This is the latest available inspection report for this service, carried out on 28th June 2010.
CQC 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Rowanweald Nursing Home 1 Weald Lane Harrow Weald Middx HA3 5EG two star good service 13/08/2009 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: Jane Shaw Date: 2 8 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Rowanweald Nursing Home 1 Weald Lane Harrow Weald Middx HA3 5EG 02084248811 02084248585 rob.adams@sanctuary-housing.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sandra Elizabeth Vigor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sanctuary Housing Association (trading as Sanctuary Care) care home 45 Number of places (if applicable): Under 65 Over 65 45 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category of service only: Care Home with nursing - Code N 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 Date of last inspection Brief description of the care home Rowanweald Care Home is a part of Sanctuary Care, a subsidiary of Sanctuary Housing Association. The home was first registered in 1998 for 45 elderly frail residents requiring nursing.
Care Homes for Older People Page 2 of 8 1 3 0 8 2 0 0 9 Brief description of the care home It is located in Harrow Weald. The back of the home faces the High Street and entrance to the home is through Weald Lane, a small road off High Street. The home is easily accessible by public transport and by car. It is close to some shops and local amenities. More extensive shopping can be found in Harrow Weald or Harrow on the Hill. There is a large car park in the front of the home for more than ten cars. There are maintained garden areas in the front, the side and the back of the home. The building is three-storey high and was purpose built to be a care home. Rowanweald as registered with the Commission, provides accommodation for residents in forty-five single rooms with en-suite facilities (toilet and wash basin). There are three units of fifteen residents each. Pelena and Rheola units are found on the ground floor and the Arden unit is found on the second floor. The first floor of the building, which has two units of fifteen beds each, is leased to and run by Harrow PCT. The home has all the necessary support facilities such as laundry, kitchen and maintenance. It is run by Sandy Vigor, the manager and Denise Tolland the deputy manager with support from the Head Office of Sanctuary Care. The home charges weekly fees of around 750 pounds for private residents, depending on the needs of the residents. It also accepts residents who are publicly funded. They do not have to pay a top-up. At the time of the inspection there were 43 residents in the home. Care Homes for Older People Page 3 of 8 What we found:
This pharmacist inspection was to review progress made in ensuring the safe handling of medication following requirements made at a key inspection 13/08/2009. We looked at storage, the recording of receipts, administration and disposal of medication in all three units, and we carried out some random auditing to see if there was evidence that medication was being administered as prescribed. We identified gaps in just two of the administration records (MAR). In both cases the medicines were not in the MDS (Monitored dosage system) so we assumed they had been given but not signed. We noticed that generally medicines were recorded when received into the home either on the MAR or in a separate register. For two new service users there were omissions in records and this made it difficult to reconcile quantities. Records of disposal of medication were up to date. We counted a total of 32 samples of medication supplied in their original boxes or bottles. 23 of these were accurate and we could be certain that the records provided the evidence that medicines were being administered as prescribed. There were four discrepancies where there were one or two, too many tablets left, suggesting perhaps that medicines were signed but not given. Records and audits of warfarin could not be reconciled in three cases. For one service user there were 7 too many tablets left. The management of warfarin was not satisfactory as there was often no evidence of the current dose prescribed, untidy recording and crossings out. Other discrepancies in audits were because we did not know what quantity was received or carried forward from the previous medication cycle. Variable doses of painkillers were all recorded accurately but when a liquid was prescribed as 10ml or 15ml the same attention was not given. We could see that service users had many allergies to foodstuffs and medicines and the details was always recorded on the MAR. Balances of controlled drugs were all accurate but the register was full and difficult to use because the index was not always completed. We saw that one service user was self administering their own creams and that there was a risk assessment in place. Two service users were receiving oxygen and there was good practice of recording this on the MAR. We asked to see the homes medication audits. One had been completed just before the inspection and we noticed that several of the issues we identified had also been identified by the home. Overall we were generally satisfied that the home was making progress in meeting the requirements made in the Key Inspection. Further attention is needed to safely manage warfarin and to ensure that the audits are always robust and acted upon promptly. What the care home does well:
The home was recording allergies of all the service users and had check lists of when to monitor the blood of service users prescribed those medicines which could have an adverse effect. In one unit there were medication profiles and in all units there were copies of the original prescription available so that instructions could be double checked.
Care Homes for Older People Page 4 of 8 There was good practice in documenting the area of application of a cream under the instructions on the MAR. 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 8 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 9 13 All medicines must be administered as prescribed, unless there are indications that they should not be administered. To make sure that residents receive the full benefit from their medicines regime. 18/11/2009 2 12 12 The home must review the level of interaction and engagement of staff with residents. To improve the quality of the social life for residents. 23/11/2009 3 38 13 The provider must ensure 24/11/2009 that all wheelchairs that are used to move residents have foot rests unless there are appropriate risk assessments in place. To ensure the safety of residents Care Homes for Older People Page 6 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, 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 To ensure that warfarin is 30/07/2010 safely managed in the home. This is to protect the health and welfare of the service users. 2 9 13 To ensure that audits are robust and identify areas of concerns and the action taken to reduce these concerns. This is to provide evidence that medicines are given as prescribed. 30/07/2010 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 1 9 That new controlled drug registers are introduced so that indexes can be completed and supplies easily located. It is considered good practice to record midazolam injection in the register. Care Homes for Older People Page 7 of 8 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People 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!
