This inspection was carried out on 15th September 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Avalon Care Home 24 Duke Street Southport Merseyside PR8 1LW two star good service 21/04/2009 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: Stephanie West Date: 1 5 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Avalon Care Home 24 Duke Street Southport Merseyside PR8 1LW 01704541203 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) : Avalon Residential Homes Ltd care home 20 Number of places (if applicable): Under 65 Over 65 20 1 3 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 0 0 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: 3). Dementia over 65 years of age: Code DE(E) (maximum number of places: 20). Mental disorder, excluding learning disability or dementia over 65 years of age: Code MD(E) (maximum number of places: 1) The maximum number of service users who can be accommodated is: 20. Date of last inspection 2 1 0 4 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home Avalon Residential Care Homes Ltd purchased Avalon care home in July 2004. Avalon is a Residential Care Home, which provides personal care and support for up to twenty elderly residents. Ann Wilson manages the home. The home is a large detached converted house, set in a residential area, within walking distance of all the amenities of the town of Southport. Access to the town can be made via the local transport services where necessary. A lift provides access to all floors of the home. There is a spacious lounge, dining room and quiet room. Steps from the main front door lead to the garden and there is also wheelchair access to the garden from the lower ground floor. Fees for the service are currently charged at 383 pounds per week. Care Homes for Older People Page 3 of 8 What we found:
This visit was carried out to look at the homes medication arrangements following receipt of a concern about the administration of medicines. The visit lasted approximately four and a half hours and involved discussing the handling of medication with the manager and senior staff, examination of medicine records and storage arrangements. This visit focused on medicines handling, other areas and requirements were not examined at this time. At the end of the inspection feedback was given to the manager. We found some weaknesses that need to be addressed to ensure that the safe handling of medication is better supported. We observed part of the morning medication round. To help ensure medicines were administered as prescribed records were referred to and completed at the time of administration to each person. We found that arrangements were in place to help ensure medicines were given at the right times of day. Home Remedies were kept to enable people to have treatment for example, for minor pain without a prescription. Where medicines were prescribed when required there was some written guidance for staff about when they may be needed and how this need may be communicated. But, in some cases this was quite brief and could be usefully expanded. This is particularly important when for example; people are prescribed more than one type of painkiller. Records showing the administration of medication were generally up-to-date but there were some areas that could be improved to ensure the completeness and clarity of these records. As previously seen, records were not always made to show the application of prescribed creams. It is important to show exactly what was administered and records for the application of prescribed creams must be accurately maintained, as for any prescribed medication. Where quantities of medication were brought forward from a previous months delivery the quantity was not always clearly recorded. This made it difficult to account for (track) the safe handling of medicines at the home. This was particularly evident for liquid medicines; it was of concern that we saw examples where records impossibly showed that more doses had been administered than was possible with the quantity received. Records for the receipt and disposal of medication were generally clearly made. But, it was of concern to find that records of communication with, and advice from healthcare professionals such as G.Ps were not always made. This meant it was not always possible to track changes to peoples medicines and so, to tell what medicines people should be having. For example, we found a box of soluble painkillers in the medicines trolley that were not included on someones current medicines administration record. It was not clear whether these had been stopped. We saw that records for a second persons eye drops were marked finished but the eye drops were on the repeat prescription form from the doctor. It was unclear whether the eye drops should still be given. It is important that clear records of doctors advice are made to ensure changes are promptly carried out and where needed, followed-up. We found that all medicines including Controlled Drugs were safely locked away; this helps to ensure that they are not misused or mishandled. But, we saw that the keys were left in the medicines trolley when it was unattended, medicines must be securely handled to reduce the risk of accidents or misuse.
Care Homes for Older People Page 4 of 8 The manager carried out audits (checks) of medicines handling but consideration should be given broadening these to give a more complete overview of medicines handling. This is important to help ensure that should any weaknesses arise they will be identified and promptly addressed. 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 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 26 18 Staff require dementia care training This will ensure they have the skills and knowledge to provide care for dementia and its associated illnesses. 21/07/2009 2 26 18 Staff require training in moving and handling, first aid, food hygiene and infection control. This will ensure they have the skills and knowledge to provide care and support to residents safely. 21/07/2009 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 There must be a complete, clear and accurate list of currently prescribed medication for each person and of the time and date of administration; including for prescribed external preparations (e.g. creams) to help ensure medication is safely administered as prescribed. 19/10/2009 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 1 9 Staff should make clear records of any GP or healthcare professional advice to ensure that any changes to peoples medicines are correctly carried out and where needed, followed-up. 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!
