Care Home: Huyton Hey Manor Residential Care Home

Similar services:

• Dystlegh Grange
• Thornton Lodge
• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside

What the care home does well From this is visit it was clear that the management team have taken seriously the concerns previously identified. They owner has recruited a consultant and three senior managers to review the practice in the service and make sure that it is improved. Staff spoken with felt positive about the future and were pleased that they would be included in deciding how the people living in Huyton Hey Manor were supported. The arrangements for care plans had reduced the size of these documents and made them less cumbersome for staff to deal with. Staff told us that they thought that this had improved the care plans significantly and meant that they would be able to use the plans in the future. People living in the home were happy and felt well supported by an optimistic staff team. During the visit staff were observed to be kind and attentive to people living in the service, morale had increased and all people living in the service were looking forward to the future What the care home could do better: Significant improvements were noted in the management of medication. Clear and accurate records regarding the medication people received were in place. There was still a lack of staff overnight, trained in medication and this prevents people from having medication from 8pm at night till 8am in the morning. Audits done on medication to identify areas of improvement and maintain good practice were not in any detail. Audits did not give a clear account of what areas were looked at, what was found and what actions if any the service needed to take to improve quality. Risk assessments for medications, moving and handling and nutritional needs were insufficient, out of date or inaccurate. As such they did not give clear instructions to staff on how to determine people`s specific needs or maintain their safety. Care plans viewed were also inaccurate or out of date. Care plans although significantly easier to read, gave no guidance on the use of creams, as needed medications and needs identified from on-going monitoring. Random inspection report Care homes for older people Name: Address: Huyton Hey Manor Residential Care Home Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ zero star poor service 24/03/2010 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: Julie Garrity Date: 1 9 0 7 2 0 1 0 Information about the care home Name of care home: Address: Huyton Hey Manor Residential Care Home Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ 01514893636 01514266415 angharad-huytonhey1@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Angharad Lloyd Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cranford Care Homes Limited care home 30 Number of places (if applicable): Under 65 Over 65 30 30 old age, not falling within any other category physical disability Conditions of registration: 0 0 Service users to include up to 30 OP and 30 PD(E) The service may admit one named service user under pensionable age. The service should employ a suitably qualified and experienced manager who is registered with the CSCI Date of last inspection Brief description of the care home Huyton Hey Manor is a converted building for older people. The service has sufficent accomidation for 30 people whose primary diagnosis is that of old age. The building is Care Homes for Older People Page 2 of 12 2 4 0 3 2 0 1 0 Brief description of the care home situated in its own grounds in a residential area close to local amenities and Huyton Village centre. There is parking availiable at the front of the building and gardens at the rear. Accommodation is provided on three floors and there is a passenger lift to all levels. The service has a variety of aids and adaptations in place around the home to assist people with their mobility. Twenty-four of the bedrooms are single, three are double and none of the bedrooms have en suite facility. Huyton Hey Manor is owned by a small group that has three homes in total. Fees for the service are in line with the rates from Knowsley social services. Information about the service is availiable in the managers office. Care Homes for Older People Page 3 of 12 What we found: The reason for this visit was to make sure that the requirements made in the two Statutory Requirement Notices, dated 5th May of 2010, had been met and the service were no longer in breach of the regulations. A Statutory Requirement Notice is a legal notice, which is sent to the provider and the manager when there has been a significant breach of regulations. The notice describes which regulations have been broken and what the provider must do to put right the breach. It also gives the date by which this must be done. We then follow up the notice by visiting the service to make sure that actions have been taken to meet the requirements and regulations. The requirements in this notice were made to make sure that people who lived in the services health was not at risk from poor medication and care practices. At this visit evidence was available that showed that the service had met the notice and had significantly improved the management of medication. A specialist pharmacist inspector together with the compliance inspector carried out the visit. The visit lasted approximately five hours. During which time we looked at records regarding, staff training, care plans, medication records, assessments and the services policy and procedures. We spoke with staff, people who live in the service and the management team working in Huyton Hey Manor. The registered manager was unavailable and full feedback on our findings was given to the provider and his representatives. The pharmacist inspector looked at how the service managed medication for people living in Huyton Hey Manor. We found that medication was stored in a safe and secure manner that maintained the safety of people living in the service. A review of medication to check if they had been given to people in accordance with the prescribers and manufacturers instructions was done. We found that staff followed the instructions from the prescribers. Records showed that people living in the service were receiving their medication correctly. Accurate records were being kept that helped staff make sure that people received their medication at the correct times. How the service gave staff instructions and guidance on giving medications safely was looked. We found that instructions for staff were not clear or up to date. Examples included applying external preparations such as creams. We found information did not guide staff where, how or when the cream was to be applied. Information available about as needed medications (PRN) did not tell staff in what circumstances staff members were to give the medication or how to monitor that it was working. Risk assessments to help people living in the service manage some or all of their medication were looked at. Staff were able to give a clear description of how they supported one particular person to manage their medication safely. The clear and well thought out description that staff gave us was not reflected in the risk assessment. Information in the risk assessment was brief and gave no instructions on monitoring that the person was managing their medication safely.Without clear and up to date written guidance that staff would rely on verbal communication. This is not good practice as it means that staff may forget or misinterpret the actions needed placing the person at potential risk. The person managed their medication in morning as staff overnight had not received training to give out medication. The management team has arranged that all staff on day shifts have up to date training. Staff spoken with said that they found this Care Homes for Older People Page 4 of 12 training of value. All night staff had been given an overview in particularly for PRN medication. There are plans in place to train night staff as well. This would be of great benefit and would make sure that people living in the service would be able to have their medication at times that better suited their individual choices and needs. As part of this visit we looked at how the service managed the practice of staff such as their ability to give out medication and checks on medication known as audits. We were told by the management team that both these good quality checks had been put into place. Records regarding staff competency were not available and audits were very brief stating audit completed. After our last visit we received an action plan from the service stating that written records of areas would be available. Written records of what checks have taken place support the management team to monitor the quality of medication management . The service can then put into place corrective actions in order to maintain medication management safely and improve the quality of the service. We looked at records regarding controlled drugs. Records were clear and showed what medication had been received and what medication staff had given. Records showed that people living in the service were receiving these strong drugs at the right times and they were kept secure. As part of our visit we looked at how the service recognised and actioned when medication needed to be ordered. We found that records showed that the service was working well with a new chemist. Medication was received in time and was monitored to make sure that people did not run out of the their medication. At our last visit we found that peoples care plans were not in sufficient detail to make sure that peoples pain and nutritional needs were monitored and addressed. At this visit we found that the service had worked hard to simplify the care plans. The care plans viewed remained inaccurate and based on of date information. A care plan stated, stands with Zimmer for transfers and walks short distances. In discussion with the person for whom the plan was written, they explained that they had not used the Zimmer in over 12 months and could no longer stand without pain. The risk assessments in place to help with moving and handling were inaccurate as this also mentioned a Zimmer frame. There was no evidence that the service had contacted external professionals to review how to move the person even though their needs had significantly changed. Nutritional risk assessments viewed were inaccurate and did not reflect changes in a persons weight. Weight lose had been recognised for one person but additional monitoring had not been put into place. Other assessments such as a potential risk of developing pressure ulcers (known as the Waterlow Score) where in place. In one case this had identified that a person was at risk. The Waterlow score had been inaccurately completed and should have showed that the person was at highrisk. There was no information in the care plan that showed what actions the staff needed to take in order to reduce the assessed risk and meet the persons individual needs. Staff spoken with were looking forward to taking part in writing care plans and told us that they thought the work that had been done made them easier and clearer. Staff also told us that they thought that the service had made significant improvements and that they would be able to have better communication amongst each other, people living in Care Homes for Older People Page 5 of 12 the home and management in the future. 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 6 of 12 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 7 15 All care plans need to be up 17/05/2010 to date, specific to the individual and accurately reflect how the staff are to meet peoples individual needs. All changes to the persons needs and condition need to update the care plan rapidly. Without clear records staff will be all able to meet peoplesneeds. 2 8 12 The service needs to identify 17/05/2010 the health and welfare needs of individuals living in the home and take action to make sure that they meet those needs. Where instructions are received by external professionals these must be actioned as per the directions of the professional. Not meeting peoples health and welfare needs places them at significant risk. 3 12 12 People living in the service need to be supported to make decisions with respect to the care they are to receive and their health and welfare. The people living in the service need to have so 30/07/2010 Care Homes for Older People Page 7 of 12 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 far as practicable their wishes and feelings determined and take into account in all matters to deal with their health and welfare. In order to support the people living in Huyton Hey Manor make informed choices about their health and welfare needs. 4 15 16 All people moving into the 26/04/2010 home need to have their nutritional needs determined and were risks our identifies a plan that needs to be available that informs staff on how to support them appropriately. In order to prevent people from not having their nutritional needs met. 5 18 22 Service needs to update its 27/05/2010 own policy and procedure on safeguarding people living in the home. This should include how to report concerns, training and staff need and how to record any concerns of this nature. This is done in order to help safeguard the people living in the home 6 27 18 Staff need to be have 17/05/2010 effective checks in place that determine their competency to undertake their job role. In order that the provide the Care Homes for Older People Page 8 of 12 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 support to people living in the service in a safe manner 7 33 13 The service needs to put into 17/05/2010 place effective arrangements to audit the management of medications. To make sure that people receive their medications safely. Care Homes for Older People Page 9 of 12 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 18 The service needs to make sure that at all times it has staff working in the service who are trained and competent to give out medications. In order to meet the individual needs of people living in the service and maintain their safety. 31/08/2010 2 38 13 All risk assessments need to be reviewed and checked that they are accurate. Where needs are identified from risk assessments clear instructions to that reflects their practice needs to be in place. To maintain the safety of people living in the service and prevent staff relying on verbal communication which is at risk of being inaccurate. 31/08/2010 Care Homes for Older People Page 10 of 12 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 1 8 Competency and audit records that show what was looked at, what the was found and what actions were taken need to be in place in order to maintain and increase good practice. Care Homes for Older People Page 11 of 12 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 12 of 12 - 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!