Care Home: Cams Ridge Nursing & Residential Care Home

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What the care home does well Residents are able to join in suitable activities, including outings. There is a choice in how residents spend their time, the time they have their meals and in the food for meals. A resident said, `I am very happy here. I couldn`t be in a better place.` What the care home could do better: Continued improvements need to be maintained regarding residents` care needs as identified at social service safeguarding meetings and monitoring visits. Individual care plans need to have details of how and when occasional medication `as required` should be administered. Staff need to have one one supervision on a regular basis. The Commission must be notified of injuries to residents. Random inspection report Care homes for older people Name: Address: Cams Ridge Nursing & Residential Care Home 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT 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: Ian Craig Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Cams Ridge Nursing & Residential Care Home 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT 01329238156 Telephone number: Fax number: Email address: Provider web address: camsridge@schealthcare.co.uk www.southerncrosshealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Alison Mary Reilly Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 51 Number of places (if applicable): Under 65 Over 65 51 0 old age, not falling within any other category physical disability Conditions of registration: 0 51 The maximum number of service users to be accommodated is 51 The registered person may provide the following categories 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 catrgory (OP) Physical disability (PD) Date of last inspection Care Homes for Older People Page 2 of 12 Brief description of the care home Cams Ridge is a care home with nursing for service users over the age of 65 years, with a condition that service users can be admitted over the age of 50 years. The Home is also registered to admit persons with physical disability. The home has been extended to provide accommodation for 51 service users. The Home is situated in a quiet residential area close to the local amenities. Potential residents are given a brochure and a Service Users Guide that provide information about the services and facilities provided by the home. Care Homes for Older People Page 3 of 12 What we found: The inspection consisted of a site visit of 4 hours and 30 minutes. Discussions took place with the manager and a member of the staff team. Two staff were interviewed about their work at home. Two residents and a residents relative were spoken to. Social services staff were consulted about regarding safeguarding matters. Reference has been made to social services safeguarding meeting records. Other records, documents and policies and procedures were looked at. Choice of Home The process of assessing the needs of those referred for admission was looked for 2 people. A dependency assessment is completed which covers the following: dressing, eyesight, continence, social dependency, waterlow dependency, moving and handling assessment, waterlow pressure area risk assessment, nutritional assessment, continence assessment, personal care needs, communicating, bathing, bedroom comfort, eating drinking and dementia assessment. Hospital discharge details were held with records for each person and records show that the home obtained copies of multi agency assessment reviews for those with mental health needs. A pre admission draft care plan had been devised so that staff have guidance on how to meet the persons needs whilst a full care plan is drawn up. Health and Personal Care Care plans were looked at for 6 people. These are in a pro forma and cover the following care needs: maintaining a safe environment, communication, breathing, eating and drinking, elimination, personal cleansing and dressing, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping, and end of life care. Staff who complete care plans record a signature and date of completion. Records show that care plans are reviewed and updated at 3 monthly intervals. The manager explained that the home intends to involve residents and their relatives in the assessment and review process. The manager explained that as a result of the input by social services that the the care plans have been revised and are now written with the focus being the individual residents needs, wishes and preferences. The manager explained how staff have been supported with this by the provision of training. The care plans are audited by the homes manager. Care records show that the home has assessed the mental capacity of residents where applicable using the guidance associated with the Mental Capacity Act 2005. It was noted that the care plan pro formas do not include a section of how mental health needs are assessed and how these needs are to be met. Consequently the home had recorded these in the communication section of the care plans. Additional assessments are completed regarding nutritional needs, bed rail risk assessments, waterlow assessments for pressure area care, mental health and dementia, Care Homes for Older People Page 4 of 12 moving and handling, dependency assessments and body mapping to record any injuries. There has been a series of ongoing meetings, monitoring and input to the home by social services because of concerns regarding the homes ability to meet the needs of the residents. This has included requests from social services for improvements in the delivery of care and how care plans are recorded. The home has devised action plans to address these. Social services report that these matters have been adequately addressed, that the home has worked with social services to improve these practices, but further work is needed on care planning for those with more complex needs. Two residents were asked for their views on the care provided by the home. One person said, I am looked after very well. The staff are friendly. Another person said that the standard of care is good and that staff talk to the residents when providing care. Both residents said that the response from staff when asking for help when using the assistance call point could be quicker. Care staff also reported that the home meets the care needs of the residents. A staff member said that the home treats residents with respect. The homes medication procedures were looked at. Staff record a signature each time they administer medication. Controlled medication procedures were looked at. 2 staff record their signature and the balance of remaining medication each time a controlled medication is administered. In addition to this, a daily audit is carried out by 2 staff who count and record the remaining medication and their signatures. Stocks of controlled medication were checked and found to balance with the records. Medication that needs to be administered on an occasional basis was checked for 3 people. There was guidance for staff to follow of when this medication should be given for 2 people. For the remaining person, there were no guidelines recorded but a staff member was able to describe how staff interact to find out if the person needs this medication. The manager acknowledged that this needs to be recorded, which she had identified during the completion of a review of the service using the Health and Social Care Act 2008 standards. Staff confirmed that they receive training in medication procedures. Daily Life and Social Activities Recreational activities records were seen for a resident. 2 residents and a residents relative confirmed that activities and outings are provided including individual sessions if requested. A resident confirmed that he/she is able to choose how he/she spends his or her time and another person said that he/she can have breakfast at the time requested and that there is a choice from a number of foods. Residents were observed taking part in a quiz in the garden in the afternoon. A resident was seen tending to plants in the garden. Residents described the food as good and that their dietary needs are catered for. A resident said that the chef asks him/her what he/she would like to eat. A staff member said that the food could be improved. Complaints and Protection Care Homes for Older People Page 5 of 12 The Health and Personal Care section of this report refers to ongoing liaison with social services regarding concerns about care matters. Social services report progress on improving care but that monitoring is needed for the future. Training records and staff confirm that training in safeguarding vulnerable adults is provided. Environment Residents were seen using one of the lounges which is comfortable and clean. A resident said how much he/she likes his/her bedroom. Staff have received training in infection control procedures. Social services have raised concerns about hygiene and the availability of liquid soap, which the home says has been addressed. Staffing The homes staffing levels were looked at. The staffing levels may vary according to the number of people accommodated. At the time of the visit there were 40 people accommodated. The manager explained that the planned staffing levels for 40 residents are as follows: 7am to 1.30pm 2 Registered General Nurses and 7 or 8 care assistants; 1.30pm to 7.30pm 2 Registered General Nurses and 4 or 5 care assistants. Night time staffing consists of 1 Registered General Nurse and 4 care assistants all on waking duty. The staff rota was checked for the week of the inspection and showed that these hours were being provided. On 14 June 2010 there were 8 care assistants and 3 Registered General nurses on duty from 7am to 1.30pm. The manager said that the home currently has sufficient staff to meet residents needs. This was also the view of staff spoken to on the day of the visit, although both staff also said that there have been occasions when there has been a shortfall due to unforeseen staff absences. The home has recently recruited a Registered General Nurse for employment on an occasional basis to cover staff absences. The manager maintains a schedule of training completed by staff as well as future training. For June 2010 the training schedule shows training in the following subjects: moving and handling, preventing abuse, challenging behaviour, nutrition, pressure care, health and safety and contamination by substances hazardous to health. Staff training needs in wound care, care planning and delivery of care have been identified by social services as a result of safeguarding of vulnerable adults investigations. The service has addressed this according to the manager and an action plan was seen to address these concerns. The homes training records show that 58 per cent of staff have completed traijing in pressure care and further training has been scheduled. Staff records show that training has been provided in nutritional assessments, medication, infection control, care planning and outcomes, use of syringe drivers and chronic pulmonary obstructive disease. Staff said that they have received training in person centred care, medication, preventing abuse, moving and handling, infection control, food hygiene and health and safety. Staff said that they considered that the training is sufficient to give them the skills to care for the residents. Care Homes for Older People Page 6 of 12 17 of the homes care assistants are qualified at National Vocational Qualification Level (NVQ) 2 or above in care with 6 trained at NVQ level 3 in care. 4 staff are due to commence NVQ level 2 and 3 staff NVQ level 3 training. Staff recruitment procedures were looked at for 2 staff. Each person had completed an application form. 2 written references had been obtained and the necessary checks made with the Criminal Record Bureau (CRB) and the Independent Safeguarding Authority (ISA)before the staff started work. Records show that the staff were assessed at an interview. Management and administration The registered manger has a number of years experience in providing and managing care for older persons. She has completed the National Vocational Qualification level 4 in care as well as the Registered Managers Award. Staff described the manager and the homes management as supportive and approachable. Staff supervision was looked at. It was not clear from staff that they received regular one to one supervision. Records show that for 18 staff only one or no supervision was recorded for 2010. Records show that monthly audit visits are made to the home and a report for the manager completed. It was noted that the home had failed to notify the Commission of a significant injury to a resident as required by Regulation 37 of the Care Homes Regulations 2001. What the care home does well: What they could do better: Continued improvements need to be maintained regarding residents care needs as identified at social service safeguarding meetings and monitoring visits. Individual care plans need to have details of how and when occasional medication as required should be administered. Staff need to have one one supervision on a regular basis. The Commission must be notified of injuries to residents. Care Homes for Older People Page 7 of 12 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 8 of 12 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 9 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Individual care plans must include details of the circumstances of when and how residents have occassional as required medication. So that residents receive medication as prescribed. 23/07/2010 2 36 18 Individual staff must receive regular one to one supervision. So that staff are supported and supervised in providing care to residents. 23/07/2010 3 37 37 The Commission must be notified of injuries to residents. So that The Commission can monitor incidents occurring at the home. 23/07/2010 Care Homes for Older People Page 10 of 12 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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