Random inspection report
Care homes for older people
Name: Address: Hawthorne Lodge 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR one star adequate service 17/02/2010 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 0 0 5 2 0 1 0 Information about the care home
Name of care home: Address: Hawthorne Lodge 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR 01519333323 Telephone number: Fax number: Email address: Provider web address: Lea@hawthornelodge.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Pauline Lynes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Stirrupview Limited Property & Estates care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: 0 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: 25 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: 25
Care Homes for Older People Page 2 of 10 Date of last inspection Brief description of the care home 1 7 0 2 2 0 1 0 Hawthorne Lodge is registered to provide personal care for twenty five older people. The home is owned by Mr Hornby. The manager is Ms Pauline Lynes. The accommodation is a mock Tudor style building located on the corner of two busy streets in Bootle. Due to its location there is good access to public transport and many local facilities are a short journey away. The shared areas include two lounges, a dining room and small back garden. Bedrooms are either single or double rooms. The home has a passenger lift and there are chair lifts to access rooms that have a number of stairs to them. A keypad fitted to the front door and other doors are alarmed so that staff are aware of and can offer assistance to any resident who wishes to go out. Bathrooms have equipment to help residents with bathing arrangements. Residents have the use of a call bell with an alarm facility. CCTV cameras view certain areas in the home. There is car parking space to the side of the premises. The weekly fee rate is three hundred and eighty three pounds a week. Care Homes for Older People Page 3 of 10 What we found:
We carried out this visit to check that medicines were being safely handled because we found shortfalls on our previous three visits that were placing the health and wellbeing of people who live in the home at unnecessary risk. Two inspectors carried out the visit that lasted six hours and included looking at medicines records, medicines stock and speaking with three members of staff and several residents. Overall we found medicines were still being handled unsafely. We found the records of medicines received into home were not always complete. One person who was receiving respite care did not have their medicines clearly recorded because not all the quantities received were recorded and some of the strengths of the medicines had been omitted. Of particular concern was the recording of medicines that were no longer required such as those that were discontinued and those that were left over at the end of each monthly medicines cycle. The acting manager and the senior carer on duty both said records had not been made of numerous medicines that had been disposed of over the last two medicines cycles and offered no explanation why this had happened. A bag of medicines was left on a shelf in the medicines room for at least 12 days even though they were no longer needed. One persons discontinued painkillers were put in the disposal bin without a record being made and the pharmacy that supplied the home said numerous medicines had been returned in April 2010 but the last record the home had made was at the end of March 2010. Incomplete records of medicines makes it impossible to account for them and can lead to serious mishandling and misuse. We carried out some detailed checks of the current stocks and records and found some medicines had not been given to people correctly. Two people missed a weekly dose of a medicine used for osteoporosis and another person missed a dose of a blood pressure tablet. Another person missed several doses of their prescribed nutritional supplement even though we had highlighted this in our last two visits. One persons liquid medicines used for depression and epilepsy did not add up showing they had either been measured incorrectly or had been missed completely on several occasions. A current course of cough medicine did not appear to have been given properly even though the records had been signed to show it had been given. Missing medicines or giving them at the wrong dose can seriously affect a persons health and wellbeing. We looked at the times medicines were given and found some were not being given at the right and best time. Medicines that needed to be given after food were often given before and a recent course of antibiotic was wrongly given after food. The carer confirmed these were given at the wrong time and was unaware of the need to give these medicines at particular times in relation to mealtimes. Another resident had been given their medicine to take in the morning however we found it in the bedroom and had to remind the resident to take it. Although the resident said they normally take it on time, the staff had not checked to ensure this. Giving medicines at the wrong time can affect peoples health because it can stop them working properly. We looked at how people were supported to look after their own medicines. Two people that were looking after some of their own medicines did not have risk assessments and care plans about how they were to be supported to manage them safely. This is a real concern as this requirement has been outstanding for the least three inspections. A
Care Homes for Older People Page 4 of 10 resident spoken with said that although they were happy to look after their medicine, the staff had not discussed the risks with them or the support they needed. In respect of assessing medicines, the resident said the staff asked, Can you look after your tablets and she said, Yes. An existing care plan and risk assessment for a resident did not evidence a recently prescribed medicine, which the resident is administering when needed. The resident said the staff had not discussed this with him. Having up to date paperwork about supporting people with their medicines helps make sure they are used safely. We looked at how the manager made sure staff were competent and made sure medicines were being handled safely. Medicines checks were carried out monthly but these had not identified the problems we had found and did not include detailed checks of the stocks and records. Staff had received medicines training in the past and their competency in handling medicines had been formally assessed by the previous manager in October 2009. However, we highlighted several issues during our visit that care staff were not always following the correct procedures for giving and recording medicines safely. We discussed these specific issues with the manager and gave some advice about developing and repeating the competency assessments. Regular training, efficient audits and formal competency checks help make sure medicines are handled safely by suitably skilled staff. 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 9 13 Put in place effective 12/11/2009 arrangements to ensure that any service user who selfmedicates is assessed to ensure that they can do so safely This will help to ensure the health and welfare of the residents 2 10 12 A privacy impact assessment 26/04/2010 must be completed for the use of CCTV cameras in the home The use of CCTV cameras must be assessed in respect of their use and the impact they have on peoples lives 3 19 23 Externally all windows must be kept in a good state of repair. This ensures the home is maintained appropriately and fit for people to live in. 23/08/2010 4 29 23 All bedrooms must be 17/12/2009 checked to ensure that windows provide for easy and safe ventilation of the home and can be opened and closed when necessary. This is with particular reference to those rooms identified on the
Page 6 of 10 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 inspection visit This will help to ensure people living in the home can moderate the temperature in their rooms 5 33 24 An annual development plan 26/04/2010 must be developed for the home, which sets clear aims and objectives for the management of the home and includes outcomes for people living there. This will evidence good management principals and ongoing / proactive management of the home. 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 Put in place effective 15/06/2010 arrangements to ensure that clear and accurate records of all medicines received, administered and disposed of are maintained. This will help make sure all medicines can be fully accounted for. Put in place effective 15/06/2010 arrangements to ensure that all medication is administered to service users in accordance with the prescribers directions. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 2 9 13 3 9 13 Put in place effective 15/06/2010 arrangements to ensure that all medication is safely administered to service users. Care Homes for Older People Page 8 of 10 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 This is important to help protect the health and wellbeing of people who live in the home. 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 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. 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 10 of 10 - 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!
