This inspection was carried out on 19th November 2009.
CQC found this care home to be providing an Adequate 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Ashmount Residential and Nursing Home 10 Southey Road Worthing West Sussex BN11 3HT one star adequate service 14/09/2009 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: Suni Chotai Date: 1 9 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Ashmount Residential and Nursing Home 10 Southey Road Worthing West Sussex BN11 3HT 01903528500 01903528502 ashmount@btconnect.com www.guildcare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Hall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Guild Care care home 50 Number of places (if applicable): Under 65 Over 65 50 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category/ies of service only: Care home with nursing - 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 - OP Date of last inspection Brief description of the care home Ashmount is registered to provide personal and nursing care for up to fifty people aged 65yrs and over. It is a large detached property situated in a residential area of the seaside town of
Care Homes for Older People Page 2 of 9 1 4 0 9 2 0 0 9 Brief description of the care home Worthing. The sea front and shopping areas are a short walk away. There is a private car park at the front of the home and a garden at the back. Accommodation is provided on 3 floors. A passenger lift allows access to all floors. Large communal sitting and dining areas are available on the ground floor. Fees are between #259 and #460 per week. Care Homes for Older People Page 3 of 9 What we found:
At a previous inspection some medicine management concerns were identified and Suni Chotai, Pharmacist Inspector from CQC visited the home to assess the current situation with medicine management in the home. The home has two main medicine storage areas and three medicine trolleys which are used when medicines are being given. The downstairs medicine storage room was 29 degree Celsius which is on the upper end of the recommended storage requirement for most medicine. We found some cream in the upstairs medicine cupboard which should be stored below 15 degree Celsius and we noted that the medicine fridge was below the temperature required by the manufacturers for medicine that require cool storage. We looked at controlled drugs records and we also looked at medicine receipt and disposal records. We found these to be completed and in order. We looked at all current months medicine administration record [MAR] charts. On these we found a significant number of gaps where either a reason for non administration should be recorded or it means that staff have not completed records when they give medicines. We found 22 such gaps and ten out of these were after the compliance date of 14/11/09 for a requirement made on this issue previously. We noted that audits had been done but the evidence showed that records are not completed. We noted that when a variable dose is prescribed the amount given is recorded on the MAR chart. This information would aid any audit that is done. We did not see a care plan on the use of medicine prescribed to be taken only when needed although on the odd occasion the reason for giving the medicine had been recorded on the back of the MAR chart. We asked if any person in the home was using any medicated creams and ointments. We were informed that for one person a cream was applied by the carers and this was evidenced by a tick marked on the MAR chart by the senior person on duty when they checked that this cream had been applied. We discussed the issues around initialling this record because a tick does not identify who made sure and checked that this cream was used. We saw that many of the MAR charts had cream and medicines prescribed to be used only when needed. On most occasions this was not received or used. We asked why so many creams and medicines to use only when needed appeared on the MAR chart and we were informed they were left on the chart in case they are needed again in the future. It would be in the interest of the residents welfare to get this medicine re prescribed following a review by the doctor when symptoms reappear so that there is medical input. A few examples were seen of hand written charts which were not initialled when the hand written instructions were added. Any action taken and recorded should be initialled to take responsibility for that action. From the records we noted that two medicines were out of stock and could not be given to the resident. For one of these medicines evidence was seen of faxes sent to the doctor to get the medicine ordered. We saw certificates of training in medicines management for staff on the non nursing
Care Homes for Older People Page 4 of 9 unit. 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 15 Sch 3 (1)(b) The registered person must ensure that residents have clear individual care plans describing the support that staff give to meet identified needs. To ensure that individual needs are met safely 14/11/2009 2 9 13 13 (2) The registered person 14/11/2009 must ensure that a record is kept of the amount of medication that is given where there is a variable dosage and why and when an as required medication is given and its effect. This will ensure that the individual receives the correct medication and helps to monitor their health. 3 9 13 13 (2) The registered person 14/11/2009 must ensure that lotions and creams are administered at the times and in the amount that it has been prescribed, and that a record is kept. This will ensure that the individual receives the correct medication and helps to monitor their health. 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 4 9 12 12 The registered person 14/11/2009 must ensure that medication that has been prescribed is available for the individual. This will ensure that the individual receives the correct medication and helps to monitor their health. 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 The registered person must ensure that records are completed when medicines are given So that there is clear information and residents health and welfare is protected. 31/12/2009 2 9 13 The registered person must ensure that medicines are stored at the recomended temperature by the manufacturers so the the medicines are fit for use 31/12/2009 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 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!
