30 March 2011
During a routine inspection
We saw that staff some were respectful in their interactions with people. They asked people where they wanted to sit and if they needed anything.
We observed staff verbally giving people living at the home choices, for example what they would like to eat. We observed that at other times, staff did not interact with people living at the home. At times we observed that the dignity of people at the home may be compromised. Staff were not always clear about how people living at the home should be supported to make choices and decisions.
We received concerns from the local authority that fund the care of some people who live at the home. The home had not completed an assessment of one person's needs prior to admission nor had they received up to date information from all the required health professionals. We saw that for another person a pre admission assessment had not been completed before admission. This should have been completed to ensure that the home was able to provide the correct level of care and support.
We were told by some people who live at the home that the staff, are very good' and that they are, 'kind and helpful'. Some of the people who we met said that they felt that they were being properly looked after.
Some people we spoke to thought that the care could be improved and that they sometimes had to wait for staff to support them. Some people told us that they would like a bath more often. Some people were nursed in bed due to ill health or frailty. We observed that these people received appropriate care during the day that we visited. People were supported to change position regularly required to prevent pressure ulcers and received regular fluids.
People at the home have a care plan in place these were found to contain a range of assessments and what actions staff must follow to help each person to meet their needs and live their daily life to their maximum potential. We saw that care plans are being reviewed and updated regularly by the staff.
A number of people we spoke told us that they were often 'bored' or 'there is not a lot to do' 'activities seem to revolve around the TV'. The home does employ an activities organiser who provides support for activities every afternoon five days a week.
Some people at the home told us that the food 'was ok' or that the food 'was good'. One person told us that she was 'sometimes hungry as the portion sizes were small'. People told us that supper is not served in the evening. One person said 'it is a long wait from 5pm until breakfast the next morning.' Staff told us that breakfast is served between 8am and 9am. This period of around 15 hours may account for people telling us that they were sometimes hungry. We observed a family member supporting their mother with her meal. This family member stated that they came in 'every day to help mum and that they had no complaints about the meals served'
We observed that during the visit that no person in the lounge area had access to fluids in between the tea and coffee rounds which take place mid morning and mid afternoon. People should have access to fluids at all times to ensure that the risks of dehydration are reduced.
During our visit we viewed all communal areas and a selection of bedrooms and we found the standard of cleanliness to be adequate with no malodours. Some areas of the home were quite cluttered which would make cleaning more difficult.
One person using the service said 'staff are always cleaning'. We were not able to see that staff had access to a good supply of equipment such as paper towels required for hand washing. On the day that we visited staff did not have access to gloves. This may lead to an increase risk of cross infection.
People who live in the home are supported to have their medicines at the times they need them. Medicines are stored in a safe way. Systems for giving people their medication do not always follow best practice for reducing the risk of medication errors.
During the site visit it we were told that some of the home's equipment had been broken in recent months. This included the boiler providing heating and hot water and the homes cooker, dishwasher and tumble dryer. Items have now been upgraded or replaced. This had caused some disruption to people living at the home. One person told us 'it has been chilly in the evenings'.