Care Home: George Leonard Rest Home

What the care home does well Staff were polite and helpful, people living in the home told us "they are good girls you know". What the care home could do better: The home needs to improvement the way in which it stores people`s medication. It also needs to review its medication policy with particular emphasis on the Homely remedies. The home environment needs to be addressed, items of worn furniture should be replaced or made good. Commodes need a thorough clean and those that are rusted need replacement or recoating. This will reduce the risk of cross infection to the people using the service. The offensive odour in some people`s bedrooms needs to be addressed.The practice of washing commode pots in the bath must cease and an alternate location sought for this. Staffing levels need to be reviewed, staff should be available to assist people in the home to take part in meaningful activity on a regular basis. We recognise that staff are assisting throughout the home with domestic duties, however, people living in the homeare telling us they are bored and understimulated the home will need to address this. Random inspection report Care homes for older people Name: Address: George Leonard Rest Home 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP three star excellent service 05/03/2009 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: Mandy Beck Date: 0 4 0 8 2 0 1 0 Information about the care home Name of care home: Address: George Leonard Rest Home 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP 01215614984 01215611783 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Christine Stanton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr R S Odedra,Mr S B Odedra care home 23 Number of places (if applicable): Under 65 Over 65 0 23 dementia old age, not falling within any other category Conditions of registration: 3 0 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 only - Code PC; 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 - Code OP 23; Dementia - Code DE 3. Date of last inspection Brief description of the care home George Leonard Care Home is located on a main road between Blackheath and Whiteheath. A number of local shops and other facilities are available within easy reach Care Homes for Older People Page 2 of 11 0 5 0 3 2 0 0 9 Brief description of the care home of the home including a main bus route. The home was originally two houses and they have been linked together, converted and extended to provide the 23 bedded care home. There is a small garden and car parking space for approximately five cars to the front of the property and a patio and lawned area to the rear. There are two storeys. The ground floor houses the office, lounge, dining room, conservatory, kitchen, laundry, one of the assisted bathrooms and toilets. The first floor houses bedrooms, toilets and the second assisted bathroom. The home provides 19 single and 2 double bedrooms. 10 single and both double bedrooms are provided with en-suite facilities. The fees are available on application to the home. Care Homes for Older People Page 3 of 11 What we found: We visited the home because we had been told people living there were bored and under stimulated, staff were not trained to care for people with dementia and music is played so loudly that it feels like a nightclub in here. We arrived mid morning, we were greeted by staff and we noticed that there was no loud music being played. Music was put on later in the day but this was more to the taste of people living in the home. We spent time talking to people who live in the home and to the staff who support them. We also looked at care records and some peoples medication. People told us I like living here but sometimes I wish the staff would listen to me, I am bored and fed up at times I want to go out more, I stay in my room theres nothing to do. I really wish that there was more to eat at tea time than sandwiches. We spoke to staff about activity provision in the home, they told us we try our hardest to do things with them but they dont want to take part. We asked what type of activities are on offer for people to take part in, we were told well the last one was about three weeks ago, it was dominoes I think one person took part. Staff also told us they are expected to deliver an activity programme both morning and afternoon. They said we do our best but we do have to do the laundry and other things first. We looked at the staff rota, we saw that there are currently four staff on duty each day until 1pm and then this reduces to three staff. There were twenty one people living in the home on the day of our visit. Staff told us they are expected to support people with washing and dressing and to make sure they have breakfast and drinks. Then we have to do the laundry. We were told that this can take up to three hours some days, this is time that is taken away from the people who live in the home. In the afternoon another member of staff is expected to make tea for people living in the home because there is no cook after 13:30hrs. This means that there are reduced activities and support during these times. The home needs to consider the deployment or numbers of staff so that people in the home do not feel they are bored and that staff are available to support them in their pursuits. We looked at the home environment, there are improvements to be made. We found that maintenance work was happening albeit slowly. The overall cleanliness of the home was in need of improvement, we saw that flooring was stained even after it had been cleaned. We saw peoples commode frames were rusting and in need of thorough cleaning. Commode pots and mops were in the bathroom on the ground floor. Staff told us this is where they wash them, there are no other facilities to do this. They told us the bathroom was not used by any of the people living in the home. We looked at the bathing facilities that are used, we found the paint was peeling off the bath hoist chair and as such in need of repair or replacement. We looked at peoples bedrooms, we found for the most part people had taken the time to decorate them with personal belongings however furniture and sink units were dusty and in some cases worn out and in need of replacement. There was an offensive odour (stale urine) in two bedrooms we looked at. The person in charge told us there were plans to change the flooring in one room but they did not know about the other. We looked at the way the home stores medication, we found improvements needed to be Care Homes for Older People Page 4 of 11 made. There are two medication trolleys in the dining room and a filing cabinet. We noted in the filing cabinet a box of paracetamol (pain killer) and a bottle of gaviscon (indigestion medicine). The person in charge told us these medicines are for homely remedies, this means staff can give out this medication to people without a prescription from the doctor. There was, however no individual agreement in place for this from the doctor. The home does not keep a record of the temperatures in this room and cannot demonstrate that it is keeping medication as recommended by the manufacturer. This also includes those medications that require cold storage. The fridge located in the kitchen was not within the recommended temperatures of 2 and 8 o Celsius. We saw people being moved by staff using the hoist, we spoke to staff about this. They told us they know what hoist to use because the manager had told them. We looked in the care records for the person and found that staff had completed a moving and handling risk assessment but they had not included extra information such as the type of hoist and the size of sling that should be used when moving people. We also noted that staff were using wheelchairs without footplates. Using wheelchairs in this way can significantly increase the risk of injury to the person seated in the wheelchair. We asked if the home had risk assessed this practice. We were told no Im sorry we didnt realise it needed to be done, but the wheelchairs are regularly checked, they do start out with footplates on them. We spoke to staff about training they had undertaken in relation to dementia care. They said I did a distance learning course, another said I did the day course. We asked staff what they had learned, they said well it was ok but to be honest you cant put it into practice can you?. Staff then told us its hard to do but we have learned that if people are fed up or aggressive to us we leave them for a bit and go back a while later, they have usually calmed down by then. The home is supported by the community mental health nurse in the management and support of peoples needs. Some people told us the staff shout at times, it makes me feel upset, they are in a rush, Staff attitudes at times are not good they can be a bit shirty. What the care home does well: What they could do better: The home needs to improvement the way in which it stores peoples medication. It also needs to review its medication policy with particular emphasis on the Homely remedies. The home environment needs to be addressed, items of worn furniture should be replaced or made good. Commodes need a thorough clean and those that are rusted need replacement or recoating. This will reduce the risk of cross infection to the people using the service. The offensive odour in some peoples bedrooms needs to be addressed.The practice of washing commode pots in the bath must cease and an alternate location sought for this. Staffing levels need to be reviewed, staff should be available to assist people in the home to take part in meaningful activity on a regular basis. We recognise that staff are assisting throughout the home with domestic duties, however, people living in the home Care Homes for Older People Page 5 of 11 are telling us they are bored and understimulated the home will need to address 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 11 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 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 8 14 The home must make sure that peoples risk assessments are kept up to date and reflect changes in peoples conditions. This will ensure that people are not placed at greater risk. 30/09/2010 2 8 12 The home must not use wheelchairs without footplates, unless there has been a comprehensive risk assessment of that persons needs beforehand. This will reduce the risk of injury occurring to the people being moved in this way. 30/09/2010 3 9 13 There must be safe systems 30/09/2010 in place for the storage, ordering, safe administration and disposal of peoples medication. This will reduce the risk to people living in the home. 4 9 13 The home must make sure 30/09/2010 Page 8 of 11 Care Homes for Older People 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 that peoples medication is sotred at a temperature recommended by the manufacturer. This will reduce the risk to the people living in the home. 5 19 12 The home must make sure that it is free from offensive odours, wherever possible. this will include peoples bedrooms. This will improve the home environment for people. 6 26 12 The home must not use 30/09/2010 bathrooms as a make shift sluice. Commode pots should not be washed in peoples bathrooms. This will reduce the risk of corss infection and also improve the bathing facilities for 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 30/09/2010 1 9 The home must make sure that it records both the temperature of the medication fridge and the room where medication is stored. They should do this at least daily so that they can demonstrate that peoples medication is being stored in line with manufacturers instructions. It is recommended the home reviews the medication policy, in particular the use of homely remedies. It needs to give Page 9 of 11 2 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 clear guidance. People need an individual agreement from their own doctor for the use of homely remedies. 3 12 The activity plans in the home need to reflect the individual choices of the people living in the home. At this time staffing levels or staffing activities do not allow for people to take part in regular activity. People have told us they do not like sandwiches every tea time, the home should review its menu, in line with the wishes of the people who live in the home. This will make sure they have some of the choices they want and more variety at tea time. The home needs to develop the quality assurance system. It should do this so that people are consulted about the service they receive and improvements can be made. 4 15 5 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!