Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Eldonian House Care Centre Eldonian Way Liverpool Merseyside L3 6JL 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: Maggy Howells Date: 1 2 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Eldonian House Care Centre Eldonian Way Liverpool Merseyside L3 6JL 01512982989 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Raydonborne Limited care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 30 0 Over 65 0 30 Conditions of registration: The registered person may provide the following category of service only: Care home only - Code PC To people 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 Dementia - Code DE The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home Eldonian House is a purpose built care home for 30 older people. It is part of the Eldonian Village in the Vauxhall area of north Liverpool, close to the city centre. The home is near to pubs, local shops and the community facilities of the village such as the village hall. The home is registered to accommodate older people with dementia. One person under 65 years old with physical disabilities also lives at the home. Residents with dementia (generally referred to as EMI meaning elderly mentally Care Homes for Older People
Page 2 of 9 infirm) are located in a self contained unit called the Seren Unit within the home. Seren is the Welsh word for star. All of the residents have single rooms with en suite facilities. There are two main lounges, one of which is in the Seren Unit, the other in the main part of the home and solely for the use of the other residents. Each wing has a small self contained courtyard and there is a spacious dining room which can be partitioned for separate use by the different groups of residents. The home was built by the Eldonian Community but is now run by Raydonborne Ltd who operate the home on a leasehold basis. Eldonian House charges fees of between 335 and 420 pounds a week, depending on the needs of the individual. Care Homes for Older People Page 3 of 9 What we found:
The home was randomly selected for a visit in order to look at the arrangements for handling medication. The visit lasted approximately six hours. We discussed the handling of medication with the manager and a senior member of staff. We also looked at medicine records and storage arrangements. At the end of the inspection feedback was given to the manager. Overall, we found some shortfalls in the arrangements for handling and recording medicines that need to be addressed to ensure peoples health and wellbeing is protected. We looked at medicines administration. All medicines are administered by trained care staff. Care is taken to ensure any special instructions such as give before food and ensure the resident remains sitting for thirty minutes are followed. There is some flexibility in the times that medicines are given, for example if people choose to get up later in the morning. Should medication be refused, staff will reoffer it later and record if the person choses not to take their medicines. We saw good information that had been recorded for staff to refer to regarding people who had difficulties taking their medication. This helped to ensure that these people took their medicines correctly. We checked medicines record keeping. Records for the safe disposal of unwanted medicines were generally clearly recorded. Most medicines were received into the home on the same day each month, again, these were generally recorded. However medicines received at other times had not always been recorded. This made it difficult to see how much stock should have been present. We found some gaps and omissions in the medicines administration records, which, in some cases, made it difficult to tell whether medicines had been given correctly. Most medicines administration records were preprinted by the pharmacy but some handwritten records had not been properly completed and did not include the date or clear instructions. The records did not list a currently prescribed medicine kept in the medicines trolley or insulin that was given by the district nurse. Handwritten entries on the records had not been signed and checked by a second person. Failure to do this means that there is increased risk of mistakes. We compared a sample of medicines stock and records. We found that medicines in the monitored dosage system were generally given correctly, however this was not the case when we checked samples of medicines contained in packets and bottles. For example, one persons record showed that in August, one hundred tablets for pain relief were received but one hundred and sixteen had been given. A new delivery of a further one hundred tablets was received in September and current records showed that ninety six had been given, but there were still thirty eight left in stock on the day of the visit. This meant it was not possible to tell whether medicines in boxes and bottles had been given correctly. It was of concern that we saw examples where records showed medicines had not been given because supplies had run out and there was none left. We saw one example where a person had missed doses of their regular pain relief tablets for eight days last month. Failure to keep adequate stocks of medicines places peoples health and well being at risk of harm. Care Homes for Older People Page 4 of 9 Records for communication with healthcare professionals such as doctors and district nurses were generally clearly made, so changes to peoples medicines could be easily tracked. A district nurse present during the inspection said that they regularly met with the manager and seniors within the home to plan care and that their instructions were always carried out by staff. Some people had medicines prescribed to be taken only when required. There was no guidance available for staff, detailing how and when these medicines should be used. When this information is not available, it means that staff may not know how to use these medicines correctly and peoples health and well being may be at risk. We looked at where medicines were kept and found that all medicines, including controlled drugs, were safely stored. This helps to reduce the risk of mishandling medication. We looked at how medicines were audited (checked). The manager said that no audits had been done recently, but he produced copies of an audit tool that he was planning to develop for use within the home. If regular audits are not carried out, there is a risk that any weaknesses in medication handling, recording or staff practice will go unnoticed and therefore not be improved. 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 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 3 14 The registered person shall only admit someone to the home when they have been properly assessed and that assessment must be fully recorded and signed. The registered person shall provide facilities for recreation and therefore needs to provide a programme of activities for residents, including if necessary the appointment of an activities organiser. 01/07/2008 2 12 16(2)(n) 01/07/2008 3 22 13(4) The registered person must 01/06/2008 ensure that unnecessary risks to residents are eliminated and must therefore ensure that all bed rails are fully assessed and copies of the assessments are kept on file and regularly reviewed. The registered person shall 01/07/2008 ensure that the home is kept clean and reasonably decorated and must therefore replace the carpet in the identified room. The registered person shall 14/04/2008
Page 6 of 9 4 24 23(2)(d) 5 28 19 Care Homes for Older People not employ a person unless they are fit to do so and must therefore obtain POVA clearance before anyone starts work at the home. 6 28 17(2) Schedule 2 Records for people employed 14/04/2008 in the home as set out in Schedule 2 must be kept in the care home. The registered person shall 01/10/2008 ensure that all staff are appropriately supervised and must therefore arrange for a programme of recorded one to one supervision for all staff. The registered person must take adequate precautions against the risk of fire and must therefore ensure that: * up to date gas and electrical safety certificates in place; * combustible materials are not kept in stairwells. 01/05/2008 7 36 18(2) 8 38 23(4) 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, 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 a complete record of each persons medication and other prescribed items so that people receive the correct treatment 28/11/2008 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 There should be an effective system of auditing all aspects of medicines handling and recording so as to assess the quality of this service. Handwritten entries on medication administration records should be double signed and dated to reduce the risk of errors. Information detailing how and when to use medicines prescribed on a when required basis should form part of an individuals care plan to make sure they are given correctly. 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: 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 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!
