Care Home: Wear Court

Similar services:

• Turret Villa Retirement Home
• Mendip House
• Beaconsfield Court Care Home
• Little Sisters Of The Poor
• Manor House
• Middleton Hall Ltd
• Middlesbrough Intermediate Care Centre

What the care home does well The care and activities staff had created several interesting picture and photographic displays within the communal lounges which reflected recent outings and activities within the home. People living at the home were all smartly dressed and looked comfortable and relaxed. People were enjoying the morning sunlight and doing what they wanted such as reading the paper, actively watching the TV or snoozing in their chairs. The home was clean and tidy throughout at this visit. The nursing team had made considerable progress in improving and maintaining medications arrangements. The staff team overall have worked hard and supported each other and people living in the home well during the continued absence of a registered manager and the changes to acting manager arrangements. What the care home could do better: Audit of the medications systems needs to be more in depth and the medicines room and fridge temperature records should be kept for longer than just one month. The home remains without a registered manager. Any new manager will need to prioritise and take a lead role in making the required improvements to the service. Senior staff need to monitor and supervise the standard of bedmaking. The inappropriate storage and management of incontinence aids must be rectified through staff supervision and training. The provider has yet to demonstrate an ongoing commitment to providing safe, accessible surroundings that will promote the wellbeing of the people who live at the home. The grounds at the rear of the home require attention to allow ease of access and improve the view for people within the home. The standard of decoration varies throughout the home and must all be brought to an adequate level for everyone using and living in the service.The unpleasant odours on entering the home and within the communal areas were detrimental and must be dealt with. A robust system of identifying and dealing with the day to day maintenance issues is required to ensure people`s comfort and safety at all times. The continued absence of a sluicing disinfector is a poor reflection on the provider`s priorities with regard to infection control. Ventilation systems were not working properly and attention is needed to allow for air exchanges and the reduction of infection risks within the home. Random inspection report Care homes for older people Name: Address: Wear Court Rock Lodge Road Roker Sunderland SR6 9NX zero star poor 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: Kathryn Reid Date: 3 1 0 8 2 0 1 0 Information about the care home Name of care home: Address: Wear Court Rock Lodge Road Roker Sunderland SR6 9NX 01915496441 01915485305 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Moorlands Care Homes (N.E.) Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 1 7 0 5 2 0 1 0 Wear Court Nursing Home provides nursing and personal care for 30 older people.The home is situated in a residential area of Sunderland approximately 50 metres from the sea front and within easy reach of public transport facilities.The three-storey house was originally a residential dwelling and was converted to a care home in 1993. There is a passenger lift, which provides access to most areas of the home. A stair lift provides access to several bedrooms on the first floor that are inaccessible via the passenger lift.There are twenty-seven bedrooms, four of which are double and are currently used as single rooms. Eight single and two double rooms have en-suite toilet Care Homes for Older People Page 2 of 16 Brief description of the care home facilities however, some are not of a suitable size to allow access for wheelchair users or people with mobility difficulties. Corridors and door widths are wide enough to allow access for wheelchair users. The laundry, kitchen, dining room and lounge areas are all on the ground floor with the majority of bedrooms on the upper floors.There is a conservatory to the rear of the building, which overlooks the private and mature gardens. Fees vary and details are available directly from the home. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Care Homes for Older People Page 3 of 16 What we found: This is an overview of what the inspectors found during the inspection. This service was assessed as providing poor outcomes for people at the last key inspection in December 2009. Random inspections have been carried out in March and May 2010. 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. Before this visit we looked at information we had received since the last visit to the home. This included how the service had dealt with any complaints and any changes to how the home is operated. An unannounced visit was made on 31 August 2010. Two inspectors were involved including a pharmacist inspector. The visits was made in order to check compliance with requirements made at the last inspection in May 2010 when warning letters were issued. Also to check compliance with the second part of a Statutory Requirement Notice issued in April 2010 which set out requirements in relation to the provision of training for staff in several key areas. We were assisted by one of the registered nurses and the operations manager. During the visits we talked with people who use the service and several staff of varying designations. We looked at information about people who use the service in particular their medication records. We walked around the premises and looked in particular at the areas where people live. We asked for information and looked for evidence in relation to staff training. Medications: We examined the medication records and medicines for all of the seventeen people who were living at the home. We found the systems for ordering, receiving, storing and disposal of medicines to be good. The standard of record keeping has also improved since the last inspection. The previously issued medication requirements were met at the time of this inspection. No gaps were seen on the medication administration records (MARs) and an audit of stock and records showed very few differences suggesting that people living in the home can expect to receive their medications correctly. We found that there were no medicines out of stock on this or the previous months MARs. Care Homes for Older People Page 4 of 16 A system was in place to audit medicines on a regular basis. However the audit we saw was too basic as it only included a check of the MAR for just one person per month and a full audit was only completed every six months. Whilst records of fridge and room temperatures had been kept for every day of August 2010, the records for previous months could not be checked because these had not been kept. Premises: Following the random inspection in May 2010 we raised ongoing concerns and issued a warning letter in relation to the condition of the premises and the fact that the home was inadequately clean and in a poor decorative state. We asked the provider to send us an updated improvement plan in relation to our concerns by 5 July 2010. However this request was not met. At this visit the operations manager was unable to provide an improvement plan and gave an assurance that he would attend to this following the inspection. We advised that further failure to upgrade and improve the premises will lead to enforcement action and this matter will be followed up. Our findings were as follows: We looked around the premises both inside and out. We saw that one of the two external clinical waste bins was overflowing with yellow bags and that the second bin appeared locked shut. The home has a spacious, enclosed rear garden which was overgrown and looked neglected. We were told that maintenance of the lawns and borders and subsequent removal of garden rubbish poses a problem as there is no side access from the front of the home. The operations manager gave an assurance that ways to resolve this matter were being explored. On entering the home we noticed a stale, unpleasant smell of urine which was mainly apparent in the communal lounge areas. The staff could not identify any reason for this problem. We found that the home was adequately clean and tidy in all areas and that previous specific concerns about cleanliness had been addressed. The old sash windows in the communal areas have not been replaced but efforts had been made to provide at least one openable window in each area which allowed for a pleasant breeze and fresh air in these areas. We await the providers written proposals on the refurbishment or replacement of these windows. There was no evidence of any redecoration and the paintwork on skirting boards and door frames in corridors remained damaged and scuffed. An area in bedroom 18 previously identified as requiring decoration was unchanged from the last inspection. The senior staff told us that they were unaware that an entire tap was missing in bedroom 27 en-suite. In addition minor maintenance issues such as oversink lights not Care Homes for Older People Page 5 of 16 working, flickering lights, trailing wires, inadequate lampshades and missing cord pulls were identified to the operations manager. These findings reflected a lack of in house audit and prompt attention to areas that can provide additional comfort and safety for people living at the home. Mechanical extractor fans, particularly in areas with no natural ventilation such as a window, were clean at this visit. However several were noisy and none of them had an overide facility and immediately ceased to operate once the light was turned off. This meant that essential air exchanges in these rooms would not take place which in turn would not assist with odour removal and which posed an infection control risk. A significant problem had arisen with the storage and management of incontinence pads within peoples bedrooms. We found these were being stored out of their packaging and in inappropriate places such as piled high at either side of the ensuite WCs, in front of vanity units, on tops of wardrobes and in unoccupied rooms. Again this posed an infection risk and was poor practice in relation to peoples dignity and confidentiality about their care needs. The standard of bedmaking at this visit was poor and we found several examples where bedding was dirty and stained with what appeared to be body fluids. Beds were not well made. Some pillows were lumpy and misshapen and sheets and duvet covers were crumpled and not properly applied. The majority of beds were without a vallance to cover the bed base. When tested during the morning the majority of communal bath and shower hot water outlets failed to produce any hot water. However very hot water was identied at wash handbasins where warning signs were visible. We raised concern over the hot water temperature at a wash hand basin in room 24 which was being used as the hairdressing room. This posed a scald risk and required some form of thermostatic control. A full length unframed glass mirror was leaning against the wall in this room and posed an accident hazard. The operations manager told us that arrangements were in place to provide the home with a sluice disinfector. However this ongoing requirement remained unmet and we saw evidence of soiled and inadequately clean commode buckets in bedrooms and sluice rooms. We await early confirmation from the provider that this matter has been actioned. We met with a domestic who confirmed that the only operational hoover was a Henry cylinder type. The operations manager later advised that a new upright hoover was also to be provided that day. The operations manager thought that water was being run and tested in out of use bedrooms and bathing facilities in order to eliminate any risk of infection. He was unable to produce any evidence of this or confirm who was carrying out these checks during our visit. We visited the laundry area in the afternoon and found it was clean and tidy with no Care Homes for Older People Page 6 of 16 backlog of washing. Only one of the two washing machines was working as had been the case at our May inspection. The nurse in charge said that due to the reduced occupancy this arrangement was sufficient. The tiled laundry floor remained broken and the threshold to the room was loose and could not be properly cleaned. The nurse in charge told us that bathroom 2 was used the most with other bathing and shower areas either rarely used or not used at all. All areas were small with low level baths which were only accessible from one side. Staff training: The operations manager helped us with our checks on compliance with a Statutory Requirement Notice issued in respect of staff training in April 2010. When we had visited on 27 May 2010 the operations manager had indicated and provided evidence to show that arrangements were in place for all staff to receive the required training by 31 July 2010. Since then the provider had not alerted us to the fact that this training would not be carried out by that date. On 14 April 2010 we had made the following requirements within the SRN and the inspection report dated 16 March 2010. :Ensure that sufficient numbers of staff receive first aid training in order that first aid assistance is always available in the home by 31 July 2010. :Ensure that all members of staff with responsibility for administering medication are trained to do so by 31 July 2010. :Provide all staff with training in adult safeguarding and whistle blowing by 31 July 2010. :Ensure that all staff are provided with training in moving and handling which is appropriate to their work by 31 July 2010. :Provide all staff with suitable training in health and safety by 31 July 2010. :Provide all staff with suitable training in infection control by 31 July 2010. :Provide all staff who prepare and handle food with suitable training in food safety and hygiene by 31 July 2010. :Provide all staff with suitable training in the Mental Capacity Act and deprivation of liberties safeguarding by 31 July 2010. At this visit the operations manager told us straightaway that the majority of this training had not yet been provided. He gave us a staff training record dated 6/7/10 which detailed twenty-nine staff names and a training schedule to refer to. We identified the following information: Care Homes for Older People Page 7 of 16 Training and update in first aid had not been provided. Seven staff were booked for training on 28 September 2010 using in-house DVD training packs purchased from an external training organisation. This training was to be provided and led by the manager of another home within the organisation. The nurse on duty confirmed that all nurses should be up to date and also updated with their first aid knowledge. She told us that she had still not received any first aid update or training since April 2010 when the SRN had been issued. This meant that first aid assistance from a person trained in first aid was not always available in the home. We were told that no further training had been provided for people who handle and administer medicines. We saw that 2009 dates had been added to the staff training record for six of the seven registered nurses on the duty rotas. However the operations manager was unable to provide documentary evidence to support this and thought that this may be training obtained via their additional NHS employment. There was no evidence of any training for one nurse. Ten staff names were listed on the training schedule as having received training in safeguarding from the operations manager on 17 August 2010. However, during the visit the operations manager was unable to produce a confirmatory attendance sheet where staff would have signed their names. We were told that these staff had completed written tests which had then been sent off to the external training organisation for marking and accreditation. These had not yet been returned. The operations manager told us that he had attended a one day basic awareness course in safeguarding on 29 July 2010 but had not yet attended a train the trainers course which is necessary to train in this topic. We were told that a manager from another home within the organisation was scheduled to carry out further safeguarding training. In relation to moving and handling training the operations manager advised that no training had been given as yet and that training was scheduled for 21 September 2010. We saw that ten staff names were listed on the training schedule. The information on the staff training record was unchanged from what we saw on 16 March 2010 where some staff had received no training since 2005 and 2006. We were told that nine staff were scheduled to receive training in health and safety on 2 September 2010 but otherwise no training had been given since service of the SRN. This corresponded with the staff training record where only four names had entries ranging from 2004 to 2007. In relation to training in infection control we were told me that nine staff had attended training in June 2010 and a further ten were scheduled to receive training on 14 September 2010. This was also detailed on the training schedule. We saw that a date of 09/06/2010 had been inserted against eight staff names on the staff training record but a confirmatory attendance record or detail of what this training had involved was not available. Also sixteen staff had dates in June 2010, either 9th or 14th, under the hand hygiene column which indicated a training provision from the Local Authority infection control team. We were told that no training in food hygiene for food handlers had been provided but Care Homes for Older People Page 8 of 16 was scheduled for ten staff on 7 September 2010. We saw that a new date of 01/08/2009 had been added on the staff training record against one of the cooks. However this date had not been provided during interview at inspection on 16 March 2010. Another cook had still not received any training. The operations manager confirmed that no training had been provided in the Mental Capacity Act and deprivation of liberties safeguarding and that this was not yet arranged or scheduled. There was nothing listed on the training schedule and only three names had dates of either 1st or 2nd September 2009 added on the staff training record with nothing additional since the inspection on 16 March 2010. What the care home does well: What they could do better: Audit of the medications systems needs to be more in depth and the medicines room and fridge temperature records should be kept for longer than just one month. The home remains without a registered manager. Any new manager will need to prioritise and take a lead role in making the required improvements to the service. Senior staff need to monitor and supervise the standard of bedmaking. The inappropriate storage and management of incontinence aids must be rectified through staff supervision and training. The provider has yet to demonstrate an ongoing commitment to providing safe, accessible surroundings that will promote the wellbeing of the people who live at the home. The grounds at the rear of the home require attention to allow ease of access and improve the view for people within the home. The standard of decoration varies throughout the home and must all be brought to an adequate level for everyone using and living in the service. Care Homes for Older People Page 9 of 16 The unpleasant odours on entering the home and within the communal areas were detrimental and must be dealt with. A robust system of identifying and dealing with the day to day maintenance issues is required to ensure peoples comfort and safety at all times. The continued absence of a sluicing disinfector is a poor reflection on the providers priorities with regard to infection control. Ventilation systems were not working properly and attention is needed to allow for air exchanges and the reduction of infection risks within the home. 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 10 of 16 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 Ensure that sufficient 31/07/2010 numbers of staff receive first aid training in order that first aid assistance is always available in the home. Ensure that all members of staff with responsibility for administering medication are trained to do so. Provide all staff with training in adult safeguarding and whistle blowing. Ensure that all staff are provided with training in moving and handling which is appropriate to their work. Provide all staff with suitable training in health and safety. Provide all staff with suitable training in infection control. Provide all staff who prepare and handle food with suitable training in food safety and hygiene. Provide all staff with suitable training in the Mental Capacity Act and deprivation of liberties safeguarding. This is to ensure that people are cared for by staff who are competent and trained for the work they are to perform. Care Homes for Older People Page 11 of 16 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 19 23 Implement and keep records 31/10/2010 of the programme of routine in-house maintenance. Ensure that in-house maintenance and repair work is carried out promptly. Replace or upgrade the communal lounge windows so that they are suitably decorated, openable and provide a suitable seal against draughts when closed. Keep all parts of the home reasonably decorated to include the ground floor corridor areas and the walls of bedroom 18. This is to ensure that people live in a comfortable, safe and well maintained environment. 2 26 13 Make suitable arrangements 31/10/2010 to prevent infection, toxic conditions and the spread of infection which must include: Page 12 of 16 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 Identification of the cause and removal of the odours of urine on the ground floor. Storage of incontinence pads within their original packaging and within appropriate areas of the home. Available written evidence that out of use water outlets have been run and checked. Repair or replacement of the laundry floor to provide an impermeable and cleanable surface. The provision of at least one sluicing disinfector. Upgrade or replacement of mechanical extractor fans throughout the home so that they are fully operational with a suitable overide facility. This is to keep the home pleasant, hygienic and reduce the risk and spread of infection 3 30 18 Ensure that sufficient 31/10/2010 numbers of staff receive first aid training in order to ensure that first aid assistance is always available at the home. Ensure that all members of staff with responsibility for Care Homes for Older People Page 13 of 16 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 administering medication are trained to do so. Provide all staff with training in adult safeguarding and whistle blowing. Ensure that all staff are provided with training in moving and handling which is appropriate to their work. Provide all staff with training in health and safety. Provide all staff with training in infection control. Provide all staff who prepare and handle food with suitable training in food safety and hygiene. Provide all staff with suitable training in the Mental Capacity Act and deprivation of liberties safeguarding. To ensure that staff are trained and competent to do their jobs. 4 38 13 Install a suitable, fail safe, thermostatic control to the wash hand basin hot water outlet in the hairdressing facility in bedroom 24. This is to prevent the risk of scalding during hairwashing. 31/10/2010 Care Homes for Older People Page 14 of 16 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 Records of room and fridge temperatures should be kept for the current and previous months. This will help with audit and record keeping. Audit of the medication systems in the home should be more detailed. This helps to identify any medication issues promptly and helps to confirm that staff are following the homes medicines policy. Take action to keep the rear garden tidy, attractive and accessible to people who use the service. Provide clean, comfortable beds that are well made and have appropriate bed linen. Ensure the safe disposal and external storage of clinical waste. The full length glass mirror within the hairdressing facility in bedroom 24 should be securely fitted to the wall. 2 9 3 4 5 6 19 24 26 38 Care Homes for Older People Page 15 of 16 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 16 of 16 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!