This inspection was carried out on 25th September 2009.
CQC 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ one star adequate service 06/07/2009 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 9 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ 01253392440 01253305705 matron@acornnursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Diane Maureen Buckley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Axelbond Ltd care home 40 Number of places (if applicable): Under 65 Over 65 37 0 old age, not falling within any other category physical disability Conditions of registration: 0 3 The registered person may provide the following category of service only: Care home with nursing - Code N. To people 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, Physical disability - Code PD. The maximum number of service users who can be accommodated is: 40. Date of last inspection Brief description of the care home Acorn Nursing Home is a large home situated in a residential part of Blackpool. The home is close to Stanley Park and Victoria Hospital. The town centre is approximately two miles away and can be reached by a bus service, which stops near by. There are
Care Homes for Older People Page 2 of 8 0 6 0 7 2 0 0 9 Brief description of the care home some small shops in the local vicinity. There are several parking spaces to the side of the house. The building has three floors and a lift is available for the residents to use. Most of the rooms are on the ground floor and the first floor. There are two dining areas and three lounge areas. The main lounge is at the rear of the house overlooking an extensive garden. There is plenty of space for the residents to sit out when the weather is warm. Information about the home is available in a welcome pack that is given to prospective residents and their families. A copy of this information is also placed in the bedrooms at the home, so that everyone has good, current information about the services that are provided. At the time of this visit the information given to the Commission showed that the fees for care at the home are from GBP 361.06 to GBP 495.97 per week, with added expenses for hairdressing and chiropody. Care Homes for Older People Page 3 of 8 What we found:
This visit was carried out to look at the arrangements for the safe handling of medication and to look at the action taken to improve medicines handling since our previous visit. We visited on two days as we were not able to access all the records we needed on the first day. The visit involved discussing the handling of medication with nursing staff, examination of medicine records and storage arrangements. Feedback was given to the nurse-in-charge on the first day and to the manager and a representative of the Provider (owner) on the second day. This visit focused on medicines handling, other areas and requirements were not examined on this occasion. Following our previous visit we sent a letter to the home detailing our concerns about the handling of medicines. During this visit we found that the requirements of our previous visit had not been met, weaknesses in the arrangements for handling peoples medicines remained to be addressed. We looked at medicines administration. People are able to take their own medication should they wish to and are able, this promotes their independence. But, we found that written assessments were not always well completed and did not detail any support people needed to help take manage their medicines safely. One person spoken with did not have a written assessment for safe self-administration. It was of concern that their medicines administration record listed two self-administered medicines, but when speaking with them they had only one. As previously seen everyone had their breakfast medicines before night staff went off duty at eight o clock in the morning, arrangements had not been made to ensure special label instructions such as before food or after food were followed. The nurse-in-charge said that a new medicines trolley had been purchased and medicines that needed to be taken with food would be separated out to help ensure they were given at the right times. Consideration should be given to the times that medicines are administered to help ensure they are offered at both the best and right times. We looked at medicines record keeping. Most medicines were provided in a monitored dosage system - this was used correctly. But, as previously seen it was always not possible to track (account for) the safe handling of medicines in bottles and boxes. This meant it was not possible to tell whether these medicines had been given properly. Comparing remaining stocks with records of medicines administered we saw some records that impossibly showed more doses had been given than had gone from stock. It was of concern that one person had run out of two of their prescribed medicines on the visit day. Records showed pain-relieving patches prescribed for two other people had been changed late because there were none left. This increases the risk that pain will not be well managed. Stock control needs to be such that sufficient supplies of medication are kept in the home to allow continuity of treatment, without overstocking. We again saw that one person had missed doses of one medicine for three days because although there was enough left, they had not been carried forward to the current months records on time. A daily record entry for one person recorded that they had asked for a prescribed dry mouth spray but, one was not available at the home on the visit day five days later. It is possible that this could have been addressed more quickly. There was no evidence to show that a note to ring the surgery in two weeks ... following a dose change to someones medicines had been followed-up. Care Homes for Older People Page 4 of 8 It was of concern that, as previously seen, medicines were not well managed on first admission to the home. Medicines for one person were being administered from medicines foils (strips), the medicines were completely unlabelled and the home had not confirmed the dose instructions with the prescriber. Medicines for a second person were in labelled boxes but the handwritten medication administration record was very poorly completed and did not include the full dosage instructions. Poor record keeping increases the risk of mistakes. We found that the correct dose of a prescribed painkiller had not been given on a number of occasions. We found that medicines including controlled drugs were stored securely. This helps to ensure that they are not misused or mishandled. But, medicines with a reduced shelf-life on opening were not dated on first use. One person was using a spray dispensed several months ago, because there was no open date, it was not possible to tell whether the spray was still within date. It was of concern that records showing the handling of controlled drugs (controlled drugs register) were poorly completed with gaps and missing signatures. It is important that the handling of controlled drugs is properly witnessed and recorded to reduce the risk of mishandling or miss-use. We were told that medicines audits (checks) had continued but it was of concern that this had not been effective in bringing about improvement in the handling of medication at the service. When asked, staff were not aware of any significant concerns around medicines handling, except failure to date limited life medicines such as eye drops on first use. 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 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 Where people choose to self- 01/06/2009 administer medication assessments need to be completed and any support needed recorded to help ensure people always receive any help they may need to safely selfadminister. 2 9 13 Complete, clear and accurate 01/06/2009 lists of currently prescribed medication must be maintained for people living at the service. And, Sufficient stocks of medicine must be maintained without overstocking to help ensure medicines are safely administered as prescribed. 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 Medication must be safely handled and administered with due consideration to current professional guidance. to help ensure peoples health and well-being is best protected. 20/11/2009 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 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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!
