Care Home: Favordale

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What the care home does well Staff were responsive to residents requiring their assistance and had a good understanding of residents needs. The security of the home was considered by an established routine for the officer on duty to check access areas throughout the home. What the care home could do better: In determining the use of pressure mats at the side of beds, this should include all eventualities and take into account those residents who could get out of bed at either side. Risk assessments must include the security provided for residents in their bedrooms. Staff have a clear duty of care to protect residents and their property, particularly where residents have diminished capacity to make informed choices regarding these issues. The risk of residents left unattended must be considered as there is a potential for a serious incident occurring during this time. Person centred care must take into account twenty four hour care required to enable residents to be given proper supervision and care from the moment their waking day begins irrespective of the time. Sufficient staff must be on duty to respond quickly to residents summoning assistance and to ensure residents who are awake in the dementia unit are not left unsupervised. Night staff should be able to take formal half hour breaks uninterupted during the night. The manager must consult with staff as to the impact on resident care that has been identified as a result of the reduction of staff on duty at night, and relay the outcome of the consultation to senior management of Lancashire County Care services. This will ensure staff views regarding resident health, safety and welfare are fully considered. Random inspection report Care homes for older people Name: Address: Favordale Favordale Byron Road Colne Lancashire BB8 0BH two star good service 23/01/2009 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: Marie Dickinson Date: 2 3 0 6 2 0 0 9 Information about the care home Name of care home: Address: Favordale Favordale Byron Road Colne Lancashire BB8 0BH 01282860449 01282866749 Debbie.Watson@careservices.lancscc.gov.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) : Lancashire County Care Services care home 44 Number of places (if applicable): Under 65 Over 65 0 3 30 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 14 0 0 The home is registered for a maximum of 44 service users to include: Up to 30 service users in the category OP not falling into any other category Up to 14 service users in the category (DE) Within the total number of OP registered places, three named service users who fall into the category MD(E) may be accommodated Date of last inspection Brief description of the care home Favordale is registered with the Commission for Social Care Inspection to provide personal care and accommodation for forty-four people. 2 3 0 1 2 0 0 9 Care Homes for Older People Page 2 of 10 Brief description of the care home The home is owned by Lancashire County Council and managed by Lancashire County Care Services. The property is a purpose built building, set back off the main road, with gardens to the side and rear. There is a central courtyard accessible to the residents. Accommodation offered is in single bedrooms. Some have en suite facilities provided. There are sufficient bathrooms and toilets, and various aids provided for residents to maintain independence throughout the home. The home is divided into two units for people requiring residential and dementia care. The residential unit is on two floors. The upper floor can be accessed via a passenger lift. Both units have lounge and dining areas. The home is staffed twenty-four hours a day, with a member of the management team on duty and on call at all times. Information about the service is available from the home for potential residents in a Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £366 and £413 per week. Private charges are £433 per week. Residents are responsible for additional extras such as newspapers and toiletries. Care Homes for Older People Page 3 of 10 What we found: This unannounced random inspection was carried out in respect of Favordale on the 22nd June 2009 at 10.30pm. The reason for this inspection was in response to concerns about insufficient staffing levels resulting in residents needs not being properly met during the night, and resident protection. Discussion took place with the officer on sleeping in duties, and staff on duty. Documents including staff rotas, procedures for staff when to alert on call officers, resident risk assessments and residents records were looked at. The dementia unit was visited. Feedback on the inspection findings was given to the manager. Other information considered included the notification received at the Commission regarding the reduction of staff by Lancashire County Care services. Records showed risk assessments had been completed for residents who got out of bed during the night. These were used to determine if an alarm mat was required to alert staff this had happened. From discussions with the officer and staff on duty it was established there were a number of residents who fell into this category. However the mats did not necessarily mean staff would be alerted as they were placed at one side of the bed only. Staff on duty knew residents identified as at risk of wandering. During the time of the inspection residents constantly used the call system. Observations showed staff were kept very busy and responded to these when they could. This meant some residents had to wait significant periods before they were attended to. Staff interviewed said they could be very busy and would not always know if a resident had alerted them to an emergency or whether they required routine assistance. Staff confirmed some residents did go into other residents rooms as the bedroom doors were not locked. They were directed not to lock the doors, despite the type of safety lock fitted, allowed residents to open their doors easily from inside the room by turning the handle and staff to gain access using a master key. In addition to this a number of residents were up and about around 5am onwards and were left unattended for periods until one day staff came on duty at 7am. This is a serious concern as there is potential for residents going into each others room to assault or be a victim of an assault. One residents notes referred to being agitated. There had been an incident in the home during the night when staff members had been assaulted by a resident. The door to the dementia unit was keypad access only. The door leading to the garden area was secured. The officer on duty said this was part of her evening duties to make sure all doors to the building were secured before she went to bed. Rotas showed two carers on duty between 10pm and 8am. Their duties included attending to resident needs, laundry duties, cleaning duties in specified areas and paperwork required for the job. Both staff was interviewed. They said they had a handover meeting with the officer on duty and had brief written notes on residents to refer to. There were a number of residents requiring the assistance of two carers. They had one to one supervision in which they had raised concerns regarding the reduction of night staff and were to attend a staff meeting the following day. Attending staff meetings Care Homes for Older People Page 4 of 10 could be difficult if they had worked the previous night. Both staff confirmed they were entitled to two half hour breaks but these were difficult to take as residents needs were priority, and quite often did not get a proper break. They worked to a routine and checked residents every hour. Laundry duties and cleaning specific areas were done throughout the night. They did have concerns regarding residents in the dementia unit left unattended in the very early hours of the morning, as they had to respond to calls for assistance in the residential unit. They were also concerned over the instruction not to lock bedroom doors. There were guidelines in place referred to as dos and donts which made it clear when staff could alert the officer sleeping in. This showed generally staff must only call an officer in an emergency. The officer was not aware of any consultation planned when staff could say how the reduction in night staff had affected them and on the impact it had on resident care. What the care home does well: 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 5 of 10 Care Homes for Older People Page 6 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 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 1 7 11 The delivery of personal care 30/07/2009 must be flexible, consistent, reliable, and person centred. This will provide residents with the right support they need when their waking day starts, irrespective of the time. 2 10 12 Suitable arrangements must be made to ensure privacy for residents in their bedrooms. This will enable residents to keep safe and their privacy respected. 30/07/2009 3 18 12 The risks around residents being unattended must be looked at properly and measures taken to reduce any risk identified. This will help ensure residents with dementia care needs keep safe. 30/07/2009 4 27 18 Sufficient staff must be on duty as appropriate for the 30/07/2009 Care Homes for Older People Page 8 of 10 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 health and welfare of residents. This will ensure residents accommodated on the dementia unit are not left unsupervised. 5 33 21 The views of the staff must 30/07/2009 be sought regarding the reduction of night staff and the impact it has on the health, safety and welfare of residents. This will make sure the home is run in the best interests of residents living in the home. 6 33 22 A report of the outcome must be forwarded to the Commission. This will allow the Commission to monitor the current situation regarding decreased night staff. 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 30/07/2009 1 7 In determining the use of pressure mats at the side of beds, this should include all eventualities and take into account those residents who could get out of bed at either side. Proper arrangements should be made for staff to have their contractual half hour breaks uninterrupted. 2 29 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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