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Inspection on 19/08/09 for Church View (Nursing Home) Limited

Also see our care home review for Church View (Nursing Home) Limited for more information

This inspection was carried out on 19th August 2009.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We found no significant examples of good practice when handling medicines.

What the care home could do better:

Medicines must be given to people correctly `as prescribed` because receiving medicines at the wrong dose, wrong time or not at all can seriously affect a person`s health and wellbeing.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Church View (Nursing Home) Limited Princess Street Accrington Lancashire BB5 1SP one star adequate 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Simon Hill Date: 1 9 0 8 2 0 0 9 Information about the care home Name of care home: Address: Church View (Nursing Home) Limited Princess Street Accrington Lancashire BB5 1SP 01254386658 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Lindsay Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Church View (Nursing Home) Limited care home 40 Number of places (if applicable): Under 65 Over 65 0 22 dementia old age, not falling within any other category Conditions of registration: 18 0 The registered person may provide the following category of service only: Care home with nursing: Code N, to people of either gender, 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: 22). Dementia - Code DE (maximum number of places 18) The maximum number of people who can be accommodated is: 40. Date of last inspection Brief description of the care home Church View Nursing Home was purpose built in 1990. The home is registered to provide 24 hour nursing and personal care for up to 40 residents, some of whom may Care Homes for Older People Page 2 of 9 Brief description of the care home have dementia. Accommodation is provided on 2 levels. The first floor comprising only four rooms and a lounge. A stair lift provides access to the first floor. All other accommodation and facilities are on the ground floor. The floor has been split to provide a dementia care unit, which is separated from the other part of the home by a door with a coded lock. Each unit has its own lounge and dining area. There are gardens and a car park for visitors and staff. The home is situated in a quiet residential area in Accrington close to local amenities. The current fees are available on request from the home manager. Additional charges are payable for hairdressing, newspapers and transport for hospital visits. A copy of the statement of purpose and service user guide is available to prospective service users on request. Care Homes for Older People Page 3 of 9 What we found: We carried out this visit to make sure medicines were being handled safely because a previous visit had found some shortfalls. The inspection was carried out by a pharmacist inspector and it lasted four hours. We checked medicines records, medicines stock and peoples care plans and spoke with staff. Overall we found some improvements but still found mistakes that meant not all medicines were being given and recorded correctly. When we checked the medicines records against medicines stock we found a clear system of stock control that made checking medicines simple and easy to do, stock was usually recorded correctly on receipt into the home as were medicines disposed of. However, we found examples of medicines not being given to people correctly. One person who was prescribed an antibiotic eye drop to be used four times a day only had it once a day for three days and only twice a day on three other days. Another person missed two of their medicines on two consecutive nights in the last week and several people had their pain relief patches replaced late. Medicines that needed to be given before food were sometimes given after food and when people refused medicines or were asleep staff did not always attempt to give them at a later time. We also found external medicines such as creams were not always recorded properly so we could not be sure that they were being used correctly. Going without prescribed medicines can seriously affect a persons health and wellbeing. We looked at a further sample of care plans and records to check if medicines were properly reflected in them. People that were prescribed when required medicines had some information about how and under what circumstances they should be given. However, some of these plans were not always up to date as they were not formally reviewed on a monthly basis. For example, one persons care plan described the use of a strong pain killer that had been changed to a different one some time ago. Having clear written plans helps make sure people get their medicines when they need them. We checked how controlled drugs (medicines that can be misused) were handled. The cupboard used for storage had now been properly attached to the wall, so it met the requirements of the law. A special register was used for record keeping but we found several mistakes including one entry not being witnessed and several entries wrongly dated. On several occasions strong pain relief patches were replaced late and sometimes the medicines records did not match the controlled drug register. Witnessed accurate records and secure storage of controlled drugs help prevent mishandling and misuse. We saw examples of recent audits (checks on medicines) that had been carried out and these had been reasonably effective at finding mistakes. Action had be taken to help make improvements but our findings showed that similar mistakes were being made every month particularly inaccurate record keeping. Given the number of mistakes we found during this visit the competence of some staff when handling medicines is of concern. What the care home does well: Care Homes for Older People Page 4 of 9 We found no significant examples of good practice when handling medicines. 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 7 15(2) Care plans must be amended 30/09/2008 as and when the persons needs change so that staff have up to date and accurate directions about the care to be provided. 2 7 15(1) Care plans must clearly identify the needs of people with dementia and provide sufficient directions for staff to meet those needs. 30/09/2008 3 8 13(4) People must not be restrained in chairs unless their assessment clearly indicates that this is the most appropriate way of temporarily controlling the risk of falls. 31/07/2008 4 8 13(4)(c) In order to protect the health 30/09/2008 and safety of people living in the home, strategies to reduce the assessed risk to peoples health must be included in their care plan. 5 9 13 Medicines must be given to 07/02/2009 Care Homes for Older People Page 6 of 9 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 people correctly as prescribed. This is important because receiving medicines at the wrong dose, wrong time or not at all can seriously affect a persons health and wellbeing. 6 29 19 In order to protect people 31/08/2008 using the service staff and show that staff are suitable to be employed all staff must have a POVA first or CRB disclosure before they start work at the home. All other required documents must be obtained and kept on file. (Previous timescale of 20/07/07 not met) 7 38 13(4)(c) Bedside rails must not be 31/08/2008 used unless there has been a thorough assessment to show that the rails are safe to use with the bed and mattress. 8 38 23(4)(d)(e) All staff must receive sufficient fire safety training and practice drills to ensure that they are completely clear about their role in the event of a fire. 30/09/2008 Care Homes for Older People Page 7 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 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI 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. 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