Random inspection report
Care homes for adults (18-65 years)
Name: Address: Hamilton Lodge Thelma Turner Homes Ltd, Hamilton Lodge Carr House Road Doncaster DN4 5HP three star excellent service 03/12/2008 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: Steve Baker Date: 0 7 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Hamilton Lodge Thelma Turner Homes Ltd, Hamilton Lodge Carr House Road Doncaster DN4 5HP 01302556046 01302329049 hamiltonvoyage@tiscalli.co.uk Voyagecare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Voyage Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 10 0 3 1 2 2 0 0 8 Hamilton Lodge is a Care Home registered to provide care for people with a Learning Difficulty. The home consists of a main building and a separate house that has been converted into 2 semi-independent living flats. The main building of the home has a good range of communal areas, which include 2 dining rooms and separate lounge spaces. All the bedrooms in the main building are single occupancy and have en-suite facilities. Each of the 2 semi-independent living flats are fully self-contained. The home is situated close to a municipal park and local shops. There is a large supermarket close by and the centre of Doncaster is approximately 1.5 miles from the home. There is a high staff ratio provided and emphasis is put on people who use the service integrating with the community and especially using the local college for
Care Homes for Adults (18-65 years) Page 2 of 8 Brief description of the care home education. Information gained on the 4th December 2008 indicates that the current fees range from 1055 pounds 61 pence to 2100 pounds 34 pence each week. Additional charges include, meals whilst out of the home and personal toiletries. The home provides information to people who use the service and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report dated 17th december 2007 is available on request from the manager. Care Homes for Adults (18-65 years) Page 3 of 8 What we found:
The reason for this visit was to undertake a pharmacist inspection of the service to follow up concerns about medication practices reported to us since the last key inspection. The visit lasted 3.5 hours and involved looking at the current medication administration record charts (MARs), a sample of care files, along with the medication storage and handling arrangements in the home. Medication administration at lunchtime was also observed during this visit. The deputy manager provided information about staff training and supervision arrangements. During the visit I gave verbal feedback to the deputy manager in charge of the home and to three team leaders. The outcome is as follows: Medication records examined and practices observed during the visit suggest that people living in the home can expect to receive their prescribed medicines correctly as intended. Improvements have been made since the medication concerns were raised and recommendations from an audit carried out by the new acting manager have been implemented. The supplying pharmacy has also checked the homes medication processes and found no problems. Some further changes in medication care planning and record keeping would help to illustrate that peoples health and wellbeing is being maintained through the safe and correct use of prescribed medicines. On questioning the staff, it is clear that they understand the need to keep accurate and detailed records of all medication received and used in the home and this mostly achieved. Monthly prescriptions are checked before the medicines are supplied. This good practice helps to make sure that any changes are acted upon and that all requested medicines are supplied each month. There are no significant gaps in the administration records meaning that people can expect to be given their prescribed medicines correctly. Regular checks of remaining medicines are carried out to ensure people have sufficient quantities each month. There are very good systems in place for accounting for all doses of medicines given to people when visiting other places or when on holiday. We found good information from health care professionals kept in care files although some medication advice should now be updated, for example, about the correct way to give those medicines prescribed to be taken only as and when needed. The care plans could be improved by the inclusion of a specific medication care plan describing each persons stated preferences for taking their medicines. This may help to reduce the likelihood of people refusing their medicines or of doses being missed. Having detailed medication care plans in place will help sure all staff give all medicines consistently in accordance with agreed directions and circumstances. The administration of medicines at lunchtime was observed to be in accordance with good practice. Drinks were offered to help with the taking of medicines and time was spent with each person and encouragement given to help them take their medication. The medication storage area is somewhat cramped but all medicines are stored securely and at temperatures recommended by the manufacturer. Some medicines, for example creams and liquids, have a limited time in which to be used once opened. Advice should be obtained from the supplying pharmacy and containers of these medicines should be marked with the date they are first opened so that staff know whether they are still safe to use. What the care home does well:
Administration practices in the home follow best practice which means that people are likely to accept and take their essential medicines regularly as needed.
Care Homes for Adults (18-65 years) Page 4 of 8 Monthly prescriptions are checked before medicines are supplied to ensure all items needed have been listed correctly. Staff make regular checks to ensure people always have sufficient medicines to take before a new supply is made. There are good systems and records in place for ensuring people take all their medicines when away from the home. 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 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 34 18 Evidence that all recruitment 02/02/2009 checks have been completed must be available at the home before staff commence employment. To ensure the safety and protection of people who use the service. 2 35 18 New staff must complete the 02/02/2009 homes induction programme, within the first six weeks of employment. To ensure they have the skills and competencies meet the needs of people who use the service. 3 35 18 Staff must complete training 02/02/2009 in areas of safeguarding adults and fire. To ensure they have the required skills and competencies to keep people safe. 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, 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 Individual medication care plans should be developed and agreed which reflect the personal preferences and needs of people living in the home. These care plans should be regularly reviewed in line with changes in peoples medication, health and wellbeing. Advice should be obtained from the supplying pharmacy and the the date of first opening should be marked on the container of those medicines which have a limited use once opened. 2 20 Care Homes for Adults (18-65 years) Page 7 of 8 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 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: 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 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!
