Care Home: Askham House

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What the care home does well All of the residents we talked to stated that the food is good for the majority of the time and that the staff were polite and treated them with respect. Staff were seen offering residents salt and pepper on their meal and asking where they would like gravy and sauce put on their plate. We also saw the nurse asking a resident if they would like help cutting up her food rather than just assuming she would. One resident told us about the various entertainers that come into the home and how much she enjoyed them. What the care home could do better: Care plans need to be more detailed so that staff have all the information they need. When the residents needs change e.g. they develop new pressure sores their care plan must be updated so that the staff know what they must do to meet the residents needs. The entrance to the home must be secure so that people can not enter the home without the knowledge of the staff. This will help to keep the resident`s safe. When administering medication the nurse must consider dignity issues i.e. not giving resident`s tablets from her fingers. Random inspection report Care homes for older people Name: Address: Askham House Benwick Road Doddington Cambridgeshire PE15 0TG one star adequate 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: Joanne Pawson Date: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Askham House Benwick Road Doddington Cambridgeshire PE15 0TG 01354740269 01354741996 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Marie Eileen Rankin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Salim Giga care home 27 Number of places (if applicable): Under 65 Over 65 0 27 27 mental disorder, excluding learning disability or dementia old age, not falling within any other category terminally ill Conditions of registration: 1 0 0 1 named adult under 65 years of age with a Mental Disorder 1 named adult under 65 years of age with a Mental Disorder Up to 8 Beds Personal Care Date of last inspection Brief description of the care home Askham House is situated just on the outskirts of the village of Doddington. From this rural location there are good road links to the Cities of Cambridge, Ely and the nearby Care Homes for Older People Page 2 of 9 Brief description of the care home town of March. Accommodation is offered on two floors in mostly single bedrooms. There are four double bedrooms. The home can accommodate up to twenty- seven service users, with a residential or nursing need. The home is comfortable, spacious and well maintained. It has a number of small sitting areas and a living room/dining room facing a small courtyard garden. The home has a third, more spacious lounge, with a bar and overlooking extensive gardens. This is also used for the provision of day care for local residents. There is also a further dining area. The home is approached through a long, private tree lined drive leading up to the main house. There are ample gardens and acres of land belonging to the owners of Askham House. On the same site is a second home belonging to the owners, but managed entirely separately. This provides accommodation to adults with physical disabilities and who may require nursing. The two homes share a main kitchen, and food is brought over to Askham House on heated trolleys. Askham House has a small kitchenette for the preparation of drinks and snacks. The weekly fees are between £343 and £650 at the time of the inspection. There is a notice in the main hall stating when the last inspection was and that there is a report available and a copy of the report was seen on a table in the inner hallway. The last key inspection was carried out on the 14th July 2009 and the home was assessed to be a 1 star adequate service. Care Homes for Older People Page 3 of 9 What we found: We inspected the home to see if the requirements from the previous inspection had been met. This report is a summary of our findings. When we first arrived at the home we able to walk straight in. At present there is extensive building work being carried out on the Askham House/Place site. This could place the residents at risk from people accessing the house without staff knowledge and the risk of residents walking onto the building site. The building work may also cause problems in the event of an emergency and the need for people to be evacuated or access to the home for the emergency services. On the day of the inspection it would have been difficult to evacuate the residents from the home using the fire exit on the side of the home as there was a large trench with railings next to it and a van pulled up to the railings. An immediate requirement was issued to ensure that fire exits are kept clear at all times. We have requested that the fire service visit the home and complete a check of the fire exits to ensure that the home is safe during the building work. We looked at the care plans for four residents and compared them to the information that was available in the wound chart folder. For the first resident we found information in the wound chart folder ( where treatment to pressure sores is recorded) that showed that the resident had a pressure sore on her sacrum. This information had not been recorded in the residents care plan. We asked the nurse in charge of the home at the time of the inspection if she knew about the pressure sore and she stated that she had not been told at handover about the new pressure sore. For the same resident there was a care plan for nutrition which stated that she was at risk of malnutrition and that she should be weighed monthly. The next page in the care plan was advice from the dietician dated the 7/4/2010 which stated that the resident should be weighed monthly. We could only find one record of the residents weight which just stated April 2010. When we asked the manager why the resident had not been weighed as the dietcian had advised she stated that the home shares the weighing scales with the other home in the same grounds and only has them for the first two weeks of the month. She also confirmed that if the scales where at the other home when a resident moved into Askham House they would not be weighed until the scales were returned. The manager stated that a MUST assessment had been completed for the resident. However when we looked for the assessment only the residents name had been filled in and no other details. The manager stated that the task of completing the MUST assessments had been delegated to a member of staff and she did not know why it had not been completed. The advice from the dietician also stated that the resident should continue to have daily fortisips. We looked at the chart that is used for recording the daily dietary intake for the resident. We looked at the period of 25th April until the 4th May. There were 3 records of poor food intake, 11 records where no food was eaten and 4 records of a fair amount eaten. However there was only one record of a fortisp being given during this time. We looked at the daily notes and found one more record of a fortisp being given. We also looked at the medication administration charts for the resident and no fortisips had been recorded as given since the 7th April. When we asked the manager if the fortisips had been given she stated that they had but the staff didnt know where to record this. Care Homes for Older People Page 4 of 9 The second care plan we looked contained more detail and gave the staff the information they required to meet the residents needs. The information in the pressure care section also reflected the information for the same resident in the wound care folder. The third care plan we looked at did not match the information in the residents daily notes. The care plan stated that the dressing on the residents hand should be checked every four to five days. The wound chart showed that the dressing had not been changed from the 21st April until the 1st May. The entry in the residents daily notes on the 1st May stated hand redressed this morning very swollen and red has pressure sore in palm of hand between fingers,Inidine applied and allevyn also granuflex pad. The daily notes on the 3rd May stated dressing renewed for Rt hand appears swollen, pressure sore in palm between index finger and thumb - is grade 2 - needs to be done every day. However the care plan had not been updated to show that there was a pressure sore or that it needed dressing daily. The fourth care plan we looked had a care plan about pressure care and refers to the residents hands and leg. However the daily notes for the same resident refer to an elbow being red and sore and a bandage applied on the 27th April and on the 3rd May a sacral sore being redressed. The manager did not give an explanation of why the care plans had not been updated. We observed two members of staff assisting residents with their lunch. The staff member sat next to the resident and took their time to help with their meal. Neither staff member explained to the resident what they were giving them on the spoon when the assisted them to eat. We observed the lunchtime medication being administered. We saw the nurse take the tablets out of a pot with her fingers and place the tablet into a residents mouth and then move onto the next resident and do the same again. This does not promote dignity and respect and could spread infection. We talked to four members of staff and all of them were able to tell us about their training and were aware of what they should do if they suspected a resident had been abused. We talked to a few residents. Their comments included we are well looked after, food on the whole is very good, you get used to the noise from the building work, the only garden area we have now is the enclosed courtyard, the entertainer on St Georges day was good. What the care home does well: All of the residents we talked to stated that the food is good for the majority of the time and that the staff were polite and treated them with respect. Staff were seen offering residents salt and pepper on their meal and asking where they would like gravy and sauce put on their plate. We also saw the nurse asking a resident if they would like help cutting up her food rather than just assuming she would. One resident told us about the various entertainers that come into the home and how much she enjoyed them. Care Homes for Older People Page 5 of 9 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 6 of 9 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 The care plans must be kept under review and updated with the necessary information so that staff have the information they require to meet the residents needs. 14/06/2010 2 8 17(1)(a)Sche All pressure sores, their 14/06/2010 dule 3(3)(n) treatment and outcome must be recorded in the care plan in sufficient detail that staff know what action they need to take and when. Care Homes for Older People Page 7 of 9 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 1 38 23 You must ensure that fire exits are kept clear from obstructions. So that in the case of an emergency the emergency services can enter the building or the residents/staff can exit the building. 18/05/2010 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 8 of 9 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. 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