This inspection was carried out on 1st September 2009.
CQC found this care home to be providing an Excellent service.
The inspector found no outstanding requirements from the previous inspection report,
but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for adults (18-65 years)
Name: Address: Harbour View Nursing Home Bransty Road Whitehaven Cumbria CA28 6HA three star excellent 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: Angela Branch Date: 0 1 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Harbour View Nursing Home Bransty Road Whitehaven Cumbria CA28 6HA 01946599963 01946599964 Telephone number: Fax number: Email address: Provider web address: www.fshc.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tamaris Healthcare (England) Ltd care home 50 Number of places (if applicable): Under 65 Over 65 6 50 0 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 50 The registered person may provide the following category of service only: Care home with nursing - Code N. 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, Dementia - Code DE, Physical disability Code PD. The maximum number of service users who can be accommodated is: 50. Date of last inspection Brief description of the care home Harbour View is a purpose built care home registered to provide nursing care for up to 50 residents from the age of 18 years. The home is built on Bransty hill overlooking Whitehaven harbour. There is a good-sized car park in front of the home. Accommodation is provided in single en suite bedrooms on two floors. The facilities are
Care Homes for Adults (18-65 years) Page 2 of 8 Brief description of the care home accessible and meet the needs of residents and aids and equipment are in place to assist where necessary. The current scale of charging, via social service referral, is £462.15 under 65 years and £396 per week over 65 years of age. Private fee payers are charged £535. Both groups may be entitled to a nursing care contribution on top of this amount for additional nursing care that may be required. Hairdressing and chiropody is not included in these fees. Information is made available on facilities and terms and conditions in the homes Statement of Purpose and Residents Guide. Care Homes for Adults (18-65 years) Page 3 of 8 What we found:
The service was visited to assess the overall management of medication following a report received by us in May 2009 of missing medicines. The pharmacist inspector looked at relevant documents, storage and meeting with the manager Gillian McAllister and other staff. The inspection took approximately six hours. Feedback was given to the manager at the end of the inspection. Overall we found that medicines were managed adequately. Residents were protected by policies and procedures for managing medication. These enabled residents to look after and take their own medication, if they wished, following assessment and management of risks to keep them safe and to help them remain independent. Care plans for these residents contained risk assessments for self-medication that were reviewed regularly. We looked at records of receipt, administration and disposal of medication. Records of receipt and administration were good so the treatment received by residents and reasons why treatment was not given were clear. However, the records of disposal of medication were incomplete. Medicines that had been refused by residents were not always recorded. For example, one medication was refused by a resident sixteen times over a thirty day period but only one dose was recorded for disposal leaving fifteen doses unaccounted for. It is important that the service has a clear and accurate system for recording the whereabouts of all medication so that it can be accounted for at all times. The service had a system of recording running balances of medication so that staff know how much is in use at any one time. We also counted a sample of medicines and compared them with records to check if they tally and to check that they are given in the prescribed dosages. Overall, the amount of medication in stock at the time of the inspection tallied with the records with only occasional discrepancies. However these records also showed that on occasions residents received medication in the wrong doses. For example, records showed that one person received only half the dose intended by their doctor on eight out of thirty days. We saw occasions when medication ran out. Usually this was for very short periods of time. However, we noted that medication was not always ordered in advance but was ordered once it had run out leading to delay in receiving it in time for the next dose. We also saw one medication that was recorded as out-of-stock for five days but records showed that a supply had been received on the second day but staff had failed to administer it. A selection of care plans, particularly those relating to medication, we examined. These were good and gave clear plans on managing residents care, and were evaluated regularly. There were protocols in place for the administration of when required medication that included information for staff on why it was prescribed and when it should be given. This ensures that residents receive their treatment appropriately when they need it. We looked at a care plan for one resident who was tube fed and required medicines to be administered through the tube. However, there was very little information in the care plan about how to safely administer this medication especially as some of it could require crushing beforehand. It is recommended that care plans contain more detail on the administration of medication to tube-fed residents. Records of visits by
Care Homes for Adults (18-65 years) Page 4 of 8 heath care professionals such as doctors and the outcomes relating to medication were well recorded although sometimes the information was kept in different parts of the residents file. It would be useful to keep all these records together for ease of reference. We checked the storage of medication that was good. We also checked the management of medicines liable to misuse, called controlled drugs. These were managed and recorded well. We were told that most staff who administer medication had recently received training from the supplying pharmacy on the safe use of medicies. The manager also assessed the competencies of staff at least annually to make sure they follow good practices when managing medicines to keep residents safe and well. She also did monthly checks, or audits, of medication so that medication issues could be identified promptly to keep residents safe. The manager shared concerns from the audits with staff. However we saw repeated medication problems that were previously highlighted in the last audit. The manager should ensure that staff act on the findings of the audits to reduce the incidence of medication errors. 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 £ No R 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 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 1 20 13 The service must make sure 06/10/2009 that residents always receive their medication in the doses prescribed by the doctors and that accurate records of medication are kept. This is to ensure residents always receive safe and effective treatment and that medicines are always 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 20 It is recommended that care plans for residents who are tube fed contain detail on the safe administration of medication. 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!
