Care Home: West Street Home

What the care home does well The area manager was not present when we arrived at the home, she was attending a training course on falls management. The acting manager who had held the position of Deputy Manager was present throughout the inspection. Documents were viewed to demonstrate that the area manager had been working with the acting manager to make improvements in the management of falls in the home. The area manager was not in the home at the time of this inspection as she was attending a training course in this area. On speaking with the acting manager and examining staff rotas, this showed that a senior person was available at the home throughout the week.We spoke to the area manager by telephone, she gave assurances that the company had already taken action towards advertising for a Home Manager, following the departure of the Registered manager on 15th April 2010. What the care home could do better: We looked at care records for two people who lived at the home, one person had fallen a number of times and we saw that action had been taken so a referral was made to a falls clinic. On examination of documents including care records, monthly internal monitoring of falls and monthly quality assurance visits carried out under regulation 26, we noted discrepancies between all three records. Examples included in April 2010, monthly monitoring stated 10 falls had occurred in the home, the quality assurance visit said 6. In March 2010 there had been 8 falls and for one person a clear pattern had formed for the location and time, however the quality assurance visit recorded only 2 that month with no pattern. In addition training records were viewed, although it is acknowledged that the management of the company had already identified shortfalls in the mandatory training of staff, however the shortfalls in this area should not have occurred in the first place and demonstrates that the service had not sustained standards in this area. The care records seen for two people needed to improve in their content, the actingmanager advised that she and the area manager were already working on these improvements. A requirement made at the last inspection for care plans to contain sufficient guidance to staff on how to care and support people had not been met. One person for example had within the past several months fallen frequently, there was no guidance to staff that they should seek medical advice, check foot wear, environmental factors or any other action to improve safety for this person. Requirements have been made relating to these matters. We will ask that an action plan be submitted to us to demonstrate how the company will address these. Random inspection report Care homes for older people Name: Address: West Street Home 198/200 West Street Dunstable Bedfordshire LU6 1NX two star good service 07/07/2009 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: Katrina Derbyshire Date: 1 9 0 5 2 0 1 0 Information about the care home Name of care home: Address: West Street Home 198/200 West Street Dunstable Bedfordshire LU6 1NX 01582477794 01582471684 audrey@benslow.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Benslow Management Company Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 36 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 36 The maximum number of service users who can be accommodated is 36 The registered person may provide the following categories of service: Care Home Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Date of last inspection Brief description of the care home West Street home is situated on a busy road close to the centre of Dunstable within a short walk of the towns many amenities. The home provides personal care for up to thirty-six people over the age of 65 years who have dementia. 0 7 0 7 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home The accommodation is distributed over four floors that are accessed by staircases and/or a shaft lift. Twenty-six rooms have an en-suite toilet and wash hand basin, one has en-suite shower facilities and the remaining nine rooms do not have en-suite facilities. The dining and lounge facilities are located on the ground floor together with the kitchen, laundry, bathrooms, WCs and some bedrooms. To the rear of the property is a garden with seating areas. A copy of the homes statement of purpose and service user guide are available in the front hall. Copies are available to prospective people who may wish to move into the home. The weekly fees range from £457.00 to £716.00 per week. Care Homes for Older People Page 3 of 9 What we found: This unannounced random inspection was undertaken on 19th May 2010 by one Regulatory Inspector. The reason for this inspection was The Care Quality Commission received information from Central Bedfordshire Council through the local safeguarding procedure. A safeguarding case relating to one person was subsequently investigated by Bedfordshire police, at the time of this visit the outcome of this investigation was not known. Further information supplied to us raised concerns surrounding the management of falls. In addition we received notification that the Registered manager had left. The outcome is as follows: What the care home does well: What they could do better: We looked at care records for two people who lived at the home, one person had fallen a number of times and we saw that action had been taken so a referral was made to a falls clinic. On examination of documents including care records, monthly internal monitoring of falls and monthly quality assurance visits carried out under regulation 26, we noted discrepancies between all three records. Examples included in April 2010, monthly monitoring stated 10 falls had occurred in the home, the quality assurance visit said 6. In March 2010 there had been 8 falls and for one person a clear pattern had formed for the location and time, however the quality assurance visit recorded only 2 that month with no pattern. In addition training records were viewed, although it is acknowledged that the management of the company had already identified shortfalls in the mandatory training of staff, however the shortfalls in this area should not have occurred in the first place and demonstrates that the service had not sustained standards in this area. The care records seen for two people needed to improve in their content, the acting Care Homes for Older People Page 4 of 9 manager advised that she and the area manager were already working on these improvements. A requirement made at the last inspection for care plans to contain sufficient guidance to staff on how to care and support people had not been met. One person for example had within the past several months fallen frequently, there was no guidance to staff that they should seek medical advice, check foot wear, environmental factors or any other action to improve safety for this person. Requirements have been made relating to these matters. We will ask that an action plan be submitted to us to demonstrate how the company will address these. 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 5 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 7 15 There must be a care plan in 11/09/2009 place for each assessed need, so people receive continuity of care and staff have sufficient guidance on how to support the person. Staff need to have written guidance on how a need should be met. Care Homes for Older People Page 6 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 8 12 Action and reporting of 18/06/2010 injuries and falls must be made in accordance with the homes policy. Monitoring and follow up must be made by staff and medical attention sought when an injury has occurred. This will ensure health and safety law is met, people living at the home are protected and people receive medical attention immediately. 2 30 18 Staff must have received mandatory training as a minimum before being allowed to provide care to people at the home. Their competency must be assessed to ensure they have a sufficient understanding of their responsibilities. This is to ensure the safety and protection of people who use the service. 18/06/2010 Care Homes for Older People Page 7 of 9 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 3 33 24 The system for quality assurance of the care standards in the home must improve and be robust enough to identify shortfalls in a timely manner. This will ensure shortfalls in standards are acted upon immediately. 25/06/2010 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 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. 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