Random inspection report
Care homes for older people
Name: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ zero star poor service 01/12/2008 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: John Hurley Date: 0 2 0 3 2 0 1 0 Information about the care home
Name of care home: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ 01929425588 01929425588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maxine Valerie Toni Jacqueline Wylie,Mr Richard Graham Wylie Name of registered manager (if applicable) Mrs Margaret Street Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home York House is a large, older style, detached property that overlooks a recreational/garden area and is close to the seafront. The home is approximately a mile from Swanage town centre, which has a G.P surgery, community hospital, shop, banks, a post office and places of worship. Accommodation is provided over three floors, all are serviced by a passenger lift. All communal lounges and dining areas are on the ground floor, also the kitchen and
Care Homes for Older People Page 2 of 12 care home 34 Over 65 34 0 0 1 1 2 2 0 0 8 Brief description of the care home managers office. There are 30 bedrooms in the home; 20 have en suite toilet facilities. Two rooms are registered for use as shared rooms. A maximum of 34 service users can be accommodated in the category OP (older persons). Mr and Mrs Wylie are the registered providers and have owned York House since 1988. The registered manager is Mrs Street, who is supported by a Deputy Manager and a team of care and household staff. The gardens and grounds are well tended with garden furniture available so that residents can sit outside in good weather. There is car parking space at the front of the house for use by visitors. Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. The fee range quoted in the service user guide at the time of inspection was £455 to £515 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk Care Homes for Older People Page 3 of 12 What we found:
We found some action had been taken to address the requirements that had been set. We first looked at the risks identified with the environment. We walked around the building with the a member of the management team and noted that not all radiators were covered and not all of the window openings were restricted. All of the peoples private rooms were either unlocked or had the key in the lock. We looked at the risk assessments for the radiators and restricted window openings. The home had completed risk assessments on all areas but these risks were based on the occupant of the room rather then the room itself. As the rooms were not locked any one could enter the room thus undermining the risk assessment made. We consider that the risks to people with regards to uncovered radiators and unrestricted windows remain. When entering the building it was noted that the visitors book is now being used to record who is in and out of the home. We looked in the communal bathrooms and found that paper towels were available along with liquid soap. We also noted that toilet roll holders had been replaced where necessary. We looked in the bathroom cabinets and found shaving creams, soap and deodorant. We noted that in one of the communal bathrooms that a sponge was on the side of the bath. Whilst looking around the private rooms of the residents it was noted that a person was using a bowl to soak soiled laundry in their en suite. All of these issues undermine the infection control policies of the home. We looked at one persons care file who had recently entered the home. The preaddmission assessment had been carried out and a plan of care developed from this. The per admission assessment identified what the needs were but did not robustly set out what the home would do to met those needs for example; the initial assessment stated that the person needed to have a falls risk assessment carried out. This was achieved but in the plan of care this was not mentioned and there was no instruction to staff with regards to how they should reduce the risk of falls. Therefore this does not fully address the acknowledged risk. Other examples are that the new resident had an pre existing medical condition. We asked the deputy manager what this condition meant as it was not recorded in the file how this may effect their life and therefore the care they may receive. They did not know about this condition. We looked at the Medication Administration Records (MAR). This informed us that some people self medicate. There was no recording of what had been handed over to the resident recorded on the MAR. We sampled the risk assessments for people who self medicate and found that some but not all had been reviewed on a monthly basis. Risk assessments generally stated that people had a lockable storage device for their medication. We checked this and found that this was the case but the keys were in the storage device on the wall. As already mentioned the doors are not locked to the individuals bedrooms and so the risk assessments were invalid. What the care home does well:
The people who live at the home consider that they receive a good quality service. The home is generally clean in all areas and some improvements have been to communal
Care Homes for Older People Page 4 of 12 toilet facilities following the inspection. From speaking with the responsible individual and management of the home we were reassured that the home has a strong desire to make the necessary improvements where identified. There is a real effort to make the home welcoming with a friendly warm and family atmosphere with one relative saying they were very impressed with the dedication of staff. The home encourages individuals to maintain their contacts with the community, friends and family.the home 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 5 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 3 14 The registered manager must ensure that initial assessments of need are carried by people trained to do so. This requirement is repeated, the previous date for compliance was the 19/02/2010 In order to ensure people do not have unmet needs. 19/03/2010 2 7 15 The registered manager 19/03/2010 must ensure that all care plans and reviews accurately reflect the needs of the person and give enough detail to guide and inform staff as to how to meet the agreed needs. This requirement is repeated, the previous date for compliance was the 19/02/2010 To ensure the person is not at risk of having unmet needs 3 7 13 The manager to make sure there are suitable arrangements to provide a safe system for moving and 01/03/2009 Care Homes for Older People Page 6 of 12 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 handling individuals. This refers to the need to undertake moving and handling assessments for all individuals in the home. 4 9 13 The registered manager 19/03/2010 must ensure that the receiving, administration, recording of and returning of medication is carried out in accordance with the National Pharmaceutical requirements. This requirement is repeated, the previous date for compliance was the 19/02/2010 So as not to put people at risk of harm 5 9 13 The registered manager to make sure there are arrangements for the recording, safe administration of medicines received in the home. This refers to the need to have written guidance as to the use of variable dosage of medication and the accurate recording of variable dosages. 6 10 12 The registered manager must ensure that all care practices treat people with respect and dignity. This was not assessed during
Care Homes for Older People Page 7 of 12 31/03/2009 05/02/2010 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 inspection To ensure people are treated with respect and dignity 7 12 16 The registered manager must ensure that there are opportunities for all to be involved in meaningful activities based on peoples assessed needs and aspirations. This was not assessed during this inspection To ensure that person have sufficient opportunities for social stimulation 8 18 10 The registered manager must ensure that the homes policy with regards to Safeguarding Vulnerable adults is updated This was not inspected during this inspection In order to protect those who use the service 9 18 10 The registered manager 26/02/2010 must make arrangements to ensure that all staff have had Safeguarding Vulnerable adults training This was not assessed during this inspection In order to protect those who use the service. 22/02/2010 26/02/2010 Care Homes for Older People Page 8 of 12 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 10 19 13 The registered manager must ensure that people are not at risk of harm through environmental factors such as hot water temperatures, uncovered radiators and unrestricted window openings 22/03/2010 To ensure people are protected form harm 11 26 13 The registered manager 12/03/2010 must ensure that infection control policies are adhered too so as to promote the well being of those at the home. This requirement is repeated, the previous date for compliance was the 12/02/2010 To ensure people are protected form harm 12 29 19 The registered manager must ensure that those who work at the home are fit to do so This was not assessed during this inspection To protect people from harm 13 30 18 The registered manager to 31/03/2009 make sure that persons employed to work at the care home receive training appropriate to the work they are to perform. 26/02/2010 Care Homes for Older People Page 9 of 12 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 refers to all staff having moving and handling and Safeguarding training. 14 30 18 The registered manager to 26/02/2010 make sure that persons employed to work at the care home receive the statutory training appropriate to the work they are to perform. This was not assessed during this inspection In order to ensure staff have the training to meet the needs of those who live at the home. 15 37 17 The registered manager must ensure that records required by regulation are maintained This was not fully assessed during this inspection In order to protect those who live and work at the home 16 37 13 The registered manager must ensure that all environmental risk assessments are kept up to date. To ensure people are protected from harm 12/02/2010 12/02/2010 Care Homes for Older People Page 10 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 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. © 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 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!
