Random inspection report
Care homes for older people
Name: Address: Avon Court All Saints Road Warwick Warwickshire CV34 5NP 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: Debby Railton Date: 0 9 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Avon Court All Saints Road Warwick Warwickshire CV34 5NP 01926401324 01926401324 Telephone number: Fax number: Email address: Provider web address: info@prime-life.co.ukwww.prime-life.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Prime Life Ltd care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Conditions of registration: Restrictions at age 65 no longer apply. 34 0 The maximum number of service users who can be accommodated is: 34 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: Dementia (DE) 34, Old age, not falling within any other category (OP) 34 Date of last inspection Brief description of the care home Avon Court is a care home providing personal care and accommodation for up to 34 service users over the age of 65 years. Accommodation consists of all single bedrooms, over two floors. Two types of service are provided at the home, dementia care and transitional care. There are 5 permanent dementia care places, 5 short stay dementia
Care Homes for Older People Page 2 of 9 Brief description of the care home care places ands 24 transitional care places. Avon Court does not take any privately funded service users. Referrals for the transitional places are through the hospital social work team. Copies of the last inspection report are available at the home. Care Homes for Older People Page 3 of 9 What we found:
The pharmacist inspection lasted just over two hours. Three people who live in the home medicines were looked at together with their corresponding Medicine Administration Record (MAR) chart, care plans and daily records. One senior care assistant was spoken with during the inspection and all feedback was given to her. The medicine management was good but there were a few areas of improvement needed. All the prescriptions are seen prior to dispensing and copied. They are not used as intended to check the medicines and MAR charts received into the home for accuracy but just filed. All quantities of medicines received and any balances carried over are recorded enabling audits to take place to assess whether the medication has been administered as prescribed and records reflect practice. The home undertakes its own auditing system mainly when medicines are running out and need reordering. Currently there is no specific time for medicines to be ordered on a 28 day cycle and staff identify when they will run out and seek further supplies of medication. Consequently some MAR charts have to be hand written. They were well written and recorded what the doctor prescribed. This system worked well in the home but it was time consuming for staff to constantly monitor what needed to be ordered to ensure a continuous supply. Audits indicated that the majority of medicines had been administered as prescribed and records reflected practice. A few errors were seen where some staff had administered one tablet instead of two (half the prescribed dose) but recorded they had administered the prescribed dose. A few other medicines had been recorded as administered when they had not been. Three boxes of injections were found in the medicine trolley, that the district nurse administered on a three monthly basis. There was no record of these at all on the MAR chart and no date recording when the district nurse was due to come into the home to administer them. There must be a record of all medicines held on the premise and a way of identifying when the district nurse visit is due. There were no records recording the application of creams despite MAR charts being available to do so. One person self administered some of her medication but there was no risk assessment recording she was able to safely do so and no compliance checks to assess whether she actually did self-administered them safely. The care plans were brief in content and lacked some clinical reasons why some of the medicines had been prescribed. All medicines prescribed to be administered on a when required basis had supporting protocols for staff to follow to ensure that they were only administered as the doctor intended. All external health care professional visits had been recorded in one diary and the information transfered to the individual records. It was easy to track when a doctor had visited and what the outcome was. There was no record at all for prescribed nutritional supplements. It was not possible to see whether a supplement had been given or not. The care plans lacked detail of an enhanced diet for staff to follow.
Care Homes for Older People Page 4 of 9 All the medicines were stored in two medication trolleys used to transport the medication throughout the home. Surplus medication was kept in a separate locked cupboard. All Controlled Drugs were stored in line with current regulations and the balances were correct and matched the entries in the CD register and MAR chart. The senior care assistant spoken with had a good understanding of what each medicine was for and medical information was readily available for staff to read if necessary. 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 £ 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 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 Medicine Administration Record (MAR) chart must record all the prescribed medication and staff must ensure that all medication is administered as prescribed at all times. All external preparations must be recorded when they are applied. This is to ensure there is a record of all prescribed medicines and their administration/ application to demonstrate they have been given as prescribed. 09/07/2009 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 8 It is advised that all nutritional supplements given are recorded and monitored. It is advised that any nutritionally enhanced diet is recorded to ensure that all staff are aware when a service user requires extra calories and
Page 7 of 9 Care Homes for Older People 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 supplements. 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!
