Care Home: Hampshire Court

What the care home does well The home provides prospective residents with whatever length of time they need to decide if they wish to live at the home. There are good arrangements for people to maintain contact with their family and friends. People have the opportunity to follow their religion if they wish to. The home is spacious with a well tended garden for people living at the home to enjoy. People enjoy a varied and nutritious diet and home baking. The home is becoming better maintained with more comfortable surroundings for people to enjoy. There is a good range of activities for people to become involved in if they choose. There is more consultation with people who live at the home and opportunities for them to make choices about their daily living requirements. What has improved since the last inspection? There is an on going programme of decoration and refurbishment around the home. The home is becoming much better maintained for the comfort and safety of people living at the home. A substantial amount of decoration and refurbishment has taken place. There is an enthusiastic activities organizer who is keen to make activities person centred. The level of staff training is continuing to improve. A large number of carers have achieved National Vocational Qualifications (NVQ) at levels 2 or 3. What the care home could do better: All requirements and recommendations must be carried out in a timely manner. The action plan submitted to CQC as a result of the last inspection should be prioritized in order to ensure the safety and well being of people living at the home. The Statement of Purpose and service user guide must be available in a form that people who have difficulty reading or seeing may understand. Enough information must be collected before a person moves into the home to ensure staff are aware of their care and support needs. Assessments must be made and up to date records maintained for care relating to pressure care, moving and handling,weight charts and nutrition.Care plans must include all the information that is necessary so staff can deliver the care and support that is required to meet the health and social needs of the person. Care plans should contain the signature of the person or relative to show their involvement in the care plan review. Life histories must be completed for all people living at the home to provide staff with more information about people for when they are unable to give this information themselves e.g.likes,dislikes,events of importance. Risk assessments must be carried out for any identified risk to the individual e.g with regard to epilepsy. All the medication requirements and recommendations made by the pharmacist from CQC should be carried out in a timely manner. Medication training must cover what was highlighted in the CQC pharmacist`s inspection visit in January 2010. An assessment should be completed and contained on file regarding a person`s ability for capacity and consent. Disposal bins should be emptied before they become over three quarters full to reduce the risk of infection. Menus must be easy to read and placed where a person may see them at any time of day. Local authority safeguarding training must be carried out so staff are aware of alerting and multi agency procedures where there is a case of suspected abuse. Staff must receive training about behaviour that is difficult to work with in order to protect vulnerable people. Staff must receive more developmental training such as about dementia care in order to help deliver more personalized care to people living at the home. A manager must be appointed and become registered with CQC for the day to day running of the home. The sluice room must be kept free from debris in the interests of hygiene. Key inspection report Care homes for older people Name: Address: Hampshire Court Hampshire Way South Shields Tyne And Wear NE34 7HR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Karena Reed     Date: 2 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Hampshire Court Hampshire Way South Shields Tyne And Wear NE34 7HR 01914555298 01914544949 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Marsden Rock Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 52 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category sensory impairment Additional conditions: The registered person may provide the following category of service only: Care Home code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia, not falling within any other category - code DE: maximum number: 52. Older People, not falling within any other category - code OP: maximum number: 52 The maximum number of service users who can be accommodated is: 52 Date of last inspection 1 9 0 1 2 0 1 0 52 0 0 0 Over 65 52 0 52 0 Care Homes for Older People Page 4 of 33 Brief description of the care home Hampshire Court is registered to provide personal and social care,dementia care and general nursing care for fifty two people. There are forty four single rooms and four double rooms,forty three of the rooms have ensuite facilities.All room are used for single occupancy. Specialist facilities and bathing equipment have been provided to assist those who need it in the bathrooms and shower rooms and toilets are situated throughout the building. The home has two floors,with a passenger lift to allow easy access between floors,and a number of lounges and dining areas. A separate smoking area is provided.External access into the home is available via a ramp with railings.And there is ample car parking. There is a small garden and patio area to the rear of the home which is easily accessible. The home is situated in a quiet residential area of South Shields close to the sea coast and within easy reach of transport and amenities,including the local town centre. A Statement of Purpose and service user guide are available at the home. The guide describes the services and facilities provided by the home and how staff are trained to meet the care and support needs of people living at the home. CQC inspection reports are also available at the home detailing the quality of care provided. The weekly fees for people living at the home range from £421 to £567 depending whether residential or nursing care is provided. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit: We looked at information we have received since the last inspection, how the service Care Homes for Older People Page 6 of 33 dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on April 26th 2010. During the visit we talked with people who use the service and staff. We looked at information about the people who use the service and how well their needs are met.We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the person in charge and owner what we found. Care Homes for Older People Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: All requirements and recommendations must be carried out in a timely manner. The action plan submitted to CQC as a result of the last inspection should be prioritized in order to ensure the safety and well being of people living at the home. The Statement of Purpose and service user guide must be available in a form that people who have difficulty reading or seeing may understand. Enough information must be collected before a person moves into the home to ensure staff are aware of their care and support needs. Assessments must be made and up to date records maintained for care relating to pressure care, moving and handling,weight charts and nutrition. Care Homes for Older People Page 8 of 33 Care plans must include all the information that is necessary so staff can deliver the care and support that is required to meet the health and social needs of the person. Care plans should contain the signature of the person or relative to show their involvement in the care plan review. Life histories must be completed for all people living at the home to provide staff with more information about people for when they are unable to give this information themselves e.g.likes,dislikes,events of importance. Risk assessments must be carried out for any identified risk to the individual e.g with regard to epilepsy. All the medication requirements and recommendations made by the pharmacist from CQC should be carried out in a timely manner. Medication training must cover what was highlighted in the CQC pharmacists inspection visit in January 2010. An assessment should be completed and contained on file regarding a persons ability for capacity and consent. Disposal bins should be emptied before they become over three quarters full to reduce the risk of infection. Menus must be easy to read and placed where a person may see them at any time of day. Local authority safeguarding training must be carried out so staff are aware of alerting and multi agency procedures where there is a case of suspected abuse. Staff must receive training about behaviour that is difficult to work with in order to protect vulnerable people. Staff must receive more developmental training such as about dementia care in order to help deliver more personalized care to people living at the home. A manager must be appointed and become registered with CQC for the day to day running of the home. The sluice room must be kept free from debris in the interests of hygiene. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Older People Page 9 of 33 order line 0870 240 7535. Care Homes for Older People Page 10 of 33 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are only adequate procedures in place to ensure that staff can meet the needs of people who come to live at the home. Evidence: The Statement of Purpose and service user guide were examined. The Statement of Purpose is a pre-printed document which requires the provider to input individual information about the service. It contained the necessary information as required by the Care Homes Regulations 2001, it had been up dated since the last inspection but was again out of date due to the change in management. The service user guide was not available in a different format for people who had difficulty seeing or understanding the written word. People living at the home are in the process of being issued with new contracts since the home changed ownership. New contracts have been drawn up but they require personalizing with the name and details of people included. Care Homes for Older People Page 12 of 33 Evidence: The acting manager was in the process of completing new documentation for people living at the home these included pre-admission assessments and documentation required for transferring to care plans to make sure peoples needs could be met. Records looked at for 7 people therefore showed that different forms were being used for these assessments and interventions,only one record was completed and showed the new system that would be used to ensure staff had enough information to complete care plans and provide personalized care to people living at the home. There was also little or no information on assessment forms to capture some significant social history of a person coming to live at the home,about their daily living preferences and likes and dislikes. The acting manager said that any person interested or needing to use the service or relatives are encouraged to visit the home to have a look around and meet the staff. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. Care Homes for Older People Page 13 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Access to health care is satisfactory, but lack of detailed care planning does not ensure that the health and personal care needs of people living at the home are being fully met by staff. Evidence: The care files of 7 people that use the service were looked at during the visit. New care planning documentation was being introduced. There was not a consistent standard of record keeping amongst the care records of people who live at the home. There was some information and assessment information that should be transferred to the new care records to ensure the information is not lost. Only one file looked at contained comprehensive and completed documentation to help staff meet all the needs of the person.This file did contain a detailed assessment of needs for the person. These covered areas including: breathing,elimination,safe environment, mobilization,nutrition,personal hygiene,sleeping,religious,social and recreational needs and dying. The assessment advised 3 monthly evaluations but the last one was dated 28/05/2009 and was therefore out of date. This assessment Care Homes for Older People Page 14 of 33 Evidence: proforma was not available on all care files. Risk assessments were completed on files looked at regarding falls,manual handling and mobility. A risk assessment was not available on file for a person with epilepsy to show action to be taken regarding seizures. All risk assessments on files looked at were incomplete and out of date. A nutritional screening tool was was used within the home but files looked at showed they had not been used or reviewed for at least 1-2 years. People who use the service are assessed by nurses working at the home to determine if they are at risk of developing pressure sores. Pressure relieving mattresses are available for those people assessed at risk or who have developed a sore. The home were using two pressure score calculators the Waterlow and Braden scale neither were used consistently or showed regular reviews of pressure care for people, the last review dates in some cases were January 2009. Records detailing any interventions with people living at the home were not up to date. There was no capacity assessment including use of a capacity and consent form for people who may require decisions to be made on their behalf. There was clear evidence of the involvement of GPs, District Nurses and other health care professionals, such as chiropodists and community psychiatric nurses. This information was available on the care records.People living at the home confirmed that if they were feeling unwell, the GP would be called. People who use the service looked cared for and staff showed respect in their actions and in the way they spoke to people they were attending to. During the inspection arrangements for receiving, storing, administering, recording and disposing of medication were observed and examined. A visit had been carried out by the pharmacist inspector of CQC as part of the last inspection. Most of the requirements and recommendations had been carried out but there were still some issues regarding medication. During this inspection it was noted that yellow plastic bins for the disposal of glasses were full and the nurse in charge inserted her bare hands to push the contents further down. These and similar containers should be replaced when three quarters full. A system had been developed for nurses to photocopy prescriptions written by the GP Care Homes for Older People Page 15 of 33 Evidence: before they were sent to the pharmacy to dispense so the staff would have documentary evidence of any drugs ordered,the quantity and dosage. The system had broken down as the previous month photocopied prescription sheets were not available. Currently only qualified nurses administer medication. Staff have received medication training from a community pharmacy but any training must include medication issues raised from the previous inspection. It was difficult to gain sufficient evidence or explanation from the nurse in charge to confirm if the medicines policy had been expanded and updated in line with best practice guidance and local practices in the home. Also it was difficult to confirm if staff were signing and dating any handwritten changes on the MARS sheets and getting any changes countersigned by a second person. Care Homes for Older People Page 16 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities to make choices about activities,daily routines and menus so that they may lead a lifestyle that matches their social care needs. Evidence: Only one care record looked at recorded much information about the social and leisure needs of the person, their likes, dislikes,personal history, things that are meaningful and of interest to the person. This information is essential to ensure all the needs of the person can be met by staff, their social as well as their health care needs. Information for a life history book could also be collected from someone who knew the person well if the person was no longer able to speak or give this information them self. A very enthusiastic activities organiser was in the process of collecting this information about people. She had a wealth of knowledge about the social interests of the person which if it was written up in the care plans of people living at the home would mean all staff would know this information about the person. Staff would then be able to be involved in relevant social activities with people when the activities organizer was not available. Care Homes for Older People Page 17 of 33 Evidence: A weekly activities plan is available for people and these include:baking, memory skills, pamper sessions, armchair exercises, quizzes,exercise, knitting, scrabble, watching cricket, knitting,scrabble,,puzzles,movies,family visits,gardening, arts and crafts and sing along. Entertainment is also arranged for people in the home.Coffee mornings also take place, sherry mornings,bingo ,choir and dvd afternoons. Staff ask each person about their wishes,interests and choices. This could be further extended if the staff team had some up to date and intensive training about memory loss and dementia care. This training should help ensure people are given some choice in order to keep some control in their lives. Staff support people to keep in touch with relatives. People living at the home are asked daily what they wish to eat from the menu selection. The cook also meets monthly with 3 people living at the home to hear their views and suggestions about menus. A menu was not available to display the daily choices available other than on a television screen. Lunch on the day of inspection was fish fingers and chips or minced pie,mashed potato and a selection of vegetables followed by banana custard or ice cream and fruit. Special diets are catered for if required. People living at the home also enjoy home baking. People were very positive about the food provided. Several changes had taken place to ensure that the dining experience of people was more enjoyable, the dining room had been decorated, there was new dining furniture and tables were well set. Care Homes for Older People Page 18 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear complaints and protection system but staff training regarding safeguarding people is not up to date to help ensure people are protected from abuse. Evidence: Information about how to make a complaint is provided in the Service Users Guide. There is a complaints procedure on display within the home. The home keeps a record of complaints. There have been 3 complaints received and investigated since the last inspection and any necessary action taken. 3 safeguarding incidents are also still being investigated under the local authoritys safeguarding procedures,these have been ongoing since the last inspection. As a result the local authority has placed an embargo on admissions to the home for nursing care and the top floor of the home has been closed and is empty at the current time. The home has a copy of the Local Authorities Vulnerable Adults procedures. Staff have received training about Protection of Vulnerable adults but it was not the local authoritys multi agency training which details action to be taken when an alert is raised. Staff have not had recent training about behaviour that may be difficult to work with,deprivation of liberty or whistle blowing. Care Homes for Older People Page 19 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is becoming better maintained for the safety and comfort of people living at the home but the standards of hygiene need to be improved to ensure their health and safety. Evidence: There is a rolling programme of decoration and refurbishment around the home. Currently the top floor of the home is closed but the rest of the home has undergone several changes since the last inspection. A maintenance man works at the home and he has been responsible for carrying out several of the changes. These include:7 bedrooms have been decorated,the hairdressing salon has been decorated and the floor re tiled,the smoking room has been re floored and decorated,the staff and visitors lavatory have been re tiled and decorated,the medication room floor has been resurfaced.Carpets have been replaced in 2 downstairs lounges and the hallways which have also been decorated. There are plans to create en suites in bedroom 28 and 3 bedrooms upstairs, to create a linen room and a further wheel chair storage area and to carry out further redecoration. The portakabin has been dismantled,a flat roof has been resurfaced and a bin bay is to be built. The ground floor sluice was not clear of debris. An empty tea mug was on the washbasin,some identified debris was in the sink. Some bins had lids that were missing. The bedpan washer was inaccessible due to the storage of commodes and Care Homes for Older People Page 20 of 33 Evidence: other equipment around it.There were no disposable gloves or aprons in the sluice area but they were located next door. The home has an appropriate amount of sitting,recreational and dining space. Furnishings and fittings were domestic in design. Room sizes all meet the minimum required. People living at the home all enjoy their own bedrooms. There was emergency lighting around the home. The washing machines have the specified programme to meet inspection standards. Care Homes for Older People Page 21 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff for the current occupancy levels of the home,they are appropriately recruited but more training is required to ensure they can provide personalized care to people living in the home and to ensure their health and safety. Evidence: Only one floor of the home is currently open and the home is therefore at only half occupancy. Discussion with management maintained that staffing levels during the day were as follows: 1 registered nurse 8:00am-8:00pm 4 carers work from 8:00am-8:00pm 1cook 2 kitchen staff 3 domestics 8:00am-4:00pm 1activities organizer 10:00am-3:00pm Maintenance person These numbers do not include a manager. Care Homes for Older People Page 22 of 33 Evidence: There is a senior staff member on each shift. The staff training matrix was not available at the time of inspection but was forwarded the following day. Information showed that 80 of senior carers have achieved National Vocational Qualifications (NVQS)at levels 3, another 20 are currently studying for this qualification. 66 of carers have achieved an NVQ at level 2 and 33 are studying at this level. Staff have received limited developmental training about the specialist needs of people living at the home there has been training about visual impairment and sensory impairment. Staff have received statutory training in moving and handling,first aid,hand hygiene, food hygiene and medication training. Future training about care planning has been identified. The training matrix did not include reference to any developmental training to help ensure staff were aware of the different specialist needs of people living at the home e.g diabetes, training about mental capacity,risk assessments or dementia care. A system for the regular supervision of staff has been introduced. Care Homes for Older People Page 23 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that needs to be better run, to ensure their health and safety and to ensure the welfare of all is promoted. Evidence: The home is currently without a registered manager. The previous manager has resigned and the clinical lead who could be responsible for running the home in the interim is on the sick for 6 weeks. The development manager for the company was overseeing the home at the time of inspection. There is an embargo on admissions to the home so one floor of the home is closed currently.Areas are being through safeguarding which should ensure more personalized care is given to people in the home to ensure all their needs are met. The maintenance of the building and the physical appearance are improving. Steps are being taken to ensure that requirements and recommendations from the last inspection are carried out but they must be carried out in a more timely way. It was evident that there was lack of systems ans auditing processes. Work must be Care Homes for Older People Page 24 of 33 Evidence: prioritized to ensure essential care records are in place for all people living at the home using the same system. A new care planning system was being introduced to help ensure personalized care was given to people and we were informed training was to be provided to staff about this. When a person does not keep control of their own money, the home is able to provide the facility to hold a small amount on behalf of the person for everyday living. The home has a suitable system for accounting any monies held on behalf of the person. Regular staff and resident meetings were taking place. Feedback from residents meetings was not timely and there was no evidence of action that may have been taken as the result of a request or suggestion made by a person at the meeting. There was evidence that some requests were asked at consecutive meetings e.g the request for menus being available. Documents detailing fire safety,water temperatures and maintenance contracts were up to date. Care Homes for Older People Page 25 of 33 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered person must 29/03/2010 ensure that the Statement of Purpose and Service User Guide is brought up to date and the Service User Guide written in a style that people can easily understand. This will ensure that people have all the information they need to make an informed decision about where to live. 2 2 5 The registered person must ensure that people living in the home are provided with an amended contract. This will ensure that each person knows what the rights and obligations of of each party is clearly understood and agreed. 01/03/2010 3 3 14 The registered person must 05/02/2010 ensure that each person has a comprehensive assessment completed by care managers and the home manager before being admitted to the home. This will make sure that peoples needs will be met and they are protected from harm 4 7 15 The registered person must 01/03/2010 Page 26 of 33 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action ensure that the care plans are up to date detailed,reviewed at least monthly,are person centred and reflect how current and changing social and health care needs will be met. This will ensure staff have up to date information about peoples care and health needs and ensure care is given safely. and consistently. 5 9 18 The registered person must 19/03/2010 provide additional medication training that reflects best practice guidance to all staff involved in the handling and administration of medicines. Staff must be assessed as competent to administer medicines. This will make sure that staff can handle and record medicines safely. 6 18 12 The registered manager must ensure that staff complete further safeguarding training and policies and procedures for dealing with physical and verbal aggression are understood and dealt with appropriately . This is to make sure everyone is protected from harm. 7 30 18 The registered person must 30/06/2010 27/02/2010 Care Homes for Older People Page 27 of 33 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action ensure that all grades of staff are provided with both mandatory and specialist training. This will make sure the the people living in the home receive the support and care they need. Care Homes for Older People Page 28 of 33 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, Care Homes 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 3 3 The registered person must 30/06/2010 ensure that each person has a comprehensive assessment completed by the homes manager or qualified representative before being admitted to the home. This will make sure that peoples needs are being met. 2 7 17 The registered person must 30/06/2010 ensure each service user has a plan of care drawn up according to relevant clinical guidelines. These care plans must be regularly reviewed. This is to ensure the correct support is given by staff to people living at the home. 3 7 13 The registered person must ensure risk assessments are carried out for all service users including and that they are regularly reveiwed 18/06/2010 Care Homes for Older People Page 29 of 33 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes 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 to help ensure the health and safety of people living at the home. This is to help protect the health and safety of people living at the home. 4 9 13 Requirements and recommendations from previous inspection regarding medication must be completed. This is to ensure the health needs of the person are met. 5 12 16 Life history books must be 30/06/2010 completed for each person to help ensure activities provided are meaningful and of interest to the person. This information must be transferred into the care plan of each person. This is to ensure the social care needs of each person is met. 6 18 12 The registered manager must ensure that staff complete further safeguarding training and policies and procedures for dealing with physical and verbal aggression are understood and appropriately dealt with. 21/07/2010 28/05/2010 Care Homes for Older People Page 30 of 33 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes 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 is to make sure everyone is protected from harm. 7 26 13 The registered person must ensure that the sluices are kept clean and free from clutter. This is to prevent cross infection and keep people safe. 8 30 18 The registered person must ensure that all grades of staff are provided with mandatory and specialist training. This will ensure the people living in the home receive the support and care they need. 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 28/05/2010 30/06/2010 1 2 7 7 People living at the home must be involved in designing and signing for their care plan. Capacity and consent forms should be completed for people where decisions are made on their behalf if they are unable to make their own decisions. The yellow plastic bins and any similar containers should be emptied when less than full in the interests of hygiene and protective gloves should be worn when handling such containers. 3 9 Care Homes for Older People Page 31 of 33 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 5 14 31 Menus should be available in large print and in different formats to remind people of the food available daily. A person should be appointed to manage the home and become registered with the regulatory authority for its day to day management. Meetings with people living at the home should give feedback about action taken as a result of their comments and suggestions in order to provide evidence that they are listened to. 6 32 Care Homes for Older People Page 32 of 33 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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