Inspection on 30/11/09 for Hawthorne Lodge

This inspection was carried out on 30th November 2009.

CQC found this care home to be providing an Poor 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

Hawthorne Lodge 08/06/10

Hawthorne Lodge 10/05/10

Hawthorne Lodge 17/02/10

Hawthorne Lodge 06/01/10

Hawthorne Lodge 06/11/09

Hawthorne Lodge 06/10/09

Hawthorne Lodge 19/08/09

Hawthorne Lodge 07/04/08

Hawthorne Lodge 11/05/07

Hawthorne Lodge 12/06/06

Hawthorne Lodge 23/01/06

Hawthorne Lodge 22/09/05

Hawthorne Lodge 30/03/05

Hawthorne Lodge 05/08/04

Hawthorne Lodge 23/03/04

Similar services:

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Random inspection report Care homes for older people Name: Address: Hawthorne Lodge 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR zero star poor service 19/08/2009 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: 3 0 1 1 2 0 0 9 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): 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 Date of last inspection Brief description of the care home Hawthorne Lodge is registered to provide personal care for twenty five older people. The home 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 Care Homes for Older People Page 2 of 13 1 9 0 8 2 0 0 9 Brief description of the care 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 public areas only. 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 13 What we found: We carried out this visit to check how medicines were being handled because after a recent visit we issued a legal notice that required the home to improve their handling of medicines in a number of areas. Overall we found some improvements in the recording and giving of medicines but we still found medicines were not always handled safely. This places the health and wellbeing of people who live in the home at unnecessary risk and means the requirements of the legal notice have not been fully met. Records of medicines received into the home, given to people and disposed of were usually signed and up to date. However, on the previous day there were numerous gaps on the medicines records of five people where a staff member had forgotten to sign the records even though our checks showed that most of them had probably been given. This shows that this staff member was not giving and recording medicines safely. We highlighted this issue at our last visit when we raised concerns about the competency of staff. We saw evidence and the manager told us that medicines handling training and an assessment of staff competence had been carried out but this had clearly not been fully effective. We carried out some detailed checks of the stocks and found some medicines had not been given correctly. One person missed two of their blood pressure tablets over the previous two days, the manager agreed they had not been given. Another person missed three doses of an important medicine used for mental health problems, two of these doses were signed as given but our checks showed that none were in stock. Of particular concern was one person not getting their prescribed food supplement which they should have got every day because they had been losing weight. We spoke with the person concerned and a member of staff who both said that it had not been given even though the records had been signed that it had. Failing to get prescribed medicines can seriously affect a persons health and wellbeing. We looked at a sample of care plans for medicines handling and related health issues. One person who had swollen ankles and a chest infection had no short term plan about how they were to be supported so there was a risk they might not get the right support. Another person who had severe sleeping problems had no information about how they were to be supported and two other people who were looking after their own medicines did not have up to date care plans about which medicines they were looking after. Of serious concern was the lack of care plan for a person with severe weight loss who we have highlighted as not having their food supplement given to them correctly. The manager agreed that these plans should have been in place. We checked how controlled drugs (medicines that can be misused) were handled. A suitable new cupboard had been obtained but it was not properly attached to the wall so it did not meet the requirements of the law. A new controlled drugs register had been obtained and the records we checked were all properly witnessed. Secure storage and witnessed records help make sure controlled drugs are handled safely and securely. We looked at how homely remedies (medicines that can be bought from the pharmacy) were used. There was no written policy about how to use them and the selection of medicines being kept were not all suitable. At least four of the medicines being used were Care Homes for Older People Page 4 of 13 recycled medicines that had been originally prescribed to a person in the home, this is illegal and unsafe. Three other medicines were loose strips of tablets and another was a tub of cream that had a persons name written on it, which was four months out of date. We also found that staff were taking paracetamol tablets that were intended for residents use. The manager said she had not looked at the arrangements for homely remedies but agreed that they were not being used safely and she would review them as soon as possible. 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 13 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 9 13 Put in place effective systems for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home This will help to ensure the health and welfare of the residents 12/11/2009 3 9 13 Put in place effective 12/11/2009 arrangements to ensure that staff responsible for the admininstration of medication are competent to do so safely This will help to ensure the health and welfare of the residents 4 9 13 Effective systems must be 12/11/2009 put in place to ensure that prescriptions and instructions from medical professionals Page 6 of 13 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 are properly recorded and followed so that administration errors do not arise. This will help make sure medicines are handled safely. 5 9 13 Put in place effective 12/11/2009 arrangements to ensure that all medications received into the home and any medication administered, disposed of or returned to the pharmacy is recorded This will help to ensure the health and welfare of the residents 6 9 13 There must be a legally compliant controlled drugs cupboard available in the home. This will help prevent mishandling and misuse. 7 18 13 The manager must ensure 17/12/2009 that all senior staff who may be left in charge of the home are aware of the local safeguarding policy and how to contact the safeguarding team This will help to ensure that any allegation of abuse is reported and managed appropriately 8 19 13 A risk assessment must address all risks within the 30/09/2009 09/01/2010 Care Homes for Older People Page 7 of 13 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 environment. For example, trip hazards, window restrictors, damp and general maintenance This will help to ensure residents have safe, well maintained accommodation 9 19 23 A programme of maintenance and decoration of the home is needed as areas are in need of repair and attention This will help to evidence work undertaken and planned to improve the environment for the residents 10 20 23 Suitable furnishings and fittings are required in the communal areas This is to help ensure the comfort and safety of the residents 11 22 13 All equipment / aids used for 09/11/2009 people living in the home must be maintained and used in accordance with safety requirements. All wheelchairs in use should therefore have footrests fitted when moving people in them. This will help to ensure the equipments used safely 12 24 16 Residents require new 19/10/2009 furniture and fittings for their Page 8 of 13 30/09/2009 30/09/2009 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 private rooms This will help to ensure residents live in private accommodation to assure their comfort and privacy 13 26 13 All areas of the home must be kept clean This will help to ensure residents live in a clean environment where the risk of cross infection is minimised 14 26 13 The manager must ensure 09/11/2009 that there are suitable procedures in place for the management of the laundry which follow good practice guidelines regarding infection control This will help to ensure that the management of laundry does not present as an unnecessary source of infection 15 26 13 All equipment used to care 09/11/2009 for people living in the home must be kept in a clean and hygienic state.This includes wheelchairs in use and the trolley in the dining area This will help to reduce the risk of cross infection and protects people living in the home 16 29 23 All bedrooms must be checked to ensure that 17/12/2009 30/09/2009 Care Homes for Older People Page 9 of 13 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 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 inspection visit This will help to ensure people living in the home can moderate the temperature in their rooms 17 29 17 Staff must be recruited safely This will help to ensure the ongoing protection of people who use the service 18 33 26 The provider [owner] or 17/12/2009 representative of the provider must visit and complete a report which complies with the requirements of this regulation. The report should be made available to the manager This will help to ensure that the home is being monitored by the provider to help ensure standards are effectively maintained and that the manager has appropriate feedback to ensure further improvements 19 38 13 There must be suitable arrangements for the training of staff in first aid This helps ensure that care Care Homes for Older People Page 10 of 13 19/10/2009 17/12/2009 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 staff have the ability to deal with accidents and health emergencies 20 38 23 The fire door on the ground 17/12/2009 floor corridor and to the kitchen must have the closing mechanisms fixed, so that the doors close correctly This will help to protect people in the event of a fire 21 38 18 Staff require training in safe 19/10/2009 working practice areas. These are particualy specified for infection control, first aid, and health and safety This will help to ensure they have the skills and knowledge to undertake their work safely Care Homes for Older People Page 11 of 13 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 Care Homes for Older People Page 12 of 13 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. 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. 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