Care Home: Camelot Nursing Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well Staff are described as “attentive and good natured”, and one person wrote that “staff look after me very well”. Good health and personal care is provided. There is a good choice of meals, and people enjoy the meals provided. What has improved since the last inspection? Improvements to the premises have included three bedrooms being remodelled, and six bedrooms have been recently refurbished or decorated. The previous requirement concerning the replacement of two bedroom carpets was found to have been met. Changes have been made to the activities provided after discussion with people living in the home. What the care home could do better: Managers are not fully ensuring that the environment is homely, safe and meeting people’s needs. There is a lack of activities and stimulation for people. People are not being supported to make the most of their abilities. Care planning records are not fully assessing the person’s needs or showing how the person’s needs will be met.Camelot Nursing HomeDS0000024127.V377534.R01.S.docVersion 5.2Staff could be better supported, as there are not at present robust arrangements for staff supervision and staff meetings. Arrangements for the administration of medicines would be made more safe by the person’s “as required” medicines being more fully recorded. Key inspection report CARE HOMES FOR OLDER PEOPLE Camelot Nursing Home 6/8 Tennyson Road Worthing West Sussex BN11 4BY Lead Inspector Ed Mcleod Key Unannounced Inspection 6th October 2009 09:30 DS0000024127.V377534.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camelot Nursing Home Address 6/8 Tennyson Road Worthing West Sussex BN11 4BY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 203660 01903 203660 julia.galloway@camelotnursinghome.co.uk Ms Susan Munro Ms Julia Galloway Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: . Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 30. 2. Date of last inspection 16th October 2007 Brief Description of the Service: Camelot Nursing Home is a care home able to provide personal care and nursing care for up to 30 older people. It is a detached property situated within walking distance of Worthing town centre, close to shops and other community facilities. Communal areas include: a lounge, a dining room and a conservatory. Some bedrooms have en suite facilities, and communal bathrooms and toilet facilities available throughout the home. The upper floors include two mezzanine levels, one, which can be accessed by a stair lift, and the other, which can only be accessed by stairs. Current fees are £550.80 to £850 per week and extra charges are made for hairdressing, chiropody and toiletries. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection visit was arranged to assess the services compliance with the key national minimum standards for care homes for older people, and to assess compliance with the requirement made at our previous visit. We prepared for this visit by obtaining the homes annual Care Quality Commission (CQC) quality assessment audit (the AQAA) which told us how they have been running the service and the improvements to the service they have made or are planning to make. The AQAA provided the information we asked for, and was returned by the date by which we had asked for it. The AQAA advises us that the service have submitted an application for planning permission to extend the premises in order to “provide additional care services to those requiring dementia residential and nursing care”. In preparation for this visit we sent CQC service user surveys to eight people living in the home, of which seven were returned to us completed. We sent CQC surveys to six staff working in the home and of these four were returned completed. We also took into account information received from the service, for example in the form of notifications, and any views on the service received from other sources. Some of the information received in the period previous to the visit to the service has been included in this report. The visit was carried out by one inspector who was on the premises for five and a quarter hours. During the visit we spoke with five people living in the home, a visitor, and five members of staff. The manager was not present on the day of the visit, and we spoke with the manager on the telephone for forty minutes on the 7th October 2009. We sampled care assessments, records and plans for three people living in the home. We observed interactions between staff and people living in the home, and attended a staff handover meeting. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 6 We sampled three sets of staff training, supervision and recruitment records to help assess how staffing arrangements were protecting and meeting the needs of people living in the home. Other records we sampled included complaints and health and safety records. What the service does well: Staff are described as “attentive and good natured”, and one person wrote that “staff look after me very well”. Good health and personal care is provided. There is a good choice of meals, and people enjoy the meals provided. What has improved since the last inspection? What they could do better: Managers are not fully ensuring that the environment is homely, safe and meeting people’s needs. There is a lack of activities and stimulation for people. People are not being supported to make the most of their abilities. Care planning records are not fully assessing the person’s needs or showing how the person’s needs will be met. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.2 Page 7 Staff could be better supported, as there are not at present robust arrangements for staff supervision and staff meetings. Arrangements for the administration of medicines would be made more safe by the person’s “as required” medicines being more fully recorded. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident the home can support them. This is because there is an accurate assessment of their needs that they or people close to them have been involved in. This tells the home all about them and the support they need. EVIDENCE: The home’s annual quality assurance assessment (AQAA) tells us that all prospective residents and their representatives are invited to visit the home as often as they wish, and may stay for a meal. Where possible, the assessment of the person’s needs is carried out in the person’s own home. We are told in the AQAA that the person’s needs will be assessed before admission is agreed, and that people are admitted initially for a 6 week trial stay. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 10 We found at our visit that arrangements were in place for the person’s needs to be assessed before admission. The home does not provide intermediate care. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met, but the service is not always assessing how the person’s need for social contact and stimulation is to be met if this is difficult for them. The individual plan of care needs to be more detailed and be reviewed and agreed with the person or someone close to them, and assist staff to meet their needs in the way the person would prefer their needs to be met. If people cannot manage their medicine the care home supports them with it. This would be made more safe by additional information on “as required” medicines being recorded and acted upon. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. EVIDENCE: Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 12 We sampled the care plans for three people living in the home. We found that the individual plans of care were including some useful strategies to help meet people’s care and health needs, for example strategies to help one person avoid abdominal discomfort. We found that care plans were being reviewed and updated regularly. The AQAA tells us that sixteen of the people accommodated are bed-bound. A number of the people who are bed bound have communication difficulties. For example one person was described in their care plan as suffering from “deafness, confusion, limited understanding”. We found that their care plan did not specify how their need for social contact and stimulation was to be met. Another care plan we sampled also recorded little about how the person prefers their care to be provided, although it is likely that staff have over time developed some knowledge of this. This indicates that important information about the person’s care needs may not always be being passed on between staff because more specific information is not always being recorded in the care plan. Ms Galloway agreed that staff do get to know each person well and learn the best way of meeting their needs. Our view was that this information needs to be recorded in the care plan so that it is consistently acted upon by all staff. The manager Ms Galloway tells us in the AQAA that “we speak informally but regularly with residents’ families, friends and other representatives for suggestions as to how the care and wellbeing of residents can be improved”. We found that people are not provided with a copy of their care plan, and there was little evidence in the care plans seen that the person, or their representative, had been involved in the review of the care plan. The service will need to consider if the present format of recording care plans can provide the level of guidance needed by staff to enable them to provide for the person’s psychological, personal, social and health care needs. Interactions we observed in the home indicated that staff are respecting the privacy and dignity of the people living there, and people we spoke to told us that staff were kind and considerate. The CQC surveys which we received from seven people living in the home told us that they were receiving the care and medical care support which they needed. One person said in their survey form that “staff look after me very well”. We looked at some of the charts and records for two people who are bed bound, and records indicated that checks and monitoring of food and fluid intake, for example, were in place. Where the person was in need of regular turning to lessen the risk of pressure areas developing the records indicated that this was taking place. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 13 The AQAA tells us that there is a weekly keep fit class for those who wish to attend, and staff we spoke to also told us about this. We are told in the AQAA that the risk of falls is identified and acted upon, and that each person’s weight and nutritional needs are monitored. Staff we spoke to told us that medication is administered by qualified nursing staff. We sampled medication records for two people living in the home. We found that where medication is being prescribed as “as required” written guidance is not always being provided to tell staff when such medication can or should be given. This would help ensure that such medication is administered by staff in a safe and consistent way. In our telephone discussion with Ms Galloway she agreed that this would be good practice. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home could do more to ensure that each person is treated as an individual and the care home is responsive to their needs and interests. People are able to keep in touch with family, friends and representatives. The service could do more to support people’s independence and to make the most of their abilities. People have nutritious and attractive meals and snacks at a time and place to suit them. EVIDENCE: Survey responses we received from seven people living in the home told us that the activities programme meets the needs of some people, some people would like more activities, and some people choose not to take part in the activities provided. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 15 For example, one person wrote that there were “lots of activities”, while another person wrote that they thought there should be more arts and crafts especially on “days when there is nothing on in the afternoon”. One person we spoke to said they felt very isolated, and said that “staff don’t have time to sit down and talk. Gets lonely if no visitor comes”. Staff we spoke to agreed that the person needed more one to one social support, but that present staffing levels did not support them doing more one to one support with people. Another resident we spoke to told us that one person who strongly dislikes being left on their own was often being left on their own and becoming very distressed. There is a programme of activities in the home, usually an activity in the afternoon such as an entertainer or arts and crafts. On the day of our visit we did not observe any activities taking place, and we did not observe past times being encouraged such as games of cards. The manager said to us on the phone the day after our visit that activities were not provided in the mornings because staff were busy with getting people washed and dressed. As discussed in the previous section, we are told in the AQAA that sixteen of the people accommodated are bed-bound. During our visit we found that a number of the people who are bed bound have communication difficulties. The care plan we sampled for one person with serious communication difficulties was not setting out how the person’s need for social contact and stimulation was to be met. Where people are not able to take part in communal activities the service needs to consider how the person’s social contact needs can be met, whatever their disability. We found that people were not always being supported to make the most of their abilities. For example one person we spoke to said they would like to supported to improve their mobility. Staff we spoke to said this was something they recognised the person needed, and with more time available they would like to do this. Staff also said that with more time available they could offer people help in writing letters, for example. We found that the care plans we sampled were not often providing guidance for staff on how the person is to be supported to maintain their independence or make the most of their abilities. The AQAA tells us that the home is visited by clergy from Church of England and Roman Catholic churches, and that two people in the home receive communion. We spoke with the relative of one person living in the home who told us that they were always welcomed when they visited. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 16 The AQAA tells us that the chef has attained a catering management qualification and has improved menu quality and choice significantly. The chef told us that there are three main choices which people are offfered, but this can be up to five choices when a person asks for something different. Meals are being provided for people who have specialist diets, such as low calorie, vegetarian or soft food diets, and the AQAA tells us that where appropriate specialist advice is sought where a person has difficulties swallowing. The survey responses we received from seven people living in the home indicated that they enjoyed the meals that were being provided. We spoke with one person living in the home who said the food was very good, and there were always fresh vegetables. The person said they preferred to have lunch in their bedroom and this wish was respected. We noted that there is a good supply of fresh fruit and vegetables, and one resident we talked to said that the food was always freshly cooked and used fresh ingredients. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns about their care they or other people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. EVIDENCE: The seven people living in the home who responded to our CQC survey told us that there was someone they could speak to informally if they had concerns. Four of the seven respondents said they know how to make a complaint, and three people said they didn’t know how they would go about making a complaint. We discussed this with the manager who said that the complaints policy is set out in the service user guide. We asked the manager if there were opportunities for the complaints policy to be explained or discussed with people living in the home. The manager said she goes round to see everyone every day, and that if people had concerns they could discuss them then. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 18 We sampled the records for four complaints received. The complaints had been investigated, and the outcome of the complaint had been given to the complainant. The AQAA tells us that 2 safeguarding investigations have taken place in the last 12 months. There was evidence that the service has acted to protect people living in the home when there have been safeguarding concerns. Training records we sampled indicated that staff continue to receive training in the protection of vulnerable adults. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some parts of the home are being well maintained and are homely, and some areas of the home are not homely or well maintained. The communal areas and facilities are presently reduced by the conservatory being used exclusively for storage. One of the bathrooms we visited was also on the day being used exclusively for storage. People’s rooms have been personalised and meet their needs, except where furniture is in need of replacement. EVIDENCE: Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 20 Improvements to the home since our previous visit have included the remodelling of two shared bedrooms into three single bedrooms, and work to similarly remodel two other shared bedrooms was underway during our visit. The remodelled rooms do not include en suite toilet or bathroom facilities. The manager told us that six bedrooms have been recently refurbished or decorated. At our previous visit we had made a requirement concerning the replacement of the carpets in two of the bedrooms. At this visit the requirement was found to have been met. We looked at the maintenance records held in the home, and found that records were incomplete – for example it was not always being recorded when a problem was identified or the action taken to remedy it. We also found a number of problems that had not been identified or recorded in the maintenance book, such as torn linoleum flooring in a bathroom and furniture which was in poor condition and in need of replacement. The maintenance of en suite facilities was found to be poor. For example, one shower had not been operating for six months to date and the shower tray had been removed and floorboards had been lifted and not fitted back in place. We found that the communal areas available for people to use had been reduced, as the conservatory was being used for storage while work was taking place on remodelling bedrooms. Staff told us that during good weather the conservatory was used a lot by residents. We were also told by staff that one resident liked playing the organ in the conservatory but was no longer able to do this as the way was blocked by items stored. We found that the dining room, which we were advised is also used for activities, was sparse and uninviting. One person living in the home who was sitting in the dining room said “it’s not very pretty in here, not very decorative”. We noted that a large flipchart on a stand with training material for staff written on it was at one end of the dining room. The painting on one part of the wall in the dining room had not been finished. At our previous visit a requirement was made concerning the condition of carpets in two of the bedrooms we visited. Two people we spoke to in their bedrooms said they found their bedrooms comfortable and that their bedrooms met their needs. We visited nine bedrooms, and found that while there has been redecoration, refurbishment and carpeting in some bedrooms there was some decoration and furniture that was not of a good standard. For example, we found chipboard sink units which were not in good condition, and chairs that were very worn or not strong enough for some people to sit on. We found on the day of our visit that one of the communal bathrooms was not accessible to people, as there were four wheelchairs stored there. Staff told us that Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 21 other bathrooms were used instead, and Ms Galloway advised us that wheelchair storage was a problem in the home. We found that one of the communal toilets had quantities of linen being stored in the room, which we did not view as a practice which is hygienic. We noted that one toilet had two rips in the linoleum flooring and had a gap in the flooring, making it potentially not safe for people to walk on. We found that the home does not have in place a schedule for the maintenance and renewal of the kind of shortcomings we noted during our visit. We discussed this with the manager Ms Galloway who told us that the person who will be carrying out maintenance in the home is presently doing the bedroom conversions. Ms Galloway advised that a repairs and replacement plan will be drawn up and commenced when the bedroom conversions are completed. The seven people living in the home who completed CQC surveys told us that the home was always fresh and clean. We found one bedroom where there was not a good odour, and Ms Galloway advised us that they have been trying different things to improve the odour, and will consider an alternative type of flooring. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. People’s needs are met and they are cared for by staff who receive relevant training. EVIDENCE: On the day of our visit we found the staff team to be experienced and able. One person told us in their survey form that staff were “attentive and good natured”. The four members of staff who returned CQC survey forms told us that there were usually enough staff on duty to meet peoples’ needs. We were told in the surveys completed by seven people living in the home that staff were “usually” or “always” available when needed. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 23 The AQAA tells us that managers ensure that there are times when staff are available for outings, medical appointments and shopping trips, and that there has not been a need to employ temporary (agency) staff in the past 3 years. In the Health And Personal Care and Lifestyle sections of this report we note that the service is having difficulty in meeting people’s social and psychological needs, and staff and residents we spoke to indicated that this is made more difficult by staff being otherwise busy. The service needs to review if staffing levels are appropriate to meet all the assessed needs of the people accommodated. We sampled the recruitment records for three staff working in the home. We found that required checks and references had been obtained for the staff. The AQAA tells us that 9 of the 13 permanent care staff hold the National Vocational Qualification (NVQ) in care at level 2 or 3 and that one carer is currently studying for NVQ level 3 in care. Training records which we sampled indicated that staff are undertaking training in required topics such as safeguarding vulnerable adults, and food and hygiene. Records and discussions also indicated that nursing staff were undertaking some specialist training relevant to their role. Ms Galloway tells us in the AQAA that “Some training updates are required and these are booked”. Staff training certificates we sampled during our visit indicated that not all staff have undertaken required training. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not always being led and managed in the best interests of the people accommodated. Not all aspects of the environment are safe for people and staff and the service need to ensure appropriate health and safety practices are carried out. EVIDENCE: Since our previous visit Ms Julia Galloway has been registered as manager of the service. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 25 We have found during this visit that the manager has not ensured that that care plans are comprehensive, and that people have enough opportunities for activities or stimulation. This was resulting in some people feeling very isolated, and others not being supported to make the most of their abilities. We have found that the manager is not ensuring a high level of safety and hygiene in the home, which for example has resulted in alarm cord wires presenting a possible trip hazard, unsafe furniture not being replaced, and quantities of linen being stored in a toilet. We are told in the AQAA that where service users express a desire for change or improvement this is implimented as soon as possible, where reasonable, and that there is an annual resident satisfaction survey. Ms Galloway advised us that the service ensures that people are happy with the service through speaking to residents each day, and monthly visits by the owner. We sampled two of the reports of the visits carried out by the owner and found that the views of people living in the home and their visitors were being obtained and recorded. The AQAA tells us that in response to suggestions made by people living in the home the musical entertainment and activities provided have been varied. The manager tells us in the AQAA that there is not an annual development plan for the home. An annual development plan is expected to set out the plan for improvements that will be made and what the aims and outcomes for people living in the home will be. The shortfalls we have identified during this inspection indicate that there is a need for managers to make a plan of improvements and take appropriate action within reasonable timescales. We are told in the AQAA that one to one staff supervision has not been carried out every two months but all staff are continuously monitored in their work by the manager, deputies, nurses and senior carers. We sampled the records for three staff, and found only one record of staff supervision – this was dated November 2008 and was in a tick box format with sections such as reliability, appearance, attitude, team working, record keeping, and training requirements. The recording of staff supervision indicated that while the performance of the staff member is discussed, there was no evidence that aspects of practice, the philosophy of care in the home and staff development needs (which the national minimum standards for care homes for older people recommend be part of staff supervision) are being discussed. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 26 Staff members we spoke to indicated that supervision is not being provided on a regular basis. We asked staff if staff meetings were taking place, and they advised us that the last staff meeting had been about a year previously. This was confirmed by the manager Ms Galloway during a telephone discussion. Ms Galloway advised us that she believed that staff handover meetings were more useful in passing on information to staff. We are told in the AQAA of the most recent services and inspections of equipment used in the home. The storage of quantities of linen in a communal toilet was not considered to be good hygiene practice. Two of the bedrooms we visited had nurse alarm wires which crossed walking space in the bedroom and could be a trip hazard. Some of the fire safety records which we sampled were up to date, although there was a lack of records in respect of fire drills. The most recent recorded fire drill was for 2nd February 2009 on the occasion of a false alarm. The service must ensure that they are following all their policy and procedures on fire safety. Staff training records indicated that staff are receiving training in health and safety topics such as infection control, health and safety, and substances hazardous to health. Ms Galloway tells us in the AQAA that some staff are due to refresh training in health and safety topics and that this is being arranged. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x 3 n/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 n/a DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 2 x x 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x 1 x 1 Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 28 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The provider must ensure there is a plan of care which sets out the individual health, personal and social care needs and how these are to be met must be provided. The plan of care for each person should evidence that it continues to be discussed and agreed with the person or someone close to them, and can assist staff to meet their needs in the way the person would prefer their needs to be met. Timescale for action 29/01/10 2. OP9 13 The provider must seek advice from a pharmacist regarding medicines dispensed for individuals in the home. We found that where medication is being prescribed as “as required” written guidance is not always being provided to tell staff when such medication can or should be given. 29/01/10 3. OP12 OP14 16 The provider must ensure service users’ interests are recorded and they are given opportunities for stimulation, leisure and recreation which suit their needs, preferences and capacities. 29/01/10 Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 29 We found that care plans are not setting out how the service user’s need for social contact and stimulation were to be met for people with serious communication difficulties. We found that service users were not always being supported to make the most of their abilities. 4. OP19 OP20 OP21 OP24 OP26 OP38 23 The provider must ensure that service users live in a safe, hygienic and well-maintained environment that meets service users’ individual and collective needs in a comfortable and homely way. People are staying in a home which is not being well maintained and is not in all respects homely. 29/01/10 5. OP30 OP36 18 The provider must ensure that staff receive training appropriate to the work they are to perform and be appropriately supervised. Not all staff are up to date with mandatory training topics, and staff are not receiving one to one supervision of the recommended type and frequency. The registered person shall produce an improvement plan setting out the methods by which, and the timetable to which, the registered person intends to improve the services provided in the care home. There is not an annual development plan for the home which sets out the plan for improvements that will be made and what the aims and outcomes for people living in the home will be. 29/01/10 6. OP33 24A 29/01/10 Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 31 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. Camelot Nursing Home DS0000024127.V377534.R01.S.doc Version 5.3 Page 32 - 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!