Random inspection report
Care homes for older people
Name: Address: Parkfield Residential Home 256 London Road Carlisle Cumbria CA1 2QQ one star adequate service 09/06/2009 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: Angela Branch Date: 1 8 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Parkfield Residential Home 256 London Road Carlisle Cumbria CA1 2QQ 01228818933 01228595173 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) : Hometrust Care Limited care home 40 Number of places (if applicable): Under 65 Over 65 0 40 0 dementia old age, not falling within any other category physical disability Conditions of registration: 40 0 40 The registered person may provide the following category of service only: Care home only - Code PC 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 Physical disability - Code PD The maximum number of people who can be accommodated is: 40 Date of last inspection Brief description of the care home Parkfield provides care and accommodation for up to 40 older people, some of who may also have dementia or a physical disability. The home is a three storey detached property quite close to the centre of Carlisle. The accommodation for service users is provided on the ground and first floors. There is a passenger lift, handrails, grab rails,
Care Homes for Older People Page 2 of 11 0 9 0 6 2 0 0 9 Brief description of the care home and ramps to assist people in moving around the home. All of the bedrooms are for single occupancy and have en-suite toilet and washbasin facilities. There are additional toilets, communal bathrooms and a shower room, which are equipped to assist people to access these facilities. There is a secure, sheltered garden area and car parking facilities at the home. A variety of information has been produced. This includes a brochure and service user guide. These documents are available on request from the manager who is also able to provide information regarding the the weekly charges for this home. Care Homes for Older People Page 3 of 11 What we found:
The service was visited in order to follow up a requirement made at the last key inspection on 9 June 2009 regarding the handling of medication, and also to assess the overall management of medication. The pharmacist inspector looked at relevant documents, storage and met with the manager Mr Brian McCubbin and other staff. The inspection took approximately four hours. Feedback was given to the manager at the end of the inspection. Overall we found that medicines were managed adequately. The manager had addressed the specific issues that resulted in the requirement being made at the last inspection. However, there were still some areas that needed review, mainly around record keeping. Residents were protected by policies and procedures for managing medication. These included provision for the administration of household remedies for minor ailments. This benefits residents as it means that they are able to have prompt relief of symptoms without needing to see a doctor. The services policies and procedures also allow residents to look after and take their own medication where this is deemed safe and appropriate, and this helps them remain independent. While some people were able to do this, the risk assessments were inadequate and the manager should review these so that risks are identified and managed to keep residents safe and well. We looked at records for receipt, administration and disposal of medication. While many of these were accurately completed a few contained errors. For example, the reasons for omissions in administration were not always clear. Also, some records for receipt of medicines were incomplete for those received between the usual four-weekly order, and disposal of medicines especially those refused by residents was not always recorded. We also counted a sample of medicines and compared them with records to check if they tally and to show they were administered as prescribed. We saw a few cases where there was more medication remaining than there should have been. This means that on occasions the medicines administration records were signed but the medicines were not given. We saw several occasions when residents missed their medicines at the morning medication round because they were asleep. However, we noted that the medicines were offered again and administered later in the morning, when appropriate, to ensure that they did not miss essential treatments unnecessarily. We also spoke with staff about medicines with specific administration requirements and they showed good knowledge of this. We looked as a sample of care plans and other records relating to medication. We found that staff kept good records of visits by health care professionals such as doctors and the outcomes of these visits including any changes to medication were clearly recorded and implemented promptly. This allows easy tracking of why and when changes were made. There was also guidance for the administration of when required medication that included information for staff on why it was prescribed and when it should be given. This ensures that residents receive their treatment appropriately and when they need it. We checked the storage and records for medicines liable to misuse called controlled
Care Homes for Older People Page 4 of 11 drugs. The service kept a bound register of receipt, administration and disposal of controlled drugs. The balance of controlled drugs was checked and was in order. However, the cabinet that was used for storage of controlled drugs was not fixed to the wall as required by the Misuse of Medicines (Safe Custody) Regulations 1973 and this should be reviewed. The manager should also seek guidance with regard to the cabinet to ensure it complies with the regulations. Storage of other medication was in order. However, the manager and staff said that on one unit medicines were transported on an open trolley during the medication round. They were asked how these medicines would be made safe in an emergency and we were told that the trolley would be locked in a bedroom. Staff said that the last time this had happened was the week before this inspection. It is recommended that the manager obtain a lockable trolley for use during medicines rounds so that they can be made safe quickly if necessary to protect residents, and to prevent delay in dealing with emergencies. The manager told us that the supplying pharmacy was providing staff training in medication. We were also told that the manager assessed staff competencies in medicines administration through monthly shadowing followed by feedback, and that weekly checks of medicines records were done to check for completeness. However, there was little documentation relating to this and it is recommended that this be 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
Care Homes for Older People Page 5 of 11 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 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 8 12 You must make sure that people using this service have full and detailed assessments of their nutritional needs and requirements. It is important to maintain the health and well-being of people using this service. Failure to eat, for example through physical inability, depression or poor oral health can lead to malnutrition with serious consequences for health. 31/07/2009 2 9 13 You must make sure that 14/07/2009 there are safe and robust arrangements in place for the administration, recording and handling of medication. People using this service must receive their medicines as the doctor intended. Safe handling and accurate record keeping of medication helps to ensure that people are safe and protected from harm or suffering. 3 18 13 You must ensure that robust 31/07/2009 safeguarding recording and reporting systems are in place and used consistently.
Page 7 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 Robust and consistent procedures help to ensure that people using this service will be properly protected from the risk of harm or abuse. 4 37 17 You must make sure that 31/07/2009 proper records are maintained regarding any accident or incident, occurring in the home, which is detrimental to the health and welfare of people using this service. Accurate record keeping helps to identify preventable accidents and incidents, promoting and protecting the health and safety of people living and working at the home. 5 37 37 The Commission for Social 30/07/2008 Care Inspection must be notified of any event, which adversely affects the wellbeing or safety of any person using this service. (Previous timescale of 01/11/07 not met). You must make sure that the 31/07/2009 Care Quality Commission are notified of any event that adversely affects the wellbeing or safety of any person using this service. The Care Homes Regulations require you to do this. This
Care Homes for Older People Page 8 of 11 6 37 37 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 information helps us to judge the quality of the service provided and of the homes ability to ensure people using this service are safe and protected. 7 38 13 You must make sure that 31/07/2009 people living and working at this home are protected from harm or abuse. People using this service have a right to live in a safe environment. Care Homes for Older People Page 9 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 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 It is recommended that risk assessments for residents who look after and take their own medicines are reviewed so that all risks are identified, documented and managed to keep them safe and well. It is recommended that that records are kept of medication audits and assessments of staff competencies in medicines handling. It is recommended that the cabinet for the storage of medicines liable to misuse, called controlled drugs, be checked for fitness for the purpose and attached to a wall in accordance with regulations. It is recommended that the service obtain a lockable trolley for use when administering medication on one of the units so that it can be made secure in emergency situations. 2 9 3 9 4 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. 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 11 of 11 - 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!
