This inspection was carried out on 22nd April 2010.
CQC found this care home to be providing an Excellent 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: Aaron Crest Care Home Tanhouse Road Aaroncrest Skelmersdale WN8 6AZ three star excellent service 22/01/2009 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: Stephanie West Date: 2 2 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Aaron Crest Care Home Tanhouse Road Aaroncrest Skelmersdale WN8 6AZ 01695558880 Telephone number: Fax number: Email address: Provider web address: aaron.crest@new-meronden.co.uk Name of registered provider(s): Name of registered manager (if applicable) Carolyn Marie Ackers Type of registration: Number of places registered: Conditions of registration: Category(ies) : Aaroncare Limited care home 66 Number of places (if applicable): Under 65 Over 65 0 37 0 dementia old age, not falling within any other category physical disability Conditions of registration: 29 0 5 The maximum number of service users who can be accommodated is:66 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 (maximum number of places 37), Dementia - Code DE (maximum number of places 29), Physical disability - Code PD (maximum number of places 5). Date of last inspection 2 2 0 1 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home Aaroncrest is a purpose built care home, providing accomodation for up to 50 older people who require support with nursing or personal care, including those whose needs are associated with a dementia related illness. There are also a small number of places available for people with a physical disability. Accommodation is on two floors served by a passenger lift. Ramps to the front of the home allow access for wheelchair users and specialised aids and equipment are available to assist those with mobility problems. The majority of rooms are single, although one companion room is available for people who might wish to share. Some en-suite facilities are provided, and there are sufficient washing, bathing and toilet facilities located throughout the home. Aaron Crest has two lounges, a large conservatory and two dining rooms. There is also plenty additional communal space and seating areas around the home offering people living there plenty of choice about where to spend their time. At the time of this Annual Service Review fees range from £373.94 to £683.17 per week with additional costs being incurred for private chiropody, hairdressing, personal toiletries and confectionary. Care Homes for Older People Page 3 of 8 What we found:
The purpose of this visit was to look at the homes arrangements for handling medication following receipt of a concern about medicines administration. This visit focused on medicines handling, other areas were not examined on this occasion. We looked at care documentation within the home and the medication systems that were in place. We spoke with staff about the arrangements made for handling peoples medicines. At the end of the visit feedback was given to the nurse-in-charge. We were concerned to find weaknesses in medicines ordering and stock control that meant people were at risk of missing doses of medication because there were none left to give. We were told that managers were aware of this concern and action was being taken to try and bring about improvement. In other areas generally suitable arrangements were in place for handling peoples medicines. We looked at medicines administration. All medicines were administered by qualified nurses or to people resident for personal (residential) care only, by staff who have completed certificated medicines training. The home has a policy in place for the use of home remedies that enables peoples to receive prompt treatment for minor ailments without a prescription. Peoples medication needs were considered when people went for short stays away from the home but we found a lack of written assessments or individual information about how medicines were supplied in practice. These should be completed to help ensure peoples medicines needs are supported in the safest and best way whilst away from the home. We found that written individual guidance about the use of when required medicines could be usefully expanded to provide clear guidance to staff about when they may be needed, and how this need is made known. We looked at a sample of medicines stocks and records. We found that medicines including controlled drugs were stored securely. This helps to reduce the risk of misshandling or miss-use. The medicines administration records were generally clearly and accurately competed enabling medicines both in the monitored dosage system and in boxes and bottles to be accounted for (tracked). But, on the nursing floor records showing the administration of prescribed nutritional supplements were not so well completed, this needs to be addressed to support and evidence their correct use, as prescribed. Most medicines administration records were pre-printed by the pharmacy, but where handwritten entries were made by staff these were not always checked and countersigned by a second person. This is recommended to reduce the risk of errors. However, we were concerned to find that on occasion some people had missed doses of medication because there were none left to give. Although this was followed-up by staff and new supplies were obtained this could probably have been addressed more quickly, we saw examples where people were without medicines for four days. Staff explained that the manger was aware of this concern and was taking action to improve the medicines ordering system in discussion with a new supplying pharmacist. What the care home does well: What they could do better:
Care Homes for Older People Page 4 of 8 Medicines ordering and stock control needs to improve to reduce the risk that people will miss doses of medication because there are none left to give. Clear and complete records need to be made for the use of prescribed nutritional supplements to support and evidence their correct use, as prescribed. 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 29 19 A person must not be 31/03/2009 employed to work in the care home unless a Criminal Record Bureau disclosure has been obtained. To ensure that people living at the home are consistently protected 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 Sufficient stocks of medication need to be kept at the home to enable continuity of treatment. 24/05/2010 2 9 12 Complete and clear records supporting the use of prescribed nutritional supplements and their administration must be maintained to help ensure they are given as needed. 24/05/2010 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 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!
