Inspection on 09/04/09 for Berwick Care Centre

This inspection was carried out on 9th April 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Berwick Care Centre 22/05/09

Berwick Care Centre 03/12/08

Berwick Care Centre 13/02/08

Berwick Care Centre 07/02/07

Berwick Care Centre 21/12/05

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Berwick Care Centre North Road Berwick Upon Tweed Northumberland TD15 1PL two star good service 03/12/2008 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Michael Earnshaw Date: 0 9 0 4 2 0 0 9 Information about the care home Name of care home: Address: Berwick Care Centre North Road Berwick Upon Tweed Northumberland TD15 1PL 01289331117 01289302473 berwick@fshc.co.uk www.fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) care home 60 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 54 0 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 3 Should any of the persons occupying the PD beds leave the home, CSCI must be notified immediately, at which time those beds will revert back to the category of OP. Date of last inspection Brief description of the care home Berwick Care Home is a purpose built two-storey building on the outskirts of Berwick town. It is of traditional brick and apex roof design. The car parking is provided to the front of the building with a level access into the front of the home. There are gardens to the rear of the premises where there are paved areas with seating provided. The home has good views of the sea. The town of Berwick is within walking distance of the Care Homes for Older People Page 2 of 9 0 3 1 2 2 0 0 8 Brief description of the care home home and there are public transport routes. Berwick Care is registered to provide care to older people, and is able to accommodate those who have been assessed as requiring nursing care. The home charges fees of between £417.57 and £556.57 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Care Homes for Older People Page 3 of 9 What we found: The reason for the visit was to undertake a pharmacist inspection of the service. The visit lasted six hours and involved looking at arrangements within the service that support the safe handling and administration of medicines. We looked at the medicines records, storage , security and stock control. We also observed some medicines been given to service users and discussed what arrangements the service had in place to monitor the medication system. Morning medicines administration was observed on the ground floor and was well managed and followed good practice guidance. Staff offered support and verbal encouragement to people taking medicines and administration times were flexible to fit in with the wishes of people getting up later or requiring medication at specific times. There were a number of gaps on the medicine administration record (MAR) charts where medicine administration had not been recorded and there was no code entered to explain why. In addition, the quantity of medication carried over from the previous month, or brought into the home when residents return from hospital is not always fully recorded. This means it is difficult to have a complete record of medication within the home and to check if medicines are being given as prescribed. There were a few discrepancies between the quantity of medicine supplied, the number of doses recorded as administered and the quantity of medicine left in stock. This suggests that not all medicines are being administered as prescribed. This generally related to medication prescribed at night time or early in the morning. For example, one person was prescribed a dose of three capsules of trazadone and this was regularly recorded on the MAR sheet.However, the blister pack containing the 10pm dose for one evening still had one capsule inside indicating that only two capsules and not three had been administered. One person missed some doses of two medicines for up to four days because they were out of stock in the home. A lot of the MAR charts are handwritten and not printed by the pharmacy because a number of people come into the home for periods of respite care. A number of these entries were incomplete and lacked dates, quantities of medicine received, the signature of the person making the entry or the signature of a witness to confirm their accuracy. Medicines were stored securely within locked trolleys, the fridge and medicines cupboards and stock appeared to be well manged with no evidence of overstocking. Detailed records of prescriptions ordered, medicines received and medicines disposed of are maintained. The medicines storage area on the ground floor does not have any hand washing facilities. The controlled drug cupboards appear to meet safe custody regulations and records in the controlled drug register were accurate and well maintained. A supply of a controlled drug injection was recorded as having been removed from the service with no stock remaining but was still in the controlled drug cupboard. The manager Care Homes for Older People Page 4 of 9 arranged for the immediate destruction of the controlled drug when we brought this to her attention. One person, who had been in hospital , had brought her medicines back to the home. The list of medications provided by the hospital did not include alendronate although the person had been taking this regularly and the previous supply was included in the bag of medicines brought into the home. We raised this with the manager who checked with the surgery who confirmed that alendronate was to continue. This discrepancy should have been picked up when the person came back into the home and the medication checked in. 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 15 16 The issues identified by the 28/02/2009 Environmental Health Officer must be addressed: a more effective cleaning routine must be introduced, redecoration/fitting of washable wall panels must be completed, the cooker and deep fat fryer must be repaired or replaced. This will ensure that adequate facilities and equipment are available so that the production of meals is not affected by the environment. 2 25 23 The hot water system must be checked to ensure that thermostats are in good working order. This will ensure that hot water is provided at an appropriate temperature to safeguard people from scalds. 31/01/2009 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 Medication must be given as prescribed and a record made at the time that it is given. To safeguard the health and well being of people living in th home. 16/06/2009 2 9 12 A system should be in place to request, obtain and maintain adequate supplies of prescribed medicines for service users so that they can be given them as and when prescribed. To safeguard the health and welfare of people. living in the home 16/06/2009 3 9 13 Best practice guidance and 16/06/2009 the providers medication policy must be followed when recording all medicines. To safeguard the health and welfare of people. living in the home Care Homes for Older People Page 7 of 9 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 Controlled drugs should be destroyed promptly when no longer required and appropriate records maintained in the controlled drug register. Regular medication audit which includes checking a sample of MAR charts records against the amount of medication remaining in stock. This will help confirm that people in the home are getting their medication and that the medication policy is being followed. A consistent practice should be followed when recording any allergies to medicines which should be recorded on the residents photo page as well as on the current MAR sheets in use. Staff should sign and date handwritten entries they make on MAR charts. Each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. A system should be in place to record all medication kept in the home including any medication carried over from a previous month or when a person is transferred from hospital to the home. 2 9 3 9 4 9 5 9 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI 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. 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