Care Home: Florence House (Ramsey)

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What the care home does well On the day of the inspection it was a resident`s birthday and the cook had made a birthday cake so all of the resident`s could celebrate the event. Because it is a small home the staff know the likes and dislikes of the resident`s very well so although there might not always been two main choices at meal times an alternative is offered to those who don`t like the main option. This was evidenced in the records of food eaten. One resident commented `the staff are excellent, they do extras. If they see a nice plant they will bring it in for us and they all buy us presents at Christmas, nothing is too much trouble`. The staff team are flexible and willing to work extra shifts so that the home does not have to use agency staff at times of staff shortage. What the care home could do better: There must be adequate numbers of staff on shift to enable them to meet the needs of the resident`s in a timely and unrushed manner.There must be food in sufficient quantities for all of the resident`s. All staff must have mandatory training up to date. Activities must take into consideration peoples likes and interests and be offered on a regular basis. Random inspection report Care homes for older people Name: Address: Florence House (Ramsey) Westfield Road Ramsey Huntingdon Cambridgeshire PE26 1JR 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 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: Joanne Pawson Date: 2 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Florence House (Ramsey) Westfield Road Ramsey Huntingdon Cambridgeshire PE26 1JR 01487812295 Telephone number: Fax number: Email address: Provider web address: jenitadavid@aol.com Name of registered provider(s): Name of registered manager (if applicable) Alfonsa Jenita David Type of registration: Number of places registered: Conditions of registration: Category(ies) : Alfonsa Jenita David care home 20 Number of places (if applicable): Under 65 Over 65 0 20 0 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old Age, not falling within any other category - Code OP, maximum number of places 20. Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Mrs David is the registered manager and is supported by her husband, who is a businessman and manages the financial accounts and the maintenance of the home. They are currently living in private accommodation situated within Florence House, so are available to provide on going support to staff and residents. Accommodation is provided for up to twenty service users over the age of 65. All the bedrooms are single. The majority of bedrooms have external doors opening on to a terraced patio. There is a dining room and separate lounge. The home benefits from a large kitchen and generous outside space. The house is situated in a quiet residential area, which is accessed by a private road and is close to the town of Ramsey. The manager stated that the current fees were £358.00 to £450 a week. The difference in fees is because some rooms have en-suite facilities. Extras are charged for items of a personal nature, such as toiletries and chiropody. A small amount of personal allowance is kept on behalf of residents. Care Homes for Older People Page 3 of 10 What we found: We looked at the staff rotas to see if there is a sufficient number of staff on shift. The managers hours were not recorded on the rota. For the majority of shifts there are two carers on shift. For parts of some shifts there are three carers on shift. The carers stated that they assist the 15 residents with personal care as well as administering medication but that the manager willsometimes do the medication round. The manager has stated that four of the service users do not need assistance with personal care and that the night carer normally assists at least three service users up. The manager also stated that she always does the medication monday-friday and that extra staff are are available at weekends if the senior carer has to administer medication. At night there is only one staff member on shift. Although the manager lives on site she is only to be called in an emergency. The night shift is from 10pm until 8am. The morning staff do not start work until 8am. When we talked to the staff they felt that this meant that sometimes the residents are waiting to get up but because there is only one member of staff on shift until 8am they have to wait until the day staff come on shift. The manager stated that she had raised this with the staff the week before the inspection but that they had said no residents would want to get up earlier. One resident told us that during the night she sometimes has to wait up to an hour for assistance if the carer is already busy with another resident. There was a situation recently when one carer was helping a resident with a bath and the call bell was pulled by another resident. The carer left the resident in the bath and went to check on the resident who had used the call bell. The second resident needed help to get on to the toilet but the carer had to explain that she was helping a resident in the bath and would come back as soon as possible. Once the carer had assisted the first resident out of the bath she returned to the second resident but it was to late as she had already been incontinent. The care staff we spoke to stated that they felt their job is task orientated and they do not have time to spend with the residents. One member of staff told us that she has to rush through personal care tasks and often does tasks for residents that if she had more time to spend with the resident she could encourage them to do for themselves. There has been an ongoing problem with not having hot water supplied to some of the rooms. This has now been resolved. There is still one bedroom where the water pressure is very low. The provider stated that she will ask the plumber to look at this to see if anything can be done to improve the pressure. We looked at the quantity and quality of the food being served at lunchtime. The main option was roast chicken and vegetables. Only one roast chicken was cooked for 15 residents. Although there was enough for each resident there was only one very small portion of chicken left over. If more than one person had wanted another helping this would not have been possible. The carers stated that there had been times when there was not enough food cooked for all of the residents so some had to have an alternative meal. The mashed potato had large lumps in it and the carer asked the cook to blend the potatoes using an electric blender. The commission received a complaint that the rice pudding was made with water. Although it was confirmed that this had happened in the past the cook stated that she now made it with milk. There was rice pudding for lunch on Care Homes for Older People Page 4 of 10 the day of the inspection and the cook confirmed it had been made with milk. There was only one small hotplate to keep the food warm whist it was being dished up. As a result of this the individual plates of food had to be microwaved before being given to the residents. There is only one domestic size cooker in the kitchen. This may not be big enough to provide larger quantities of food when residents move into the new extension and the number of residents increase to 20. The manager stated that the chicken purchased is extra large and that the residents had been asked if they receive enough food and they confirmed they did. There were mixed views about the activities. Some residents felt there was enough to do and others didnt. We spoke to the activities co-ordinator who stated she only worked two shifts a week and part of the shift was for care work. There is no budget for activities and when there is a bingo or quiz the staff often supply the prizes. Residents are given a manicure but the same files and equipment are used for all of the residents. There is a communion service once a month and karaoke three to four times a year. One member of staff also does an exercises to music session every other weekend. There has been no trips out of the home in the last year. We looked at the staff training file. It was not clear when all of the staff had received their most recent training. The moving and handling training was out of date for all 11 of the staff. According to the training matrix the fire training was also out of date although a member of staff confirmed that all of the staff had just completed fire training. The infection control section of the training matrix had been ticked but no dates entered so it was not possible to see if this was up to date. The manager has stated that the infection control training was up to date. The safeguarding training had not been updated since 2008. What the care home does well: What they could do better: There must be adequate numbers of staff on shift to enable them to meet the needs of the residents in a timely and unrushed manner. Care Homes for Older People Page 5 of 10 There must be food in sufficient quantities for all of the residents. All staff must have mandatory training up to date. Activities must take into consideration peoples likes and interests and be offered on a regular basis. 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 £ 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 12 16 Consult the residents about activies and provide them regularly. To ensure that there are enough activites that people enjoy on a regular basis. 01/07/2010 2 15 16 Ensure there is adequate quantities of suitable, wholesome, and nutrtious food which is varied and properly prepared. So that the residents have enough food to eat that they enjoy. 01/07/2010 3 27 18 Ensure that there are suffcient staff on shift at all times to meet the needs of the residents. This will help to ensure the residents receive the support they need in a timely manner. 01/07/2010 4 30 18 All staff must have mandatory training up to date. 01/09/2010 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 This will ensure that the staff have the knowledge and skills to care for the residents. 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 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. 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