Care Home: Star Residential Home Ltd

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What the care home does well This was not assessed on this occasion What the care home could do better: There is much this home needs to do to improve its service and ensure people received good quality care: All medication must be securely locked away from residents and records made when medication is given to residents must be accurate and complete to demonstrate that they receive their medication as prescribed. Managers or senior staff should regularly audit the MAR sheets to ensure they are being completed correctly. All residents must be dressed appropriately to ensure their dignity is maintained. All areas of the home must be kept clean, safe and hygienic for residents: in particular you must ensure that: - all bedrooms, bed frames, mattresses, walls and floors are cleaned - that fire doors are not held back - that the door to bedroom 6 is repaired - that operational calls bells are available to residents - that fire exits are kept clear - that lighting works in all areas of the home to help residents see - that the hot radiator in bedroom 16 is made safe All residents must be weighed regularly and appropriate action taken when weight loss is identified. Food and fluid charts must be completed in much more details to ensure there is an accurate record of what people have consumed. Training records must be available for staff so there is a clear and accessible way of telling what training they have completed and what training is due. We must be informed of all significant events that affect the well being of residents, and also of any changes to the management arrangements of the home. Random inspection report Care homes for older people Name: Address: Star Residential Home Ltd 56-64 Star Road Peterborough PE1 5HT 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: Janie Buchanan Date: 2 6 0 8 2 0 1 0 Information about the care home Name of care home: Address: Star Residential Home Ltd 56-64 Star Road Peterborough PE1 5HT 01733777670 01733552311 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dawn Bent Type of registration: Number of places registered: Conditions of registration: Category(ies) : Star Residential Home Limited care home 30 Number of places (if applicable): Under 65 Over 65 4 0 0 30 dementia mental disorder, excluding learning disability or dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 0 1 2 0 Category MD is for named service users for the duration of their residency. Date of last inspection Brief description of the care home The Star is situated in a residential area close to Peterborough city centre. The home consists of former terrace houses that have been adapted and extended to provide accommodation for 30 older people. All rooms are for single occupancy. The home has Care Homes for Older People Page 2 of 11 Brief description of the care home 10 WCs, 4 bathrooms one including a hydrotherapy bath, 2 showers, 2 shower wet rooms and a shaft lift. Eleven bedrooms have en-suite facilities. There are also two lounges, a dining area, a sun lounge, a quiet room and a separate smoking area for residents. The weekly fees range from £387 to £440 depending on residents needs. The inspection report is available on the residents notice board in the home. Care Homes for Older People Page 3 of 11 What we found: We undertook this inspection to investigate some concerns about the home that had been raised at an adult safeguarding meeting. For the inspection we visited the home and talked to residents, staff, the acting manager and the responsible individual for the company that owns The Star. We undertook a tour of the premises and checked medication administration and a range of documents. This report has highlighted serious shortfalls with the management of the home and a clear decline in the standards of care people receive since it was last inspected. As a result we left a number of immediate legal requirements. MEDICATION We checked medication storage and a sample of residents medication administration records. We noted considerable shortfalls: a bottle of liquid medication had been left unattended on top of the medication trolley in a room where a number of confused residents were seated; there was no signature tally to identify staffs initials; there were a large number of signature gaps on the MAR sheets where it was not possible to tell if residents had received their medication or not; hand written additions to the MAR sheets had not been signed or dated or checked by a second person to ensure their accuracy; the number of tablets recorded as having been administered on the MAR sheet did not tally with the number of tablets in the blister pack; there was one error in the controlled drugs book; staff were signing to say they had administered medicines (such as topical creams) despite another member of staff actually applying them and codes used for why some residents had not received their medication were confusing. CARE Most residents we observed were dressed in clean and appropriate clothing. However, we noted one female resident with unsightly lip and chin whiskers another male resident who was very unshaven. It was of concern to note that almost all of the female residents had been dressed without stockings the only female resident who actually had stockings on had dressed herself. When we asked staff about this their reply was vague one staff member reporting that laundry wasnt always available when needed and stockings couldnt always be found in drawers. We visited one resident at 9.30am. He was in bed unshaven, wearing a badly stained and dirty white top with no pajama bottoms and his lower half was covered in faeces. His pillow case was stained and the sheet he lay on was badly marked with what appeared to be urine and faeces. Dried faeces was also evident on his air mattress, the bed frame and the wall beside him. A continence pad had been placed between his legs but no net knickers to hold it securely in place. His catheter was tangled up between his legs and had not been attached to a nearby catheter stand. There was a jug of juice on the bedside table but not near enough for him to reach easily and no glass had been left for him to use. The floor was dirty and dusty and a decaying biscuit was found under the bed head. We returned to this resident at 11.10am, once staff had been in to deliver care to him. Care Homes for Older People Page 4 of 11 His top bed cover had been replaced but a new sheet had just been placed on top of the badly stained one. He remained unshaven in his dirty white top and although his lower half had been washed there was still faeces on his heals the bed sheets mattress bed frame and walls. His catheter was still not placed on the catheter stand the floor was still dirty the decaying biscuit was still under the bed head and the jug of juice remained without a glass. We visited another resident who was in bed at 9.10am She told us: I should have been up a long while ago. This resident was eventually brought down to the main lounge just before lunch. She told us she had been waiting to get up all this time and had not been given any breakfast or even a cup of tea , despite being nutritionally at risk. Staff we spoke to confirmed this to be the case but were unable to offer an explanation why. We received concerns from visiting health professionals that one resident was severely malnourished and the home had ignored requests for him to be referred to a dietitian. Scrutiny of their care plan showed this to be the case. We checked care plans and weights for a sample of residents. Information in the plans was variable, some of it was detailed, giving a good picture of peoples needs. However we noted that some peoples weights had not been recorded regularly; that food and fluid charts were not completed in enough detail to ascertain what people had eaten and drunk and that appropriate action to address significant weight loss had not been taken. There was no evidence that those residents who required a fortified diet actually received a different diet from other residents. ENVIRONMENT We undertook a tour of the premises to check on the environment and health and safety. Building work was being undertaken on the top floor of the home to update and refurbish it. Despite this we came across the following shortfalls: the ceiling in the main lounge had large chunks of plaster coming away due to a leaking radiator valve in the room above; the fire door to bedrooms 6 and 8 was held open by a fire extinguisher thereby preventing it from closing in the event of a fire; the door to bedroom 6 had a large split in it (we were told that this was where the door had to be forcibly broken down as a resident was locked inside and no key could be found to release them), this room also smelled strongly of urine and there was damp and peeling paint around the electrical sockets. We came across a fire exit that had been blocked with building materials and a large bookcase. The light in the toilet next to bedroom 2 did not work making it very dangerous for residents to use. Room 2 smelled strongly of urine its chair was ripped and torn on the arms and it contained a broken chest of drawers. The light above the sink in bed room 1 did not work and the window overlooked a pile of rubbish and discarded building material. The chest of drawers in this room was badly chipped and the wardrobe didnt close safely. Room 16 contained a very hot radiator whose cover had been removed increasing the risk of residents scalding themselves. We came across two bedrooms upstairs where residents lived but had no calls bells installed in them. One staff member told us that she found one resident banging his shoe on the door in order to attract staff as they had no call bell. RECRUITMENT We checked the personnel files for two recently employed staff members. These showed Care Homes for Older People Page 5 of 11 that appropriate ISA first checks and references had been obtained before they started working at the home. However neither member of staff had received a proper induction in line with the Skills for Care Induction standards. We also requested to view staff training files but these could not be found although staff we interviewed confirmed they had received all the mandatory training for their role. MANAGEMENT At the time of our inspection both the manager and the deputy had recently resigned and a temporary manager had been appointed to oversee the running of the home until a new manager is appointed. We had not been formally notified of the managers resignation or the interim managements in place. We had also not been notified of a two significant incidents affecting the well being of residents. 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 Care Homes for Older People Page 7 of 11 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 30 18(2) Accurate, orderly and up to 01/07/2009 date training records for staff must be kept so there is a clear and easily accessible way of telling what training they have completed and what training they are due. Care Homes for Older People Page 8 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 1 8 12 You must weigh all residents 08/09/2010 regularly, and provide evidence that there are receiving a fortified diet as required. You must also make appropriate referrals to the dietitian as soon as residents begin to lose weigh or have nay difficulty eating You must do this to ensure residents weights are maintained 2 9 13 Records made when medication is given must be accurate and complete, and that medication is locked away form residents You must do this to demonstrate that people get their medication as prescribed 08/09/2010 3 10 12 Residents must be dressed appropriately You must do this to ensure their dignity is maintained 08/09/2010 4 19 23 You must ensure that; bedrooms are clean and hygienic that the door to bedroom 6 is repaired that there are operational calls bells available in all bedrooms where residents reside 08/09/2010 Care Homes for Older People Page 9 of 11 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 that fire exits are kept clear that lighting is available in all parts of the home that the hot radiator in bedroom 16 is made safe You must do this to ensure that residents live in a clean and safe environment. 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 37 37 You must ensure that CQC is 08/09/2010 notified of any events affecting the well being of residents. You must do this so that we can monitor serious events 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 manager or senior staff should regularly audit medication records to ensure they are completed accurately 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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