This is the latest available inspection report for this service, carried out on 12th February 2009.
CSCI found this care home to be providing an Adequate 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Ranelagh House Residential Care Home 533 Aigburth Road Liverpool Merseyside L19 9DN 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 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: Maggy Howells Date: 1 2 0 2 2 0 0 9 Information about the care home
Name of care home: Address: Ranelagh House Residential Care Home 533 Aigburth Road Liverpool Merseyside L19 9DN 01514274486 Telephone number: Fax number: Email address: Provider web address: lil@ranelaghhouse.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Prima Health Care Limited care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care home only - Code PC 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 The maximum number of service users who can be accommodated is: 26 Date of last inspection Brief description of the care home Ranelagh House is situated in the Aigburth area of Liverpool, close to local amenities and on bus routes to the city centre, Speke retail park and John Lennon airport. The home provides care for up to 26 older people who have single rooms, with up to two rooms available for those who may want to share (for instance married couples or partners). Most of the bedrooms have en suite facilities. The rooms are on two floors and there is a passenger lift to the first floor. Three rooms on the first floor cannot be Care Homes for Older People
Page 2 of 10 Brief description of the care home reached by the lift so people who live in that part of the home have to either use the stairs or a stair lift. There is car parking at the side of the house and on the main road, and a secure, welltended garden to the rear. Fees for Ranelagh House are from £307.50 to £340 a week. Care Homes for Older People Page 3 of 10 What we found:
We visited the home because we had concerns about how medicines were handled and recorded following the last inspection. A pharmacist inspector carried out the visit. It lasted three hours and involved speaking with the manager and two senior members of staff. We checked the medicines storage areas and a sample of medicines stocks and records. We gave detailed feedback throughout the visit, and repeated the main findings to the manager at the end of the inspection. Overall we found that whilst most medicines were given correctly, some poor practice when handling and recording medicines meant that the health and wellbeing of people who live in the home may be at risk of harm. Before we looked at the medication administration record charts (MARs), a carer signed for all the medication that she had given earlier that morning. She also signed for medication that had been given by the night staff. This is dangerous practice. People are placed at risk of harm when carers do not sign for medicines promptly or when they sign for medicines they have not given themselves because mistakes are more likely to happen. We looked at a sample of records and stock and could account for most medicines. This meant that they had been given to people correctly. It was not possible to see whether the correct amount of creams and nutritional supplements were present as the records for these were not clear. When the administration of medicines is not accurately recorded, people are at risk of being given the wrong amount of medicine (too much or too little). Some people were prescribed medicines to be taken only when required e.g. painkillers. There was no formal system for recording detailed information about how and when these medicines were to be given. Having clear written information helps to ensure that people are given their medicines consistently and correctly. Staff were aware of the importance of giving certain medicines before or after breakfast. Whilst these medicines were generally kept separately and had been given correctly, we found four examples where they had not been given at the right time. Peoples health and well-being may be at risk of harm if medicines are not given at the correct time of day. We looked at how medicines were stored. Most medication was stored in a trolley, but this was not secured to a wall. Other medicines were kept securely in a locked room. Some asthma inhalers were found loose in the kitchen and records showed that sometimes these had not been given correctly. Medicines are at risk of being mishandled if they are not stored safely. Medicines that needed cold storage were kept in a fridge, but this was not locked and contained a variety of defrosting, raw and prepared food. This is unhygienic and can lead to contamination of both food and medicines that could cause people harm. The manager told us that audits (checks) of the medicines stocks were carried out, but the details of these were not recorded. There were no audits done on other aspects of Care Homes for Older People Page 4 of 10 handling medicines. This meant that poor practice was not being found and acted upon to stop it happening again. For example, the manager said that staff knew to sign records straight away, but this had not been done. Audits that cover all aspects of dealing with medication can help to maintain and improve standards. We looked at training and found that staff who were authorised to handle medication, had completed appropriate trainings. There was no formal system for checking and recording the competence of staff actually administering or recording medicines. Checking the competence of staff ensures that staff have understood the training and are safe to carry out their duties without supervision. 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 Older People Page 5 of 10 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 9 13(2) The Registered Person must 01/09/2008 make arrangements for the recording and administration of medicine and must therefore ensure that each medication episode is accurately recorded and all medication can be fully and properly accounted for. (Original timescale 17/01/07) The registered person must 01/11/2008 keep the home in a good state of repair and must therefore: *Thoroughly clean or replace the carpets in the identified bedroom and the identified rear corridor; *Re-hang or replace the curtains in the rear lounge. The registered person shall 01/08/2008 not employ a person to work at the home unless the person is fit to do so and the documents required in Schedule 2 of the regulations are in place; in particular, CRB checks, POVA clearance and references. The registered person must 01/08/2008 notify the CSCI without delay of any serious injury to a
Page 6 of 10 2 19 13(4), 23(2) 3 29 19 4 38 37 Care Homes for Older People service user, theft and all of the other matters set out in Regulation 37. 5 38 23(4) The Registered Person must 01/08/2008 take adequate precautions against the risk of fire and must therefore: *remove any combustible material from the stairwell; * ensure that fire doors are only propped open by an approved device which closes the door if an alarm is sounded; *conduct and record checks on fire safety equipment (Original timescale 19/06/07) The registered person shall ensure that all parts of the home are free from hazards and must therefore keep secure the boiler cabinet on the first floor. The registered person must complete a risk assessment when bedleaver bars or other bedrails are in use. 09/07/2008 6 38 13(4) 7 38 13(4) 01/08/2008 Care Homes for Older People Page 7 of 10 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 9 13 Staff must read the medication administration record charts carefully and sign them as soon as they have administered medication to each person so that records are maintained accurately and there is less risk of making mistakes 13/03/2009 2 9 13 All medication must be stored securely and away from foodstuffs at all times in order to reduce the risk of medicines being contaminated mishandled or accessed by unauthorised people. 13/03/2009 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 improving their service.
No. Refer to Standard Good Practice Recommendations 1 9 There must be a system for regularly auditing (checking) the standard of handling and recording medication within the service so that standards can be monitored and
Page 8 of 10 Care Homes for Older People improved where necessary. There should be a formal system for checking and recording the competence of staff who administer medicines. This helps to ensure that staff are safe to carry out their duties without supervision. Care Homes for Older People Page 9 of 10 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 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: 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 Older People Page 10 of 10 - 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!
