Random inspection report
Care homes for older people
Name: Address: Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX zero star poor service 03/02/2010 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: Naveeda Knopp Date: 2 1 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX 01159228151 01159223759 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Gamble Type of registration: Number of places registered: Conditions of registration: Category(ies) : Minster Care Management Limited care home 46 Number of places (if applicable): Under 65 Over 65 0 46 dementia old age, not falling within any other category Conditions of registration: 46 0 The maximum number of service users who can be accommodated is 46 The registered 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 Dementia - Code DE Date of last inspection Brief description of the care home Falcon house is a purpose-built modern home providing accommodation for up to 46 people. The care home provides personal care for people who have needs due to older
Care Homes for Older People Page 2 of 9 0 3 0 2 2 0 1 0 Brief description of the care home age and or dementia. There are bedrooms, bathrooms, lounges and dining rooms on ground and first floor levels. The first floor can be accessed via a shaft lift or stairs. The home is in the centre of Beeston near to local shops and amenities. There is a car park to the rear of the home. Bus routes operate along the road outside the home. The range of fees are from £366.00.00 to £475.00 per week. The last inspection report is made available within the reception area of the home. Care Homes for Older People Page 3 of 9 What we found:
The current manager is new in post but has been working in an acting capacity since January 2010. In February 2010 the home have had support to improve their medication handling practises from Nottingham County Council (NCC). From this, an in depth report had been provided to the home with a list of actions and recommendations. An improvement plan had also been submitted from the home to the Commission to ensure compliance to requirements made from a key inspection in Feb 2010 will be followed. Two of the four must do actions have been completed within the timescales submitted. The outstanding actions relate to self administration and competency assessments on the staff ability to give out medicines safely. The staff who give out medication have recently attended medication handling training by the supplying pharmacy and also from an external training company. The manager of the home is aware that the medication handling policies need updating and is awaiting further advise from NCC. Currently no one at the home self-administers their own medicines but the manager acknowledges that there has not been any formal assessments with people to identify if they want this right. A member of the staff who gives out medicines was able to explain how he would deal with the situation of a refused dose of a medicine. He did not understand what a homely remedy was and said if a person had a minor ailment like a headache he would organise a prescription. The manager explained that creams are applied by seniors and occasionally by carers but they have not had any formal training for this task. During observations of a medication round it was concluded that one of the seniors was not following best practises in safely administering medication. She did not wait to witness the administration and asked another staff member to ask a person in another room if they wanted their medicines. A second senior who also gave out medicines at this same drugs round followed best practises , gave medicines as prescribed and ensured that this was carried out respectfully. It was noted a diabetic was offer a chocolate cake pudding as a dessert at lunch time- he refused to eat it. Reviewing this persons care plan there was information stating he likes diabetic desserts , needs a diabetic diet -sugar free. This person is prescribed paracetamol tablets.There are no specific directions on the medication administration sheets- just states to be taken as directed by your doctor. The senior said we always give him two when he needs it for pain in his neck and shoulders. This person is also prescribed a pain relieving gel, to be applied three times a day but according to the medication record sheets, he is having this once daily. The carer informed me that he generally refuses the second application. Which they offer him at 10pm. Medication is stored securely at the home. A second treatment room had been established to house medicines but there were no temperature checks made on the environment to ensure it is within the correct range. Medication is supplied continuously and in a blister system but on one occasion an interim medicine had not been available to a person living at the home.
Care Homes for Older People Page 4 of 9 Generally medicines are given as prescribed but there were some anomalies seen on the day of this inspection. A newly admitted person had an incomplete and inaccurate handwritten medication sheets produced, which was countersigned by the manager. This mistake could have led to this person receiving double the dose of a blood pressure lowering tablets for up to eight days. The record sheets showed signatures as if this had been double dosed for 8 days but the stock audit did not support this. A serious concerns letter was issued to home due to this matter. The manager acknowledges that standards of medication handling need improvement but she explained with the support of NCC Pharmacist and Boots Pharmacist that they are working together to tackle the homes issues but believes the home is progressing all the time. She explained that she is currently going through all the care plans and updating the reviews. 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 9 13 You must ensure that there 28/02/2010 is a policy and staff adhere to procedures, for the receipt, recording, storage, handling, administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. To ensure that service users receive their medicines as prescribed. 2 28 18 You must ensure that the 30/11/2010 home has a minimum ratio of 50 of care staff trained to level 2 National Vocational Qualification. To ensure staff are trained in the needs of people in the home. 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 7 12 For a diabetic person the 31/05/2010 home need to produce and implement a comprehensive plan in how they are meeting the nutritional and healthcare needs of this person. This is to ensure that the home are minimising the risks relating to diabetes. 2 9 13 Competency assessments 21/06/2010 should be carried out on all staff who give out medicines. The outcomes need to recorded and actioned This is to safeguard the health and welfare of people who live at the home 3 9 13 Robust procedures must be 31/05/2010 put in place to ensure the safe and accurate administration and recording of all medication. To safeguard the health and welfare of people living at the home Care Homes for Older People Page 7 of 9 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 4 9 13 All medication policies need 21/06/2010 to be updated to include best practises for all aspects of safe handling of medicines in a care home setting. This is to include how to deal with treating minor ailments, medication errors and handwriting administration records. This is safeguard the health and welfare of the people who live at the home. 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 The care plans of people who are prescribed medicines that are to be used on a when required basis should contain information on why it is given, how long it could be continued and in what circumstances should the person be referred back to the GP. All medication that do not have specific dosaging directions should be referred back to the GP or Pharmacist. All medicines should be given following specific instructions. Medication that is kept in the trolley on the top floor is split into another trolly Room temperature monitor should be carried out for all areas where medication is stored. 2 9 3 4 9 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!
