This inspection was carried out on 28th May 2009.
CQC found this care home to be providing an Good 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 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: Altham Care Home Burnley Road Clayton-le-moors Lancashire BB5 5TW two star good service 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: Simon Hill Date: 2 8 0 5 2 0 0 9 Information about the care home
Name of care home: Address: Altham Care Home Burnley Road Clayton-le-moors Lancashire BB5 5TW 01254396015 01254871335 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Rajinder Singh care home 36 Number of places (if applicable): Under 65 Over 65 0 13 dementia old age, not falling within any other category Conditions of registration: 23 0 The registered person may provide the following category of service only: Care home only - Code PC. To service users 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 (maximum number of places 13), Dementia - Code DE (maximum number of places 23). The maximum number of service users who can be accommodated is: 36. Date of last inspection Brief description of the care home Altham Care Home offers 24 hour personal care for up to 36 older people including 23 people with dementia. The property is purpose built with a car park and garden. It is located in Clayton-Le-Moors close to local amenities and public transport. Accommodation is provided on two levels in thirty single and three twin-bedded rooms. Twenty of these rooms have en-suite facilities. Communal rooms include two
Care Homes for Older People Page 2 of 9 Brief description of the care home separate lounge areas with television, and two dining rooms. One dining room has a kitchenette for residents to make their own drinks and snacks. Toilets and bathrooms are conveniently located close to communal rooms and bedrooms. The current fees charged at Altham Care Home are £345.35 to £435 per week. Additional charges are payable for hairdressing and newspapers. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Care Homes for Older People Page 3 of 9 What we found:
We carried out this visit to make sure medicines were being handled safely. The visit was carried out by a pharmacist inspector and it lasted approximately five hours. We checked medicines records, medicines stock and spoke with two members of staff. Overall we found shortfalls in the way medicines were being handled that place the health and wellbeing of people that live in the home at unnecessary risk. We checked a sample of peoples current medicines and records and found good procedures for the receipt and stock control of medicines that made accounting for them usually simple and easy to do. However, we found some medicines were not always properly recorded when received into the home and when we checked a sample of past records we found that some short courses of medicines did not add up showing that they had been missed or had been given at the wrong dose. Liquid medicines such as antibiotics and cough medicines did not add up correctly and some boxed medicines could not be fully accounted for. An inhaler for one person had not been given even though the records were signed to say it had and another person received the wrong dose of a medicine because staff had written the medicines record incorrectly. Failing to get medicines as prescribed can seriously affect a persons health and wellbeing. We looked at the times medicines were given and found the records did not always state the correct time to take medicines in relation to food intake. Staff said that all medicines were given with or after food but we found several medicines that should be given at least 30 minutes before. Medicines must be given to people at the right time to help make sure they work properly. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We found out of date information about how a medicine used for anxiety was to be used so there was a risk it might not be given at the right and best time for this person. We also could not account for five of these tablets, the acting manager said that this was probably because staff had given them but had not signed the record. We gave some advice to the acting manager about how to develop the paperwork because having clear written care plans helps make sure people get their medicines when they need them. We checked how controlled drugs (medicines that can be misused) were handled. A suitable cupboard was used for storage to help make sure they were safely kept. A special register was used for record keeping and the entries we checked were usually witnessed, accurate and complete. However, we found a strong pain relief patch had been replaced late on several occasions, which could have resulted in this person suffering unnecessary pain. Records of how this patch was used were poorly made and when they were no longer required they were kept for four months longer than necessary. Poor procedures for handling controlled drugs places the health and wellbeing of people at risk and increases the chances of mishandling and misuse. We looked at the records of medicines disposed of and found not all medicines could be fully accounted for. We discussed specific examples with the acting manager who agreed that some medicines stocks did not add up. We gave some advice about how medicines should be handled and recorded to help make sure they can be accounted for and to help
Care Homes for Older People Page 4 of 9 prevent mishandling and misuse. We saw an example of a recent audit (checks of the medicines) that had been carried out but this had not found the types of mistakes that we had found so we gave some advice on how to improve this. The acting manager said that all staff had attended formal medicines handling training and this was to be repeated shortly. Formal competency assessments had been carried out on three new staff members and this involved observing them give medicines out to people but it had not been done for all staff so there was a risk that some staff might not be following the correct procedures. Regular training, formal competency assessments and detailed auditing help make sure staff have the necessary skills to handle medicines safely. 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 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(1) To ensure all members of 30/11/2007 staff are fully informed about the care needs of each resident care plans must fully address all care needs. 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 9 13 Records of medicines 30/06/2009 received into the home, given to people and disposed of must be clear, accurate and complete. This will make sure all medicines can be fully accounted for. 2 9 13 Staff competency in giving 30/06/2009 and recording medicines should be regularly assessed. This will help make sure medicines are handled safely 3 9 13 Medicines must be given to people as prescribed. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 30/06/2009 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 Care plans and supporting paperwork should have up to date detailed information about how when required medicines should be given to people. This will help make sure they are used properly. 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!
