Random inspection report
Care homes for older people
Name: Address: Coombe Grange Residential Home Coombe Lane Sway Lymington Hampshire SO41 6BP 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: Vashti Maharaj Date: 0 2 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Coombe Grange Residential Home Coombe Lane Sway Lymington Hampshire SO41 6BP 01590682519 Telephone number: Fax number: Email address: Provider web address: coombegrange@bmlhealthcare.co.uk www.coombegrange-rh.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Tarina Price Type of registration: Number of places registered: Conditions of registration: Category(ies) : Coombe Grange Limited care home 40 Number of places (if applicable): Under 65 Over 65 0 0 40 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 40 40 0 The maximum number of service users to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home only ? (PC) 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 (OP) Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Date of last inspection
Care Homes for Older People Page 2 of 8 Brief description of the care home Coombe Grange is a registered care home set in a rural location on the edge of the village of Sway in the New Forest, with limited access to local amenities. It provides accommodation and personal care for up to 40 elderly residents, some of who may have dementia. The home is on ground, first and second floors and there is a lift between ground and first floors. There are a variety of aids and adaptations to allow residents to move about more independently. Twenty-four of the bedrooms are single, and eight are doubles. There are two communal toilets and a bathroom on the ground floor, and one toilet, two bathrooms and two showers on the first floor. There are large, accessible, gardens around the building. Care Homes for Older People Page 3 of 8 What we found:
We carried out a random inspection at the home following on from a number of medication errors during 2009. At the last key CQC inspection in January 2008 there were no issues with medicines handling, and no requirements made. We inspected medication records, storage areas, training, observed medicines being given to residents and interviewed the Deputy Manager. We found that all prescribed medicines were available at the home and that medicines were being given as prescribed. We found that accurate records of medicines given, received and returned were being kept, and all medicines can be accounted for. Records were clear and of a good standard. There are good policies for medication handling, and evidence this is being followed. We looked into all the medication incidents and found that the home has taken appropriate action to correct the cause of the error. These have been documented well. What the care home does well: What they could do better:
A controlled drug is being stored with other prescription medicines, this needs to be stored separately in a cupboard which meets the Misuse of Drugs Safe Custody Regulations. Medicines are kept locked in trolleys, however these are occasionally left in hallways, unsecured. These should be secured to the wall when not in use, or stored in the medicines room. Post inspection note-the Manager contacted CQC after the inspection to advise that medicines are not stored in these medicines trolleys, they are only used during the medicines round then medicines are returned to the locked clinical room. The temperature of the medicines storage room should be monitored to ensure medicines are kept at the correct temperatures and do not deteriorate.
Care Homes for Older People Page 4 of 8 Medicines are given to residents when they leave the home for social leave e.g. for lunch or to stay with relatives. For planned periods of social leave, the supply of medicines should be given to the residents if safe to do so, or a separate supply dispensed by the pharmacy as staff should not be secondary dispensing as this is unsafe and introduces the riskof error. For occasional unplanned leave, if it isnt possible to give medicines before or after leaving the home, or the original container, staff can give medicines in a separate container, which must be labelled with the residents name and the drug name, with a robust process to check that what has been supplied is accurate. There were a very small number of missing signatures from earlier in the month where staff have not checked if this was due to a missed dose or staff forgetting to sign after giving a dose. A note should be made on the medication record immediately the missing signature is found, so it is clear whether or not the dose has been given. In a very small number of cases, it wasnt clear if medicines had been discontinued. Staff should record clearly on the medication record when a medicine is stopped and by whom. 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 8 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 8 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 Storage of medicines must be secure, in particular -Controlled Drugs must be stored in a cupboard which meets the requirements of the Misuse of Drugs Safe Custody Regulations. To comply with the law and ensure the safety of residents. 30/11/2009 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 Medicines for unplanned occasional social leave must be supplied in a container labelled with the residents name and drug name with a robust check for accuracy. For other periods of social leave, the original supply should be given, or a separate supply dispensed by the pharmacist to avoid secondary dispensing by care staff. The temperature of all medicines storage areas should be monitored to ensure medicines are kept at the correct temperatures to avoid deterioration. 2 9 Care Homes for Older People Page 7 of 8 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 8 of 8 - 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!
