Inspection on 11/02/10 for Broomwood Care Centre

This inspection was carried out on 11th February 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Random inspection report Care homes for older people Name: Address: Broomwood Care Centre 53D Mainwood Road Timperley Altrincham Cheshire WA15 7JW zero star poor 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: Maggy Howells Date: 1 1 0 2 2 0 1 0 Information about the care home Name of care home: Address: Broomwood Care Centre 53D Mainwood Road Timperley Altrincham Cheshire WA15 7JW 01619808001 Telephone number: Fax number: Email address: Provider web address: care@schealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Southern Cross OPCO Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 50 Number of places (if applicable): Under 65 Over 65 0 50 dementia old age, not falling within any other category Conditions of registration: 50 0 The maximum number of people who can be accommodated is:50 The registered person may provide the following category of service only: Care Home with Nursing - Code N, to people 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 Dementia - Code DE Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Broomwood Care Centre is a large, purpose built care home that provides accommodation on two floors. Each floor is run as separate units with the unit on the ground floor designed specifically to meet the needs of people with mental health and dementia type illnesses. The first floor is to support people who need nursing care including twelve places for people who need a short stay placement. Broomwood Care centre offers 50 single bedrooms which have an en suite shower and toliet to provide increased privacy. There are a number of communal lounge areas throughout the home and a pleasant garden area. The home is situated in a quiet area of Timperley and is close to a small variety of shops. The current weekly fees for Broomwood Care Centre range from five hundred and ten pounds to six hundred and sevent eight pounds. There are additional charges for toiletries, haidressing, chiropody, newspapers and outings. Care Homes for Older People Page 3 of 11 What we found: We visited the home because we had been told about an incident that had happened when giving and recording medicines. The visit was carried out by a pharmacist inspector. It lasted approximately five hours and involved speaking with the manager, a nurse and carers on duty. This was an unannounced visit, which meant that neither management nor staff knew we were going. We checked one of the medicines storage areas, a sample of medicines stocks and medicines records. We gave detailed feedback to the manager and one nurse throughout the visit, and repeated the main findings to the manager at the end of the visit. Overall we found that there was some poor practice when handling and recording medicines, which meant that the health and wellbeing of people who live in the home may be at risk of harm. We looked at a sample of records and stock and we found it very difficult to account for medicines. This meant that we could not be sure they had been given to people correctly, or if the right amount of stock was left in the cupboards. There was no obvious system of stock control because stock was not properly recorded (carried forward) at the beginning of each month. Of the medicines that we could check, we found some that did not add up correctly, showing that they had been missed. For example, one person had not been given a medicine for strengthening bones for the last seven doses. Another person was prescribed medicines for epilepsy, these had been signed as being given three times a day even though they were prescribed to be given only twice a day. Missing medicines or being given too much medication can seriously affect a persons health and wellbeing. When the administration of medicines is not accurately recorded, people are at risk of being given the wrong amount of medicine (too much or too little). Some medication administration records were confusing as they had lots of entries for medicines that were no longer given. Mistakes are more likely to happen when records are not kept up to date. Some people were prescribed medicines to be taken only when required e.g. painkillers. There was a system in place for recording detailed information about how and when these medicines were to be given in peoples care plans, but this had not always been followed and instructions were not always available. Having clear written information helps to ensure that people are given their medicines consistently and correctly. Some medicines have to be taken at specific times, for example an hour before food, in order to work properly. We could see no evidence that these medicines were given correctly. There were numerous examples of medicines prescribed to be taken before food being given at the same time as other medicines that should only be taken after food. People are unlikely to get the best from their medication if it is not given at the correct time in relation to food and drink. We looked at the storage of medicines and found that the service had appropriate medication cupboards and a trolley available. We checked how controlled drugs (strong medicines that can be misused) were handled. Care Homes for Older People Page 4 of 11 A suitable cabinet was used for storage and a special register was used for record keeping. We found that important details, such as the name and strength of medicines were not always recorded. We also found that the administration of these medicines had not always been witnessed by a second member of staff. We looked carefully at how pain relief patches were handled and found that on occasions patches had been changed too soon or left on for longer than recommended. If patches are not changed at the right time, then they will not control the persons pain properly. Controlled drugs must be handled carefully and in accordance with the law at all times to prevent them being mishandled, misused and placing people living in the home at serious risk of harm. The manager told us that staff were supposed to keep checks of stock balances and note any discrepancies. This clearly was not happening as these sheets had not been completed for several days. There were no effective formal audits (checks) of the medicines handling system in place. This meant that mistakes were not being found and acted upon to help prevent them happening again. We gave some advice to the manager on how audits can be performed and how they help to maintain and improve standards. We looked at training and found that only qualified nurses were authorised to handle medication. However in practice, non nursing staff also administered some creams and nutritional supplements and some acted as witnesses to the administration of Controlled Drugs. There was no evidence of a formal system for checking and recording the competence of either nurses or care staff (including temporary staff) actually administering or recording medicines. Checking the competence of staff ensures they are safe to carry out their duties without supervision. Given the serious nature of our findings the competence of some staff is questionable. 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 11 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 3 14 The manager must ensure 11/01/2010 that the needs of prospective people for whom accommodation is provided have been appropriately asssessed and a copy of the assessment has been obtained. This is so that an accurate decision can be made as to whether the persons needs can be met by the service. 2 7 13 Risk assessments must be 11/01/2010 completed for all identified risks for individuals. This must include risk assessments for moving and handling, nutrition and the provision of diet and fluids. This is to ensure that all known risks are identified, recorded and actions taken to minimize the risks. 3 7 15 You must ensure that each 11/01/2010 person living at the home has an up to date and detailed plan of his or her care needs. The plans must include comprehensive details of the needs of service users relating to their health and welfare and clear Page 6 of 11 Care Homes for Older People 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 instruction to staff in how to meet those needs. So that staff have clear guidance how to meet peoples assessed needs and provide them with appropriate support. 4 7 17 You must ensure that records 11/01/2010 are kept up to date and are accurately recorded. This is to ensure the information provided is accurate and up to date to reflect changes in a persons health care needs. 5 8 13 You must ensure that the 11/01/2010 staff carry out the necessary care and this is monitored. This is to ensure peoples safety and well being is maintained. 6 8 12 Where people are at risk of poor nutrition, due to poor health or dementia, you must ensure that diet and fluids is provided in accordance with nutritional guidance and at reasonable intervals througout the 24 hour day. Records must be kept up to date to monitor this. This is to ensure peoples health and well being needs are being met. 7 9 13 1.All medicines must be 11/01/2010 Page 7 of 11 08/01/2010 Care Homes for Older People 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 administered as prescribed in a timely manner. 2. All records about medicines must be clearly recorded. 1.To make sure that peoples health is not at risk. 2.So that all medicines are shown they are given as prescribed. 8 27 18 The registered person must make sure there are enough suitably qualified staff to meet peoples needs. This is to make sure that there are enough staff available at all times to meet the health and social care needs of people living in the home. 9 33 24 Systems must be in place to monitor and check the care practices in the home. This is to make sure shortfalls are identified and improvements are made particualrly in relation to care plans, medication and staffing. 29/01/2010 31/12/2009 Care Homes for Older People Page 8 of 11 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 24 There must be system for 30/04/2010 regularly auditing (checking) the standard of handling and recording medication within the service so that standards can be monitored and improved where necessary. Medicines must be given at the correct time of day, particularly with regard to food and drink intake in order for medicines to work properly and/or reduce side effects. 30/04/2010 2 9 12 3 9 18 There should be a system in 30/04/2010 place for checking and recording the competence of all nurses and care staff involved in administering and/or handling medication in order to ensure these tasks are performed safely 4 9 12 All medication must be administered/used only as 30/04/2010 Care Homes for Older People Page 9 of 11 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 prescribed in order to safeguard the health and well being of people who use this service 5 9 13 There must be complete and 30/04/2010 accurate records of all controlled drugs received, administered and leaving the service in order to account for these potent medicines. 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 Medication administration records should be updated regularly, so that only currently prescribed medicines and dressings are listed. Detailed information for the administration of when required medication should be available for staff to refer to, so that these medicines are given correctly and consistently. 2 9 Care Homes for Older People Page 10 of 11 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. 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