Random inspection report
Care homes for older people
Name: Address: Albany House The Square Tisbury Salisbury Wiltshire SP3 6JP one star adequate service 04/08/2009 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: mary collier Date: 1 9 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Albany House The Square Tisbury Salisbury Wiltshire SP3 6JP 01747870313 F/P01747870313 albanyhouse@bmcare.plus.com www.bmcare.plus.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) BM Care Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 21 Number of places (if applicable): Under 65 Over 65 1 21 dementia old age, not falling within any other category Conditions of registration: 0 0 Albany House can accommodate one named service user with Dementia however, the registered person must notify CSCI if the service user is no longer accommodated. This condition will then be removed. Date of last inspection Brief description of the care home Albany House is an older detached building, which is situated in the village of Tisbury, Wiltshire. The home benefits from a good location within the centre of the village, within walking distance of the local amenities. A main line station from Waterloo to the
Care Homes for Older People Page 2 of 11 0 4 0 8 2 0 0 9 Brief description of the care home west country is also located in Tisbury and again within walking distance of Albany House. Accommodation is provided on 2 floors of the home with the majority of the bedrooms provided being single. The home provides two communal areas and a large conservatory, which leads to a pleasant patio area and garden. Albany House is registered to provide personal care for 21 older people. The home was purchased by BM Care Limited in Jan 2006. Currently there is no registered manager. Care Homes for Older People Page 3 of 11 What we found:
This inspection was a random inspection by the Pharmacist Inspector to follow up on concerns raised at the last inspection about the handling of medicines in the home. During the last inspection it was noted that some people look after their own medicines but there were no risk assessments or reviews to protect them. At this inspection we saw two people who managed their own medicines. Their records contained no risk assessments or care plans about this practice and their safety had not been reviewed. Staff expressed some concerns about one persons ability, but this had not been recorded. Some people are prescribed medicines to be taken when required. At the last inspection it was noted that there were no care plans or guidance to support staff when deciding to use these medicines. During this inspection we saw many medicines prescribed as required and none of them were subject to any guidance for staff as to the appropriate use of these medicines for different people. The records of administration of medicines used as required were not clear. For example a pain killer prescribed up to four times a day when required had been given regularly three times a day with no explanation. The medicines had been given at the times of the usual medicine round and there was no indication that they were available at other times. The exact times of administration had not been recorded so staff could not guarantee that the medicines had been given at the correct time intervals. The medication administration records were printed by the pharmacy but it was necessary for staff to make some written additions or alterations. These were not all clear and some contained no information as to dose or dosage interval. These records were not dated, signed or checked for accuarcy. During the last inspection staff were seen to administer medicines from containers that they had previously put the medicines into. During this inspection we saw that this practice had ceased and all medicines were administered individually from the original container. All medicines were stored appropriately and records kept of medicines received and returned for disposal. What the care home does well: What they could do better:
There are still outstanding requirements from the previous inspection. People are still at risk from the lack of risk assessments and reviews when they manage their own medicines. The recording of medicines prescribed as required is not clear or accuarate, and the administration is not supported by care plans or guidelines. The medication administration records do not always contain sufficient detail to ensure people are
Care Homes for Older People Page 4 of 11 receiving the treatment as prescribed by their doctor. These concerns must be addressed to ensure the safety of people in the home. 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 11 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 must identify guidance to staff on how peoples care and support needs are to be met and monitored. So that peoples current care and support needs are met. 30/09/2009 2 7 13 Bathing risk assessments 30/09/2009 must identify whether people need staff with them in the bathroom or not. To reduce the risk of drowning or scalding. 3 7 17 The home must keep their own notes and not rely on those kept by the district nursing service. So that records are kept of monitoring and healing. 30/09/2009 4 7 13 Risk assessment outcomes must be clearly identified in peoples care plans. There must be information about how any identified risks are managed and monitored. For peoples safety 30/09/2009 5 7 13 The home must record size and colour of any wounds, together with details of 30/09/2009 Care Homes for Older People Page 6 of 11 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 whether the skin is broken. For peoples safety 6 7 15 The Registered Person will 15/09/2007 ensure that care plans are fully completed and reviewed monthly or when the care needs of the service users change. 7 9 13 Care plans must identify 30/09/2009 when people should take medication that is prescribed to be taken only when needed. So that people only have medication when they need it. 8 9 13 Handwritten entries in the medication administration record must accurately record the prescribing instructions. So that people have their medication at the right time. 30/09/2009 9 9 13 Risk assessments must be carried out with people who may wish to manage their own medication. For peoples wellbeing. 30/09/2009 10 22 13 Call alarms must be turned off where the person is, rather than in the dining room. 30/09/2009 Care Homes for Older People Page 7 of 11 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 So that staff can see whether the call is an emergency. 11 26 19 Decisions about why staff 30/09/2009 who may have convictions, cautions or police information have been employed, must be recorded. To ensure there is a robust recruitment procedure which protects people from staff who may be unsuitable to work with vulnerable people. 12 29 19 Decisions about why staff 30/09/2009 who may have convictions, cautions or police information have been employed, must be recorded. To ensure there is a robust recruitment procedure which protects people from staff who may be unsuitable to work with vulnerable people. 13 31 8 A manager must be 30/10/2009 appointed who meets the requirements for registration. So that all aspects of management can be developed. Care Homes for Older People Page 8 of 11 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 Records for medicines 14/12/2009 prescribed as required must show that they are available when the person needs them and not just at the times of medication rounds. The exact time of administration must be recorded. This will ensure that people receive their medicines at the appropriate and safe time. 2 9 13 Written additions to the 14/12/2009 medication administration record must be complete and accurate. They must be signed, dated and checked by a second member of staff. This will ensure that people receive the treatment as prescribed by their doctor. Care Homes for Older People Page 9 of 11 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 10 of 11 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 11 of 11 - 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!
