Care Home: Wentworth Croft

Similar services:

• Claremont House
• Chesham House
• Oak Ridge
• Argyll House
• Sun Court Nursing Home
• Ashville House
• Bramley Avenue (73)
• Bilney Hall

What the care home does well There has been an improvement in the way pressure area care records are kept; there is more detail and these show improvements in pressure sores and how they are healing. Information from health care professionals is obtained and is also recorded as part of the care plan, so that staff have up to date advice about how to manage health related care. Two of the three requirements about medication have been met; staff have a good understanding of the special instructions for administering one medication. Most medication does not run out, which means that people receive their medication as prescribed. People have access to staff members and are able to call them when they need to. What the care home could do better: Staff should archive care records when they are no longer being used. This prevents care files becoming too full and cumbersome and also means that new care needs and plans can more easily be found. Turn charts should record all the changes in position each person has over the 24 hour period. This is so that there is an audit trail of the care that is given, but also so that the person is not unduly disturbed as lack of rest can also have a detrimental effect on the healing process. Information must be obtained about how people want to be treated at the end of their lives, so that the care and treatment they receive is what they would like it to be. Clear records must be kept for medication that requires medical monitoring and so that people are not at risk of being given incorrect doses. The amount of medication available must be accurate and reflect the amount of medication available and received into the home for that person. This is so that the medication does not run out before being supplied and so that large stocks do not accumulate. Random inspection report Care homes for older people Name: Address: Wentworth Croft Wentworth Croft Bretton Gate Peterborough PE3 9UZ one star adequate 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: Lesley Richardson Date: 1 1 0 5 2 0 1 0 Information about the care home Name of care home: Address: Wentworth Croft Wentworth Croft Bretton Gate Peterborough PE3 9UZ 01733269200 01733269665 Telephone number: Fax number: Email address: Provider web address: www.bupa.com Name of registered provider(s): Name of registered manager (if applicable) Henry Mutambo Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (CFHCare) Ltd care home 156 Number of places (if applicable): Under 65 Over 65 0 0 0 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 0 2. The maximum number of service users who can be accomodated is: 156 The registered person may provide the following service only: Care 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 categories: Old Age, not falling within any other category - Code OP Physical Disability - Code PD Mental Disorder, ec=xcluding learning disability or dementia - Code MD Dementia - Code DE Care Homes for Older People Page 2 of 9 Date of last inspection Brief description of the care home Wentworth Croft is situated in Peterborough City, four miles from the city centre and is accessible by public transport. The home is situated in well-maintained and landscaped gardens including an enclosed garden for those living at Harvester House. Wentworth Croft is arranged into four houses Yeoman provides support and care, including nursing care, for people who have mainly a physical disability; Hayward provides support and care for people with dementia but who do not have challenging behaviours; Harvester provides care and support for people with mental health needs including challenging behaviours and Woolsack provides personal care and support. The age range is mainly for people over 65 years of age. An application to vary the registration has been submitted for the Care Quality Commission to consider; the application is to allow the home to have ten registered places for people over 50 years of age. Current fees range from GBP387.00 to GBP816.16. Additional costs include those for chiropody, hairdressing, toiletries and confectionary. Further information about the fees can be obtained from the home. A copy of the inspection report is available on request at the home or via the Care Quality Commission website www.cqc.org.uk Care Homes for Older People Page 3 of 9 What we found: We carried out this inspection to look at whether the requirements that were made at the last key inspection have been complied with and to look at the amount of information that is available to guide staff when people are coming to the end of their lives. We looked at the end of life information because we receive notifications from the home that dont give us enough details about why staff take particular actions. We looked at records for two people who have or have recently had pressure sores. We found the care plans contain enough information about the pressure sores, information about dressings and when health care professionals have visited the person. The care plans are updated when there are changes to the type of dressing or when the health care professional has made suggestions or given advice. Wound charts are available for each pressure sore and record when dressings are changed and give a description of the pressure sore. Both peoples records show that their pressure sores have improved; one persons sores have healed. However, we found in this persons records that there was a lot of old information that had not been archived, which made it difficult to find out if the person had any new pressure sores and how they might be treated. Records that show when and how people have been turned (turn chart) while in bed are also kept by staff. We looked at these for one of the people whose care records we examined. The turn charts were written in more detail that those described in the last inspection report, and gave details of which side the person was turned to or whether they were sat up. However, we noticed that there are still gaps between turning this person of up to 10 hours of one occasion and the record for another day only shows the persons position was changed twice. Not changing a persons position for this amount of time puts them at great risk of developing or worsening pressure sores. Because other records show the pressure sores are improving we feel this is not happening and it is due to poor record keeping. However, staff members must complete these records in full to make sure there is an accurate audit trail of the care they provide. We talked to the person who had not received adequate personal care to make sure their hand and nails were clean and not pressing against the palm of their hand. They said they have exercises that they do to prevent their fingers bending further and showed us how they keep their hand clean and dry. The care plan gave staff clear guidance about what they need to do and included information from a visiting health care professional. Information about how people want to treated when they die and the procedures they want happen are not well recorded. We looked at four peoples care records and only found information in one persons records to show they didnt want to be resuscitated. Two other peoples records showed that they were not able to discuss their wishes at the time of the entry and that staff should review the plan and information at a later date. However, only one these entries had been reviewed after the person had been admitted to hospital, but no specific information had been obtained. We looked at medication administration records (MAR) and talked to staff members about giving medication that has specific instructions and must be given in a particular way. The staff members were able to tell us exactly how the medication should be given and medication records also prompted staff to look at guidance before giving it. The Care Homes for Older People Page 4 of 9 medication time was recorded as before other medication that is also given in the morning. We only found one record to show a medication may have run out before new supplies were ordered. Staff told us the medication was not available from the pharmacy and after review by the doctor it had been stopped, although this was not recorded anywhere. Records of decisions made about medication must be recorded by staff so that there is an audit trail to show a person with the authority to stop medication has done so. We were not able to assess whether the home has met the requirement about the need to risk assess the use of medical gases as staff confirmed to us that there was no person using these at the time of our inspection. Assessment of the MAR charts showed that recording for one particular medication that requires close medical monitoring is not at an acceptable standard. We saw two records, each with two different dosage prescriptions for the same medication, that showed the amount of medication available and the information on the prescriptions do not tally. A staff member was also not able to give us a clear, or correct, answer for how much medication there should be. Records to show when the medication has been changed and a new regime started is also not clearly written on the records that stay in the home. When the therapy booklet is sent for updated prescription, the only reference for staff is a photocopy of the most recent order. Changes to this are not recorded in the care records and clear information is not always written on the photocopied sheet of paper, none of which had the persons name written on it. One person received incorrect dosages on two consecutive days. Although this had no overall effect on the amount of medication the person received, it means that people taking this particular medication are at risk of not receiving the prescribed amount, which puts them at risk. During our inspection we saw that most people who stay in their rooms have access to call bells and are able to contact staff when they need them. One person whose care records we looked at has information to tell staff they need to visit the room every hour to check on them as they cannot use the bell. We saw staff going into this persons room to do this. What the care home does well: What they could do better: Care Homes for Older People Page 5 of 9 Staff should archive care records when they are no longer being used. This prevents care files becoming too full and cumbersome and also means that new care needs and plans can more easily be found. Turn charts should record all the changes in position each person has over the 24 hour period. This is so that there is an audit trail of the care that is given, but also so that the person is not unduly disturbed as lack of rest can also have a detrimental effect on the healing process. Information must be obtained about how people want to be treated at the end of their lives, so that the care and treatment they receive is what they would like it to be. Clear records must be kept for medication that requires medical monitoring and so that people are not at risk of being given incorrect doses. The amount of medication available must be accurate and reflect the amount of medication available and received into the home for that person. This is so that the medication does not run out before being supplied and so that large stocks do not accumulate. 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 9 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 9 13 Risk assessment and risk 30/09/2009 management plans must be in place for people using medical gases. This will protect residents from harm. Care Homes for Older People Page 7 of 9 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 9 13 Instructions for medication that requires medical monitoring must be clearly written. This will ensure people receive the correct dosage of medication. 20/06/2010 2 9 13 Records must clearly show 20/06/2010 the amount of medication available for each prescribed medication. This will provide an audit trail and ensure stocks do not run out or accumulate. 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 Care records that are no longer being used should be archived to ensure new care needs and plans are easily seen by care staff. Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!