Random inspection report
Care homes for older people
Name: Address: Birkdale Park 6 Lulworth Road Southport Merseyside PR8 2AT 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: Stephanie West Date: 2 4 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Birkdale Park 6 Lulworth Road Southport Merseyside PR8 2AT 01704566055 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) : Mrs Carol Patricia Cunningham care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: Service users to include up to 25 OP Date of last inspection Brief description of the care home 0 Birkdale Park provides nursing care for 25 older people. It is owned by Mrs C Cunningham and is managed by Mrs D Furnival. The home has been converted from a large house to a care home and is situated in a residential area of Southport. It is on the main bus route to town and is close to Birkdale village. Recreational areas comprise of a lounge to the front of the building and a conservatory overlooking the garden. This room is also used as a dining room. The home has single and double bedrooms but all rooms are currently used to provide single accommodation. There is lift access to both floors and the mezzanine level (floor not serviced by a lift) has 2 bedrooms. These bedrooms are accessed by a short flight of stairs and a chair lift has now been fitted. The home has 2 bathrooms with adapted baths to assist those who
Care Homes for Older People Page 2 of 9 Brief description of the care home are less independent and a call system with an alarm facility. Gardens are landscaped to the front and rear; the rear garden is spacious and enclosed. The home has ample car parking space and a minibus is available for hospital appointments and trips out. Care Homes for Older People Page 3 of 9 What we found:
The reason for this visit was to look at the homes medication arrangements following a concern identified by the Nurse-in-Charge about the handling of Controlled Drugs. We discussed this incident and found it had been resolved and measures put in place to reduce the risk of re-occurrence. This visit focused on medicines handling, other areas and requirements were not examined on this occasion. Overall, we found although suitable arrangements were in place for handling peoples medicines, the homes policies and current good practice guidance were not always followed in practice. This needs to be addressed to help ensure peoples health and well-being is best protected. We looked at medicines administration and were concerned to find that although on arrival at the home most people had taken their breakfast medicines, records showing their administration had not been signed. Instead, the medicine records were completed all together at the end of the medicines round. This unnecessary reliance on memory increases the risk of making mistakes. We spoke with one person who nurses had told us managed one of their own medicines and found they had several other medicines that nursing staff were unaware of. A risk assessment had been completed for a second person who managed their own medicines but their care plan did not clearly record the specific arrangements made to support safe self-administration. Where people need extra help to be able to manage their medicines, such as special monitored dosage systems, the supplying pharmacy should be approached to see if they can help. It is important that risk assessments are completed and that care plans are kept up-to-date to help ensure people always receive any support they need to manage their medicines safely. We saw that arrangements were in place to ensure that courses of new medicines were promptly delivered to the home. However, it was of concern that there was a delay in starting an antibiotic eye drop for one person as it had arrived at the same time as the main monthly delivery and put into the stock cupboard by mistake. This should be looked at to try and reduce the risk of re-occurrence. The home had arrangements in place for the administration of homely remedies this benefits residents as they can receive treatment for minor ailments without delay. Nurses also administered one homely remedy that someone had purchased for their own use. Where nurses agree to administer purchased medicines consideration should be given to how checks are made to ensure the medicine is safe and suitable for that person. We looked at medicines record keeping and found some areas that need to be addressed to help improve the clarity of these records: We found that records for prescribed creams were not so well maintained as those for other prescribed medication. It is important that clear and accurate records for the application of prescribed creams are maintained to help ensure they are used correctly. Most medication administration records were pre-printed by the pharmacy but where handwritten entries were made by nursing staff these were not checked and countersigned to reduce the risk of mistakes. Where medicines were not administered we found the reason for non-administration was not recorded. This is important as where medicines are regularly not taken as prescribed, advice should be sought from the doctor. We found that there was sometimes a lack of information about the administration of medicines prescribed when required. This can lead to inconsistency in the administration of their medication. For example, the nurse-on-duty explained that she always administered someone two painkillers in a morning because she felt this
Care Homes for Older People Page 4 of 9 helped, but we could see that different staff administrated the painkillers differently. Written guidance and monitoring will help to ensure peoples pain is best managed. We saw that some people may need a medication review because their medicines were given differently from originally prescribed. For example, someone was prescribed paracetamol to be taken regularly and a stronger painkiller to be taken when needed. But, their needs had changed and the stronger painkiller was now given regularly and the paracetamol less frequently. We looked at medicines storage and found that all medicines including controlled drugs were safely locked away. The nurse-in-charge had recently started to complete audits (checks) of medicines handling. These checks focused on stock control and the medicines administration records. Consideration should be given to completing a wider audit to help ensure that should any weaknesses arise they are promptly identified and 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 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 (2) (i) The registered person must 01/09/2007 ensure that residents have a choice of meals in the evenings and individual preferences are catered for. The registered person must 01/09/2007 ensure that sufficient staff are employed to ensure that residents care needs are not compromised. This is an outstanding requirement from the previous inspection 16/2/07. The registered person must 01/09/2007 ensure two written references are obtained prior to staff being employed in the service, to ensure residents are not placed at risk. 2 27 18 (1) (a) 3 29 19 (1) b (i) 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 safely 27/07/2009 administered as prescribed with due consideration to the homes policies and procedures and current good practice guidance. Complete, clear and accurate records of medicines administration must be maintained to help ensure medicines are administered correctly and to reduce the risk of mistakes. 2 9 13 Where people self-administer 27/07/2009 medication risk assessments must be completed and any support needed recorded and kept under review to help ensure people always receive the help they may need to safely manage their own medicines. 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 Where medicines are prescribed when required there should be written individual guidance about when they may be needed and how this need is made known. There should also be written information about the use of prescribed creams to include for example, where they are to be used. Handwritten entries on the medicines administration records should be signed, checked and countersigned to help reduce the risk of mistakes. 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!
