Random inspection report
Care homes for older people
Name: Address: Dorset House Blackfriars Avenue Droitwich Spa Worcestershire WR9 8DR 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 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: Morag Ross Date: 0 6 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Dorset House Blackfriars Avenue Droitwich Spa Worcestershire WR9 8DR 01905772710 01905771476 dorset@agecare.org.uk www.agecare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Emma Miles Type of registration: Number of places registered: Conditions of registration: Category(ies) : Royal Surgical Aid Society care home 42 Number of places (if applicable): Under 65 Over 65 0 42 dementia old age, not falling within any other category Conditions of registration: 42 0 The maximum number of service users who can be accommodated is: 42 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: Dementia (DE) 42 Old age, not falling within any other category (OP) 42 Date of last inspection Brief description of the care home Dorset House is a large attractive building, set within its own gardens near to Droitwich town centre. The older part of the building was built in 1928. There are currently 40
Care Homes for Older People Page 2 of 9 Brief description of the care home single rooms that measure at least 10 square metres, all of which have en-suite facilities. There is one double room currently occupied by a single occupant. Two shaft lifts are available to enable people with mobility concerns to move easily between floors, a stair lift is also provided on a small flight of stairs on the first floor. The home is one of several care homes for older people run by Age Care, a charity formed in 1862 as the Royal Surgical Aid Society. Car parking is available in the grounds of the home. For up to date information regarding fees the reader should ontact the service directly. Care Homes for Older People Page 3 of 9 What we found:
The pharmacist inspector visited the home on 6th August 2009 as part of a random inspection to check the management and control of medicines within the service in particular compliance with statutory requirement notices issued on 7 July 2009. A previous inspection had found that the room where medication was stored was too hot. At this inspection we saw that a new air conditioning unit had been fitted into the room. The temperature of the room was recorded daily between 23 and 25 degrees centigrade which is within the correct storage temperature for medication. This means that peoples medication was stored correctly within the recommended temperature ranges. A previous inspection had found that the storage arrangements for medication requiring storage under the Misuse of Drugs (Safe Custody) Regulations 1973, was not stored according to legal requirements. At this inspection we found that the service had added additional bolts to the cupboard to ensure that the legal requirement was met. A previous inspection had found that there were no written individual homely remedies available for people who live in the service. At this inspection we were shown individual homely remedy lists dated and signed by the persons doctor.The list was kept next to each persons individual medication administration record. This means that homely remedies, such as paracetamol, had been checked by a doctor to ensure that medication was safe to give when necessary. We were shown a medication policy provided by Age Care, which was not dated. It included details for the disposal of medication. We were shown the disposal records for all medication. We were shown two labelled bags for one person who had recently refused their medication. The medication record was seen and it had been correctly documented as refused and destroyed. This means that the service accurately records the disposal of medication and ensures safe practice is undertaken. We looked at the medication administration records and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We saw current records for the receipt and disposal of medication.The date of opening of boxes and bottles of medicines were recorded and balances of medication were usually carried forward from old records to new records. We were shown a weekly audit check, which is completed by senior staff to ensure that medication records are documented accurately. However, some of the checks we made were not always accurate, for example one persons medication records had not been completed correctly. The medication was to be given every day from Monday to Friday and a different strength of the medication was to be given on a Saturday and Sunday.The medication records showed that there were two strengths available to give and two places to document the administration record. However, staff had only completed one section and failed to document the correct administration of the Saturday and Sunday doses. This was shown to the senior person on duty who agreed that the medication administration records had not been correctly documented. This could increase the risk of confusion and possible errors.However, we were able to show that the medication had been given to the person. Care Homes for Older People Page 4 of 9 We found that the majority of counts and checks made on medication were accurate, which showed that people who live in the service were being given medication as prescribed by a medical practitioner. We found that the service had made changes to ensure that peoples medication was handled safely. The four statutory requirement notices, compliance date 20th July 2009, for Regulation 13(2) had been met. 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 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 (1) Ensure each service user has 30/06/2008 a written care plan that sets out in detail the action, which needs to be taken by care staff to ensure that all aspects of their health and personal care needs of the service user are met. 2 7 15 (2) Review care plans at regular intervals and where necessary update plans to reflect changing needs and current objectives for health and personal care. 30/06/2008 3 9 13 Regulation 13 (2) Ensure 20/07/2009 that the care plan for each person using the service has a list of the homely remedies that can be safely administered to them alongside their prescribed medications. To ensure the health and well being of people using the service. This requirement is subject to a Statutory Requiement Notice. 4 9 13 Regulation 13 (2) Make 20/07/2009 arrangements to ensure that
Page 6 of 9 Care Homes for Older People 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 medication administration records are accurately maintained including all records of the disposal of medicines refused at the time to be administered by people using the service. To ensure the health and well being of people using the service. This requirement is subject to a Statutory Requiement Notice. 5 9 13 Regulation 13 (2) Put a 20/07/2009 procedure in place to ensure effective arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. To ensure the health and well being of people using the service. This requirement is subject to a Statutory Requiement Notice. 6 9 13 Regulation 13 (2) Make arrangements to secure the Controlled Drugs cabinet as is require by the Misuse of Drugs Act (Safe Custody) Regs 1973. To ensure the health and well being of people using the service. This requirement is subject to a Statutory Requiement Notice. 20/07/2009 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 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!
