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Inspection on 07/07/09 for Coble House

Also see our care home review for Coble House for more information

This inspection was carried out on 7th July 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

There are robust arrangements in place for the ordering, receipt, administration and disposal of medicines. Regular and detailed audits of the medication system are carried out and changes to medication practice are clearly communicated to staff working in the home.

What the care home could do better:

Medicines storage and security within the home could be improved.

Random inspection report Care homes for older people Name: Address: Coble House North View Whitley Bay Tyne & Wear NE26 2EU two star good 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: Michael Earnshaw Date: 0 7 0 7 2 0 0 9 Information about the care home Name of care home: Address: Coble House North View Whitley Bay Tyne & Wear NE26 2EU 01912510694 01912513605 Telephone number: Fax number: Email address: Provider web address: www.southerncrosshealthcare.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross BC OpCo Ltd care home 52 Number of places (if applicable): Under 65 Over 65 52 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 52 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 52 Date of last inspection Brief description of the care home Coble House is a modern, purpose built care home with nursing situated in a residential area of Whitley Bay. The home provides care for up to fifty-two elderly people. Within this there are four beds allocated for the use of local general practitioners (GP) and the health authority pays for the retention of these beds. The beds can be used for respite or emergency care and the normal length of stay is approximately two weeks. Care Homes for Older People Page 2 of 9 Brief description of the care home Accommodation is provided on two floors and there is a passenger lift in the home. All bedrooms have en-suite facilities. There are selection of lounges and dining rooms that people have the choice of using. The home is located near to local shops and public transport links. There is information available about the service provided at the home in the Service User guide, Statement of Purpose and recent inspection reports, which are kept in reception. The charges for the home range from #369:99 to #483:19 per week depending on the needs and requirements of the residents. 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.The visit lasted five hours and involved looking at arrangements within the service that support the safe handling and administration of medicines. We looked at medicines records, storage, security and stock control. We also observed medicines being given to service users and discussed with the manager what arrangements the service had in place to monitor the medication system. Medicine administration was observed on both floors and was well managed and followed good practice guidance. However, the nurse left the medicines trolley unlocked whilst she administered medicines to individual service users. People who preferred to take their medicines in the privacy of their own room or later after a meal were accommodated. The medicine administration record (MAR) charts were looked at on both floors. There were no significant gaps in the administration records and the quantities of medicines received into the home and carried over from the previous month were accurately recorded. There were very few discrepancies between the quantity of medicine supplied, the number of doses recorded as administered and the quantity of medicine left in stock. This suggests that people are being given their medication as prescribed. Three people were prescribed warfarin but there was no supporting dosage information from the hospital clinic attached to the MAR charts to enable the nurse to check the prescribed dose at the point of administration. However, full dosage details were filed within each service users care plan. The controlled drug cupboard appears to meet safe custody regulations and there were no discrepancies between controlled drugs held in the home and the relevant entries in the controlled drug register and on the MAR charts. The time of administration of three controlled drugs had not been recorded in the register the evening prior to the inspection and the quantities of controlled drug remaining had not been entered. Medicines with limited use once opened were not always labelled with the date of first opening. This means that some medicines may be used beyond the date recommended by the manufacturer and so may not be safe to use. Medicine storage facilities within the service were generally secure and tidy although there appeared to be insufficient cupboard space to enable all medicines to be securely locked away or to enable ointments and creams to be stored fully separated from medicines for internal use. The lock on one medicines cupboard was broken. Some medicine inhalers were stored on top of a filing cabinet in the first floor office and were not locked away. Detailed records of medicines ordered, received and disposed of are well maintained and a system is in place to manage any medicine supply shortages promptly to ensure that supplies of medication do not run out. The medicines policy is comprehensive and is supplemented with written guidance given to staff and copies were located in the treatment room. Care Homes for Older People Page 4 of 9 Audit of the medication is comprehensive and regular which helps identify any problems with the medication promptly and helps confirm that staff are following the medicines policy closely. 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 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 13 The maximum/minimum thermometer should be used to record the medicines refrigerator temperature range to confirm that medicines are stored at the appropriate temperature and so are safe to use The date of opening of all medicines with a limited use once opened should be recorded to make sure that the medicine is not used beyond the date recommended by the manufacturer The medicines trolley should be locked and all medicines secure whilst the nurse administers medicines to service users A secure cabinet should be installed on the first floor for storage of inhalers The faulty lock on the floor standing medicines cupboard should be replaced to provide additional secure storage space for medicines The written dose instructions provided by the anticoagulant clinic should be kept attached to the MAR chart of persons receiving anticoagulation. This makes sure that staff have Page 7 of 9 2 13 3 13 4 5 13 13 6 13 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 accurate and up to date information about the dose at the time that medicines are given 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. 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