Care Home: Pickering Lodge Care Centre

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What the care home does well From the comments received, and observation, most of the time staff do meet people`s needs. People praised how staff responded to them and we saw how staff used their initiatives to add some interest to people`s days: a visitor had brought an agility dog with them and staff invited a few residents who they thought would enjoy this, to come out to the garden to watch him. The home has taken major steps towards establishing a permanent group of staff, rather than using agency staff or people from another home. Some training has begun. What the care home could do better: The manager must establish systems to make sure that care plans are comprehensive, up-to-date and make use of the information known by all the staff. There should also be a system to make sure staff are made aware of any changes in them. Moving and handling assessments must be carried out where necessary. Information about nutritional needs, such as diabetes, must always be readily available in the kitchen, in case someone other than the usual cooks, are working there. The manager must continue efforts to recruit enough staff so that shifts are always covered by people who are familiar with people living in the home. All staff must receive the training they need to perform their roles safely and competently. The manager must make sure he is aware of all the systems and practices in the home so that he is aware of anything which is not working well or where staff are not, forexample, recording as they should do. Random inspection report Care homes for older people Name: Address: Pickering Lodge Care Centre Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX 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: Kathy Bell Date: 1 9 0 8 2 0 0 9 Information about the care home Name of care home: Address: Pickering Lodge Care Centre Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX 01207271900 01207270966 Pleuropeancare@aol.com www.europeancare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : European Care (England) Ltd care home 30 Number of places (if applicable): Under 65 Over 65 30 0 old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 30 Pickering Lodge is owned by European Care (England) Limited and is registered to provide residential and nursing care for up to thirty older people. The home is a converted village school on the outskirts of Stanley. The original building has been extended to provide accommodation over two floors. Inside, the home has a range of different size lounge areas and dining spaces. Bedrooms are currently used to provide single room accommodation but some bedrooms are large enough to provide double room accommodation should it be required. One set of first floor bedrooms can be reached via a passenger lift. A stair lift takes you to first floor bedrooms that are on the opposite side of the building. Some of the bedrooms within the home have en-suite facilities. Outside, the home has a small front garden and a medium size back garden Care Homes for Older People Page 2 of 10 Brief description of the care home and these are reasonably well maintained. The home overlooks the main road that runs through the village and is close to all local amenities and residential housing. Care Homes for Older People Page 3 of 10 What we found: This random inspection took place because we received some comments when we did the annual service review which concerned us. Some people had noticed a lot of changes of staff and GP had been concerned at failures to pass on and act on information. The selfassessment document completed by the manager confirmed that there had been frequent use of nursing staff who did not work in the home permanently. We looked at the records used in the home to pass on information between staff. There was a satisfactory diary system to alert staff to appointments, blood tests to be taken etc. Nurses complete written handover sheets. But there was not a system to enable staff to check if any care plans had been changed since they were last on duty. One of the care staff said that the care assistants did not look at care plans. If they knew of changes in needs, they told the nurse on duty whose job it was to change the care plan. We looked in detail at the records for a resident, whose daughter had complained she had not been bathed and her hair was greasy. (The manager said he had not been made aware of this complaint and we did not see any records of a response to the daughter.) There were two separate records kept of baths and these confirmed that there had been at least two weeks between baths. But there did not seem to be an effective system for somebody to notice this and take action. The care assistant explained that this lady was often reluctant to have a bath and became agitated, but they had found she responded better to older carers. This essential information was not in her care plan. The care assistant did say that they would try again another day if she had refused, but this clearly was not often successful. Also the nutrition section of this ladys care plan did not include the information that she had Type 2 diabetes. But the cook was aware of this. Three other care plans showed that moving and handling assessments were completed where appropriate although one stated just that a resident needed one care assistant to help her get out of bed. This needs to be much more explicit and an assessment made if there are moving and handling needs. Information from the speech and language therapy team was available for a resident with eating difficulties. In the kitchen we found a list available of the residents who needed, for example, a soft diet. The Cook also had information about foods suitable for a soft diet and said she had information available on improving the nutritional value of food. But a board in the kitchen which apparently had showed a list of who was diabetic, had been wiped clean. Following this visit the manager has undertaken to set up a system for care staff and nurses to complete and review care plans together. This should enable residents to benefit from the knowledge of both staff groups. The rotas showed that there were usually one nurse and three care assistants on duty throughout the day. This seemed enough for the 18 people currently cared for in the home. We spoke to 2 visitors and a resident. The visitor was aware of a lot of staff changes and felt that hadnt always been enough staff. But he felt the staff did seem to know what they had to do for people and had a nice manner with residents. A resident explained that staff have to take her to the toilet, and when she rings for them to come back to her, they come practically at once. She also praised the staff, very kind, good. But the catering staff finish in the late afternoon which means that care staff have to clear up after the evening meal. This is not ideal in terms of food hygiene and takes care staff away from their care duties. The manager agreed to look at the hours the kitchen assistants work. Care Homes for Older People Page 4 of 10 The home also has domestics, laundry workers, an administrator and a part-time handyman. The manager has sufficient hours for his management duties as he only covers nursing shifts in emergencies. But the home has had difficulties this year in providing a consistent group of staff, often using nursing and care staff from another home run by the company. They recruited three nurses in July and are still trying to recruit care staff. Most of the care staff have worked there for at least a year and some for several years. But they are still using four staff from the other home to cover care shifts. The problems with communication and knowledge of residents may well have been caused by the combination of factors : nurses who were not working permanently in the home, covering many shifts, and the systems for care planning and information sharing which did not make best use of the information known to care assistants who worked permanently at the home. Training records show that not all staff have received the training they must have. However the records did not show clearly when each person had last received training in, for example, moving and handling, so the picture may not be as bad as the records suggest. But the current record shows that only five staff have had moving and handling training and most are to do this in October or November this year. One of the cooks does not have a current food hygiene certificate. Seven staff have not yet had training in safeguarding adults. Six staff have not had basic fire awareness training. The company procedures explain how fire drills should be done in a way which incorporates refresher training, but no fire drills have been recorded since the beginning of this year, although the manager believes one was done a few weeks ago. Without this record it is not possible to see whether staff have received refresher training in fire safety. However a programme of training has started: in July some staff have had training in food hygiene and moving and handling. Almost all the staff have been doing a distance learning course in infection control. What the care home does well: What they could do better: The manager must establish systems to make sure that care plans are comprehensive, up-to-date and make use of the information known by all the staff. There should also be a system to make sure staff are made aware of any changes in them. Moving and handling assessments must be carried out where necessary. Information about nutritional needs, such as diabetes, must always be readily available in the kitchen, in case someone other than the usual cooks, are working there. The manager must continue efforts to recruit enough staff so that shifts are always covered by people who are familiar with people living in the home. All staff must receive the training they need to perform their roles safely and competently. The manager must make sure he is aware of all the systems and practices in the home so that he is aware of anything which is not working well or where staff are not, for Care Homes for Older People Page 5 of 10 example, recording as they should do. 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 10 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 38 23(2) A copy of the electrical wiring 31/08/2008 certificate must be submitted to the CSCI as soon as it is available. Care Homes for Older People Page 7 of 10 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 Care plans must be up-todate and include all the information staff need to meet peoples needs. This must include moving and handling and nutritional needs. The manager must develop systems to make sure that staff are kept up-to-date with any changes in care plans. This is required so that all staff know what they need to do for people. 25/09/2009 2 15 15 Information about nutritional 25/09/2009 needs must be available in the kitchen. This is essential so that anyone who may be responsible for providing meals has this information. 3 27 18 The manager must continue efforts to recruit enough permanent staff to cover shifts in the home. 25/09/2009 Care Homes for Older People Page 8 of 10 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 This is so that residents will benefit from staff who know them well. 4 30 18 Staff who provide care for 25/09/2009 residents must be trained in moving and handling and safeguarding adults. All staff must receive regular training in fire safety. This is to make sure the home is a safe place to live and work and people are protected from harm as far as possible. 5 31 12 The manager must make 25/09/2009 himself familiar with all the current systems in the home and records. This is essential so the manager is fully aware of what staff are doing. 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 30 Staff should receive training in dementia care. Care Homes for Older People Page 9 of 10 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. 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. 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