Random inspection report
Care homes for older people
Name: Address: Ashley Manor Nursing Home 17 - 19 Cambridge Road Waterloo Liverpool Merseyside L22 1RR 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 0 0 7 2 0 0 9 Information about the care home
Name of care home: Address: Ashley Manor Nursing Home 17 - 19 Cambridge Road Waterloo Liverpool Merseyside L22 1RR 01519282249 01519200094 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) A.C.G. Management Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 75 Number of places (if applicable): Under 65 Over 65 45 30 dementia old age, not falling within any other category Conditions of registration: 0 0 The registered person may provide the following categories of service only. Care home with Nursing - code N, to people 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: 30) Dementia over 65 years of age - Code DE (E) (maximum number of places: 45) The maximum number of people who can be accommodated is: 75 Date of last inspection 0 3 1 1 2 0 0 8 Care Homes for Older People Page 2 of 8 Brief description of the care home Ashley Manor is a large care home situated in Waterloo. The home overlooks a public park and there is access to local transport. Ashley Manor provides accommodation for up to 75 older people and is divided in to 3 categories of care. This includes 30 places for residents with general nursing care needs, 33 places for residents who have dementia and nursing care needs and 12 places for people who have dementia and require personal support. The home is divided into 3 separate areas thus enabling residents to have their own recreational areas and bathroom facilities. There are 55 single and 10 double bedrooms, some of which are ensuite. The home is equipped with a call system with an alarm for the residents and the home has manual handling equipment to assist those who are less independent. There is car parking space to the front and patio areas and gardens. Ramp access is available. CCTV cameras operate in main entrance areas for security purposes only. The fee rate for accommodation is from 428 pounds to 565 pounds a week. Care Homes for Older People Page 3 of 8 What we found:
We visited the home because we found shortfalls in the way medicines were handled at our last inspection. A specialist pharmacist inspector carried out the visit and checked a sample of medicines records, medicines stock and peoples care plans. Overall we found some medicines had not been given to people correctly because they had run out of stock, which places their health and wellbeing at unnecessary risk. When we checked the records we found several examples of medicines being out of stock. In the last month ten medicines for different people were not given because they were not available to give. This problem was a recent issue that seems to have coincided with the home using a new pharmacy. One person went without pain relief for two days and two people went without their inhalers to help their breathing for several days. A medicine used to prevent dementia was out of stock for seven days and another person had no medicine to help control their agitation for over a week. Going without prescribed medicines can seriously affect a persons health and wellbeing. We found the records of medicines received, given to people and disposed of were usually clear, accurate and complete, which made accounting for medicines simple and easy to do. Checks by the home and our checks on the day of the visit showed that medicines were usually given to people correctly and accurate records were made. However, we found that medicines that needed to be given before food were not always given at the right time because the instructions were not always clearly printed on the records and on other occasions when the instructions were on the records they were not correctly followed by staff. Also a person that was recently admitted to the home had several discrepancies with their medicines including one being given with food instead of before and two being out of stock for a short period of time. Another person missed several doses of their medicines including one for epilepsy because they were asleep when staff tried to give it, staff failed to return later to try and give it when they were awake. Failing to get medicines as prescribed can seriously affect the health and wellbeing of people who live in the home. We checked a sample of care plans to check that medicines were properly reflected in them and found some good information about how to manage a persons anxiety and agitation and another persons swallowing difficulties. However one care plan for a person that was being given their medicines covertly (given in drinks without them knowing) did not have a care plan about this and no paperwork about how their mental capacity had been assessed, which means their rights and best interests might not be properly protected. Staff on duty said that their previous care plan had some information about this but the new care plan had not been updated. Having detailed care plans about medicines issues helps make sure peoples medicines are handled safely. We checked how controlled drugs (medicines that can be misused) were handled and found them to be securely stored and the records were usually accurate and complete. However, one controlled drug that had been discontinued over six weeks ago had not been promptly disposed of, which increases the chances of it being misused or mishandled. We saw examples of daily checks and running stock balances of medicines and these had
Care Homes for Older People Page 4 of 8 helped improve the general record keeping of medicines received, given and disposed of. Prior to this visit the manager sent us the paperwork about how staff were recently assessed for competence when handling medicines, although these were not available on the day as the manager was off sick and staff did not have access to her office. Regular checks of the medicines and staff competence help make sure medicines are handled safely. Throughout our visit we found the facilities for hand washing were not always adequate because paper towels and suitable hand wash was not always available, although, by the end of our visit a suitable antiseptic hand scrub was provided for visitors to use when entering and leaving the home. Good arrangements for the washing of hands helps prevent the spread of infections. 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 8 Are there any outstanding requirements from the last inspection? Yes £ No R 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 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, 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 Medicines must be given to people correctly and must not be allowed to run out of stock. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 21/08/2009 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 7 of 8 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 8 of 8 - 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!
