This inspection was carried out on 3rd April 2009.
CQC found this care home to be providing an Good 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Gedling Care Home 23 Waverley Avenue Gedling Nottingham NG4 3HH two star good 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: Denise Clark Date: 0 3 0 4 2 0 0 9 Information about the care home
Name of care home: Address: Gedling Care Home 23 Waverley Avenue Gedling Nottingham NG4 3HH 01159879792 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) : Kalbro Care Uk Limited care home 26 Number of places (if applicable): Under 65 Over 65 26 dementia Conditions of registration: 6 Within the total number of beds, a maximum of 26 may be used for the category DE(E). Within the total number of beds, a maximum of 6 may be used for the category DE. Date of last inspection Brief description of the care home Gedling Care Home provides residential care for 26 older people in the early stages of dementia. The home is located in an inner city area of Gedling, Nottingham, close to the local shops, general practitioners? surgery and other amenities. The home is an extended residential house, which consists of three-storeys. The home has two lounges, a conservatory and a separate dining area. The home has 20 single rooms one of which is fitted with an en-suite facility and 3 double rooms. There is a passenger lift permitting access to the first and second floor. A small enclosed garden is to the rear of the property. The current fee are £348 to £388 per week; this does not include toiletries, clothing, hairdressing, holidays and outings. This information and
Care Homes for Older People Page 2 of 9 Brief description of the care home a copy of the last inspection report is available to people who use the service and their representatives on request. Care Homes for Older People Page 3 of 9 What we found:
We asked about the training staff are given on medicines, and looked at staff training records. Four members of staff were attending medicines training on the day of the inspection, and two staff were due to attend training the following month. We noted that the manager assesses the ability of staff to administer medicines and ensures that a carer who can carry out this task is on duty until 10pm. We learned that the night staff are currently being trained to give medicines. We asked about the way in which medicines were administered and were told that different procedures were followed by the manager and other carers. We found that the homes policy on medicine administration was not always followed. The policy was not dated, and did not give staff all the information they needed to follow the homes system for handling medicines. The reference book on medicines was out of date, and no leaflets on medicines supplied by the pharmacy in blister packs were available. We found that the date when medicines are received by the home is not recorded, but the amount supplied is entered on each persons medication chart. The book for recording the disposal of unwanted medicines was at the pharmacy and so not available. The home did not have appropriate facilities for storing and recording controlled drugs, should these be prescribed for someone in the home. We saw that the medicine refrigerator was not locked and that the fridge temperature was not adequately monitored. We looked at the medication charts of all the people living in the home.We found one discrepancy between the record of medicine administration and the number of capsules in stock. We noted four instances where people had not received medicines prescribed for them. We saw that for two people a medicine dose printed on their chart had been amended by two members of staff. However, there was no record of when or why the doses had changed, either in the peoples care plans or elsewhere. We watched medicines being administered at lunchtime and saw that the correct procedure was followed. We spoke to two people who said that staff were kind to them when giving out medication. We interviewed three carers who were fully trained to administer medicines. They all said that medicines were given at the correct time of day. We found that the home does not have a policy about medicines that can be bought from a pharmacy without a prescription (homely remedies). We were told that mistakes or near misses involving medicines were reported to the manager but not written down. Medication audits are not carried out to find discrepancies. 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
Care Homes for Older People Page 4 of 9 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 35 17 To promote the health and wellbeing of people who use the service financial records must be up to date at all times. 01/09/2008 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 The homes medicine policy 30/06/2009 must describe the arrangements for the ordering, receipt, storage, administration and disposal of medicines. The policy must be regularly updated. For staff reference and to ensure a consistent approach to handling medicines. A cabinet that complies with The Misuse of Drugs (Safe Custody) regulations and a controlled drugs register must be available in the home. So that controlled drugs can be legally stored and recorded if prescribed for a person living in the home. Errors or near misses involving medicines must be documented. so that staff can learn from mistakes and action can be taken to reduce the risk of 30/06/2009 2 9 13 3 9 13 29/05/2009 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 further errors 4 9 13 Arrangements for 29/05/2009 administering medicines must be consistent with national guidance and the homes own medicine policy. to minimise the risk of medication errors 5 9 13 Medicines must be 29/05/2009 administered as prescribed. This must be demonstrated by record keeping practices. for the safety and well being of people living in 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 2 9 9 Regular medication audits should be carried out to identify shortfalls so that action can be taken to improve practice. A homely remedies policy should be introduced if people in the home occasionally require a non-prescription medicine for their comfort and well-being. The medicine refrigerator should be locked; the temperature of the fridge should be monitored with a minimum/maximum thermometer. The community pharmacy should be asked to supply patient information leaflets for medicines packaged in the monitored dose system. The current edition of the British National Formulary (BNF) or other refernce book on medicines should be available for staff use. 3 9 4 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. 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!
