staff. 01/09/2009 Care Homes for Older People Page 8 of 12 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 7 15 Resident must be involved in 01/03/2010 planning and reviewing their care. You must do this to ensure that they have an active say in how they are to be helped by staff 2 9 13 Records made when medication is given to residents must be accurate and complete. You must do this to demonstrate that residents receive their medication as prescribed 01/02/2010 3 9 13 Medication must only be given in line with the prescribed instructions. You must do this to ensure residents receive their medication as intended 01/02/2010 4 18 13 All staff must receive training 01/03/2010 in safeguarding vulnerable adults. Care Homes for Older People Page 9 of 12 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 You must do this so that staff have an understanding of the adult protection systems in their local area an the part they play should the need arise. 5 24 16 Screens must be provided in 01/02/2010 all shared bedrooms rooms. You must do this so residents have their privacy and dignity maintained. 6 24 12 Residents must be able to lock their bedrooms doors. You must do this so that residents can maintain privacy and security. 7 30 18 Domestic staff must receive 01/02/2010 training in health and safety, infection control, moving and handling, and COSHH. You must do this to ensure they have the knowledge and skills to do their job safely 8 36 18 All staff must receive formal supervision You must do this so that staff have their working practices reviewed, their training needs identified and so they are supported. 01/03/2010 01/03/2010 Care Homes for Older People Page 10 of 12 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 11 Residents need to be given opportunities to discuss their preferences about end of life issues and to record these to ensure their wishes are respected. We raised this at our last inspection but there has been no improvement. Information about how to raise complaints and concerns and also how to report any adult protection issues should be made easily available around the home so that residents their visitors and staff know who to contact should they wish to raise concerns Better signage and orientation aids should be provided around the home to help residents find their way about. In particular bedroom doors should have peoples names on them so they are easier to find. Notes from interviews with prospective employees should be kept to demonstrate that the recruitment process was fair and in line with good employment practices. Staff should not commence employment until a full CRB check has been received by the home. 2 16 3 19 4 29 5 29 Care Homes for Older People Page 11 of 12 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 12 of 12 - 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!
