Care Home: Goldcrest

What the care home does well The staff at the home have worked hard to introduce new systems to monitor the effectiveness of the work that they do in meeting the needs of those who live at the home. The staff have worked well with other outside agencies in ensuring that peoples needs are assessed and met where possible. The staff and management have improved their approach to the safe handling of medicines at the home. What the care home could do better: The responsible individual needs to ensure that the safeguarding policy used at the home balances consent issues against the safety of not only the individual but also all who live and work at the home. The responsible individual needs to improve infection control practices within the home to ensure people are not at risk of infection. Random inspection report Care homes for older people Name: Address: Goldcrest 183 Dorchester Road Weymouth Dorset DT4 7LF zero star poor service 29/03/2010 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: John Hurley Date: 3 0 0 6 2 0 1 0 Information about the care home Name of care home: Address: Goldcrest 183 Dorchester Road Weymouth Dorset DT4 7LF 01305830400 01305781810 goldcrestcare@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Purusram,Mr Rajendrasen Purusram Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Conditions of registration: 0 A maximum of ten service users in the category of DE(E) may be accommodated. Room no.1 may be used as a double. The occupancy level at Goldcrest (the home) must not exceed 13 and prior to admitting any further admissions written consent must be obtained from the Care Quality Commission. This condition shall remain in place until such time as it is removed by the Care Quality Commission. Date of last inspection 2 1 0 5 2 0 1 0 Care Homes for Older People Page 2 of 15 Brief description of the care home Goldcrest is a large detached property situated on the main Dorchester to Weymouth road, within a mile of local amenities and one mile from Weymouth town centre. The home is run on Christian principles.The accommodation is spread over ground and first floor levels; all bedrooms have en-suite toilet facilities. Communal areas comprise of two lounges and a dining room. There is one assisted bathroom at the home, the home does not provide showering facilities. A passenger lift provides level access to most of the first floor; the remaining rooms are accessed via the stairs. Stairlifts are available on three of the four staircases. There is easy access to a pleasant garden and patio area situated in the central courtyard. Mr and Mrs Purusram are the registered providers. An acting manager is in post but not currently registered with the Commission. Details of the current fees can be obtained direct from the home. Additional charges being made for chiropody, hairdressing and newspapers. Care Homes for Older People Page 3 of 15 What we found: The inspection took place over the course of one day and was undertaken by two compliance inspectors. The purpose of the visit was to ensure that the National Minimum Standards were being maintained at the home and to verify the representations made by the responsible individual that certain recommendations from previous inspections have been met. The first area we looked at was in relation to the homes safeguarding policy. The updated policy states that the person at the centre of any safe guarding concerns must give consent to staff to alert the authorities or take action on their behalf. This may put others who live at the home at risk if the staff cannot use the information they may have to protect others. Therefore in general terms we found the policy had been improved but consent issues still require further thought to ensure the continued protection of those who live at the home. The second area we looked at was in connection with the Medication Administration Record (MAR) charts. These were kept in good order, all handwritten entries were double signed and a good audit trial exists. This represents an improvement from the last inspection. The third area we looked at related to the environment in particular infection control and health and safety issues. We looked at three out of the four bathrooms at the home. The first bathroom we were told was not in use. We looked into this bathroom and found that the door was unlocked and it was being used as a store. There was no floor covering in this area. As the bathroom could still be used by independent people who live at the home we considered that there were a number of issues that may put people at risk such as tripping over items stored and cleaning chemicals. The designated manager agreed with our observations and locked this room immediately. The second and third bathrooms we looked in contained a number of infection control practice issues such as bars of soap which it was not clear who they belonged too, this was also the case with talcum powder. This means that anybody may use the same soap and toiletries which may be a source of cross infection. We also noted that the waste bins which were not foot operated which means people have to touch the bins to put waste material into them which again may be a route for cross infection. We looked at the laundry area and found that the floor has now been covered and can be easily cleaned. However the area behind the sink did not have any form of splash back which may again undermine infection control issues as it cannot be thoroughly cleaned. We looked in the kitchen area and found it to be clean and reasonably well maintained. Freezer temperatures are generally being monitored but more needs to be done to ensure that this is consistent as there were a number of gaps in the recording and evidence that one of the freezers was not consistently working to the correct temperature. We therefore consider that the responsible individual needs to make improvements with regards to infection control and health and safety issues at the home. The fourth area we looked at was in relation to the provision of supper and the monitoring of those people who have specific nutritional needs. We found that the records Care Homes for Older People Page 4 of 15 available now evidence that people are being offered food and drinks in the early evening and throughout the night if appropriate. The staff have also improved the use of food and fluid monitoring charts to ensure those who have assessed needs are being met. Staff told us that their shift has been organized in such a way as to ensure that at least one staff member remains in the dinning room throughout the lunch period. We therefore consider there has been some improvement in this area. The designated manager asked us to look at the new care plans that were being generated. We sampled one and found that it contained all of the information required to be able to meet the persons needs. However as the staff had yet to work with these new care plans there effectiveness has yet to be evaluated. 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 15 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 4 18 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons working at the care home. To make sure that peoples assessed needs are met. ( Previous timescale of 12/05/2010 not met). This requirement was not considered at this inspection. 12/05/2010 2 7 12 The registered person must ensure that they review and put systems in place to promote secure proper provision for the health, welfare and care of the service users. To make sure that service users needs are met and clear guidance put in place to staff. (Previous timescale of 30/10/09, 04/01/2010 and 30/03/2010 not met). Outstanding timescale should read 30/03/2010 12/05/2010 Care Homes for Older People Page 6 of 15 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 This requirement was not considered at this inspection. 3 7 15 (1) & (2) Care records must include 26/11/2009 evidence of consultation with people living at the home, and be regularly reviewed. (Previous timescale of 05/06/09,26/11/2009, 04/01/2010 and 23/02/2010 not met). To ensure that residents are in agreement with the way that care is provided for them. This requirement was not considered at this inspection. 4 7 15 The registered person must 12/05/2010 ensure that changes in service users mobility and dexterity are adequately reflected within service users planning. To ensure service users needs are identified and clear guidance put in place the staff on how to meet such needs. (Previous time scale of 04/01/2010 and 20/04/2010 not met). Outstanding timescale should read 20/04/2010 This requirement was not considered at this inspection. 5 7 15 The registered person must 12/05/2010 Page 7 of 15 Care Homes for Older People 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 ensure that they review and maintain teh accuracy and necessary detail within service users care planning. (previous time scale of 04/01/2010, 23/02/2010 and 20/04/2010 not met). Outstanding timescale should read 20/04/2010 To ensure the residents needs are identified and clear guidance put in place on how staff are to meet such needs. This requirement was not considered at this inspection. 6 7 12 The registered person shall 12/05/2010 ensure that the assessment and service users needs are kept under review and revise at any time when it is necessary to do so having regard to any change of circumstances. To make sure that peoples needs are met. ( Previous timescale of 12/05/2010 not met). This requirement was not considered at this inspection. 7 7 15(1) The registered provider shall 22/01/2010 after consultation with the service user or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. Page 8 of 15 Care Homes for Older People 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 (Previous timescale of 30/10/2009 and 22/01/2010 not met) This is to ensure that residents needs are identified and clear guidance put in place on how staff are to meet them. This requirement was not considered at this inspection. 8 7 12 The registered person must ensure that service uses psychological needs are adequately met. To ensure that residents needs identified in clear guidance put in place and how staff to meet such needs. (Previous time scale of 04/01/2010 and 20/04/2010 not met). Outstanding timescale should read 20/04/2010 This requirement was not considered at this inspection. 9 12 16 (2) n People living at the home must be provided with opportunities to meet their social and leisure needs. (Previous timescale of 08/05/09, 26/11/20009 and 05/01/2009 not met). 26/11/2009 12/05/2010 Care Homes for Older People Page 9 of 15 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 To ensure that people are provided with social opportunities and stimulation. This requirement was not considered at this inspection. 10 18 13 The registered person shall 12/05/2010 make arrangements to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. This relates to the lack of action on serious concerns raised about staff conduct. To make sure people who live at the home are safe. Timescale should read 20/04/2010. This requirement was not considered at this inspection. 11 19 13 The registered person shall 12/05/2010 ensure that all parts of the home to which service users have access are so far as practicable free from hazards to their safety. This refers to the lack of risk assessments in relation to unrestricted windows. To make sure people who live at the home are safe. ( Previous timescale of 12/05/2010 not met). This requirement was not considered at this inspection. Care Homes for Older People Page 10 of 15 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 12 19 13 The registered person shall 30/04/2010 ensure that all parts of the home to which service users have access are so far as practicable free from hazards to their safety. This refers to the lack of risk assessments in relation to unrestricted windows. To make sure people who live at the home are safe. This requirement was not considered at this inspection. 13 22 13 The registered person must ensure that all residents have a call bell accessible to them when they are in bed. To make sure that people can call for assistance whenever required. This requirement was not considered at this inspection. 10/05/2010 14 22 13 The registered person must ensure that all residents have a call bell accessible to them when they are in bed. To make sure that people can call for assistance whenever required. This requirement was not considered at this inspection. 12/05/2010 15 29 19 The registered person must 15/05/2010 ensure that they are satisfied on reasonable grounds as to the authenticity of the Page 11 of 15 Care Homes for Older People 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 references provided by applicants. To keep people who lived at the home safe from the risk of harm. 16 31 8 The registered person shall appoint an individual to manage the care home where the registered provider is not a fit person. To make sure that the home is effectively managed. This requirement was not considered at this inspection. 17 38 23 The registered person shall make arrangements to persons working at the care home to receive suitable training in fire prevention. To keep people who live and work in the home safe. ( Previous timescale of 12/05/2010 not met). This requirement was not considered at this inspection. 18 38 13 The registered person shall 27/08/2010 ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. This refers to the temperatures of fridges and freezers. To make sure that fresh and frozen food is stored at the Care Homes for Older People Page 12 of 15 10/05/2010 12/05/2010 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 correct temperature to avoid the risk of possible food poisoning. previous timescale was 12/05/2010 19 38 13 The registered person must ensure that all care staff have completed training in safe moving and handling. To make sure that people who live at the home safe. (Previous timescale of 22/02/2010 and 20/04/2010 not met). Outstanding timescale should read 20/04/2010 This requirement was not considered at this inspection. 20 38 18 The registered person shall 20/05/2010 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the home. This refers to the lack of training in infection control for staff. To reduce the risk of cross infection to staff and residents. ( Previous timescale of 20/05/2010 not met). This requirement was not considered at this inspection. 12/05/2010 Care Homes for Older People Page 13 of 15 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 38 13 The registered person must 27/08/2010 take appropriate steps to ensure that people live within a safe environment. This refers to improved infection control procedures. ( previous timescale of 07/07/09, 26/11/09 an 12/05/10 not met) This is to make sure people who live at the home are safe 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 14 of 15 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. 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