Inspection on 09/06/10 for Afton Court

This inspection was carried out on 9th June 2010.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Afton Court 27/01/10

Afton Court 17/12/08

Afton Court 18/12/06

Afton Court 25/01/06

Afton Court 20/04/05

Afton Court 17/01/05

Afton Court 04/08/04

Afton Court 04/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Random inspection report Care homes for older people Name: Address: Afton Court 66-72 Marshall Avenue Bridlington East Riding Of Yorks YO15 2DS one star adequate service 27/01/2010 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: Steve Baker Date: 0 9 0 6 2 0 1 0 Information about the care home Name of care home: Address: Afton Court 66-72 Marshall Avenue Bridlington East Riding Of Yorks YO15 2DS 01262606888 01262677999 aftoncourt@live.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Samantha Jane Berry-Dagnall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Afton Court Limited care home 41 Number of places (if applicable): Under 65 Over 65 41 41 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 2 7 0 1 2 0 1 0 Afton Court consists of four adapted terraced houses close to the centre of the seaside town of Bridlington. The home is registered to provide personal care and accommodation for up to 41 older people who may also have dementia. It is conveniently located for all local amenities and facilities including public transport. The home can provide on-street parking permits for visitors. Single and shared bedrooms all have en suite facilities of a wash-hand basin and toilet. Some rooms also have a bath or shower. There is also a self-contained ground floor flat suitable for a married couple. A vertical passenger lift provides access to all three floors. There is a choice of Care Homes for Older People Page 2 of 10 Brief description of the care home lounges and dining areas. A large private and well maintained courtyard provides a safe area for people living there and the outside space is very easy to access. The Statement of Purpose and service user guide, as well as the latest inspection report completed by the Commission for Social Care Inspection are made available in the home, for people to read. Care Homes for Older People Page 3 of 10 What we found: We carried out this inspection to find out what actions had been taken to improve medication practices in the home following information received since the last full inspection in January 2010. A pharmacist inspector spent 5 hours in the home looking at the medication ordering, storage, handling and disposal arrangements, examining medication administration record charts (MARs) and speaking to staff. The outcome is as follows. We found the systems for medication ordering, receipt, checking, storage and record keeping to be generally good. Although most medicines management processes in the home now follow best practice, some additional improvements in record keeping are recommended to ensure a complete record is maintained of how all medicines are used in the home. All previously issued medication requirements were found to be met at the time of this inspection. We examined the 28 current MARs for accuracy and completeness and found no significant gaps in the records of those medicines taken by mouth. This indicates that people living in the home can expect to receive these essential medicines correctly. However, records of the use of prescribed skin care products on 15 MARs were unclear, meaning it is difficult to be sure people are receiving all the intended benefits of such products. For those people prescribed regular pain killing skin patches, we also found no records describing the skin location used each time a new patch is applied. In order to reduce the risk of skin irritation, it is important not to apply patches to the same skin location time after time. Further improvements in record keeping could be made by ensuring that each persons care plan includes a detailed and up to date description of the circumstances in which medicines prescribed to be taken when required are to given and also information about when and how people living in the home prefer to receive their medicines. Such guidance helps staff to give medicines correctly as directed and also helps to reduce the risk of refusals or omissions. We also noted that some hand written changes and entries on the MARs lacked a witness signature. All hand written entries and changes to MARs must be clear, detailed, and complete. Safe arrangements must be made to ensure staff know the reasons for the changes. A second person should always check these entries for accuracy so that all staff follow the changes on the MARs correctly. Medication ordering, receipt, and disposal arrangements in the home are good, and the GP prescriptions are checked by staff each month when the medicines are delivered. This good practice helps to make sure that the home is aware of any prescription changes and that staff will know that sufficient quantities of everyones medicines have been prescribed each month. The medicines storage arrangements in the home have improved since the last inspection. The manager has agreed to seek advice from the local Crime Prevention Officer about general security arrangements in order to minimise the risk of any loss or diversion of peoples medicines from the home. The management team is clearly commited to ensuring all medication practices Care Homes for Older People Page 4 of 10 throughout the home continue to be safe. Some authorised staff have received update training in medication safety and further training is planned. Arrangements should now be made to check that all staff who have received this training follow best practice when looking after and administering peoples medicines. Finally, the homes medicines management policy and procedure documents should be updated to reflect current professional guidance. 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 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 7 15 Care plans and the risks associated with difficult to manage behaviour must be clear, describe what is required, how often and by whom. This would ensure that staff are clear about the needs, risks and how these are to be managed. 10/05/2010 2 7 13 If restrictions are to be put in 10/05/2010 place then the decision must be made with other people involved in providing care, this must be subject to a mental capacity assessment and detailed risk management plan and agreed in a multi agency setting. This would ensure that people are involved in any decisions about their life and if a restriction is put in place this has been done in consultation with others involved in providing care and in the persons best interests. 3 18 18 Staff must undertake 11/05/2010 essential training that would safeguard people living in the Page 6 of 10 Care Homes for Older People 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 home. To ensure that people living in the home are protected from harm or abuse. 4 18 12 The home must only hold money on the premises that they are insured for. To ensure that peoples finances are protected. 5 19 23 The home must be maintained to a safe standard, carpets must be fitted correctly and not pose a trip hazard. To ensure that people live in a well maintained and safe home. 6 21 23 All communal bathroom/shower rooms must be in working order. To ensure that there are sufficient bathrooms for the number of people and they can have a bath/shower when they choose to. 7 26 23 The home must be free from 10/05/2010 offensive odour. To ensure that people live in a safe, clean and hygienic home. 8 27 18 The staffing hours must be 10/05/2010 reviewed and increased as the numbers of people living in the home increases. Page 7 of 10 11/03/2010 10/03/2010 10/03/2010 Care Homes for Older People 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 To ensure that there are sufficient staff on duty at all times, and in particular for busy periods. 9 28 19 Staff must only be employed 10/05/2010 using a POVA 1st check in exceptional circumstances and not as a matter of course. To ensure that people live in the home are supported by staff who have been recruited safely. 10 30 18 An audit of the training is required to find out which essential training staff have not undertaken. To ensure that the staff group are well trained and have the skills to deal with the people they support. 11 38 13 All hot water to which people 31/01/2009 living there have access to, should be monitored so that the registered person is satisfied that the risk of people being scalded by water that is too hot, is minimised. This will contribute to protecting people from harm. 10/05/2010 Care Homes for Older People Page 8 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, 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 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 2 3 9 9 9 Accurate records of skin care product usage should be maintained, including stating the location of skin patch use. The medication policy and procedures should be updated to reflect current professional guidance. Care plans should include detailed information guiding staff how to use medicines prescribed to be given when required. All hand written entries and changes should be checked for accuracy and completeness by a second carer. Competency assessments of staff should be updated following their recent medicines safety training. 4 5 9 18 Care Homes for Older People Page 9 of 10 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. 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