This inspection was carried out on 23rd September 2008.
CSCI found this care home to be providing an Excellent service.
The inspector found no outstanding requirements from the previous inspection report,
but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Grimsargh House Residential Home Preston Road Grimsargh Preston Lancashire PR2 5JE The quality rating for this care home is: The rating was made on: three star excellent 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: Stephanie West Date: 2 3 0 9 2 0 0 8 Information about the care home
Name of care home: Address: Grimsargh House Residential Home Preston Road Grimsargh Preston Lancashire PR2 5JE 01772651031 01772653994 info@grimsarghhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Stanner Manufacturing Limited Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 28 Conditions of registration: 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 The maximum number of Service Users who can be accommodated is: 28 Date of last inspection Brief description of the care home Grimsargh House is situated within extensive grounds in the village of Grimsargh. The home is registered for 28 service users and provides personal care to older people over the age of sixty-five years both male and female. The home is not purpose built and has three floors accessible by a lift. There is ample communal space with two Care Homes for Older People
Page 2 of 8 conservatories as well as a large dining room and lounge. The service provided is intended for service users who are fairly dependent but do not require nursing care. Care Homes for Older People Page 3 of 8 What we found:
The home was randomly selected for a visit to look at the arrangements for handling medication. The visit lasted approximately three and a half hours and involved discussing the handling of medication with senior staff handling medication, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the person-in-charge. Overall, we found some shortfalls in the arrangements for handling medicines that need to be addressed to ensure peoples health and wellbeing is best protected. We looked at medicines administration. All medicines are administered by trained care staff. Care is taken to ensure any special instructions such as ‘before food’ are followed and there is some flexibility in the times that medicines are given, for example if people choose to get up later in the morning. We checked medicines record keeping. Records for the receipt of medicines into the home and safe disposal of unwanted medicines were generally clearly recorded. However, we found some ‘gaps’ and omissions in the medicines administration records, which made them less clear, in some cases making it difficult to tell whether medicines had been given correctly. Most medicines administration records were pre-printed by the pharmacy but a handwritten record had not been properly completed and did not include the date, month and year of administration. The record did not list a currently prescribed inhaler kept in the medicines trolley. Entries had not been signed by the author and checked by a second person, this is recommended to reduce the risk of mistakes. We compared a sample of medicines stock and records. We found that medicines in the monitored dosage system where generally given correctly. We tried to check a more detailed sample of medicines contained in packets and bottles but this was not possible because there was no clear system of stock control. For example, one person’s record showed that in August twenty medicine sachets were received but twenty-eight were given. A new delivery of twenty sachets was received in September, current records showed twenty-two had been given, there were none left in stock on the visit day. This meant it was not possible to tell whether medicines in boxes and bottles were given correctly. It was of concern that we saw examples where records showed medicines had not been given because there were none left (run out). We saw one example where someone had missed doses of one of their tablets for seven days last month, and had again ‘run out’ of this tablet on the visit day. The same person had also ‘run out’ of eye drops and had not been given any for the last twelve days. Records for communication with healthcare professionals such as doctors were generally clearly made, so changes to people’s medicines could mostly be tracked. However, staff explained that they had contacted the doctor about a night sedative that they felt was making the resident still sleepy in the morning. Staff said the sedative had not been ‘stopped’ but it was not being used and staff were uncertain about when, or if it should be given. It is important that where necessary, sufficient information is recorded about the use of people’s medicines to ensure staff know what Care Homes for Older People Page 4 of 8 to do. Where short courses of medicines for example, antibiotics were started these were normally obtained without delay, ensuring treatment was started promptly. Staff explained that one person had recently been on holiday away from the home. They had prepared enough medicines for the holiday and spoken to relatives who would be supporting the resident to take their medicines whilst away. However, these arrangements were not recorded and records of any medicines leaving the home were not made. It is important that when holidays are planned, all options are considered (risk assessed) to ensure medicines are supplied in the best and safest way for each visit. We looked at how medicines were stored and found that all medicines including controlled drugs were safely stored helping to reduce the risk of miss handling. We looked at how medicines were checked and audited. Records showed a medicines audit had been carried out in April, but the outcome of this could not be found. It is recommended that regular audits of medication handling and checks of staff competency continue to ensure any weaknesses can be quickly identified and addressed. 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 8 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People 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 1 9 13 Sufficient stocks of prescribed medicines must be kept at the home to ensure continuity of treatment. 10/11/2008 2 9 13 To support the safe 10/11/2008 administration of medication, records must be clearly and accurately completed so that all medicines can be fully accounted for. 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 All hand written medication administration records should be signed and countersigned by a second person to ensure accuracy. When necessary, information on how medicines should be used should form part of an individuals care plan to make sure they are given to people correctly. Care Homes for Older People 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 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: 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 Older People 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!
