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Inspection on 29/01/09 for Allambie Court

Also see our care home review for Allambie Court for more information

This inspection was carried out on 29th January 2009.

CSCI found this care home to be providing an Poor service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Allambie Court 55 Hinckley Road Nuneaton Warwickshire CV11 6LG zero star poor service 16/10/2008 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Debby Railton Date: 2 9 0 1 2 0 0 9 Information about the care home Name of care home: Address: Allambie Court 55 Hinckley Road Nuneaton Warwickshire CV11 6LG 02476383501 Telephone number: Fax number: Email address: Provider web address: allambiect@btinternet.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : ADL Plc care home 30 Number of places (if applicable): Under 65 Over 65 30 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: Date of last inspection Brief description of the care home 0 30 1 6 1 0 2 0 0 8 Allambie Court Nursing Home is situated in Nuneaton approximately 1 mile from the town centre, and is easily reached by a local bus service. The home is an Edwardian building converted into a nursing home and has had an extension built to accommodate 30 people who have a diagnosis of dementia and mental health problems. There is a small secure garden to the rear of the property and sufficient parking to the front. The home has a mixture of single and shared occupancy and all bedrooms are fitted with a hand washbasin. Written information about the current scale of charges for the home was not available on the day of this inspection visit. Care Homes for Older People Page 2 of 8 What we found: The pharmacist inspection lasted two hours. Four residents medicines were looked at together with their care plans and daily records. All feedback was given to the manager, Peter Jones who was present throughout the inspection. Some of the issues regarding the safe handling of medication had been addressed resulting in three of the five requirements left at the last key inspection on 16th October 2008 being met. Storage of medication is good and the medicines are safely transported throughout the home. Whilst staff do photocopy the prescriptions prior to dispensing they do not adequately check these with the previous medicine chart. They do record the quantities and any balances carried over onto the new medicine administration record (MAR) chart but do not check these entries against the previous MAR chart. This resulted in one person who lived in the home, who had a medicine discontinued by the doctor as a rash had appeared, having the medicine restarted with no rationale as to why. Staff had not documented that the doctor wanted this to be re-started. This is of serious concern as the possible causative medicine of the rash was restarted without staff realizing the potential to the persons health and well-being. This matter was addressed immediately after the inspection and the medicine was discontinued by the doctor. A second person who lived in the home had a medicine prescribed to be administered daily but this was administered when required only and some entries had no record of administration or non-administration. We, the commission, were assured that the medicine was only administered when he needed it and on the whole it was not given but there was no documentation that doctor had authorized the nursing staff to do this. Again with was discussed with the doctor immediately after the inspection. Audits indicated that the majority of medicines though had been administered as prescribed. A few mistakes were seen where staff had recorded they had administered a medicine when they had not done, not recorded anything after the transaction had taken place or failed to record the exact reason for non-administration resulting in some medicines being unaccounted for. The care plans did support the clinical indications of the people who live in the home but not all the multidisciplinary visits had been recorded. It was not possible to see, for example, the reason a dose had been changed in one instance. All controlled drug balances were correct and entries on the MAR chart reflected those recorded in the controlled drug register. We, the commission were assured that all staff sign and witness all entries in the CD register after the transaction. Cream application was not recorded so it was not possible to evidence whether a cream had been applied as prescribed or not. What the care home does well: Care Homes for Older People Page 3 of 8 The home safely stores medication and Controlled drugs. The manager had addressed some of the issues raised at the last inspection, was pro-active throughout the inspection and keen to address the two remaining requirements. The manager takes an active role in the care of the people who live in the home and ensure that they receive medication reviews were possible. 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 4 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 9 13 Changes to residents prescribed medication must be recorded accurately. This is to make sure residents receive their prescribed medication at the correct dose and frequency to promote their health and well being and minimise the risk of medication errors. 30/11/2008 2 9 13 Records relating to the 30/11/2008 receipt, storage, administration and disposal of medicines prescribed for residents must be accurately maintained. Staff must be able to account for medicines recieved into the care home. This is to make sure an accurate audit trail of medicines can be maintained so staff can demonstrate medicines are administered as prescribed and residents are protected from the risk of medicine misuse. 3 15 12 Arrangements must be made 30/11/2008 for meals to be served in a way that promotes the independence of residents. This is to make sure residents have the opportunity to enjoy their Care Homes for Older People Page 5 of 8 meals and retain their skills to promote their independence and uphold their personhood and dignity. 4 18 13 Senior staff must be aware 30/11/2008 of their roles and responsibilities in responding to suspicion or allegation of abuse. A copy of the current social services safeguarding guidelines must be available in the home for reference. This is to safeguard people using the service. 5 18 13 Arrangements must be made 30/11/2008 to make sure staff have an awareness of the symptoms and types of abuse when they start working in the home This is to safeguard people using the service. 6 30 18 New staff must receive 31/12/2008 induction training that meets the Skills for Care Common Induction Standards withing 12 weeks of starting work in the care home. This is to make sure staff develop the knowledge and skills required to care for people using the service. 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, Care Homes 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 All prescriptions must be 25/02/2009 seen prior to dispensing and checked against the previous medicine administration record (MAR) chart for accuracy. All dispensed medicines and MAR charts must be checked against a copy of the prescription for accuracy. Any discrepancies must be addressed before the administration of the medication This is to ensure that the right medicine is administered at the correct dose to ensure the health and wellbeing of the service users 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 It is advised that all cream applications are recorded. Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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