Latest Inspection
This is the latest available inspection report for this service, carried out on 14th September 2010. CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Deerwood Grange Nursing Home.
What the care home does well This is a random inspection and therefore not all the standards were assessed. People are supported to keep in touch with their family and friends so they can maintain relationships that are important to them. Relatives can visit at any time and are made welcome. Many of the staff that work there have worked there for a long time so they know the people living there well. There is a large garden at the back of the home so that people have a nice view from their lounge and if they want to can spend time outside. What the care home could do better: This is a random inspection and therefore not all the standards were assessed. A lot of improvements have been made to ensure the health, safety and welfare of the people living there. More work needs to be done on care plans to ensure that they reflect the individual needs of the person so that staff know how to support them. Staff records must show that recruitment procedures are robust to protect the people living there. People should be offered opportunities to take part in activities that they enjoy so ensuring their well being. Staff must support people appropriately and ensure their health needs are being met, to ensure their well being. Random inspection report
Care homes for older people
Name: Address: Deerwood Grange Nursing Home 22 Wentworth Road Four Oaks Sutton Coldfield West Midlands B74 2SD zero star poor service 10/05/2010 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: Sarah Bennett Date: 1 4 0 9 2 0 1 0 Information about the care home
Name of care home: Address: Deerwood Grange Nursing Home 22 Wentworth Road Four Oaks Sutton Coldfield West Midlands B74 2SD 01213550060 F/P01213550060 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) BAMH (MIND) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 23 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 23 23 The maximum number of service users who can be accommodated is: 23 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: Dementia (DE) 23 Mental disorder, excluding learning disability or dementia (MD) 23 Date of last inspection 1 0 0 5 2 0 1 0 Care Homes for Older People Page 2 of 11 Brief description of the care home Deerwood Grange is a large detached adapted nursing home in the Four Oaks conservation area of Birmingham. The home is approached from a driveway, and is set back from the main road. To the rear of the building are large gardens, which are utilised by the people living there in good weather. The building was extended to provide most people with single bedrooms apart from one that is shared. There are two large lounge areas, and a large dining room. In the extension there is a laundry, a disabled toilet and down stairs shower room. The upstairs bathroom has been converted into a shower room. There is a staircase to access the first floor of the extension, access to the first floor using the passenger lift is via the original building. The home provides nursing care to people over the age of sixty-five with a diagnosis of dementia and/or mental health issues. The home is staffed 24 hours a day and there is always a qualified nurse on duty. Care Homes for Older People Page 3 of 11 What we found:
The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last key inspection of this service was completed on the 10th May 2010. This random visit was undertaken by two inspectors over five hours. There were eighteen people living there. The home did not know that we would be visiting that day. The reason for this visit was to check compliance with requirements made at previous inspections. These had not been fully complied with at the random inspection on 7th July 2010. During this visit we looked at two care files in detail, staff rotas, staff recruitment records and at four bedrooms. We spoke to the deputy manager, staff on duty and a visitor. The home is still subject to a suspension of placements by the local authority. This means the home is not able to take admissions until satisfactory improvements have been made. At this time this has not happened. These are our findings: A lot of work has been done to improve care plans and all the people living there now have a detailed care plan. This is to ensure that staff know how to support the people living there to meet their needs in the way the individual chooses to be supported. Some of these included a lot of detail about how the person liked to dress, which is important to ensure peoples well being. On one persons care plan another persons name was stated on a few occasions. Some of these care plans identified the needs of another person. This may mean that staff do not have the information they need to support individuals. Each person has a care plan for their specific needs and also with this is carers information. At our last visit staff said this was helpful as it was a clear overview of the persons need and what they needed to do. One persons record had missing information in the carers information to what was written in the care plan. For example, it said in their care plan that they needed to have a dim light left on at night in their room to help prevent them falling when they got out of bed. This information had not been transferred to the carers information, but it is the carers who would be doing this. One persons care plan stated that they should be allowed to take positive risks around the home with supervision of the qualified nurse in charge. The deputy manager was not clear what positive risks meant for this person and stated that it would not be possible for them always to be supervised by a nurse. Therefore, if this is the persons need staff may not be able to meet it. One persons hygiene plan detailed the continence pads they wear. Their continence care
Care Homes for Older People Page 4 of 11 plan stated they did not wear pads. This could cause confusion for staff as to how to support the individual. Daily records are kept for each individual. These did not include much detail about how the person had spent their day. For example, one record stated that the person had refused care but did not say what this care was. Another said that the person was active during the day but did not say what they were active doing. Another record said that a persons mood had changed throughout the day and at times they had been aggressive, hitting out at staff. There was no indication of how this behaviour had been managed. It is useful to record this and any triggers for the behaviour i.e. what happened before, what the person was doing and who was around them, so that positive steps can be taken to reduce their behaviours. Records showed that people had been referred to other health professionals where needed for advice as to how their health needs could be met. Records showed that people had regular health checks to ensure their health and well being. People had been weighed regularly. Staff monitored individuals weight records, which is important, as a significant loss or gain of weight can be an indicator of an underlying health need. One persons records stated that staff had observed they had discharge from their ear. There was no further mention of this until six days later when the GP was called and the person was prescribed antibiotics for an ear infection. The person had a care plan concerning their ears, which seemed to be an ongoing need for them. The deputy manager said because of this staff would have been aware, so would be monitoring for any deterioration in the persons health. However, there was no record of any action taken until the infection was diagnosed. This could have impacted on the persons health and well being. Two part time activity workers are employed by the home. We looked at the activity records of two people. These showed that in the last month they had been involved in little activity and had not been outside the home. The deputy manager said they would have done some activities, but these are not always recorded. During the morning some people were reading a newspaper and others were watching a film. Families have been involved in writing life histories which we saw detailed a lot of information about what the individual had achieved in their life and their interests and hobbies. This information had not been transferred to the persons care plan so that staff may not know how to support them to meet their social, cultural and religious needs. We have previously noted that records of food stated 100 or 50 eaten, which does not give a clear picture of whether the person has received the nutrition they need. Care plans had stated that staff were to record this more accurately. Not all food records had been completed to give an accurate record of what the person had eaten, which could affect the persons well being. Two bedrooms have been redecorated to a high standard. The person and their relatives had been involved in choosing the decoration and furnishings. Rooms had been personalised to individual tastes and interests. The deputy manager said that other bedrooms are planned to be redecorated, however the four vacant bedrooms are currently being redecorated. They hope that the suspension of the contract will soon be lifted by the local authority so they can show these to people who may want to live at the
Care Homes for Older People Page 5 of 11 home. There were sufficient staff on duty to meet peoples needs. New staff have been recruited to fill the vacancies. There is one vacancy for a night care assistant and recruitment is taking place for this. Less agency staff are being used and where they are needed they are staff that work there regularly. This helps to provide staff that know the people living there and how to meet their needs. We looked at the records of four of the staff that work there. Previously staff records had not been kept at the home but at the organisations Head Office. Records were kept in a sealed envelope and were only for inspectors to look at. Records included completed application forms. One record only included one reference, others included the two that are required. None of the records included proof of the persons identity which is required. A separate record showed evidence that a satisfactory Criminal Records Bureau (CRB) check had been received for staff. This did not include one of the staff whose records we looked at. The deputy manager rang the Human Resources Department who stated that as this person had their check over three years ago it was not included on this record, as inspectors would have seen this previously. However, they said that this person did have a satisfactory CRB check. What the care home does well: What they could do better:
This is a random inspection and therefore not all the standards were assessed. A lot of improvements have been made to ensure the health, safety and welfare of the people living there. More work needs to be done on care plans to ensure that they reflect the individual needs of the person so that staff know how to support them. Staff records must show that recruitment procedures are robust to protect the people living there. People should be offered opportunities to take part in activities that they enjoy so ensuring their well being. Staff must support people appropriately and ensure their health needs are being
Care Homes for Older People Page 6 of 11 met, to ensure their well being. 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 11 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 7 12 Ensure that care plans clearly reflect individuals needs. So that staff know how to support them to meet these. 30/06/2010 Care Homes for Older People Page 8 of 11 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 29 19 The required staff 30/09/2010 recruitment records must be available for each staff employed at the home. To ensure that the recruitment procedures are robust to protect the people living there. 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 8 Records should state how staff have managed inappropriate behaviours and any triggers for it. This will help staff to take positive action to reduce these behaviours and manage them consistently. It is advised that further training is completed to enable staff to manage challenging behaviour without the need to administer sedating medicines. Not assessed at this inspection. It is advised that all the people living there have a medication review to reduce the reliance of sedating medicines used in the home. Not assessed at this inspection.
Page 9 of 11 2 9 3 9 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 4 9 Staff should administer medication appropriately so not to put people at risk of cross infection. Not assessed at this inspection. All people should be offered regular activities to ensure they have opportunities for social interaction and to promote their well being. Outstanding from previous inspections. Food records should state what the person has eaten and the portion sizes, so it can be monitored whether or not the person is receiving the nutrition they need to be well. Outstanding from previous inspections. People should be offered a varied, healthy and nutritious diet to ensure their health and well being. Not assessed at this inspection. There should be at least six staff meetings a year to ensure that staff have the opportunity to discuss the needs of the people living there and are kept updated with best practice. Not assessed at this inspection. There should be an induction process for agency staff so they know how to support individuals they are working with and are aware of safety procedures, if needed while working there. Not assessed at this inspection. Quality assurance systems should be in place to ensure that the home is regularly monitored and improvements can be made so it is run in the best interests of the people living there. Not assessed at this inspection. 5 12 6 15 7 15 8 27 9 27 10 33 Care Homes for Older People Page 10 of 11 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 11 of 11 - 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!
