Care Home: Crown Meadow Care Centre

What the care home does well We found improvements in all aspects of medicine management. People`s assessment are being regularly updated as their needs change. Therefore care can be planned and delivered in accordance with those needs and risk assessments undertaken. Nutritional and hydrational needs monitoring has improved so that those identified at risk can have these need actioned appropriately. What the care home could do better: We found improvements in care planning but further work is required to meet the standard and to ensure that staff have comprehensive instructions on how to meet peoples needs. We will assess the recruitment procedures at some point in the future once new staff have been recruited. The safety of people living in the home is paramount and good recruitment practices are fundamental to this. Random inspection report Care homes for older people Name: Address: Crown Meadow Care Centre Bayleys Bridge Tipton West Midlands DY4 0HB zero star poor service 18/03/2010 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: Karen Thompson Date: 0 3 0 8 2 0 1 0 Information about the care home Name of care home: Address: Crown Meadow Care Centre Bayleys Bridge Tipton West Midlands DY4 0HB 01215200700 01215578279 Telephone number: Fax number: Email address: Provider web address: www.schealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Care Centres Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category of service only: Care Home with Nursing (Code 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) 35 Date of last inspection Brief description of the care home Crown Meadow Nursing Home provides nursing care for up to 35 people who are over 65 years of age. The home is situated on a main road close to Great Bridge, Tipton and other local shops and amenities. The property is a purpose built three-storey building Care Homes for Older People Page 2 of 10 1 8 0 3 2 0 1 0 Brief description of the care home with parking to the front and garden at the rear of the property with patio and seating that can be used when the weather permits. The home consists of 31 bedrooms, there are some shared bedrooms as well as single occupancy and all have en-suite facilities. There is a large lounge/dining room on the ground floor fronted by a conservatory, which forms the entrance of the home plus a small quiet lounge on the first floor. Bedrooms are located on all floors and there is a hairdressing salon and staff room on the second floor. There are two passenger lifts giving access to all areas of the home and there is one assisted bathroom that is suitable for people with mobility problems on each floor; showers are also available in most bedroom en-suites. Information in the form of a welcome pack and service user guide were available in the reception area, so people had access to information about the services and facilities availaable in the home. The notice advised people to ask for a copy of our latest inspection report if they wished to see it. The information available did not include the range of fees and people will need to discuss this with the manager at the time of making enquiries. Care Homes for Older People Page 3 of 10 What we found: Two inspectors of which one was a specialist pharmacist inspector, visited the home on 3 August 2010 to check compliance with the three statutory requirement notices which were issued following our random inspection visit of 8 June 2010. A statutory requirement notice is issued when the home has failed to meet a legal requirement and is one of the first stages we use in our enforcement process. The statutory requirement notices were issued in relation to medication management, recruitment practice and assessment of peoples health and welfare needs. We were only able to check compliance with medication management and assessment of peoples health and welfare needs. The home had met both these statutory requirement notices. We were not able to check compliance with recruitment practice as the home has not employed any new staff since our visit of 8 June 2010. We are aware that the home is in the process of recruiting new staff and was informed that they had not been employed by the home to date. We will return to the home at a later date to check this statutory requirement notice to ensure that the recruitment process is robust and does not place anyone living at the home at risk. We also looked at the seventeen outstanding requirements from our March 2010 key inspection. We found fourteen of these requirements to be met, one was in relation to recruitment which we were unable to check, one requirement has now been moved to a recommendation as significiant process has been made in this requirement and finally one requirement remains outstanding but we have been given assurances this will be met by mid August 2010. There was one requirement made following 8 June 2010 random visit which is again in relation to recruitment so will remain until we are able to check. Following our 8 June 2010 inspection the home was sent a warning letter for those outstanding requirements listed above detailing our concerns and informing the home that they had been included in our improvement strategy programme and that we would continue to monitor the service. Commissioners of the service such as the Primary Care Trust and local authority have suspended all new placements to the home following concerns identified in February 2010. This remains in place which means no new people are being placed by them in the home to live and they are carrying out their own checks as to the quality of the service provided. The pharmacist inspector visited the home on 3rd August 2010 to check the management and control of medicines within the service. The purpose of this inspection was to check compliance with a Statutory Requirement Notice (SRN) relating to medicines. We looked at medication storage and medication administration records. We found that there was good documentation and recording of medicine records. We looked at all of the medication administration record (MAR) charts and overall found that they were documented with a signature for administration or a reason was recorded if medication was not given. We saw that the times of administering medicines were clearly highlighted on the MAR charts. We were told by the manager that regular spot checks were made by the service on peoples medicines to ensure they were being given safely and as prescribed. This means that there were arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labelled and supplied for. We looked at the storage of peoples medicines. We saw that medicines were stored neatly and tidily, which made it easy to locate peoples medicines. Care Homes for Older People Page 4 of 10 We found that there had been improvements in the management of medicines to ensure that medicines are given to people safely and as prescribed. We gave feedback to the Manager and explained that the service had complied with the SRN relating to medicines. We also looked at how peoples needs are assessed and reassessed during or following a change in needs as part our checking with one of the statutory requirement notices. We looked at one persons care records they had recently had a change in health care needs which had required a hospital admission. The home was able to demonstrate they had implemented a system of reassessing peoples needs on return to the home. They were also able to demonstrate that an appropriate follow up referral had been made to the General Practitioner (G.P) on their return to the home in relation to weight loss. The home has also implemented a food and fluid recording system to monitor that persons nutritional and hydrational intake. The food and fluid records demonstrated that snacks and drinks were being given between meals. Whilst this is positive and it was clear action was being taken, the care plan had not been amended to reflect this action. Staff rotas were looked at and with the exception of one oversight they were an accurate reflection of the staff available to meet peoples needs. We were informed that twenty five people were living in the home at the time of the inspection. We observed that there were two trained nurses and five carers on duty for the morning and one trained nurse and four carers for the afternoon shift. The number of staff on duty since our 8 June 2010 visit has been reduced by one per shift despite only a reduction of one person living in the home. We were informed that the home was hoping to employ a number of new staff in the near future including both trained nurses and carers. At present the home only has one permanent qualified nurse working in the home. The organisation continues to second qualified nurses for short periods of time within the home from other homes within the group. The key inspection visit of March 2010 required all staff working in the home to have training in relation to the Mental Capacity Act 2005 by 30 July 2010. We have been advised that this training is to commence mid August 2010. This requirement will remain outstanding and will be checked at our next inspection visit. We observed one person having their wound dressed in the treatment room. We were told that people requiring insulin now have this administered in the treatment room, thus promoting and protecting their privacy and dignity. What the care home does well: What they could do better: Care Homes for Older People Page 5 of 10 We found improvements in care planning but further work is required to meet the standard and to ensure that staff have comprehensive instructions on how to meet peoples needs. We will assess the recruitment procedures at some point in the future once new staff have been recruited. The safety of people living in the home is paramount and good recruitment practices are fundamental to this. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 18 17 The home must make sure 30/04/2010 that staff allowed to work in the home without a satisfactory CRB and only an ISA adult first check have a written risk assessment completed and that a copy of the risk assessment is kept in the staff members file. This will demonstrate how the home intends to protect the people living in the home when staff start work without all of the required safety checks in place. 2 18 13 The home must make sure that staff have training in relation to the Mental Capacity Act 2005 and the deprivation of liberty safeguards. This will help staff understand their role in supporting those people who do not have the capacity to make decisions for themselves. 30/07/2010 Care Homes for Older People 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, 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 1 The home needs to make sure that the details of the Care Quality Commission are correct. They should do this so people have the correct information to be able to contact the Commission if they choose to do so. (Recommendation made 18 March 2010, not looked at during this inspection) The home should source further training for staff in specialist areas such as nutrition, pressure area care adn pain management. (Recommendation made 18 March 2010, not looked at during this inspection) The home should make sure that peoples care plans contain the correct and comprehensive information about peoples needs and how they are to be met. This will give staff clear guidance about peoples care needs and give people the assurance that staff knwo what they need to do. 2 8 3 8 4 26 When mops are not in use the home should store all mops inverted (upside down), this reduces the risk of cross contamination. (Recommendation made 18 March 2010, Page 8 of 10 Care Homes for Older People 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 not looked at during this inspection) 5 26 The home should have a detailed cleaning schedule for the laundry, this should include the daily laundering of all mops heads. (Recommendation made 18 March 2010, not looked at during this inspection) The home should keep a copy of the induction records for new staff. They should do this so they can demonstrate new staff have been supported through the process and have received a suitable induction to social care work. (Recommendation made 18 March 2010, not looked at during this inspection) 6 30 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. 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. Care Homes for Older People Page 10 of 10 - 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. 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