Random inspection report
Care homes for older people
Name: Address: Chasedale Tynedale Drive Cowpen Estate Blyth Northumberland NE24 4LH two star good service 28/01/2009 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: Michael Earnshaw Date: 2 7 1 0 2 0 0 9 Information about the care home
Name of care home: Address: Chasedale Tynedale Drive Cowpen Estate Blyth Northumberland NE24 4LH 01670-365997 01670365732 chasedale@fshc.co.uk www.fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Robert Nelson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tamaris Healthcare (England) Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 10 dementia old age, not falling within any other category Conditions of registration: 50 0 The maximum number of service users who may be accommodated is 60. The registered person may provide the following category of service only: Care home with nursing - Code N To service users 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, maximum number of places: 10 Dementia - Code DE, maximum number of places: 50 Date of last inspection 2 8 0 1 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Chasedale Nursing Home is a two storey, purpose built facility of traditional brick build and tiled construction. It is situated on the edge of a large residential estate approximately two miles from the centre of the town of Blyth. The home is well served by public transport. The home has a car park to the front from which there is level access to the main entrance. There are grassed sitting areas, which are accessible to, and for the use of, residents and visitors. The home is registered to provide care to 60 persons 10 of which are the category of old age requiring nursing care and the remaining 50 under the category of dementia care (nursing). The home charges fees of between £444.60 and £504.60 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 following a report from the home that a service user had missed medication for four days. The visit lasted five hours and involved looking at a sample of medication administration record charts (MARs), and the medication storage and handling arrangements in the home. Medication administration was not observed during the visit. Information about staff training and audit of the medication system was provided by Bob Nelson, the manager of the home. During the visit I gave verbal feedback to the manager. The outcome is as follows: The storage of medicines in the home is generally well managed, although at the time of the inspection a large quantity of medicines for disposal were in open boxes on the floor of the treatment room. These medicines had still not been recorded in the disposal record book despite the new cycle of treatment having started 11 days earlier. There were detailed records of medicines ordered and received and there was no evidence of any medication being out of stock and not available to administer. Prescriptions are delivered to the home first, for checking, before being sent to the pharmacy for dispensing and a copy of the prescription is kept with each MAR. This good practice helps to make sure that any changes are acted upon and that all required medicines are supplied each month. MARs were looked at on both floors of the home. There were no significant gaps in the administration records where administration had not been recorded or a non administration code not added. In addition, there were very few discrepancies between the quantities of medicines received, the number of doses recorded and the quantities of medicines remaining. This indicates that people living in the home can expect to receive their prescribed medicines correctly. One person did not receive a night time dose of regularly prescribed gaviscon advance on 11 continuous occasions and the MAR indicated that the person was always asleep. On another persons MAR night time doses of medication for epilepsy had been omitted because the person was regularly asleep or refused the medicine. There was no evidence that advice had been sought from health care professionals to address this continued non administration or to consider administration at an earlier time. Some people were prescribed medicines to be taken as and when required, for the treatment of agitation, for example. Sometimes there was no additional guidance with the MAR to help staff decide when treatment might be appropriate. There were a number of handwritten entries on MARs on the ground floor which had not been checked and countersigned by a second person to confirm their accuracy and to reduce the risk of error when copying medicine details. The date of opening of medicines with limited use once opened was not always recorded. This means that there is a risk that the medicine may be used beyond the date recommended by the manufacturer and may not be safe to use. Care Homes for Older People Page 4 of 9 The controlled drug cupboards appeared to meet safe custody regulations. Records in the controlled drug register could be improved by ensuring that all receipts and administrations are countersigned by a second nurse. Some amendments to entry errors had not been made appropriately in line with good practice guidance. Regular checks on controlled drugs are not carried out. The medicines policy is comprehensive but does not include sufficient detail about local practices within the home to handle medication, particularly useful for new staff. Although audit of the medication system is carried out every three months this is not regular enough to identify any medication problems promptly and to help confirm that staff are following the providers medicines policy. 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 £ No R 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 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 Best practice guidance and 29/12/2009 the providers medicines policy must be followed when storing, giving, recording and disposing of medicines. To protect people from the risk of medication error or omission. 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 The medicines policy should be updated to reflect local practices in the home and how staff should deal with medicine administration when people are asleep or regularly refuse medication. The dates of opening should be added to the containers of medicines with a limited use once opened. 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. Written guidance should be kept with the MAR for every person prescribed as required medication to ensure that
Page 7 of 9 2 3 9 9 4 9 Care Homes for Older People 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 staff are fully informed and can give treatment appropriately. 5 9 Stocks of controlled drugs should be regularly checked and a record of this check made in the controlled drug register. 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!
