Care Home: Pendennis Residential Home

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What the care home does well People we spoke to were extremely happy living at the home and felt confident to tell a member of staff, the manager or their relatives if they had any concerns of complaints. The relatives we spoke to were also extremely happy with the standard of care provided at the home. People were also very happy with the quantity and quality of the food provided at the home, and knew that there were alternatives if they did not like the meal of the day. Staffing levels are stable and reflects the needs of people at the home. People appreciate and enjoy the program of activities provided at the home. What the care home could do better: Staff at the home must ensure that the standard of their record keeping reflects the care that is provided. All records should be accurately dated, regularly reviewed and reflect the care needs of each person. Care plans must contain information to show what support and care is needed to meet the general and specific needs of each person. Assessments and monitoring documents should contain relevant up-to-date information, which will show trends or changes in condition which can then prompt action to be taken. Medication management must improve to ensure that medication is stored at the home are done so in a secure manner. Staff must be reminded to only use prescribed products on the person they are prescribed for. The provider should introduce a programme of quality assurance to monitor the record keeping, ensuring it is accurate, relevant and reflects the care needs people at the home. Random inspection report Care homes for older people Name: Address: Pendennis Residential Home 64 Dartmouth Road Paignton Devon TQ4 5AW two star good 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: Clare Medlock Date: 1 8 0 8 2 0 1 0 Information about the care home Name of care home: Address: Pendennis Residential Home 64 Dartmouth Road Paignton Devon TQ4 5AW 01803551351 01803555100 pendennis64@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Barbara Denise Wright Type of registration: Number of places registered: Conditions of registration: Category(ies) : Pendennis Ltd care home 22 Number of places (if applicable): Under 65 Over 65 22 22 22 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 Pendennis is a care home registered for up to 22 people, who are generally over 65 and who may or may not have a physical disability or suffer with dementia. The home is an extended three storey detached property, situated in a residential area of Paignton. The home is near all local facilities and within a short walk from the sea front. The home is situated in its own grounds to which people who live at the home have ramped access. Within the home, all but two of the bedrooms have en suite Care Homes for Older People Page 2 of 11 Brief description of the care home bathroom facilities. Bedrooms are located on all three floors and a mezzanine level between the first and second floors. One of the large rooms within the home is currently being used as double room by a married couple. The home has a passenger lift, stair lifts to the mezzanine level and a variety of aids and adaptations for physically disabled people. The range of fees as at February 2010 was from £314 to £500 per week dependant on need. The owners make the report available within the homes statement of purpose, which is sited within the entrance hallway. Care Homes for Older People Page 3 of 11 What we found: The reason for this random inspection was to ascertain whether regulations had been breached following receipt of a complaint. The complaint related to nutrition, diet, management of specialist diets and mealtimes at the home. Further information also raised issues regarding access to the home by visitors, attitude of staff, and specific risks to people in the home. The inspection took place on Wednesday, 18 August 2010 between the hours of 12:40 and 4:15 PM. We looked at care records for four people who either had specialist diet or required help eating their meals. We spoke to 4 members of staff, three people who live at the home, three visitors and the provider (who was informed of the inspection and wanted to be present.) We had a brief tour of the home including the kitchen area, several bedrooms and one specific bedroom highlighted following further information received. We also looked at staff rotas and elements of the way medication is managed at the home. We arrived at lunchtime to find 13 people eating lunch in the well presented dining area. Two people were enjoying their lunch in the lounge area. Some people had their food cut up and we saw one person being assisted with their meal in their bedroom. Lunch consisted of roast turkey, potatoes, fresh carrots and cabbage. Desert was fresh fruit trifle with whipped cream. A menu was displayed on the wall of the dining area. This is located wheelchair height and reflected the meal being provided. Although there was no choice indicated on the main menu, alternatives were recorded the bottom of the menu sheet. All of the people we spoke to said they were enjoying their lunch and other people said that the food was smashing, always good and very tasty. We were told by people that if they did not like the meal of the day staff ensured that they were provided with alternatives. One person said she particularly liked salads and staff often ensure she received a salad on request. The kitchen was clean, tidy and well organised. Fridge areas were also clean with food being stored appropriately. There were sufficient quantities of fresh frozen and dried food products of a good quality. Discussion with the cook revealed that they were written records and notice boards displaying specialist diets, likes and dislikes and specific other information. The cook explained that the manager informed her of dietary requirements as people were moved into the home. This information is recorded in the pre-admission record. Care records were not well maintained or clear to follow. We saw examples of care assessments, but not plans of care showing how people were to be supported or cared for to have their needs met. One example related to a person who had showed significant weight loss. A nutritional assessment recorded nutrition risk as low-despite significant weight loss. Care records did not show that referrals have been made to healthcare professionals or show what action was being taken, such as supplementary foods and offering further food portions which would be an appropriate response. Staff confirmed that this person had not been referred to healthcare professionals and were unsure whether supplements were being given or not. Daily care records stated that food and fluid intake was good, but observation indicated that the portion size for this person was quite small and had not been questioned. Another care record did not contain information Care Homes for Older People Page 4 of 11 on the medical history that the person was a diabetic. Other examples of poor record keeping indicated that people who were losing weight or had a poor nutritional assessment had not had their assessments reviewed within the last six months-despite changes occurring. Other examples of poor practice included staff recording daily care notes under a daytime heading of 8 AM to 8 PM. This does not reflect accurate contemporaneous record keeping, especially when the member of staff left their shift at 2 PM. Two examples were seen where staff had recorded that people had eaten and drunk well, before the meal had actually finished. One of these people was of high risk. Food recording charts were used for people with a poor appetite, but the quality of information recorded on these charts was inadequate and did not accurately record the amount of food taken by a person. Another person had been recorded as being high risk on a nutritional assessment. This person was also a diabetic- controlled via diet. There were no care plans to indicate what care was being provided to support dietary needs, although many good assessments were present. Records mentioned supplementary drinks, but did not clearly indicate how often these should be, and were being provided. Discussion with the provider took place regarding the importance of accurate record keeping. The provider gave assurances that improvements would be made. People we spoke to stated that they were very happy at the home. Four people told us that they found the staff wonderful, very good, and lovely. One person specifically stated that she found all the staff are wonderful especially the Filipino staff. All of the people we spoke to stated that they found the manager approachable, polite and okay. One person said she gets the job done. Visitors were also complimentary about the management, staffing and care at the home. All visitors stated that they were welcomed at the home at any time, and should this be at a mealtime they are always offered a meal. One person said I speak as I find on notice that Im happy if theyre happy and weve got nothing to complain about. Another person said I know how to complain but have never needed to. Staff rotas showed that staffing levels were stable. At night there is one waking staff and one sleeping staff. Records showed when these sleeping staff were called. Staff explained that on-call staff slept in an adjoining bungalow and were alerted using a walkie-talkie system. Staff stated that the system works well. When we arrived at the home staff were performing the medication round. Individual medicines were administered in an appropriate way. Once completed the medication trolley was taken to the staff office. It was noted that there were no facilities to ensure it was securely attached to the wall. There is also a large bag containing medications in blister packs these were present throughout the inspection and were not safely stored. During a tour of the building it was noted that a prescribed cream had its label removed, with another persons name written overworked enable had been removed. These findings are poor practice and were fed back to the provider. Staff informed us that staff are only allowed to administer medications once they have attended the appropriate training. we spoke with the provider about quality assurance procedures to monitor systems at the Care Homes for Older People Page 5 of 11 home. We were informed that formal regulation 26 visit reports were not conducted at present. 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 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 7 15 The Provider must ensure that each person is plan of care is kept under regular review (at least once a month). This will mean that any changes in condition or deterioration will be noted and plans of action implemented as necessary. 24/09/2010 2 7 15 The Provider must ensure 24/09/2010 that details within a persons plan of care are accurate and reflect their needs. This will mean that staff are able to accurately communicate the health care needs of a person. 3 7 17 The Provider must ensure 24/09/2010 that each person has a written plan as to how their needs in respect of their specialist health and nutrition needs are to be met. This will mean that staff understand clearly how to meet peoples needs in a safe Page 8 of 11 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action and consistent way. 4 8 13 The Provider must ensure 24/09/2010 that people receive where necessary, treatment, advice and other services from healthcare professionals. This will mean that people have access to relevant treatment and advice where their condition changes. 5 9 12 The Provider must ensure that our arrangements in place for the safekeeping, storage and safety administration of medicines at the home. This will mean that medicines are stored securely and prescribed products are only used for the person they are prescribed for. 6 33 26 The provider must conduct a 24/09/2010 self-monitoring quality assurance system. This will mean that the system is used at the home is effective and reflects good practice guidance 24/09/2010 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 7 The Provider should consider improving food and fluids Page 9 of 11 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 records to obtain accurate information regarding what a person has eaten or drunk. 2 7 The Provider should ensure that daily entries made to a persons care plan are recorded accurately according to the time of entry. The provider should send the regulation 26 report to the Care Quality Commission until further notice. 3 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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