This inspection was carried out on 17th August 2009.
CQC found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Farmhouse Rest Home 87 Water Lane Totton Southampton Hampshire SO40 3DJ 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: Suni Chotai Date: 1 7 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Farmhouse Rest Home 87 Water Lane Totton Southampton Hampshire SO40 3DJ 02380868895 02380868865 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Richard E Kitchen,Mrs Elizabeth Kitchen care home 20 Number of places (if applicable): Under 65 Over 65 0 20 dementia old age, not falling within any other category Conditions of registration: 20 0 The maximum number of service users to be accommodated is 20 The registered person may provide the following category 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 category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Farmhouse is a registered care home providing personal support and accommodation for up to twenty older people who may have dementia. The home comprises of ten single and five shared bedrooms, eleven of which have en-suite facilities. Communal
Care Homes for Older People Page 2 of 11 Brief description of the care home space includes two lounges and a dining room. Car parking and a small, enclosed patio can be found at the front of the property. The home is privately owned by Mr and Mrs Kitchen and Mrs Jean Hunt is the registered manager. Farmhouse is situated in a residential area on a main road close to the centre of Totton. The homes fees range from £504-£520 a week. Care Homes for Older People Page 3 of 11 What we found:
The Pharmacist Inspector from CQC visited the home on 17th August 2009 to check compliance with requirements issued around medicines at a previous inspection. All current months medicine administration record [MAR] charts, the medicine storage facility, controlled drugs [CD] cupboard and records relating to medicine use were checked. Medicines are received in a multi dose medicine dosage system [MDS]. There were no descriptions to identify individual tablets. A carer was asked to identify a tablet between two white tablets and she was not able to. Identification of individual doses is necessary if a medicine has to be omitted for a valid reason. On checking the CD register a discrepancy was found where the balance in the book did not correspond to the amount in the cupboard. Further questioning revealed that a resident had gone home with this medicine and this was not entered in the CD register. The CD cupboard is a standard household safe and this would not comply with the requirement of the relevant law. Regarding medicine disposals records only one entry was made since in April 2009 for three items. There was evidence on several occasions of medicines omitted for valid reasons. Any of these single doses not administered during the last five months were not entered in the disposals record. Keeping accurate records on medicine use is important for audit purposes. We watched a carer giving the lunch time medicine. The carer first got the medicines out of the MDS and gave the medicines. She then went to sign on the MAR sheet. Best practice is to check the MAR first for what is required; doses might have changed or medicines already given by another member of staff. Staff had not had any training in recent months on medicine management as was the requirement from the last inspection. When questioned the manager informed us that she had asked the area manager to source and arrange training on medicines for all staff. There was no evidence of any arranged training. Care plans examined did not show any guidelines to staff for medicine to be given only when needed. This means that consistency in the use of this medicine would not be guaranteed. A MAR check showed several gaps where a signature should appear. Corresponding medicine was not in the MDS. This a another example of medicines use records not being completed. 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 4 of 11 Care Homes for Older People Page 5 of 11 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 3 14 People moving into the home 09/07/2009 must be provided with assurance that their specific needs can be met before moving in. This is to ensure that the home can meet assessed needs. 2 7 15 All care plans, daily records, 17/07/2008 risk assessments must be up to date with clear guidance for staff such as for when working with aggressive behaviour, or meeting all short and long-term health needs. The manager must ensure 09/07/2009 that proper arrangements are made for the storing and administration of medication with accurate records held. This is to ensure that people received their medications prescribed by the doctor. 3 9 13 4 9 18 The manager ensure that 09/07/2009 staff are competent before they are involved in administration of medication, and provide any additional training assessed as needed. Care Homes for Older People Page 6 of 11 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 This is to ensure that people living in the home are supported by correct medication procedures. 5 10 12 The registered person must 09/08/2009 ensure that the dignity and privacy of all people living in the home is maintained. . 6 29 19 The manager must ensure 30/06/2009 that there is full evidence of employment checks available in the home including written references , employment gaps, and testimonials about why people left previous care employment. This is to ensure that people living in the home are safeguarded by the recruitment process. 7 29 19 You must have evidence of a 30/06/2009 POVA first check or a fully completed CRB check before people start working in the home. This is to ensure that the safety of people living in the home is safeguarded 8 30 18 The registered person must have clear records to demonstrate that staff are trained in relevant skills including infection control,adult protection and specific needs such as 30/07/2009 Care Homes for Older People Page 7 of 11 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 mental health and alcohol dependence. this is to ensure that staff have the skills required to meet needs. 9 33 24 The manager must review 09/10/2009 information received in quality audits of the home and through consultation and ensure that it informs a plan for development and is made available to people living in the home or their representatives. This is to ensure that people are consulted and know that their views are taken into account. Care Homes for Older People Page 8 of 11 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 to have a careplan on the use of medicine to be taken only when needed so that there is a person centred approach and consistency in the use of this medicine 21/09/2009 2 9 13 to keep accurate and true record around medicine use in order to provide a true picture of medicines given to residents 21/09/2009 3 9 13 to obtain a controlled drugs 20/11/2009 cupboard that complies with the Misuse of drugs Act 1973 and its amendments to comply with the law 4 9 13 Staff giving medicine to 21/09/2009 resident must be trained and deemed competant in handling medicine so that safe practices are followed and the resident are protected from any risk of Care Homes for Older People Page 9 of 11 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 mismanagement around medicines. 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 to ensure medicine are obtained so that they are individually identifiable. Care Homes for Older People Page 10 of 11 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 11 of 11 - 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!
