This inspection was carried out on 29th December 2009.
CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 3 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 1 2 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 9 2 9 0 9 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 9 What we found:
The purpose of this visit was to look at action taken to improve medicines handling in order to meet with current requirements. Previous visits to the service found weaknesses in medicines handling and we issued a legal notice requiring the home to make improvements in this area. 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 nursing staff, the manager and three people living at the home about the arrangements made for their medicines. Overall, we found improvements in the way medicines were being handled that meant the requirements of our legal notice were met. But, we were concerned to find that weaknesses in medicines record keeping and a lack of up-to-date information in some care plans increases the risk that peoples healthcare needs may not be fully met. We looked at medicines administration. Arrangements had been made to ensure that any special instructions such as before food were followed helping to ensure people receive the most benefit from their medicines. Where people chose to self-administer medicines written assessments were completed but, these could be expanded to provide clearer guidance to staff about any support people may need. Both people spoken with were happy with the arrangements in place to support them to manage their medication. We looked at a sample of medicines stocks and records. We found that 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). A new system had been introduced for re-ordering medicines needed outside the normal monthly delivery. We saw that this had helped to improve stock control at the home but in some cases orders were still placed too late increasing the risk that medicines will run out. For example, an order for a painkilling patch for one person was only due to arrive on the day it needed changing. A second person had missed two doses of a sleeping tablet because there were none left; the order had not been placed until the tablets ran out. The new system of ordering needs further monitoring to ensure it is used effectively by all nursing staff. The home had also introduced a new system for handling and recording external preparations e.g. creams, but this had been less successful. One person spoken with confirmed that care staff applied his creams when needed. But, this was not supported by good record keeping. We saw several examples were records were not made to show creams had been applied. This meant it was not always possible to tell if creams had been used correctly. Incomplete records can result in mistakes that can affect peoples health and wellbeing. We looked at how medicines were recorded and found recent records of receipt, administration and disposal to be generally clear and accurate. We looked at how care plans supported the safe use of medicines. We were concerned to find that for one person, a protocol describing the administration of prescribed nutrition had not been updated following advice from the dietician, nor where there any clear records of the recent changes that had been made to their diet regimen. Although staff confirmed that they were following the new instruction, the lack of up-to-date written guidance increases the risk of mistakes. Additionally, because records for communication with doctors or other healthcare professionals were not always clearly completed changes to medicines could not always be tracked and confirmed as correct. We saw that advice to continue to
Care Homes for Older People Page 4 of 9 give a nutritional supplementary drink to one person had not been followed and that although it was identified on admission to the home that they needed support with their dietary intake, records of diet taken were not made. We saw a second example where a change to someones medicine could possibly have been followed-up more quickly. There was a delay of a month between a trial of a new dosage and the new dose being started. Clear records of dose changes and healthcare advice need to be made to reduce the risk of mistakes. We were concerned to find that someone who had been at living at the home for two months did not have a completed care plan. It is expected that care plans are in place in a timely manner to help ensure that peoples identified health and personal needs are met and monitored by staff. Regular audits (checks) were carried out to help ensure that should any weaknesses arise they will be promptly identified and addressed. This has helped to bring about some improvement in medicines handling. 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 9 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 6 of 9 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 7 15 The care plan must contain current and accurate information. Information must be accurate in order that health needs are dealt with properly and consistently 12/02/2010 2 9 13 Clear records of healthcare professional advice must be maintained to help ensure that changes to peoples care or treatment are promptly and accurately carried out. 12/02/2010 3 9 13 Complete, clear and accurate 12/02/2010 records of all medication, including external preparations (e.g. creams), received into and administered at the home must be maintained to support and evidence their correct use. Care Homes for Older People Page 7 of 9 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 Where people self-administer medication there should be clear written guidance about any support they may need to do so safely. The new system for re-ordering medication needs to be monitored to ensure it is effectively used by all staff. Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!
