This inspection was carried out on 6th January 2009.
CSCI found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.
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 The quality rating for this care home is: The rating was made on: one star adequate service 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: 0 6 0 1 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): Type of registration: Number of places registered: Church View (Nursing Home) Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 18 0 Over 65 0 22 Conditions of registration: 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 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 Care Homes for Older People Page 2 of 10 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 10 What we found:
We visited the home because it had been randomly selected for a visit by a pharmacist inspector to look at the arrangements for handling medicines. The visit lasted approximately five hours and involved speaking with the manager and the area manager. We looked at the arrangements for the storage and recording of medicines and gave detailed feedback at the end of the visit. Overall we found some shortfalls in medicines handling that need to be addressed to make sure medicines are handled safely. We checked a sample of medicines records and stock and found most medicines difficult to account for as there was no clear system of stock control in place. New supplies of medicines were not always recorded clearly on receipt and when stock was left over at the end of the month it was not clearly carried forward. We carried out some random checks of the medicines and found that most medicines did not add up so we could not confirm whether they had been given to people correctly. We found a medicine used for blood pressure was being given at the wrong dose because staff had not checked the new record carefully. Another person was using the wrong inhaler because it had been recently changed but staff had not noticed and as a result it was also being recorded wrongly. We found some packets of the same medicines had been decanted together, this is poor practice as it could lead to mistakes when giving medicines and it makes it very difficult to account for them. We looked at the times medicines were given and found the records did not state the correct time to take them in relation to food intake. The manager confirmed at least two medicines were being given at the wrong time notably those that should be given before food were being given after. Giving medicines at the wrong time can stop them working properly. We looked at a sample of care plans and records to check if medicines and peoples health care needs were properly reflected in them. There was some paperwork kept with the current medicines records that was used to highlight information about how when required medicines were to be given but when we checked several peoples records and medicines we found this information was not up to date. We checked three peoples records that were currently taking when required medicines for anxiety and could not find any information about how their medicines were to be used. We also found information missing for when required laxatives, pain relief, angina sprays and sprays used for asthma. We saw several examples of currently prescribed medicines still kept with the main stock but not recorded on the current list of medicines, which means they could have been missed when people needed them. Having clear written care plans and up to date records helps make sure people get their medicines when they need them. We looked at how controlled drugs (medicines that can be misused) were being handled. The cupboard used for storage was not fully secure and we gave some advice on how to put this right. A suitable special register was used for record keeping and this was generally used correctly. When we checked the records of medicines given we found two recent mistakes when strong pain relief patches had been replaced a day late, which means these two people might have suffered some pain unnecessarily. Care Homes for Older People Page 4 of 10 We saw some formal recorded checks of the medicines records and these had identified some mistakes that the manager said had been acted upon to help prevent them happening again. However, these checks did not look at all issues of medicines handling such as whether medicines are properly given as prescribed, stock accountability, medicines care plans and staff competency when giving out medicines. We gave some advice on how to develop these checks further so that the type of mistakes that we had found are found by the homes managers and acted upon to make the necessary improvements. We looked at how medicines were stored and found they were securely kept. Spare stock was generally well organised and there was a suitable lockable fridge for storing medicines that required cold storage. We gave some advice on how to improve the security and recording of medicines for disposal to help prevent any misuse or mishandling. 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 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
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)(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. 4 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 5 29 19 In order to protect people using the service staff and show that staff are suitable 31/08/2008 Care Homes for Older People Page 6 of 10 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) 6 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. 7 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 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, Care Homes 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 There must be sufficient information in peoples care plans about their medicines. This will help make sure they are given to them correctly. 07/02/2009 2 9 13 Controlled drugs must be securely stored in a legally compliant cupboard. This will help prevent mishandling and misuse. 07/02/2009 3 9 13 Records of medicines receipt, 07/02/2009 medicines stock and medicines given must be clear, accurate and complete. This will make sure medicines can be fully accounted for. 4 9 13 Medicines must be given to 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. 07/02/2009 Care Homes for Older People Page 8 of 10 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 recorded medicines audit should be reviewed and updated to include all key medicines handling issues to help make sure medicines are handled safely. Care Homes for Older People Page 9 of 10 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 10 of 10 - 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!
