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Inspection report

Date of Inspection: 26 March 2012
Date of Publication: 24 April 2012
Inspection Report published 24 April 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

People were not always receiving care which met their assessed needs. Records did not always provide the information that staff needed to provide support for people.

User experience

People told us that staff at the home were kind and caring. One person said “they’re all really good” and “the care is very good”. A relative told us that staff “nursed my mother wonderfully” and that they had “no problem with the care”. We saw that staff took time to explain everything to the people they were supporting, and got down to each person’s level to speak with them.

Many of the people who were living at the home were not able to express their views verbally, so we spent time sitting with them in the lounges and dining rooms, observing the daily life of the home. There were many occasions during the day when there were no staff in some of the lounges. On one occasion we heard a person calling out for several minutes. We went to the lounge and saw that there were no staff. The person was trying to get out of their wheelchair and was very distressed. We went to find a member of staff to come and reassure the person.

We saw that most people were sitting in armchairs with nothing to occupy them for long periods of time. Although there was music playing in some of the lounges, in others the television was on and there did not appear to be anyone watching it. In some of the lounges there were items for people to use such as soft toys and colouring books, but one visitor told us “there’s not a great deal for them to do all day”. Although there were some reminiscence and sensory items in the corridors, some of these were not in good condition.

The weather was very warm on the day of our visit, and we were concerned to see that there was a lack of drinks available to people in most of the lounges during the day. In one lounge, the temperature of the room was 25 degrees Centigrade and only one person out of the nine people in the room had a drink. We checked the fluid recording charts for some people who had been assessed as being at risk of dehydration. The charts indicated that some people may not have been drinking enough to meet their needs. There was no evidence to show if these people had been offered drinks, and there was no evidence of action taken when the records indicated a low fluid intake. This means that staff could not be certain that people’s hydration needs were being met.

Some people who live at the home had been assessed as being at risk of developing pressure area damage. Records showed that this risk had been regularly re-assessed, and that care plans were in place so that the risk was reduced as far as possible. For example, one person’s care plan stated that they needed to sit on a pressure relieving cushion and that an air mattress should be on their bed at the correct pressure for their weight. We saw that the person was sitting on the correct type of cushion and that there was an air mattress on their bed which had been set at the correct pressure. This means that the home is taking appropriate action to ensure that people do not develop pressure area damage.

We saw that staff were encouraging people to take short walks around the home, and staff told us that they were aware of the health benefits of exercise for older people.

At lunchtime, we saw that some people were not getting the support they needed. In one of the dining rooms, there were five staff members who were supporting people who could not eat independently, but we saw that there were ten people who were not able to manage their meal without assistance. For example, one person who was eating with their hands tried to get up and leave the table and was gently encouraged to stay. A passing staff member put a spoon into the person’s hand. The person put down the spoon and used their fingers to eat. They spat the food out onto their fingers and then put it on the table. The food fell off onto the person’s lap, and a staff member picked it up and again gave the person a spoon. Therefore this person was not given the support they needed to eat their meal. In another dining room, we saw that lunch w

Other evidence

Care plans had been reviewed and updated regularly, and we saw that when people’s needs changed, this was recorded in the care plans. The home had care plans in place for people’s short-term needs such as chest infections, so that staff would know how to provide the care and support that the people needed.

Some of the information in the records was not consistent and this could have meant that staff did not have correct information. For example, one person’s care plan stated that their skin was intact but the daily records included a recent entry about a dressing to a wound. The manager assured us that this record was not correct, and that the person’s skin was intact. It is important that records are kept accurately so that staff have the correct information about people’s care needs.

There was evidence in the records that the home had requested medical help whenever necessary, and one relative told us “they get the doctor in if they need to and they always ring me to let me know”. Records showed that the home had also requested support from other health care professionals such as dieticians. This means that staff were able to get specialist advice and support so that they could meet people’s needs.