Inspection on 15/07/10 for Hadrian Park

This inspection was carried out on 15th July 2010.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hadrian Park 19/08/10

Hadrian Park 03/06/10

Hadrian Park 25/03/08

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Random inspection report Care homes for older people Name: Address: Hadrian Park Marsh House Avenue Billingham Stockton-on-Tees TS23 3DF 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: Simon Hill Date: 1 5 0 7 2 0 1 0 Information about the care home Name of care home: Address: Hadrian Park Marsh House Avenue Billingham Stockton-on-Tees TS23 3DF 01642566322 01642566744 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Lois Kate Morgan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross OPCO Ltd care home 73 Number of places (if applicable): Under 65 Over 65 24 49 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is: 73 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: Dementia, over 65 years of age - Code DE(E), maximum number of places: 24 Old age, not falling within any other category - Code OP, maximum number of places: 49 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Hadrian Park is a purpose-built home opened in 2004. There are 73 beds available, 24 of which are specifically for those suffering from dementia. The dementia unit is separate to the rest of the home, and is built around a courtyard, therefore enabling those who live at the home access to a secure, outdoor space, which has been landscaped. This unit is on the ground floor. The remainder of the home has both ground floor and first floor rooms, which are reached by a lift. All rooms are for single occupancy, and all have en-suite facilities consisting of a toilet and wash hand basin. Residents are able to personalise their rooms, according to preference and taste. Care Homes for Older People Page 3 of 10 What we found: We carried out this visit to look at how medicines were being handled, it was carried out by a specialist pharmacist inspector who checked a sample of medicines stocks, medicines records and care plans. We spoke with three carers and one person who lives in the home and gave detailed feedback to the registered manager at the end of our visit. Overall we found some improvements are needed to help make sure medicines are always given and recorded properly. We found medicines stock to be well organised, records were clearly presented and spare stock was stored securely in clean and tidy rooms. Records of medicines received into the home were clearly made and medicines could usually be accounted for. We carried out some detailed checks on the current stocks and records and found regularly prescribed medicines that were kept in the specially dispensed system provided by the pharmacy were usually being given correctly. However, we found medicines that were supplied in traditional packets and bottles did not always add up showing they had sometimes been missed. The manager was aware these medicines were at risk of being missed and had introduced a new stock check sheet that was to be completed every time the medicine was given. Although these check sheets had helped make some improvements we still found mistakes in the stocks and these sheets were not always completed properly. Our checks showed and the check sheets confirmed that one person missed their medicine to prevent blood clots on three occasions and another person was only given one instead of two of their capsules used to prevent stomach acid on five occasions in the last three weeks. Another person had their pain relief patch applied two days late because staff had not replaced it on time and another person missed four sachets of their Calcium supplement. We also looked at the times medicines were given to people and found some were wrongly given with food instead of before because the medicines rounds had not been properly organised. Giving people their medicines at the wrong time, wrong dose or not at all is poor practice because it can seriously affect their health and wellbeing. We looked at how medicines were recorded when they were not taken, for example, when people were asleep, refused them or did not need them. We found the records did not always explain this because staff had not correctly used the key code on the bottom the medicines records. Of particular concern was the number of medicines that were not given because people were asleep when staff tried to give them. The manager agreed that the carers should have returned to give some of these medicines when people had woken up so important doses were not missed. We checked a sample of care plans and supporting paperwork for information about medicines such as those prescribed as when required and for detailed information about specific medicines and the health issues they were prescribed for. The manager said new care plans were currently being written about when required medicines. We saw some good information in two peoples care plans about how and when their painkillers were to be used and detailed information in another persons plan about how they were to be supported to look after some of their own medicines. However, in other care plans we Care Homes for Older People Page 4 of 10 found little or no information about medicines used for anxiety, pain relief, laxatives and a medicine used to prevent clots that needed the person to have regular blood tests. The manager agreed that these care plans needed to be improved and we gave some advice about how to do this. Having detailed care plans about medicines helps make sure they are used properly. We checked how medicines liable to misuse, called controlled drugs, were handled. We found they were securely stored in suitable cupboards and when we checked the current stocks we found these were correct and all records were properly witnessed. Having secure storage and witnessed records helps prevent the mishandling and misuse of controlled drugs. We looked at how medicines were checked by the managers and saw recorded audits that usually found mistakes. When mistakes were found suitable action was usually taken to help prevent them happening again. However, an in depth audit had not been carried out in the last month so the extent of the problems we had found were not fully known by the managers. All staff had received regular medicines training and this was repeated on a regular basis. Formal competency assessments had been carried out to help make sure staff were following the correct medicines handling procedures and these were repeated on a regular basis. Regular audits, good training and formal competency assessments help make sure staff have the necessary skills to handle medicines safely. 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 10 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 Assessment information must be full completed and must contain a good level of information. This will ensure that there is sufficient information to demonstrate that peoples needs can be met. 28/07/2010 2 7 15 Where a need is identified a care plan must be in place. This will ensure peoples needs are being met. 28/07/2010 3 9 13 The management of homely remedies must be reviewed and staff must follow the correct procedure. This will ensure that people are provided with homely remedies inaccordance with the procedure and have their medication reviewed if needed. 28/07/2010 4 18 12 There must be written evidence to show that accidents are investigated and followed up. This will ensure the health, safety and well being of the people who use the service. 28/07/2010 Care Homes for Older People Page 6 of 10 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 5 33 24 There must be an effective 30/09/2008 quality assurance system, based on seeking the views from people who use the service and others. So that the home can make sure it is meeting the aims, objectives and statement of purpose. (09/04/08 the home informed us, surveys have been sent to people) 6 36 18 Staff must have one to one 31/07/2008 supervision at least six times yearly. Care Homes for Older People Page 7 of 10 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 Medicines must be administered to people correctly as prescribed. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 23/08/2010 2 9 13 Records of medicines 23/08/2010 administered to people must be clear, accurate and complete. This is important 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 Care plans and supporting paperwork should have detailed information about how peoples medicines should be handled including when required medicines and medicines that need to be closely monitored. This will help make sure Page 8 of 10 Care Homes for Older People 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 they are handled and administered safely. Care Homes for Older People Page 9 of 10 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. 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