Inspecting for better lives Random inspection report
Care homes for adults (18-65 years)
Name: Address: Granville Court 4 The Esplanade Hornsea East Yorkshire HU18 1NQ The quality rating for this care home is: The rating was made on: two star good 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: Steve Baker Date: 2 3 0 9 2 0 0 8 Information about the care home
Name of care home: Address: Granville Court 4 The Esplanade Hornsea East Yorkshire HU18 1NQ 01964532160 01964534495 moira.gillyon@eastriding.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Moira Gillyon Type of registration: Number of places registered: East Riding of Yorkshire Council care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability 24 24 Over 65 20 20 Conditions of registration: To offer respite care to service users aged 16 - 18 (those in transition from childrens services to adult services). Date of last inspection Brief description of the care home 4 Granville Court is a purpose built care home offering up to 20 placements to adults both under and over the age of 65 years (male and female) who have a learning disability. The home is situated in the seaside town of Hornsea and is positioned close to the sea front, the local shops and amenities. Accommodation at the home is in three small units, called bungalows, one of which is currently not being used. This means that currently there are 14 bedrooms available for use in the home. Each service user has a single room. The bungalows have a lounge/dining area and a small kitchen on Care Homes for Adults (18-65 years)
Page 2 of 8 each unit and service users have access to a large communal activity room and a smaller snoozelem. This is a room that contains specialist equipment for sensory stimulation. However this is currently not in use. The home has a spacious courtyard area with seating that is enclosed and secure with good access, including for people in wheelchairs or with mobility problems. A new sensory garden is in place. The home is owned by a multi agency organisation, which includes Social Services and the Local Health Authority, and is know as the Spice Trust Project. The registered provider is the East Riding of Yorkshire Council. The weekly fees are #993.40, with additional charges for items such as toiletries and hairdressing. This information was provided by the registered manager at the site visit. Care Homes for Adults (18-65 years) Page 3 of 8 What we found:
This inspection visit was carried out at the request of the lead inspector following the receipt of medication error notifications, one of which involved controlled drugs. The visit lasted 4.5 hours and involved examining the homes medication policy, the current medication administration record (MAR) charts and the storage & handling arrangements for all medicines, including controlled drugs. We also observed medicines being given to people after breakfast. I gave verbal feedback during the visit to the staff nurse in charge as the manager was away from work. The medication policy in use in the home does not provide clear information for staff on current legislation and guidance in social care settings. Best practices are therefore not always followed. For example, the current NHS Trust policy prevents nursing staff working in the home from amending and updating entries on MAR charts. This causes problems when medicines or doses are changed. We noticed that when one persons dose of medicine had been reduced the new dose direction was written on a piece of paper clipped to the MAR chart. This unsafe practice would not be necessary if amendments were made directly onto the MAR chart as recommended in current professional guidance. Local medication procedures designed for social care settings would enable all staff in the home to understand exactly what is expected of them when handling and administering medication. The Royal Pharmaceutical Society of Great Britain guidance on handling medicines in social care is not available for staff to consult. We observed good practice when medicines were given to people by the nurse in charge. However, the need to fetch & carry medicines from each persons bedroom in turn gives rise to greater opportunities for interruption & distraction, despite the use of the red warning apron. The use of the daily reminder log sheet to record all essential care tasks completed, including medication administration, is an example of good practice which should be followed consistently by all staff. There were very few gaps on the MAR charts. This means there is a record kept of people receiving their medication as prescribed. The notable exceptions are emollients and other preparations applied to the skin where very few entries are made. The MAR chart should describe the use of all prescribed medication, including skin preparations. The quantity of medication from one monthly cycle to another is not consistently recorded on the new MAR chart. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. We found up to date care management plans for the use of midazalom to treat an acute seizure, but no similar plan for the use of risperidone. The home should request further information to guide staff in using those medicines prescribed as required which do not have current management plans. The record of staff authorised to administer medicines should be reviewed to make sure it is up to date. This will help to correctly identify who was involved if a problem or administration error was to occur. Most medicines are stored securely either in locked drug cupboards within individual bedrooms or in locked store rooms. Eye drops and ear drops kept in the kitchen fridge were accessible to unauthorised staff. The temperature of one store room being monitored is satisfactory. There are no temperature records for the store room in the Care Homes for Adults (18-65 years) Page 4 of 8 main building or for any of the bedroom cupboards. All medicines must be stored securely at temperatures recommended by the manufacturer so that staff know they are safe to use. Three oxygen cylinders (including an empty one awaiting return) were found in the main building store room. These cylinders were free standing on the floor and as such posed a safety risk to staff and could be damaged if knocked over. Medical gas cylinders should be stored securely attached to a wall or cylinder trolley. The arrangements for ordering, receiving and disposal of medication are in line with good practice guidance. Regular monthly prescriptions are seen by the home before sending to the pharmacy. This good practice makes sure a check is made that all the medicines required have been listed and prevents people from being without. Controlled drugs are stored securely in line with current safe custody regulations. No further discrepancies were found on checking the quantities held against the register and MAR charts. Regular checks by senior staff or the manager of the newly introduced arrangements would help to reduce the risk of errors being made. 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 Adults (18-65 years) Page 5 of 8 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 33 18 The registered person must 07/12/2007 ensure that all staff are adequately trained, to ensure the service user needs are met. The registered provider must 07/07/2007 ensure that the requirements of Regulation 26 visits are met. This is an ongoing requirement with a previous compliance date of 30/6/05. 2 39 26 Care Homes for Adults (18-65 years) Page 6 of 8 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 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 20 The temperature of all medication storage areas should be regularly monitored. This makes sure that medicines are being stored at the temperature recommended by the manufacturers. The prescriber or community pharmacist should be asked to provide further information about medication prescribed ‘when required’. This makes sure that the medication is given correctly. A safe system for amending entries to MAR charts should be introduced. Changes should be accurately recorded and sufficiently detailed. This makes sure that the correct information is recorded so a person receives their medication as prescribed. A system should be in place to record all medication carried over from the previous month. This helps to confirm that medication is being given as prescribed and permits accurate checking of stock levels. A set of local medication procedures for all staff to use when handling and administering medication should be introduced. These new procedures should reflect current professional best practice guidance in social care settings. 2 20 3 20 4 20 5 20 Care Homes for Adults (18-65 years) Page 7 of 8 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 Adults (18-65 years) 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 © (2008) 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 Adults (18-65 years) Page 8 of 8 - 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!
