Care Home: Cameron House

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What the care home does well Three residents` care records were viewed during the site visit. All three contained a preadmission assessment detailing the resident`s care needs that had been undertaken prior to admission. This included an assessment of needs/abilities for personal care, physical well being, mental state and cognition, mobility and dexterity, weight, diet and preferences including nutritional assessment, sight, hearing and communication, skin integrity etc. All three files viewed contained detailed care plans that provided clear guidance to staff when providing care to meet resident`s needs. All had been signed by the resident/or their representative confirming their agreement to their care plan. A range of care plans were seen to meet residents` individual needs, for example personal cleansing and dressing, mobilising, eating and drinking and eliminating etc. Nutritional risk assessments were undertaken on admission and reviewed with weight monitoring also undertaken monthly. Risk assessments were seen for risks associated with manual handling, risk of falls, pressure sores, use of bed rails etc. All had been regularly reviewed. Two residents spoken with during the visit to the service said they were very happy with the care they received and said that staff looked after them well. Residents` access to healthcare services was discussed with the manager and confirmed from the care records. Residents were registered with the local GP practice who attended regularly on request. Four resident`s care records were viewed during the visit to the home andwere seen to include visits from their GP, occupational therapist, chiropodist and district nurse. A health professional visiting the home confirmed that they had good liaison with the manager and staff at Cameron House and another healthcare professional told us that they communicated concerns regarding residents very well. We were informed that the manager was planning to establish a local network group to include the end of life care facilitator, Boots pharmacist, Primary Care Trust pharmacist and the community matron with the objective of sharing knowledge and expertise and to provide joint training. The manager said that she planned to introduce the Gold Standards Framework for end of life care which is acknowledged to be best practice. In preparation for this care staff had received palliative/end of life care training, also confirmed from the training matrix. The systems for administration of medicines was discussed with a senior care assistant. Medication was supplied from the local supplying pharmacy in monitored dosage systems and individual containers. Medication was stored in medication rooms on the ground floor and first floor of the home. The ground floor medication systems were inspected. The room was small and storage at a premium. However an air conditioning unit ensured temperatures remained within safe recommended limits and systems were also in place to monitor and record the room (maximum 25 degrees centigrade) and fridge temperatures. Medication was stored in a locked trolley that was secured to the wall and in wall cupboards. A controlled cupboard and drug fridge were also available for storage of medicines requiring cold storage. Due to the limited space available, monitored dosage systems were hung from hooks on the wall. The home had a medication policy and procedures for staff guidance and information on medicines was also available for staff and seen in the medication room. There were appropriate procedures for the receipt and disposal of medication available and were seen to be well adhered to. Medication was given by designated senior care staff employed at the home who had received medication training and confirmed from the records viewed. A list of staff signatures and initials was held to enable appropriate follow up in the event of an adverse incident. The medication storage and medicines administration records for four residents were examined. Records were completed accurately and in full and all medication was available as prescribed. The Controlled Drugs (CD) storage met requirements and a CD register was in use. Records were completed accurately and confirmed by two staff signatures. However this did not include the name and address on receipt and disposal of CD drugs as is required and a recommendation has therefore been made in this report. Staff were observed to be friendly and relaxed in their conversations with residents and to knock before entering their rooms. Residents` personal care was observed to be provided in private. Rooms included personal items of furniture and lockable facilities for storage of valuable and medication in the event that a resident chose to self medicate. We were informed that the manager and trainer were `dignity champions`. This involved promoting residents` right to choice, independence, dignity and respect with residents and their relatives and was based on the Department of Health `Dignity in Care` Challenge initiative. Evidence of this was seen from posters on the doors to remind staff and visitors to respect residents` privacy when personal care was being provided. Notice boards also included information for staff, residents and visitors about the programme. A relative spoken with during the visit to the service also confirmed that staff respected their loved one`s privacy and dignity. The home had a complaints procedure that was included in the statement of purpose and service user guide and was seen on display in the entrance of the home. We were informed that each resident was provided with a service user guide. This was alsoconfirmed from those seen on residents` room doors. The record of complaints was viewed and confirmed that complaints were fully investigated in line with the home`s procedures. The AQAA informed us that residents are provided with a copy of the procedure and encouraged to raised any concerns they have. One resident told us `I have no complaints` and a relative also said they had no concerns. The home had policy and procedures for safeguarding adults and the manager confirmed that the Essex safeguarding procedures were available for staff guidance in the event of needing to refer an allegation. A whistle blowing policy was also available to support staff should they witness an allegation of abuse. The AQAA informed us that all staff receive safeguarding adults training and are aware of the procedures to be followed in the event of an allegation bein What the care home could do better: The controlled drugs register detailed the name of the supplying pharmacist on receipt and disposal but not the address. A recommendation has therefore been included in this report. Random inspection report Care homes for older people Name: Address: Cameron House Plumleys Pitsea Essex SS13 1NQ two star good 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: Diana Green Date: 2 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Cameron House Plumleys Pitsea Essex SS13 1NQ 01268556060 01268556161 cameronhouse@schealthcare.co.uk www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Beverley Hickey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 44 Number of places (if applicable): Under 65 Over 65 44 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Old age, not falling within any other category - Code OP Either whose primary care needs on admission to the home are within the following categories: Date of last inspection Brief description of the care home Cameron House provides care and accommodation for forty-four older people, it is not registered for people with dementia. It is a modern, purpose built home comprising of two floors with a passenger lift and stairs access to both floors. There are 42 single and 2 double bedrooms all with ensuite facilities. There is a dining room and separate Care Homes for Older People Page 2 of 10 Brief description of the care home sitting room on both floors. There is a range of bath and shower facilities and a separate hairdressing room. The home is situated in a residential area and is close to local shops in Basildon town centre. The weekly fees charged to residents range from £453.11 to £750.00. Additional charges for residents relate to hairdressing, chiropody, newspapers/magazines, personal toiletries, sweets and carers to provide escort for individual residents to hospital/GP appointments etc. This information was provided on 27th May 2010. The homes Statement of Purpose and Service Users Guide is readily available, within the homes main reception area. Each resident is issued with a copy of the homes Service Users Guide and these are located within their own bedroom. The above information was correct at the time of the last inspection. Please contact the manager direct for details of the current fee structure and any updated information. Care Homes for Older People Page 3 of 10 What we found: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. This was a random unannounced inspection that took place on 27th May 2010. The inspection focused on health and personal care, complaints and protection, staffing and management and administration. This report has been written using accumulated evidence gathered prior to and during the site visit, including the homes Annual Quality Assurance Assessment (AQAA). The Annual Quality Assurance Assessment (AQAA), which is required by law to be completed by the service, is a self assessment that focuses on how well outcomes are being met for people using the service. This was completed by the registered provider and returned to us prior to the visit to the home. Information received in the AQAA provided us with some detail to assist us in understanding how the registered persons understand the services strengths and weaknesses and how they will address them. The inspection process included reviewing documents required under the Care Home Regulations. A number of records were looked at in relation to residents, staff recruitment and training, staff rotas and policies and procedures. Time was spent talking to the residents, their relatives, the Registered Manager and staff. Surveys were sent the residents, staff and health professionals using the service and to obtain their views on how well the service was meeting residents needs. Completed surveys were received from two members of staff and two health professionals. The Manager and staff were welcoming and helpful throughout the inspection. What the care home does well: Three residents care records were viewed during the site visit. All three contained a preadmission assessment detailing the residents care needs that had been undertaken prior to admission. This included an assessment of needs/abilities for personal care, physical well being, mental state and cognition, mobility and dexterity, weight, diet and preferences including nutritional assessment, sight, hearing and communication, skin integrity etc. All three files viewed contained detailed care plans that provided clear guidance to staff when providing care to meet residents needs. All had been signed by the resident/or their representative confirming their agreement to their care plan. A range of care plans were seen to meet residents individual needs, for example personal cleansing and dressing, mobilising, eating and drinking and eliminating etc. Nutritional risk assessments were undertaken on admission and reviewed with weight monitoring also undertaken monthly. Risk assessments were seen for risks associated with manual handling, risk of falls, pressure sores, use of bed rails etc. All had been regularly reviewed. Two residents spoken with during the visit to the service said they were very happy with the care they received and said that staff looked after them well. Residents access to healthcare services was discussed with the manager and confirmed from the care records. Residents were registered with the local GP practice who attended regularly on request. Four residents care records were viewed during the visit to the home and Care Homes for Older People Page 4 of 10 were seen to include visits from their GP, occupational therapist, chiropodist and district nurse. A health professional visiting the home confirmed that they had good liaison with the manager and staff at Cameron House and another healthcare professional told us that they communicated concerns regarding residents very well. We were informed that the manager was planning to establish a local network group to include the end of life care facilitator, Boots pharmacist, Primary Care Trust pharmacist and the community matron with the objective of sharing knowledge and expertise and to provide joint training. The manager said that she planned to introduce the Gold Standards Framework for end of life care which is acknowledged to be best practice. In preparation for this care staff had received palliative/end of life care training, also confirmed from the training matrix. The systems for administration of medicines was discussed with a senior care assistant. Medication was supplied from the local supplying pharmacy in monitored dosage systems and individual containers. Medication was stored in medication rooms on the ground floor and first floor of the home. The ground floor medication systems were inspected. The room was small and storage at a premium. However an air conditioning unit ensured temperatures remained within safe recommended limits and systems were also in place to monitor and record the room (maximum 25 degrees centigrade) and fridge temperatures. Medication was stored in a locked trolley that was secured to the wall and in wall cupboards. A controlled cupboard and drug fridge were also available for storage of medicines requiring cold storage. Due to the limited space available, monitored dosage systems were hung from hooks on the wall. The home had a medication policy and procedures for staff guidance and information on medicines was also available for staff and seen in the medication room. There were appropriate procedures for the receipt and disposal of medication available and were seen to be well adhered to. Medication was given by designated senior care staff employed at the home who had received medication training and confirmed from the records viewed. A list of staff signatures and initials was held to enable appropriate follow up in the event of an adverse incident. The medication storage and medicines administration records for four residents were examined. Records were completed accurately and in full and all medication was available as prescribed. The Controlled Drugs (CD) storage met requirements and a CD register was in use. Records were completed accurately and confirmed by two staff signatures. However this did not include the name and address on receipt and disposal of CD drugs as is required and a recommendation has therefore been made in this report. Staff were observed to be friendly and relaxed in their conversations with residents and to knock before entering their rooms. Residents personal care was observed to be provided in private. Rooms included personal items of furniture and lockable facilities for storage of valuable and medication in the event that a resident chose to self medicate. We were informed that the manager and trainer were dignity champions. This involved promoting residents right to choice, independence, dignity and respect with residents and their relatives and was based on the Department of Health Dignity in Care Challenge initiative. Evidence of this was seen from posters on the doors to remind staff and visitors to respect residents privacy when personal care was being provided. Notice boards also included information for staff, residents and visitors about the programme. A relative spoken with during the visit to the service also confirmed that staff respected their loved ones privacy and dignity. The home had a complaints procedure that was included in the statement of purpose and service user guide and was seen on display in the entrance of the home. We were informed that each resident was provided with a service user guide. This was also Care Homes for Older People Page 5 of 10 confirmed from those seen on residents room doors. The record of complaints was viewed and confirmed that complaints were fully investigated in line with the homes procedures. The AQAA informed us that residents are provided with a copy of the procedure and encouraged to raised any concerns they have. One resident told us I have no complaints and a relative also said they had no concerns. The home had policy and procedures for safeguarding adults and the manager confirmed that the Essex safeguarding procedures were available for staff guidance in the event of needing to refer an allegation. A whistle blowing policy was also available to support staff should they witness an allegation of abuse. The AQAA informed us that all staff receive safeguarding adults training and are aware of the procedures to be followed in the event of an allegation being made. There had been one allegation made since the previous inspection that was appropriately investigated and a staff member dismissed. One medication alert had also been raised by the manager and additional training provided for staff to minimise the risk of this being repeated. The homes recruitment procedures were inspected and were confirmed to protect residents by ensuring all relevant checks were undertaken prior to appointment. There were forty-one residents at the home. The manager was off duty but did attend later during the inspection. the deputy manager was out of the home assessing a potential client and attended later during the inspection. We were informed that staffing levels comprised a minimum of three care staff on each floor and four care staff during the night. This was also confirmed from the staff rotas viewed. An administrator, one maintenance person, a chef and kitchen assistant, laundry assistant and two domestic assistants was also on duty. During the visit to the home, residents were observed to be well cared for indicating that staffing levels were appropriate for their needs. We were informed that the home employed a total of twenty-seven care staff of which eleven had an NVQ level 2 qualification and four had an NVQ level 3 qualification. This exceeds the 50 needed to meet the recommended standard. In addition a further five were undertaking NVQ level 3. During the visit to the home the recruitment files for two recently employed staff were viewed. All files included evidence that the relevant checks (CRB, two satisfactory references, identification etc.) were undertaken prior to appointment. We were informed that a copy of the General Social Care Council (GSCC) Code of Practice was given to all new staff on appointment to ensure they were aware of their responsibilities as a care worker. The files also included staff contract/terms and conditions detailing their legal rights of employment. The training programme was discussed with the manager and records viewed. A copy of the training matrix was provided. This comprised a rolling programme of training (health and safety, manual handling, fire safety, food hygiene, COSHH, safeguarding adults, infection control and nutrition). Senior care assistants had received initial training in administration of medicines and the records confirmed that updated training was also provided. The records also showed that training in pressure area care, customer care, care planning, challenging behaviour, dementia awareness and safe use of bed rails had been provided for all care staff since the previous key inspection. We were informed that palliative care training had also been provided for care staff. Discussions were held with the manager for the home who informed us that she had managed the home for four years and held the Registered Managers award and an NVQ Care Homes for Older People Page 6 of 10 in Business Management and Administration. From discussion and the records viewed it was evident that updated training had been provided relevant to the manager of a care home for older people. One member of staff who completed a survey told us I have worked at Cameron house for several years and I am supported and very happy in my working environment and another staff member told us the training is excellent. From observation and an inspection of records, the home appeared to be well managed. The homes quality assurance policy and procedures were discussed with the manager. Questionnaires with an anonymous response were forwarded annually to residents and their representatives. Information received was used to develop an action plan to address any issues raised. We were informed that regulation 26 reports were completed from provider visit and internal audits were undertaken by the Quality Officer. The manager and deputy manager also undertook regular audits of care planning and medication to ensure standards were adhered to. During the visit to the service a quality monitoring report from a recent visit by representatives from Essex County Council was viewed and was confirmed to have one requirement. The home had a comprehensive range of policies and procedures in place for staff guidance that had been regularly reviewed ensuring they met with up to date legislation and best practice guidance. The arrangements for handling residents monies were discussed with the manager and administrator. Neither the manager nor representative were appointee for any resident. Personal allowances were held for residents in one bank account . This was audited monthly and confirmed by the records viewed. Amounts of cash were also held for some residents in secure facilities. The personal allowances and records were inspected for three residents. The amounts of money were present and correct for all three residents with records of transactions made and receipts held as evidence. The home had a health and safety policy and procedures in place for staff guidance that had recently been reviewed. The records confirmed that staff had attended health and safety training following appointment. Evidence of a sample of records viewed showed that there were systems in place to ensure the servicing of equipment (hoists, sling etc.) and utilities and there was evidence of appropriate weekly and monthly internal checks being carried out (e.g.checks on fire equipment, fire alarms and emergency lighting etc.). 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 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 8 of 10 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 1 9 A record should be made of the name and address on receipt and disposal of all CD drugs in the Controlled Drugs Register. Care Homes for Older People Page 9 of 10 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. 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