Inspection on 07/05/09 for Bywell House

This inspection was carried out on 7th May 2009.

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

Bywell House 26/05/09

Bywell House 10/03/09

Bywell House 05/03/08

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Random inspection report Care homes for older people Name: Address: Bywell House 2 Longfellow Road Worthing West Sussex BN11 4NU 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: Lesley Webb Date: 0 7 0 5 2 0 0 9 Information about the care home Name of care home: Address: Bywell House 2 Longfellow Road Worthing West Sussex BN11 4NU 01903236062 01903236062 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) : Hazelwood Care Ltd care home 20 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 20 20 The maximum number of service users to be accommodated is 20. The registered person may provide the following category/ies of service only: Care home only - (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) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Bywell House is a care home registered to accommodate up to 20 older people in the categories dementia, (DE), and mental disorder (MD). The property is a detached building situated in a residential area on the outskirts of Worthing. The town centre and seafront are within walking distance and there are local shops and other facilities nearby. Buses and mainline trains are easily accessible. Care Homes for Older People Page 2 of 10 Brief description of the care home People living at the home are accommodated in twenty single bedrooms, which are located on the ground and first floors. A vertical lift provides access to each floor. Communal accommodation consists of a lounge and a dining area, which are located on the ground floor. There is an enclosed garden to the front and side of the property for people to use. This service is privately owned by Hazelwood Care Ltd. The Responsible Individual who acts on behalf of the company is Mr. Manvinder Singh. The fees for this care home currently range from four hundred and eighty five pounds to five hundred and thirty five pounds per week. Care Homes for Older People Page 3 of 10 What we found: The reason for this inspection was to assess compliance with a Statutory Requirement Notice (SRN) for medication issued on the 15th April 2009. The compliance date for the SRN was 1st May 2009. The SRN consists of 4 elements, these being i) Have a system in place at the Home to ensure that all medicines are safely and securely stored, so that service users do not have access to medicines that have not been prescribed for them. ii) Have a system in place to store medicines according to the manufacturers instructions and at the correct temperatures. This will ensure that medicines will not deteriorate and become ineffective. iii) Have a system in place to ensure that the expiry date on all medicines is monitored so that medicines are not kept past their expiry date. iii) Have a system in place to ensure that medicines are not administered to service users when they have passed their expiry date. This will ensure that people will not be harmed. Before our visit we received a written response from the Responsible Individual informing us that all elements of the SRN have been acted upon. The outcome of our visit is as follows: On arrival at the home we informed the manager of the reason for our visit. She then left the office to arrange refreshments. After 5 minutes she had not returned and we proceeded to the medication room. When we walked into the medication room we witnessed a member of staff holding a thermometer to a fan located in the room. We asked the member of staff what she was doing. She stated, Just seeing if it is working, if the reading will go down. We viewed the thermometer and saw that it was showing a reading of 28 degrees Celsius. We asked the member of staff if the manager had instructed her to attempt to lower the temperature reading on thermometer and she said yes. We looked at 8 items of medication that was stored in the medication room. The manufacturers instructions detailed on the medication containers for 7 of the items instruct that the medication should not be stored above 25 degrees Celsius. We asked the manager if a record is in place with regard to the monitoring of the temperature in the medication room. She informed us it is not. We viewed a record for monitoring medication storage and stock that instructs staff to undertake checks every Friday. The record instructs staff to check that no out of date medication is in use, that all medication is stored correctly, that the medication trolley and fridge have no spills and that the trolley and fridge are in good working order. Records detail checks having being undertaken on 10.04.09, 17.04.09, 24.04.09 and 07.05.09. No record was found of a check taking place for week ending 1st May 2009. Care Homes for Older People Page 4 of 10 We randomly sampled 7 prescribed medications in the medication room. All included the expiry date. Records that we looked at demonstrate that none of these have been administered after the expiry date. A separate fridge is located in the in medication room for the storage of prescribed medication in order that medication can be stored in line with manufacturers instructions. We viewed the records for monitoring the temperature in the fridge. These have been completed daily. On the day of our visit one prescribed medication cefaclor 250mg/5ml was seen to be stored in this facility. We sampled 6 residents current medication administration records. All state they are prescribed creams and ointments. Staff signatures were in place to say these have been administered as per the dispensing instructions. We could not find the prescribed creams and ointments for 4 of the residents. These being Aqueous cream for one resident, Ibugel gel 5 for the second, Diprobase cream and Diclofenac diethylanmonium gel 1 for the third and Ibuprofen gel 5 and Aqueous cream for the fourth. We asked the deputy manager where the prescribed creams and ointments were that we could not find in the medication room. She informed us, in their rooms in cupboards. This was also confirmed by the manager. We asked the manager if any resident living at the home self medicates and she said no. We also asked the manager if care plans and/or risk assessments have been completed for medication. She stated, Yes care plans but no risk assessments. We then viewed the bedrooms of 3 of the 4 residents where the manager had earlier informed us that their prescribed creams and ointments were stored. We did not view the bedroom of the forth resident as the manager informed us they were in bed asleep. Prescribed creams and ointments were seen to be stored in the 3 residents bedrooms. We observed these to be in baskets that also stored their toiletries. For 2 of the residents these were in sink vanity units and for the third with their toiletries in a wall cupboard. None of the storage facilities were lockable. We asked the manager if any of the 3 residents have any form of dementia and she stated, Yes. When we returned to the office we asked the manager for the medication care plans that she had earlier informed us were in place. She stated, Sorry not got. We asked the manager if there was any documentation of any kind regarding storing prescribed medication in residents bedrooms that would demonstrate how this decision has been arrived at as safe. She stated, No. We asked the manager why prescribed medication is stored in residents bedrooms and she stated, Because they always have been. What the care home does well: On the day of our visit no out of date prescribed medication was being administered to residents. Care Homes for Older People Page 5 of 10 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 6 of 10 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 12 16 In line with Regulation 22/05/2009 16(2)(m)(n) the registered person must ensure activities are offered that are varied, flexible and meet the expectations, preferences and capacities of residents. This must happen to ensure residents have to opportunity to lead full and active lives. 2 19 16 In line with Regulation 16(2)(c) the registered person must ensure all residents bedrooms have working lights, hot running water and furniture in good working order. This must happen to ensure residents needs are met. 22/05/2009 3 26 16 In line with Regulation 16(2)(j) the home must consult and act on any recommendations made by the Environmental Health Agency with regards to the kitchen. This must happen to ensure the kitchen is fit for the purpose of preparing meals for residents. 10/06/2009 Care Homes for Older People Page 7 of 10 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 4 33 24 Quality monitoring systems must be undertaken on a regular basis, including obtaining the views of people. This must happen to ensure residents receive a consistent and safe service. 10/06/2009 5 38 13 In line with Regulation 13(4) 25/04/2009 the registered person must ensure detailed risk assessments are in place for the use of bed rails and that these include instructions on safety checks that must be carried out and recorded when used by residents. This must happen to reduce the risk of harm to residents. Care Homes for Older People Page 8 of 10 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 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 Care Homes for Older People Page 9 of 10 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). 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