Care Home: Korniloff

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What the care home does well The home has thorough pre-admission assessment procedures to help them find out about people`s health, mobility, social network, and about their preferred daily routines: these assessments were evident in the files we examined. Considered is also given to any possible health risks people may face, such as poor nutrition due to lack of appetite and ill health, or the risk of developing pressure sores due to restricted mobility, and any actions necessary to reduce those risks, including provision of specialist equipment. The home is very spacious with beautiful views and was found to be very clean and tidy with no unpleasant odors. The home has followed safe procedures for the storage and administration of medicines in general use, but still needs to seek guidance on the storage and records for controlled drugs. Good records have been maintained to show medicines received into the home and administered. Staff have received training on medicine administration. People said the meals were very nice and they are offered a varied and healthy range of home cooked meals to meet individual dietary needs, likes and dislikes. People said they felt they could talk to the owner about any issues they may have and the home has good procedures in place to make sure people can raise any concerns or complaints and feel confident they have will be listened to and acted upon appropriately. What the care home could do better: We looked at the care files for three people and found that whilst all three had clear risk assessments relating to nutrition, mobility and the risk of falls and the prevention of pressure sores, only one had a written care plan of daily personal and health care needs and how staff should offer support. Each person living in the home must have a written care plan that details their care needs to ensure these are fully met in a consistent andsafe manner and to the the person`s satisfaction. The owners must make detailed records of all accidents that occur in the home and ensure these are kept safely and securely; they must also notify the commission under the provision of Regulation 37 of the Care Homes Regulations 2001 of events that affect the well-being of people living in the home. As noted above the home must include the use of the gates preventing access to the stairs on all three floors in the Fire Risk Assessment and the Service User Guide. Staff and the people spoken with said there are leisure activities organised several times a week both facilitated by the staff and those from professional entertainers, however there was little information in the care files of what activities people had participated in and how they had spent their day. With regard to the recommendations made at the last inspection, we found that Mrs Phillips had made a start on addressing some of these. There was evidence that a family member had signed one care plan to demonstrate their involvement and agreement with the plan, but in the other two care files examined there was no evidence of the person`s or their family`s involvement. The home still needs to obtain the correct type of record book for controlled drugs with pre-printed pages to prevent tampering and to check with the local pharmacist that the storage for controlled drugs is acceptable. Social and leisure activities should be better recorded to demonstrate what activities are provided by the home and how people have spent their day. The redecoration of the home and bedrooms continues but the carpet in the first floor landing it still to be refitted as it is wrinkled and could cause a trip hazard. An overview of staff training should be produced to enable an easy audit of the training undertaken by staff and when updates are due. Mrs Phillips, the owner, should either obtain the qualifications to manage the home or appoint a manager to register with the commission: Mrs Phillips said that she is hoping to appoint a manager by the end of the month. Mrs Phillips has purchased a quality assurance guide which will provide a system for monitoring the quality of the care and services provided at the home: this is yet to be implemented. Random inspection report Care homes for older people Name: Address: Korniloff Warren Road Bigbury-on-Sea Kingsbridge Devon TQ7 4AZ one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Gurnell Date: 0 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Korniloff Warren Road Bigbury-on-Sea Kingsbridge Devon TQ7 4AZ 01548810222 01548810222 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Georgina Suzanne Phillips care home 17 Number of places (if applicable): Under 65 Over 65 0 17 0 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 17 0 17 Korniloff is situated in Bigbury on Sea and has extensive sea views. Bigbury on Sea is a small coastal village with limited facilities. The home is registered to provide care for seventeen older people who may have physical disabilities or dementia. The accommodation comprises of eleven single and three double rooms. All of the rooms are currently used as single accommodation. The property is a detached three storey Care Homes for Older People Page 2 of 11 Brief description of the care home building with the bedrooms situated on the lower ground floor and the first floor. These can be accessed by two chair lifts. There are three spacious lounges and a dining room. A service users guide including the last inspection report is available on request from the home. Care Homes for Older People Page 3 of 11 What we found: Korniloff was previously inspected in September 2009 when the home was judged as providing adequate services to the people who live there. This inspection was undertaken on Thursday 6th May 2010 to review the progress made with the requirements and recommendations made at the inspection in September. Mrs Phillips was present throughout. We spoke the majority of the people living in the home as well as the staff on duty. We examined records relating the the care of three people, the medicines, peoples money held by the home for safekeeping, accidents and two staff recruitment and training files. People said they were well cared for and enjoyed living at the home: one person said I couldnt wish for better. When asked what would make living in the home more comfortable, no one had any suggestions to make and all said they were very happy as it was. Three regular visitors said they felt people were well cared for, and one relative said she was kept fully informed of her relatives care needs and had confidence in the staff and the owner. In response to the requirement made at the previous inspection to always obtain two written references and a check against the vulnerable adults list prior to the commencement of staff employment, we found that this was now happening and was evident in the files of the two most recently recruited staff. The records for peoples money kept by the home for safekeeping were found to be accurate and there was evidence that two staff members always checked money received or spent. There were 11 people living in the home at the time of this inspection and there were two members of staff on duty during the day and evening: in addition there is a cook from 8am to 2pm as well as the owners who are present everyday as they live on site. However overnight, there is a sleeping member of staff, who checks everyone before going to bed and who answers the call bells or responds to the door alarms during the night. (Alarms are fitted to the doors of people who are at risk from wandering during the night). There are also two listening devises placed around the home to alert the staff member if anyone calls out rather than uses their call bell. Due to the description of the people living in the home provided by the owners, staff and written in the care files, Mrs Phillips has been asked to consider providing waking night staff who can respond more readily to peoples needs. In the mean time Mrs Phillips has been asked to provide the staff with more appropriate sleeping-in facilities rather than a sofa bed in one of the communal lounges. We looked at how the home records accidents and found that generally these were well recorded, however the records relating to one specific event were partially missing and only a statement by Mrs Phillips was available. The owners have an obligation to inform us of events that affect the health, safety and well-being of people living in the home and Care Homes for Older People Page 4 of 11 we found that we had not been informed of this event. Following this accident, the home had consulted with an Occupational Therapist who had advised placing gates across access to the stairs to prevent people using the stairs, particularly during the night, without the assistance of staff. Three gates were found: one across the hallways on the lower ground and first floor stairs, and one adjacent to the ground floor stairs which prevented only one person whose bedroom was the other side of the gate from accessing the stairs. Following the inspection, we discussed the situation with the Fire Officer from Devon and Cornwall Fire Service who indicated that the use of these gates must be included in the homes Fire Risk Assessment. The use of the gates must also be included in the homes Service User Guide to indicate to people considering moving to the home the restrictions placed upon their movements around the home. What the care home does well: What they could do better: We looked at the care files for three people and found that whilst all three had clear risk assessments relating to nutrition, mobility and the risk of falls and the prevention of pressure sores, only one had a written care plan of daily personal and health care needs and how staff should offer support. Each person living in the home must have a written care plan that details their care needs to ensure these are fully met in a consistent and Care Homes for Older People Page 5 of 11 safe manner and to the the persons satisfaction. The owners must make detailed records of all accidents that occur in the home and ensure these are kept safely and securely; they must also notify the commission under the provision of Regulation 37 of the Care Homes Regulations 2001 of events that affect the well-being of people living in the home. As noted above the home must include the use of the gates preventing access to the stairs on all three floors in the Fire Risk Assessment and the Service User Guide. Staff and the people spoken with said there are leisure activities organised several times a week both facilitated by the staff and those from professional entertainers, however there was little information in the care files of what activities people had participated in and how they had spent their day. With regard to the recommendations made at the last inspection, we found that Mrs Phillips had made a start on addressing some of these. There was evidence that a family member had signed one care plan to demonstrate their involvement and agreement with the plan, but in the other two care files examined there was no evidence of the persons or their familys involvement. The home still needs to obtain the correct type of record book for controlled drugs with pre-printed pages to prevent tampering and to check with the local pharmacist that the storage for controlled drugs is acceptable. Social and leisure activities should be better recorded to demonstrate what activities are provided by the home and how people have spent their day. The redecoration of the home and bedrooms continues but the carpet in the first floor landing it still to be refitted as it is wrinkled and could cause a trip hazard. An overview of staff training should be produced to enable an easy audit of the training undertaken by staff and when updates are due. Mrs Phillips, the owner, should either obtain the qualifications to manage the home or appoint a manager to register with the commission: Mrs Phillips said that she is hoping to appoint a manager by the end of the month. Mrs Phillips has purchased a quality assurance guide which will provide a system for monitoring the quality of the care and services provided at the home: this is yet to be implemented. 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 1 5 The registered provider must 01/06/2010 ensure the homes Service Users Guide provides a statement as to the facilities and services provided at the home. This is to ensure people considering moving to the home are aware of the use of gates which prevent access to the stairs for those people who are unsafe to use them unaided. 2 7 15 The registered provider must 31/05/2010 ensure each person living in the home has a written plan that details how their needs in relation to their health and welfare are to be met. The registered person must demonstrate that the person the plan has been written about or their relative has been consulted. This is to ensure peoples needs are met in a consistent manner and to their satisfaction. Care Homes for Older People Page 8 of 11 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 3 38 23 The registered person must include the use of the gates restricting access to the stairs in the homes fire risk assessment. This is to ensure the gates are safe to use and staff are aware of their responsibilities should their be a fire in the home and people have to be evacuated. 31/05/2010 4 38 37 The registered person must notify the Commission without delay all the events in the care home that adverely affect the wellbeing or safety of people living in the home. The registered person must make a record of all accidents in the home and notity the commission when medical advise is sought following an accident. 31/05/2010 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 9 The registered person should seek specialist advice to ensure that their facilities for storing and recording controlled drugs held in the home are safe. The registered person should consult with people about their social, recreational and educational interests and check that a plan of activities covers these. Records should be made of the activities people have participated in and how they have spent their day. Page 9 of 11 2 12 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 3 19 The registered person should ensure the carpets are laid correctly to ensure they do not place people at risk from tripping. The registered person should review the arrangement for staffing the home during the night and consider providing waking night staff who can respond more readily to peoples needs. More suitable facilities should be provided for staff who sleep-in. The registered person should prepare an overview of staff training so that it is clear what training has been undertaken by staff and when updates are due. Mrs Phillips, as the registered provider, should either obtain the qualifications to manage the home affectively herself or register a manager for the home. A quality assurance system that measures the quality of the services provided at the home and takes into account peoples view should be fully introduced. 4 27 5 31 6 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. 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