Random inspection report
Care homes for older people
Name: Address: Elwick Grange Elwick Road Hartlepool TS26 9LX one star adequate service 24/11/2009 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: Janet Long Date: 0 6 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Elwick Grange Elwick Road Hartlepool TS26 9LX 01429278000 01914877865 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross OPCO Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 16 44 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is: 60 The registerd person may provide the following category of service only: Care Home only - Code 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 - Code OP, maximum number of places 44 Dementia, over 65 years of age - Code DE(E) maximum number of places 16 Date of last inspection Brief description of the care home Elwick Grange is a purpose built residential care home that provides accommodation for 60 people. All 60 bedrooms are spacious and have en-suite facilities. People living
Care Homes for Older People Page 2 of 9 2 4 1 1 2 0 0 9 Brief description of the care home at the home have access to 8 communal lounge areas and 3 dining rooms. A passenger lift is available for people to access the first floor. Outside the home there are a number of car parking spaces and the home is surrounded by garden and patio areas. The home is located near to the centre of Hartlepool and is easily accessible to people using cars or public transport. There are a number of shops nearby and a well-kept public park area is opposite the home. The weekly fees depend on the type of care and whether funded by a local authority. There are additional charges for items such as hairdressing, clothing, reading materials, toiletries and other personal items. Please check current fees and additional charges with the manager. Care Homes for Older People Page 3 of 9 What we found:
The reason for this inspection was to assess compliance with the medicine requirements made at the Key Inspection in November 2009. At a further inspection on May 2010 it was found that these had not been met and a Warning Letter was issued. During this inspection we spent seven hours in the home and the inspection involved looking at medication storage, stock control, administration and procedures relating to medicine management in the home. We looked at the medication administration records ( MARs) and talked to the manager and staff about the systems in place. The recording of medication administration was poor; there were a number on gaps on the MAR charts and an audit of medication in the home and records showed that some medication had been signed for but not given. One person had received the incorrect dose of medication on six occasions. For two other people MAR records show that each person had a cream applied at a dosage different to that prescribed. Some medication was given when required when this was not the the dose specified on the prescription. There were inconsistencies in handwritten entries. To make sure there is an accurate record the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. There is inconsistency in the recording of the quantity of medication in the home. The quantity of medication from one monthly cycle to another is not always recorded on the new MAR. Where medication is prescribed as a variable dose the actual dose given is not clearly recorded. This means it is difficult to have a complete record of medication in the home and to check if medication is being administered correctly. Some Homely remedies were available in the home, however the permissions which were contained in the MAR folders were now out of date and listed medication which was now prescribed to the person. Medication stored in the homely remedies box had been prescribed and supplied for individual people. Only medicines that have been bought should be used for homely remedies. Copies of prescriptions supplied as part of the regular monthly cycle were kept however the copies of some medication supplied mid month could not be found. The prescription is the authority for the staff to administer medication to the person and checking the prescription is an important part of the management of medication. Documentation which gives information on when to use medicines prescribed when required were available alongside the MAR charts, however these were not always up to date and some medicines were not listed and others listed were no longer prescribed. Good records are kept of fridge and room temperature and all temperatures recorded are in the range recommended by the manufacturer. For two people medication with a limited use once opened was used past the expiry date recommended by the manufacturer. From this visit it is clear that the requirements of the warning letter have not been fully met.
Care Homes for Older People Page 4 of 9 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 Where a new care need is 11/07/2010 identified there must be a care plan developed that includes the action being taken by staff and any health professional input, to support and improve their health. This is to ensure that people receive the right support with any changing health needs. 2 31 8 The Provider must ensure that there is a registered manager in place. This is to ensure that the daily running of the home is managed by a person who has demonstrated they understand their legal responsibilities under the Care Standards Act 2000 and associated regulations. 01/02/2010 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 1 9 13 Medication must be given as 30/08/2010 prescribed and a record must be made at the time that it is given This will make sure that people receive their medications correctly and the treatment of their medical conditions not affected 2 9 13 A system must be in place to 30/08/2010 check expiry dates of medicines and medication with a limited use once opened This makes sure medication is safe to administer by reducing the risk of contamination. 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 Handwritten entries and changes to MAR should be accuratley recorded and detailed. This makes sure that the
Page 7 of 9 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 correct information is recorded and a person receives their medication as prescribed. 2 9 A copy of prescriptions supplied not as part of the monthly cycle should be kept. The prescription is the authority for the staff to administer medication to the person. Homely Remedies authorisation should be updated and stock should be obtained for this purpose. Where medication is prescribed at a variable dose, records should indicate the dose given. This makes sure that medication records are accurately detailed and audit is possible. A system should be in place to record all medication received into the home and carried over from a previous month. This helps to confirm medication is being given as prescibed and when checking stock levels 3 4 9 9 5 9 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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!
