Care Home: Ponteland Manor

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What the care home does well Staff showed a good understanding of the needs of the people in their care. Care staff knew which residents required help to eat or drink and could identify those people who needed to have their fluid intake recorded. Senior care staff on the ground floor kept good records of the care needs of people. The care plans on this floor were person centred and reflected the actual care needs of the residents. We examined the arrangements made to protect people from pressure sores. Pressure relieving mattresses were in place for people at risk of tissue damage. These were appropriately set for the weight of the resident. We examined the fluid charts for four of the most vulnerable residents. Generally these were properly filled in and showed that people were receiving enough to drink. All of the residents, including those who were frail or ill, looked clean and well cared for. People wore clean, matching and appropriate clothes. Most of the female residents wore jewellery and make up. Male residents were clean-shaven and all those spoken to confirmed that they were helped to bathe or shower regularly.There were no mal odours in the home. All areas of the home were clean and tidy. We observed that staff responded quickly when residents rang their call bell. We spoke to two residents who told us that staff also come quickly during the night if they ring their bell. The staff have a scanning system, which is used throughout the night, this records how long bells are ringing in bedrooms before staff answer. Staff assisted residents to eat in an appropriate and sympathetic way. Staff sat alongside residents while they were eating and we noted that they gave plenty of time for the residents to take their meal. The medication system had recently been audited by the provider who had required the manager to improve this in a number of areas. These improvements had been made. Some residents manage their own medication. Records were in place to show that the associated risks with this had been assessed and were balanced against the positive aspects of maintaining independence. Complaints and safeguarding issues were properly recorded. These had been reported to the appropriate authorities, including CQC. Some recent complaints have been investigated by the local authority or the provider and found to be unsubstantiated. Staff have received training and guidance in the management of complaints and the recognition and management of abuse. The manager has followed disciplinary procedures where it was needed to ensure that residents are safeguarded. The provider has carried out a series of monitoring visits within the home. The provider is required under regulation 26 to produce a report of these monitoring visits. We examined the latest report which showed that the provider had identified some areas for improvement and produced an action plan for the manager to follow. This had been done and all areas had been addressed. There were adequate numbers of staff on duty to care for residents. Records indicated and staff confirmed that these numbers were maintained despite the home having some staff vacancies. Agency staff are used to cover any shortfalls. What the care home could do better: One resident, who was frail and appeared ill, was not receiving enough to drink and had not eaten for three days. Records showed that this person was refusing to drink fluids. No medical intervention had been sought for this resident, this was because it was thought to be a normal pattern of behaviour and outcome for her illness. The nurses did not have a system in place to overview the fluid intake of residents. We case tracked three people. This means that we spoke to residents or observed their care then matched our observations to what was written in the care plan. One of the three case tracked care plans did match the actual care needs of the resident. The remaining two care plans did contain all of the information but it was not written in a logical way or in the correct place. This means that staff were not given clear directives about how to care for the person or what their current needs were. For example a care plan stated that the resident had a shower twice weekly but the evaluations indicated that the resident was bedbound and required a bed bath daily.The food intake record is a standard document used by the provider. It requires staff to enter a code indicating whether all, half, quarter on none of a portion of food has been taken. There is not enough room on the form to record how big the portion was initially. Therefore the record might show that someone has eaten half a portion of main meal but that portion may have been a small piece of fish or large portion of steak pie. The manager has been at the home for a number of years and has been the manager since January 2008. However she has still not registered with CQC. The manager is required to do this to enable CQC to assess her fitness for the role and ensure that she understands her legal responsibilities. Random inspection report Care homes for older people Name: Address: Ponteland Manor Thornhill Road Ponteland Newcastle Upon Tyne NE20 9PZ 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: Janet Thompson Date: 1 9 0 5 2 0 1 0 Information about the care home Name of care home: Address: Ponteland Manor Thornhill Road Ponteland Newcastle Upon Tyne NE20 9PZ 01661821400 01661821402 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross OPCO Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 52 Number of places (if applicable): Under 65 Over 65 52 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 52 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category. Code OP - maximum number of places 52 Date of last inspection Brief description of the care home Ponteland Manor is a two-storey purpose built home situated in the centre of Ponteland. The home is close to local shops and transport links. Access to local facilities is within Care Homes for Older People Page 2 of 10 Brief description of the care home walking distance. Ponteland Manor cares for elderly people, some of who require nursing care. The first floor of the home is mainly used for those requiring nursing care or a higher input of personal care. Access to the first floor is provided through a passenger lift. The fees for the home vary, details can be obtained at the home. Further information about the home can be found in the service users guide, the statement of purpose and previous inspection reports. These are readily available in the home. Care Homes for Older People Page 3 of 10 What we found: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service 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. The last Key Inspection of the home was in February 2008. This inspection was carried out to ensure that the service was still operating at a good level. This inspection was also carried out to follow up on some complaints and concerns that have been raised in the last few months. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they care for people. During the visit we talked with people who use the service, some staff and the manager. We focused mostly on healthcare and checked staffs understanding of the care required by the people living in the home. Following the inspection feedback was given to the manager. What the care home does well: Staff showed a good understanding of the needs of the people in their care. Care staff knew which residents required help to eat or drink and could identify those people who needed to have their fluid intake recorded. Senior care staff on the ground floor kept good records of the care needs of people. The care plans on this floor were person centred and reflected the actual care needs of the residents. We examined the arrangements made to protect people from pressure sores. Pressure relieving mattresses were in place for people at risk of tissue damage. These were appropriately set for the weight of the resident. We examined the fluid charts for four of the most vulnerable residents. Generally these were properly filled in and showed that people were receiving enough to drink. All of the residents, including those who were frail or ill, looked clean and well cared for. People wore clean, matching and appropriate clothes. Most of the female residents wore jewellery and make up. Male residents were clean-shaven and all those spoken to confirmed that they were helped to bathe or shower regularly. Care Homes for Older People Page 4 of 10 There were no mal odours in the home. All areas of the home were clean and tidy. We observed that staff responded quickly when residents rang their call bell. We spoke to two residents who told us that staff also come quickly during the night if they ring their bell. The staff have a scanning system, which is used throughout the night, this records how long bells are ringing in bedrooms before staff answer. Staff assisted residents to eat in an appropriate and sympathetic way. Staff sat alongside residents while they were eating and we noted that they gave plenty of time for the residents to take their meal. The medication system had recently been audited by the provider who had required the manager to improve this in a number of areas. These improvements had been made. Some residents manage their own medication. Records were in place to show that the associated risks with this had been assessed and were balanced against the positive aspects of maintaining independence. Complaints and safeguarding issues were properly recorded. These had been reported to the appropriate authorities, including CQC. Some recent complaints have been investigated by the local authority or the provider and found to be unsubstantiated. Staff have received training and guidance in the management of complaints and the recognition and management of abuse. The manager has followed disciplinary procedures where it was needed to ensure that residents are safeguarded. The provider has carried out a series of monitoring visits within the home. The provider is required under regulation 26 to produce a report of these monitoring visits. We examined the latest report which showed that the provider had identified some areas for improvement and produced an action plan for the manager to follow. This had been done and all areas had been addressed. There were adequate numbers of staff on duty to care for residents. Records indicated and staff confirmed that these numbers were maintained despite the home having some staff vacancies. Agency staff are used to cover any shortfalls. What they could do better: One resident, who was frail and appeared ill, was not receiving enough to drink and had not eaten for three days. Records showed that this person was refusing to drink fluids. No medical intervention had been sought for this resident, this was because it was thought to be a normal pattern of behaviour and outcome for her illness. The nurses did not have a system in place to overview the fluid intake of residents. We case tracked three people. This means that we spoke to residents or observed their care then matched our observations to what was written in the care plan. One of the three case tracked care plans did match the actual care needs of the resident. The remaining two care plans did contain all of the information but it was not written in a logical way or in the correct place. This means that staff were not given clear directives about how to care for the person or what their current needs were. For example a care plan stated that the resident had a shower twice weekly but the evaluations indicated that the resident was bedbound and required a bed bath daily. Care Homes for Older People Page 5 of 10 The food intake record is a standard document used by the provider. It requires staff to enter a code indicating whether all, half, quarter on none of a portion of food has been taken. There is not enough room on the form to record how big the portion was initially. Therefore the record might show that someone has eaten half a portion of main meal but that portion may have been a small piece of fish or large portion of steak pie. The manager has been at the home for a number of years and has been the manager since January 2008. However she has still not registered with CQC. The manager is required to do this to enable CQC to assess her fitness for the role and ensure that she understands her legal responsibilities. 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 £ 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 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 reflect the current and changing health and welfare needs of individuals. This means that staff will have access to up to date information about people in their care. 31/08/2010 2 8 12 Ensure that an accurate record of food and drink is maintained for individual residents. Ensure that medical advice is sought when individuals have deteriorating or failing health. This means that people recieve good medical care and treatment. 30/06/2010 Care Homes for Older People Page 8 of 10 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 31 The manager must pursue registration with CQC. 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. 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