Care Home: Anson Court

What the care home does well The home has made improvements in the way it records people`s weights. It has also improved the way in which it records the fluid balance for those people considered to be at risk of dehydration. Both of these improvements will help the home recognise when people`s needs are changing and prompt them to take action in meeting people`s healthcare needs. What the care home could do better: The home must make sure that staffing levels do not place people at risk. During this visit we saw that all but one of the recorded accidents had occurred during the night. The manager has told us that she has put in place changes to the rota which means that an extra carer is available to assist the night staff from 6 am each morning. Whilst this is positive and would offer more protection to the people living in the home, the home must be able to demonstrate that it is meeting people`s needs and is protecting them from harm. Current night staffing levels may not always do this and should be reviewed again. The care planning systems in place still need to be reviewed so that people have their own individual care plans based upon their needs. At present the home has a pre printed care plan system and people`s names are inserted into the care plan. This means that care is not being planned to show people`s preferences or choices in relation to their health care. The manager told us that she intends to change all the care plans in the near future but has been busy with other improvements needed as a result of our November visit. The home has other outstanding requirements in relation to staff recruitment and selection and complaints, which were not looked at during this inspection. The home will be telling us how they intend to meet these requirements in their improvement plan for the home. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Anson Court Harden Road Leamore Walsall West Midlands WS3 1BT 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Mandy Beck Date: 1 3 0 1 2 0 0 9 Information about the care home Name of care home: Address: Anson Court Harden Road Leamore Walsall West Midlands WS3 1BT 01922409444 01922409111 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) : Manor Court Health Care Limited care home 33 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: Date of last inspection Brief description of the care home 33 Anson Court is a purpose built two-storey care home in the Harden area of Bloxwich. The Home provides accommodation for 33 people who have dementia. The Home is situated close to local shops. Each person using the service is able to have a single bedroom with an en suite toilet facility. The communal areas consist of a large lounge, one smaller lounge, a conservatory and a separate dining room. The Home has an enclosed, secure courtyard garden area with raised flower beds. Entrance and exit to the main door of the home is via a security system people are unable to leave the home without staff assistance. The current charges are not available in the service user guide. People are asked to contact the service directly for this information. Extras that the people using the service must buy themselves include personal toiletries, newspapers, chiropody, private healthcare, dentist, dry cleaning and hairdressing. Care Homes for Older People Page 2 of 13 What we found: We found the home has made some improvements since our inspection in November 2008. The manager, Mandy Halls, told us the home has recently purchased a set of weighing scales and has started regularly weighing and recording peoples weights. We looked at peoples weight charts and saw that since November 2008 the home has taken steps to record peoples weights. Although most of the peoples records we saw showed there was no weight loss one person had lost weight. We have spoken to the manager about the actions that need to be taken in respect of this. The manager has made arrangements for all staff to have access to the care records of the people they are caring for. This means that staff will now have access to the information they must know in order to meet peoples needs. We looked at the homes records in relation to peoples fluid intake. We saw that two people are currently considered to be at risk of dehydration and as such are having their fluid intake recorded by the home. When we visited in November 2008 we found there were gaps in this type of information and the home could not accurately demonstrate how much fluid people were actually drinking. It was pleasing to an improvement and the fluid balance charts we looked at had been completed in full and gave a record of the amount of fluid each person had taken over a 24 hour period. The manager has told us there has been a review of staffing levels and one extra carer is now available to assist night staff from 6 am each morning. What the care home does well: What they could do better: The home must make sure that staffing levels do not place people at risk. During this visit we saw that all but one of the recorded accidents had occurred during the night. The manager has told us that she has put in place changes to the rota which means that an extra carer is available to assist the night staff from 6 am each morning. Whilst this is positive and would offer more protection to the people living in the home, the home must be able to demonstrate that it is meeting peoples needs and is protecting them from harm. Current night staffing levels may not always do this and should be reviewed again. The care planning systems in place still need to be reviewed so that people have their own individual care plans based upon their needs. At present the home has a pre printed care plan system and peoples names are inserted into the care plan. This means that care is not being planned to show peoples preferences or choices in relation to their health care. The manager told us that she intends to change all the care plans in the near future but has been busy with other improvements needed as a result of our November visit. The home has other outstanding requirements in relation to staff recruitment and selection and complaints, which were not looked at during this inspection. The home will be telling us how they intend to meet these requirements in their improvement Care Homes for Older People Page 3 of 13 plan for the home. 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 4 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 4 12 (4) (b) The Home needs to consider how they can better meet the needs of people with specialist needs, including dementia. This includes activities, training for staff and individual care planning and risk assessment. This will ensure that the care provided focuses on the individual person and their specific needs. 30/06/2008 2 7 15 Peoples needs must be recorded in a care plan that is individual to them. This will make sure that people are getting the care they want and need from the home. 31/01/2009 3 8 13 People who are at risk of dehydration must have a clear record of the fluid they consume. The home must also be able to demonstrate the actions it has taken to meet peoples needs in relation to dehydration. Peoples fluid intake will be correctly recorded and action will then be taken by the home to meet their needs. 31/12/2008 Care Homes for Older People Page 5 of 13 4 8 13 People must have their 31/12/2008 weight recorded at least on a monthly basis. The home must also demonstrate how it has addressed any unexplained weight loss or gain. This will make sure that those people at risk of weight loss are identified and the home will take action to meet their needs in relation to their weight loss. 5 8 12 Care staff must have access to peoples care plans and risk assessments. This must include the night staff. All staff should know what risks are involved with care delivery. This will also make sure that staff are aware of peoples needs and how to meet them. 31/12/2008 6 9 13 The home must keep 31/01/2009 accurate records of peoples medication from the point of admission. These records should be updated to reflect changes and will make sure the home is very clear about the medication each person is to take. 7 9 13 (2) The temperature of the medicines refrigerator must be taken daily with a maximum/minimum thermometer and recorded. 11/04/2008 8 16 22 The home must make sure that any complaint made under the complaints procedure is fully investigated and recorded. 31/01/2009 Care Homes for Older People Page 6 of 13 This will mean that people feel their views are important and that their views will be listened to and acted upon. 9 27 13 there must be at least one 31/01/2009 member of staff in the communal area where people are sitting at all times. This will mean that people are being observed and are not being left alone unsupervised. 10 29 19 The manager must appoint 31/01/2009 an experienced worker to supervise new staff employed with only a PoVAfirst check in place until the return of a satisfactory CRB disclosure. This will offer an additional safeguard for people living in the home. 11 29 19 (1) The manager must not 11/04/2008 employ a person unless he/she has obtained the information and documents specified in Schedule 2 and is satisfied as to the authenticity of the references for that person. This will ensure the people using the service are safeguarded. 12 30 18 (1) (i) The staff must receive more 30/06/2008 instruction and training as to how to meet the needs of people with dementia, to ensure that their needs are met. 13 31 15 The manager must make 31/12/2008 sure that staff have access to Page 7 of 13 Care Homes for Older People peoples care records and risk assessments. This must include all of the night staff. This will mean that staff are aware of peoples needs and how to support them. 14 35 13 The home must review the 31/12/2008 way in which it manages peoples money. It must not allow people to be in debt to the home. This will ensure that people have sufficient funds to pay for their own extra services that are not included in the weekly fees for residency. 15 38 37 The home must report to the 31/01/2009 commission the occurence of deaths, illness and other events. They must do this to make sure they are meeting their regulatory duties under Regulation 37 16 38 12 When people are moved in 31/01/2009 the wheelchair without footplates. The home must complete a risk assessment that shows the risks involved in moving people this way and the steps the home will take to reduce the risk to people being moved in this way. This will make sure that people are safe when being transported about the home in a wheelchair. Care Homes for Older People Page 8 of 13 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, Care Homes 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 Peoples needs must be 22/01/2009 recorded in a care plan that is individual to them. This will make sure that people are getting the care they want and need from the home. This requirement was made during the homes inspection in November 2008. The timescale of 31/12/08 has not been met 2 16 22 The home must make sure 22/01/2009 that any complaint made under the complaints procedure is fully investigated and recorded. This will mean that people feel their views are important and that their views will be listened to and acted upon. This requirement was made during the homes inspection in November 2008. The home must make sure 23/01/2009 that staff are supplied in appropriate numbers to meet peoples needs and keep them safe. Page 9 of 13 3 27 12 Care Homes for Older People This will reduce the risk of harm to people living in this home. 4 29 19 The home must appoint an experienced worker to supervise new staff employed with only a PoVA first check in place until the return of a satisfactory CRB disclosure This will offer an additional safeguards for people living in the home. This was not assessed during this inspection. The original timescale for meeting this requriement was 31/12/08 5 35 12 The home must review the 22/01/2009 way in which it manages peoples money. It must not allow people to be in debt to the home. This will make sure that people have sufficient funds to pay for their own extra services that are not included in the weekly fees for residency. This was not assessed during this inspection. The original timescale for meeting this requirement was 31/12/08 The home must report to the 22/01/2009 commission the occurrence of deaths, illness and other events. They must do this to make sure they are meeting their regulatory duties under Regulation 37. This was not assessed during this inspection. The original timescale for meeting this requirement was 31/12/08 22/01/2009 6 38 37 Care Homes for Older People Page 10 of 13 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Staff should have training in person centre care. This should help them with their understanding of people with dementia and the importance of person centred care when caring for people. This recommendation was made during the homes previous inspection in November 2008. The home should consider purchasing sit on weighing scales for use. This will allow the home to record the weight of those people who may not be able to use conventional stand on scales because of reduced mobility. Two staff should sign all handwritten MAR sheet entries. This will hekp reduce the risk of errors occuring. This recommendation was made during the homes previous inspection in November 2008. The home should not send back unused medication at the end of each month. It should consider carrying forward the balance and refrain from ordering that medication for the following month. This will reduce the amount of waste medication each month. This recommendation was made during the homes previous inspection in November 2008. The home should consult with people and their families about peoples preferences for getting up and going to bed. This should be clearly recorded in peoples care plans and adhered to. This will make sure people are not being got out of bed earlier than they would like. This recommendation was made during the homes previous inspection in November 2008. The home should make sure that each person living in the home is engaged in an activity they can take part in. This recommendation was made during the homes previous inspection in November 2008. The home should consider further training for staff that specifically looks at the types of activity they could offer to the people who live in the home. This recommendation was made during the homes previous inspection in November 2008. The home should consider that people with dementia may not always be able to ask for snacks and drinks and will need to be offered these at regular intervals between meals and at supper time. This recommendation was made during 2 8 3 9 4 9 5 10 6 12 7 12 8 15 Care Homes for Older People Page 11 of 13 the homes previous inspection in November 2008. 9 19 The stained carpets that are evident throughout the home need to be thoroughly cleaned or replaced. This will improve the environment for the people living there. This recommendation was made during the homes previous inspection in November 2008. All seating requires a deep clean or replacing where it is worn. This should be done for peoples comfort. This recommendation was made during the homes previous inspection in November 2008. When people are recruited with only a PoVAfirst check in place, the manager should make sure that written risk assessment is completed and kept in the persons file. This will demonstrate what the home is doing to keep people safe until the return of a satisfactory CRB disclosure. This recommendation was made during the homes previous inspection in November 2008. The induction programme currently in place for new staff should be updated to meet skills for care standards. This will mean that people are supported when they begin work and will have the necessary skills to meet peoples needs. This recommendation was made during the homes previous inspection in November 2008. The home should contact the Fire Officer for advice about updating the homes fire risk assessment. The risk assessment should also include individual person emergency evacuation plans for people. This will help in the swift evacuation in the event of fire breaking out. This recommendation was made during the homes previous inspection in November 2008. The broken bath seat evident during this inspection should be repaired promptly for peoples comfort when bathing. This recommendation was made during the homes previous inspection in November 2008. 10 19 11 29 12 30 13 38 14 38 Care Homes for Older People Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 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 We want people to be able to access this information. 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