Care Home: Choice Care Home

What the care home does well People at the home have opportunities to join in group activities or have 1:1 time doing what they would like to do. this helps make sure people do not miss out on stimulation just because they don`t like group activities. Lots of evidence of craft work and seasonal celebration could be seen in the home. Rooms available and bright and well decorated with en suite facilities. People can havetheir own belongings with them when they move in. Meals are home cooked and well presented. People are offerred a varied and interesting diet. The gardens to the home are enclosed and attractive, offering a safe place for people to sit. The home is in a level position close the local facilities and servies. ther is a church opposite and a local seafront is nearby. The home has access to a vehicle so people can be taken out. The staff seen were interacting well with people. What the care home could do better: The home owners and manager need to make sure that care plans are being followed through. This means that people should receive the care and attention they need. Safe systems should be put in place for the transportation of medication around the home. this should help to reduce the risks of people getting hold of medication that is not their own. All medication or prescribed nutritional supplements given to people must be recorded. This is to ensure that a full audit trail can be completed and also that staff can be sure people are rceiving the supplements they have been prescribed. The bolt fitted to the front door needs to be discussed with the fire officer and also reviewed in the light of the Mental capacity Act. This is to ensure people`s rights are protected and that a fire exit is not obstructed. Supervision should be given to all staff. it is recommended that this happen at least six times a year. this should help ensure staff are working consistently and to their full potential to support people. Training and development plans need to be updated and implemented. this is so that staff rcieve the training and updates they need. in particular dementia care training needs to be updated for all staff. Windows should be examined to make sure they contain glass thatbis safe. this is to prevent injury. The use of bin liners and covers on cushions in the lounge should be discontinued. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Choice Care Home Cary Avenue Babbacombe Torquay Devon TQ1 3QT three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Michelle Finniear Date: 2 5 0 3 2 0 0 9 Information about the care home Name of care home: Address: Choice Care Home Cary Avenue Babbacombe Torquay Devon TQ1 3QT 01803403026 01803403026 Choice-carehome@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rosepost Healthcare Ltd care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Conditions of registration: 24 0 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) The maximum number of service users who can be accommodated is 24 Date of last inspection Brief description of the care home Choice Care Home is situated on the level to the small shopping areas of Babbacombe and St Marychurch, about 2 miles from the centre of Torquay. Close by is also Babbacombe Downs which has magnificent views out to sea. The home is a large detached property with ample parking at the front and level access into the home. Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home There is an attractive enclosed garden area at the rear of the home that has seating for use in good weather. There are 18 single rooms and 3 double rooms spread over three levels, those above ground floor being accessible by stair lifts. All single and double bedrooms have ensuite fcilities ranging from toilet and wash hand basin to basin and bath. Every room has a wash hand basin either in the en-suite or in the room itself. The home is registered to provide personal care to a maximum of 24 older people who may have a physical disability or suffer from dementia. The home is laid out over 3 levels, ground, mezzanine and first floor. In terms of communal space, the home has a large lounge, 2 conservatories, and a dining room. Fees commence at #340 per week. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This inspection was carried out following the issues raised in the Annual Service review in November 2008. The review raised concerns over a high staff turnover; several changes of manager; an increase in the dependency level of the people being cared for; three complaints being made about the home in the preceeding year; and requirements and recommendations made following a visit from the CSCI pharmacist to review the homes medication systems. We also had not received any response to questionnaires about the home from either staff or people living at the home. This visit was carried out on a weekday morning. To complete the inspection we spent time looking at records and systems; we looked at the way the home manages peoples medication; and we did a tour of the home looking at peoples rooms and we spoke to some staff on duty. The manager was not available on the day of the visit so Mrs Owen came to the home to assist with the inspection. She told us that this manager is also leaving now for personal reasons, but that they have appointed a new manager who will be starting in a month. This means that the home has not had a registered manager in post for over a year, which has caused problems with consistency and carrying through systems. As an example we looked at peoples care plans, which set out how each individual needs to be supported and how that support is to be given. One file showed that this person needed their blood sugar levels needed monitoring weekly due to Diabetes. However the file notes showed this had last been recorded in December 2008, and the chart in the file was last completed in May 2007. This could have put the person at risk. We also looked at the response to the requirements and recommendations made by the CSCI pharmacist on their Inspection in May 2008. This showed that the home has responded to the requirement to monitor the temperatures of medication needing refrigeration. However they had not responded to the requirement to record all medications given, including nutritional supplements, or the recommendation to ensure safe systems of transporting medication around the home. This could put people at risk. The care plans seen also need some attention to make sure they are being compiled consistently. Plans seen were being updated regualrly in general, and reviews of peoples needs were being carried out. A bolt has been fitted to the front door. This needs to be discussed with the fire officer and risk assessed without delay. Any locking device also needs to be examined with respect to issues of restraint and restirction of liberty, particularly in view of the Mental Capacity Act and deprivtion of liberty safeguards. The owner agreed to make sure that the windows were fitted with safety glass or risk assessed and made safe. Some chair cushions in the lounge were being protected from fluids by black bin liners and a linen overlay. This looked unsightly and could be uncomfortable or distressing to people. The owner agreed to address this. Care Homes for Adults (18-65 years) Page 4 of 10 No complaints have been made to the home since the Annual service review in November 2008. The owner told us that the staff group has now settled and there has been a much reduced turnover. They also said that most staff are currently undertaking National Vocational Qualifications, which are an award reflecting the competency of staff in their working role. The current manager has been working on supervision systems, but the records seen showed they were behind schedule. At least one supervision session is said to have been done with staff in the last few months. When we looked at records of planned supervision some dates and records were not completed, however the owner later contacted us to let us know that these had been completed but were not available at the time of the site visit. Supervision is a system of 1:1 contact between management and staff looking at suporting them to work in accordance with best practice and consistently. We looked at the recruitment file for the most recently employed staff. This showed that recruitment systems were generally being followed through and that an Induction programme had been started. However a Criminal records bureau check was still not returned although it had been applied for. Training plans had been constructed to show where people needed updating in core training such as First Aid and food hygiene, but some of these were out of date. It was agreed by the owner that all staff need at least a refresher training in caring for people with dementia, and that for some people such as senior staff this needs to be more comprehensive. The quality asurance cycle was also discussed, and in a later telephone call the manager agreed to send the completed information to CSCI, as it could not be located on the day of the visit. During the visit we made a tour of the home, and looked at many of the bedrooms and communal areas. The rooms seen were bright and well decorated, and communal areas were being well used on the visit with an activity and keep fit session. An excellent home cooked meal was being prepared, and evidence of recent craft work could be seen on walls and in the homes entrance hallway. The owner said that an activities organiser visits twice a week and spends time individually with people who do not wish to join in organised activities to ensure they do not miss out. We have decided that we will bring the next key inspection of the home forward, so this will be done before the 8th December 2009. What the care home does well: People at the home have opportunities to join in group activities or have 1:1 time doing what they would like to do. this helps make sure people do not miss out on stimulation just because they dont like group activities. Lots of evidence of craft work and seasonal celebration could be seen in the home. Rooms available and bright and well decorated with en suite facilities. People can have Care Homes for Adults (18-65 years) Page 5 of 10 their own belongings with them when they move in. Meals are home cooked and well presented. People are offerred a varied and interesting diet. The gardens to the home are enclosed and attractive, offering a safe place for people to sit. The home is in a level position close the local facilities and servies. ther is a church opposite and a local seafront is nearby. The home has access to a vehicle so people can be taken out. The staff seen were interacting well with people. 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 Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 9 13(2) 17(1) Arrangements must be made 30/06/2008 to record the administration or refusal of all prescribed medicines. This includes nutritional supplements. Arrangements must be made 30/06/2008 to ensure that medicines are stored securely and within the correct temperature range. 2 9 13(2) Care Homes for Adults (18-65 years) Page 7 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, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The owner and manager 16/05/2009 must make sure that staff follow through the care detailed in the service users plan. This is to make sure that people rceive all the care they need. 2 9 13 All prescribed medication given to people must be recorded. This includes prescribed nutritional supplements. This is so that people are aware that medication has been given out and that a full audit trail can be completed. 16/05/2009 3 19 23 The bolt fitted to the front 16/05/2009 door must be discussed with the Fire Authority and their advice taken on the safety of premises. The bolt should also be examined from the perspective of the mental capacity Act and restraint and restriction of peoples liberty. This is to ensure people are Care Homes for Adults (18-65 years) Page 8 of 10 safe and their rights are respected. 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 2 3 9 19 26 A safe system for the transportation of medication around the home should be provided. The responsible individual must ensure that the glass in the windows in the home is safe. The practice of using bin liners and covers for cushions on chairs in the lounge should cease. It may be distressing and uncomfortable for people. Discussion may be advisable with the continence nurse advisor. Staff should receive training suitable to the work they are doing . This should include updates in core training such as First Aid and moving and handling as well as training in caring for people with dementia. Staff should receive appropriate supervision. 4 30 5 36 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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