This is the latest available inspection report for this service, carried out on 22nd December 2008.
CSCI found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for adults (18-65 years)
Name: Address: Lower Clapton Road (Flat 1) Flat 1 219 Lower Clapton Road Hackney London E5 8EH The quality rating for this care home is: The rating was made on: two star good service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Lawrie Allum Date: 2 2 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Lower Clapton Road (Flat 1) Flat 1 219 Lower Clapton Road Hackney London E5 8EH 02089861876 02089861876 lcr1@hilt.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hackney Independent Living Team care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability 4 Over 65 0 Conditions of registration: Date of last inspection Brief description of the care home Lower Clapton Road (Flat 1) offers support, personal care and accommodation for a maximum of four service users who have learning difficulties. Some of the current service users are physically disabled and are living with complex health conditions. Hackney Independent Living Team, (HILT) manages the home, which is a voluntary sector provider of care services. The home is situated within a modern small complex of flats at a busy intersection near Clapton Pond within the London Borough of Hackney. The home has good bus links and is within walking distance of local shops, and amenities including a post office. Care Homes for Adults (18-65 years) Page 2 of 8 What we found:
It was the homes first day of the 4-week cycle of prescribing and supply of medication dispensed by their regular pharmacy by monitored dosage system (MDS). The pharmacy also supplied printed medicine administration record (MAR) charts for each resident and although a significant mount of the medication was unable to be packed in the MDS blister cards, particularly in liquid forms, there was adequate storage space. Being the first day of the medication cycle only the first dose had been administered, however, the receipt of medication was correctly recorded. Records for the previous cycle of medication were complete with additional written guidance provided on the MAR charts where the prescribers directions required further information. Where monitoring the service user influenced the administration of medication, for example bowel habits and the use of laxatives, this was recorded on a separate chart and kept with the MAR chart. In order to account for signed entries on medication records it is necessary to have a record of specimen signatures and signed initials of staff handling medication. This is usually provided on a separate sheet and made available for auditing medication records. Documented medication policies and procedures were not readily available and involved some delay in accessing on the homes computer. Finding information within the document also involved unnecessary delay that could be resolved by providing an index to the document. Section 6 of the document provides guidance with respect to medication errors and would benefit by direction to the NHS Direct support service whenever there is delay in contacting a service users GP. Further information is required on medication storage, particularly with respect to Controlled Drugs and cold storage. Although the home had no medication requiring refrigerated storage, the home had no provision for security or adequate temperature monitoring using a maximum/minimum thermometer. The home relied on patient information leaflets and online sources for reference on medication whereas a recent edition of the BNF would provide an accountable and readily available source of information. Medication guidance documents available from the CSCI and the Pharmaceutical Society were not available in the home for reference and copies were printed from the websites of these organisations at the time of the inspection for reference in the home. I was informed that medication remaining from a previous cycle was retained in reserve in case of supply difficulties. The retention of medication surplus to that currently dispensed is confirmed in section 12 of the homes medication policies and procedures as requiring return to the pharmacy. There were no Controlled Drugs (CD) in the home although a CD cupboard was provided and located inside the medicines cupboard. The CD cupboard did not meet the requirements of the Misuse of Drugs Regulations, as it was not fixed to the wall by means of bolts. In order to meet these requirements and to increase storage space it was decided that the regulations would best by met by means of a separate CD cupboard bolted to the wall outside the medicines cupboard. Care Homes for Adults (18-65 years) Page 3 of 8 What the care home does well: What they could do better: 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 Adults (18-65 years) Page 4 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 24 23(2)(b) All damaged areas to be repaired, particularly in personal rooms where damage impacts directly on the quality of life for that person. (Brought forward from the last inspection as not yet fully completed) 31/05/2008 Care Homes for Adults (18-65 years) Page 5 of 8 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, Care Homes 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 20 13 To return retained surplus 09/01/2009 medication to the pharmacy. To avoid misuse and the risk of use beyond the in-use shelf life. 2 20 13 A record of specimen 16/01/2009 signatures and signed initials of staff handling medication. To enable auditing of medication records to ensure administration is in accordance with the prescribers directions. 3 20 13 Medication policies and procedures to be complete and readily available for reference at the point of medication use. For the ready reference of staff handling medication to ensure action can be readily implemented for the safe control of medication. 22/03/2009 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 Care Homes for Adults (18-65 years)
Page 6 of 8 improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 20 20 To make readily available a recent edition of the BNF as a source of reference on medication. To make arrangements for cold storage and Controlled Drugs to meet legal requirements. Care Homes for Adults (18-65 years) Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 Adults (18-65 years) 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 8 of 8 - 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!
