Random inspection report
Care homes for older people
Name: Address: Greensleeves 19 Perryfield Road Southgate Crawley West Sussex RH11 8AA 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: Lawrie Allum Date: 1 7 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Greensleeves 19 Perryfield Road Southgate Crawley West Sussex RH11 8AA 01293511394 01293513680 greensleeves19@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Jean Thompson Kennedy Gisbey care home 41 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 0 The maximum number of service users that can be accomodated is 41. The registered person may provide the following category/ies 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 categories: Dementia (DE) Date of last inspection Brief description of the care home Greensleeves is a care home providing accommodation and personal care for up to forty one older people who suffer from dementia. The owner is Mrs Jean Gisbey, and there was not a manager registered for the service at the time of our visit. The home
Care Homes for Older People Page 2 of 9 Brief description of the care home is situated in a residential area of Crawley, being close to the town centre, local amenities and transport links. Greensleeves consists of two linked houses and a large purpose built extension. There are two units, and each unit has a sitting room and dining area. Bedrooms are on the ground and first floors, with a lift serving most rooms on the first floor. There is off-road parking for staff and visitors. Care Homes for Older People Page 3 of 9 What we found:
The following indicates the findings of an unannounced inspection of the service by a CQC pharmacist inspector on Wednesday seventeenth March 2010. This inspection was requested by the homes CQC regulatory inspector, Edward McLeod, via Jan Foley, CQC local area manager, following the last inspection of the service on 28/1/2010. Following that inspection medicines related requirements were made that resulted in a statutory requirement notice being issued with a date for compliance on 15/03/2010. The concerns included that: the service failed to ensure that medication is administered appropriately and safely through adhering to safe medication practises and procedures; failed to ensure that service users received their medication correctly, as prescribed by the GP; failed to maintain accurate medication records that evidence the medication administered therefore exposing the Service Users to a risk of their medication needs not being met. On arrival at about 9.30AM, I met Jean Gisbey, the service manager and proprietor, who together with her daughter and pending service manager, Pamela, assisted me with my inspection. Since the last CQC inspection of the service staff had received training from Boots, the pharmacy dispensing medication to the home, to reinforce usage of the monitored dosage system. The manager had also met with the six GP practises serving the homes residents with the result that the 4-weekly medical prescriptions for the residents now provide for the medicines and medication administration record (MAR) charts being dispensed and delivered to the home at least 3 working days in advance of their commencement. This now provided adequate time for any issues to be addressed prior to commencement of the new medication cycle, whereas previously, delivery was made late on a Friday to start administration on the Monday, preventing the opportunity to refer issues back to the prescriber or pharmacy. Two medicines trolleys provided for medication administration to residents in the homes two units and a third trolley is pending to increase the provision to Unit 1 that has the greater number of residents and correspondingly more medication. A new Controlled Drugs cupboard had been fitted since the last CQC inspection and this was correctly attached to the wall in accordance with the Misuse of Dugs Regulations. The current cycle of medication for most residents was started on the first of March and therefore administration was on the seventeenth day of the cycle. Audit to reconcile the medication records with medication available in the home found records to be complete and accurate, indicating that administration was in accordance with the prescribers directions. MAR charts were well presented and each residents charts were preceded by a sheet including a named photograph of the resident together with their date of birth. Residents with an allergy had this entered on their MAR chart, however, it would be good practise to also enter a residents allergy status when none is known. Some medical procedures such as changing wound dressings and administering insulin is carried out by district nurses visiting the home and recorded on a separate chart. It would be good practise to enter reference to this additional record on the main MAR chart. Insulin in use by the district nursing service was stored in the medicines fridge, contrary to the instructions on the pack requiring storage at room temperature when in use. Care Homes for Older People Page 4 of 9 A dedicated fridge for the storage of medication was available and the temperature monitored daily by recording the temperature. Although a maximum/minimum thermometer was used, only the single temperature current at the time of recording was being recorded. Staff were unaware of how to reset the maximum/minimum temperature readings and it is recommended to record these readings to ensure the correct temperature is maintained at all times. 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 The provider must ensure that the service users health, personal and social care needs are set out in an individual plan of care which sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the persons care are met. The complex needs of people living in the home are not being satisfactorily addressed in the individuals plan of care. 30/04/2010 2 29 19 The registered person shall 30/04/2010 not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2, Care Homes Regulations 2001. The home is failing to protect people living in the home by commencing staff before the required checks and references have been obtained. 3 30 18 The registered person shall 30/04/2010 ensure that people employed
Page 6 of 9 Care Homes for Older People 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 to work at the care home receive training appropriate to the work they are to perform. Not all staff have received all the training they require to provide safe and appropriate care - for example training in safeguarding, dementia care, managing aggression, and food hygiene. 4 31 8 The registered provider shall 30/04/2010 appoint an individual to manage the care home. There is not a manager registered to manage the service at present. 5 36 18 The registered person shall 19/10/2009 ensure that persons working in the care home are appropriately supervised. There are not arrangements in place for staff to formally and regularly sit down with a senior member of staff or manager to talk about all aspects of practice, the philosophy of care in the home, and their career development needs. This formal supervision should aim to assist staff in meeting the needs of the people receiving care and support. Care Homes for Older People Page 7 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 Insulin in current use is required to be stored at room temperature, in accordance with the directions on the pack. to meet licensed therapeutic requirements 31/03/2010 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 record the maximum/minimum temperatures of the medicines fridge, in addition to the single current temperature, to improve assurance of correct storage temperature. To record reference on the primary medicines administration record (MAR) chart when administration is recorded on a secondary chart. To include documented reference with the medicines administration record (MAR) charts when a residents allergy status is none known. 2 9 3 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!
