Random inspection report
Care homes for older people
Name: Address: Anna Victoria Nursing Home Peace Haven Pole Barn Lane Frinton On Sea Essex CO13 9NH one star adequate service 26/01/2009 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: Derek Brown Date: 2 2 0 5 2 0 0 9 Information about the care home
Name of care home: Address: Anna Victoria Nursing Home Peace Haven Pole Barn Lane Frinton On Sea Essex CO13 9NH 01255675609 01255673791 cnunn@annavictorianursinghome.org 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) : Anna Victoria Nursing Home care home 28 Number of places (if applicable): Under 65 Over 65 2 28 old age, not falling within any other category physical disability Conditions of registration: 0 0 Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 2 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 28 persons) The total number of service users accommodated in the home must not exceed 28 persons Date of last inspection Brief description of the care home Anna Victoria provides nursing and personal care for up to 28 older people. The home provides palliative care for up to 3 residents with a terminal illness. Anna Victoria is owned by a charitable organisation, named Anna Victoria Nursing Home. The home is
Care Homes for Older People Page 2 of 11 2 6 0 1 2 0 0 9 Brief description of the care home founded on Christian principles and there is a Christian ethos in the home. The home is a two-storey building that was purpose built when first opened in 1992. There are 28 single en-suite bedrooms on two floors that are accessible by stairs and a lift. The home offers large communal areas. The rear of the home has an enclosed wellmaintained garden and is accessible by ramps. The open plan sensory garden to the front of the premises provides a pleasant outlook from the home. The home has a visitors room and overnight accommodation can be arranged. There is a loop system installed at the home for the benefit of those with a hearing impairment. The home is accessible by car and the nearest railway station is nearby. Parking is available for staff and visitors in the large car park located to the front of the home. The home is located within walking distance of the main shops in Frinton-on-Sea. The fees range from £695 to £772 per week and include toiletries, aromatherapy massage and reflexology. There are additional costs for chiropody, hairdressing and newspapers. This information was provided to the CSCI in January 2009 Care Homes for Older People Page 3 of 11 What we found:
This visit be a pharmacist inspector was to assess progress towards meeting the requirements about medication and medication training made at the key inspection on 26th January 2009. We looked at medication storage and medication records for 16 people in the home and talked to staff about the procedures for giving medication and for their training. What the care home does well: What they could do better:
The records of temperatures of the medication storage room on the ground floor show it has been at the maximum of 25C on several occasions and steps must be taken to ensure that the temperature does not exceed this. The failure to store medication at the correct temperature could result in people receiving medication that is ineffective. The fridge used to store medicines also contained a bottle of wine. This is unacceptable practice as food and drink must never be stored alongside medication. It is expected that this will be managed without the need to make a requirement on this occasion. The temperature of the current fridge used to store medicines is also too high and the records should indicate the maximum and minimum reached, not simply the current temperature when it is recorded. It was noted however, that a new fridge has been installed but is not yet in use. We looked at the records made of medicines received into the home and these were satisfactory but the records made when medicines are given to people showed some deficiencies. We looked at the records for 16 people and there were unexplained omissions or inaccurate records for 14 of these. This includes gaps in the records made when medicines are given giving no clear indication of whether medicines are administered or not. The record of the time medication was given to people was inaccurate in some cases, even when it was important that different medicines are separated by a period of time. This could result in people receiving incompatible medicines too close together. The morning medication round did not finish until 11:45am which means that people who are prescribed medication at lunchtime could be at risk of receiving an overdose of medication. Where medicines are prescribed on a variable dose basis e.g. one or two tablets the actually quantity given is not alway recorded and so people may receive too much or too little medication. In another example the record showed that 30 tablets of a medicine were received but the record made when medicines are given to people was signed on 32 occasions. This medicine was also prescribed to be given four times a day but on two days it was recorded as only given three times a day. The requirement made on the last inspection that nurses make accurate records of all medicines they administer, document the reasons why any are omitted and provide a clear audit trail of all medicines in the home has not been met and has been given a new timescale for action. Medication is only given to people by qualified staff. Further medication training has been
Care Homes for Older People Page 4 of 11 arranged and the manager is to conduct competence assessments of nurses once further training has been undertaken. The requirement that nurses must have regular refresher training on the management of medicines and an assessment of competence has not been met by the given timescale of 01/05/09 but a new timescale has been agreed. 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 14 The manager must ensure 01/04/2009 that residents assessments are regularly reviewed and updated when their condition changes. In order that they reflect residents current condition and the support and care they need from staff. Not inspected on this occasion. 2 7 15 The manager must ensure 01/05/2009 that care plans are drawn up in consultation with residents, relatives and care staff where appropriate. In order that residents priorities, preferences, abilities and wishes are reflected in the plans and they are written in a language that is accessible to residents, relatives and care staff. Not inspected on this occasion. 3 9 13 Nurses must have regular refresher training on the management of medicines and an assessment of 31/07/2009 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 competence. In order to ensure that they have up to date knowledge and understanding of the receipt, administration, recording and disposal of medicines. Previous timescale of 01/05/2009 not met. 4 9 13 The manager must ensure that nurses make accurate records of all medicines that they administer, document the reasons why any are omitted and provide a clear audit trail of all medicines in the home. In order to demonstrate whether residents have received all their prescribed medicines and what dose has been administered. Previous timescale of 16/03/2009 not met. 5 19 13 Risk assessments of the 16/03/2009 premises must be carried out on a regular basis and action taken whenever needed. In order to ensure that the environment is safe and meets the needs of current residents. Not inspected on this occasion. 6 26 13 Hand washing facilities 20/04/2009
Page 7 of 11 15/06/2009 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 facilities must be available in all areas where staff carry out personal care. Hand washing facilities facilities must be available in all areas where staff carry out personal care. Not inspected on this occasion. 7 30 18 The manager must ensure 04/05/2009 that a training review is carried out for each member of staff. In order to identify the training needed for staff to undertake their role and provide good support and care to residents. Not inspected on this occasion. 8 33 24 The manager must ensure that the quality assurance audits are comprehensive. In order to identify and address risks to residents health, safety and welfare. Not inspected on this occasion. 9 38 13(4) The registered person must ensure that the laundry and maintenance cupboards are kept locked when unsupervised. Not inspected on this
Care Homes for Older People Page 8 of 11 01/07/2009 31/03/2007 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 occasion. Care Homes for Older People Page 9 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 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 The temperatures of the fridge used to store medication should be recorded as the current temperature, the maximum and minimum reached within a 24 hour period to ensure the quality of medicines stored there. 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!
