Random inspection report
Care homes for older people
Name: Address: Anjulita Court Anjulita Court Bramley Way North Brickhill Bedford Bedfordshire MK41 7GD zero star poor service 15/12/2009 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: Nicky Hone Date: 0 8 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Anjulita Court Anjulita Court Bramley Way North Brickhill Bedford Bedfordshire MK41 7GD Telephone number: Fax number: Email address: Provider web address: www.mha.org.uk Name of registered provider(s): Name of registered manager (if applicable) Methodist Homes for the Aged Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 62 Number of places (if applicable): Under 65 Over 65 0 62 dementia old age, not falling within any other category Conditions of registration: 62 0 The maximum number of service users who can be accommodated is: 62 The registered person may provide the following categories of service: Care Home with Nursing - Code N, 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, Dementia - Code DE Date of last inspection 2 9 0 1 2 0 1 0 Care Homes for Older People Page 2 of 9 Brief description of the care home Anjulita Court is a stunning new building which has been designed to give a feeling of space throughout, and has been built round a large enclosed courtyard. On their website, the MHA describes it as: The impressive new building has a dramatic triple arch frontage to welcome residents and visitors into an interior full of open spaces, as well as facilities that include a hydrotherapy room, hairdressing salon, and a range of lounges - one of which is set up to allow film screenings. The spectacular entrance hall has a very high ceiling, and two walls are almost completely glass. The accommodation is divided into 4 units, each of which is selfcontained with a lounge, quiet room, sitting areas, dining room, kitchenette, bedrooms, and bathrooms. All bedrooms (a few of which are double rooms) have an ensuite shower room. There are 2 units each side of the hall, 2 on the ground floor and 2 on the first floor. The first floor units are accessed by stairs and lifts, and there is a walkway at first floor level across the hall so that people can walk from one unit to the other. There is a main kitchen on the ground floor, and a very large laundry, as well as offices, and staff facilities. The Gordon Ibbett room is on the first floor above the main entrance, and there is a coffee shop in the entrance hall. This is open to the general public and staffed by volunteers, and it is hoped will be used more and more once the flats next door have been completed, and the surrounding area has been developed into a country park. There are fenced gardens all round the building, with a series of pathways and seating areas, and a large landscaped courtyard opening off the entrance hall. There is adequate parking to the front of the building. Care Homes for Older People Page 3 of 9 What we found:
This random inspection was unannounced and was carried out by 2 inspectors. The purpose of the inspection was to check compliance with the requirements about medication made at the key inspection on 15/12/09 and a random inspection on 29/01/10. There is no registered manager at Anjulita Court. The home is being managed by Debbie Phillips who is registered to manage a Methodist Homes care home in another part of the country. Ms Phillips was on duty when we arrived and we had a brief discussion about progress being made in a number of areas. Ms Phillips told us that there had been further medication training and assessments of competency had been carried out by the supplying pharmacists area manager. The pharmacist inspector explained the purpose of this random inspection, and we told Ms Phillips that there will be a key inspection to check compliance with the other requirements from the December 2009 inspection, in the next few weeks. At the end of the inspection we gave feedback to the acting manager and the deputy manager. The pharmacist inspector found that overall the medication administration records (MAR)were well completed. There were records of receipts of medication and when medicines were carried forward from the previous medication cycle, balances were recorded. The current medication cycle started on 31st March 2010 and we noticed that nurses and care workers were also recording stock balances on a daily basis in addition to signing when they administered a medication. We looked at the MAR charts for all 30 residents and noticed three omissions in recording administration on the residential unit and one on the nursing unit. We audited the medication and could see that two tablets in the monitored dosage system and one in an original box had not been given. We could not check whether an inhaler had been administered on one occasion. We counted 29 other samples of medication and could not reconcile balances of five of these medicines. There was one too few of a medicine for parkinsons disease, one too many sleeping tablets and too many antispasmodics and laxatives. We noticed on several occasions that there were errors in staff calculations of balances. Allergies were now documented on the MAR and some variable doses. When a laxative was prescribed up to threex5ml spoonfuls the actual dose given was not recorded. The home was carrying out regular audits and had identified the gaps on the MAR and incorrect calculations of stock balances. When a medicine was not available on the first day of the cycle they had recorded the reason and discussed the prescription delay with the GP. We noticed that room temperatures were under 25 degrees centigrade and that the minimum and maximum temperature of the fridge was between 2 and 8 degrees. Dates of opening were written on eye drops and liquid medicines and none had expired. We noticed that several residents had received medication reviews and that the new medicine and dose was clearly documented on the MAR. We tracked two of these to the care plans and were unable to see records for one. Controlled drugs were stored securely and balances were correct in the register and could
Care Homes for Older People Page 4 of 9 be reconciled with records on the MAR. The home kept records of waste medicines and disposed of CD and other waste medicines via a licensed waste carrier. 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 Care/support plans must give 28/01/2010 sufficient information and guidance for staff. So that each person can be sure their individual needs will be fully met. 2 8 12 There must be evidence to show that peoples healthcare needs are monitored and met. So that peoples health is maintained. 28/01/2010 3 12 16 The choices available to 28/02/2010 people at mealtimes, and the way meals are served, must improve. So that mealtimes are pleasant occasions for everyone. 4 12 16 The level of activities offered 28/02/2010 to people who live here must improve. So that people are able to lead satisfying and fulfilling lives. 5 27 18 There must be enough staff on duty at all times. So that peoples needs are 28/01/2010 Care Homes for Older People Page 6 of 9 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 fully met. 6 30 18 Evidence must be available to show that staff receive adequate training. So that we know that staff are equipped to do their jobs properly. 7 37 26 The provider (or 28/01/2010 representative) must carry out visits as required by this regulation. The reports of the visits must be available for inspection. So that the provider can monitor the service the home is providing. 28/01/2010 Care Homes for Older People Page 7 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 All medicines including variable doses, must be recorded accurately when received into the home, carried forward from a previous medication cycle, and when administered. So that people who live in the home receive their medication safely. 14/05/2010 2 9 13 That regular robust auditing of medication continues. So that there is evidence that people are receiving their medication as prescribed. 14/05/2010 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 That the home consults with the GP and considers a homely remedies policy . 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. © 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. 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!
