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 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: 0 6 1 0 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 11 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 11 What we found:
We carried out this visit to make sure medicines were being handled safely because serious shortfalls were found on our last inspection. The visit was carried out by a pharmacist inspector and it lasted four and a half hours. We checked medicines records, medicines stock and spoke with two staff and two residents. At the end of the visit we took some photocopies of the records because we found continued shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. When we arrived at the home the acting manager and the carer on duty said that the morning medicines had all been given out from approximately 8am. We checked the medicines records at 10:30am and found none of them had been signed. This is poor practice that shows staff were not always checking and signing for medicines correctly. The current medicines records were not accurate because they were not dated properly, this made them very confusing and both the acting manager and the carer on duty said they did not understand why this had happened. Because the records for the previous month were incorrectly dated this made them completely meaningless. Records of medicines received into the home were not accurate as they were not properly dated so it was not possible to account for all medicines. Poor record keeping can lead to serious mistakes that can affect the health and wellbeing of people who live in the home. There was no clear system of medicines stock control in the home so it was not possible to check whether most medicines were being given to people correctly. The specially dispensed system to help give medicines in a more organized way did not match the records as it should have done and medicines in packets and bottles could not be easily accounted for. Staff said medicines were given with or just after mealtimes but we found several medicines that should have been given before food. Giving medicines at the wrong time can stop them working properly. We observed part of the lunchtime medicines round and found best practice was not being followed because the carer carried some peoples medicines in their hands rather than using a medicines pot, this is unhygienic and unprofessional. Staff had not been trained properly to give medicines out and formal certificated training had not been carried out by all staff. We saw no arrangements for the assessment of staff competence and there were no formal audits (checks) so mistakes were not being found and improvements were not being made. Staff training, competency assessment and regular auditing help make sure medicines are handled safely and help make sure staff have the necessary skills. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We looked at how four people were supported to look after some of their medicines. One persons paperwork had been recently updated and this was reasonably detailed. However, the other three people had no paperwork in place so there was a risk that they might not receive the right amount of support from staff and one of these people showed us some medicines that staff did not know they were taking. Having good paperwork and procedures for supporting people to look after their own medicines helps them retain some of their independence in a safe way. Care Homes for Older People Page 4 of 11 We checked how controlled drugs (medicines that can be misused) were handled. The cupboard used for storing them did not meet the requirements of the law because it was not properly attached to the wall and there was no special register available for making records. Although no controlled drugs were held at the time of our visit suitable storage and recording arrangements must be in place to help prevent mishandling and misuse. 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 11 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 7 15 Residents care plans must accurately reflect their current health and social care needs. Staff must be provided with the information they require to support residents effectively and safely This will help to ensure the residents needs are met in a safe and supportive manner 30/09/2009 2 19 13 A risk assessment must address all risks within the environment. For example, trip hazards, window restrictors, damp and general maintenance This will help to ensure residents have safe, well maintained accommodation 30/09/2009 3 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 30/09/2009 Care Homes for Older People Page 6 of 11 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 4 20 23 Suitable furnishings and fittings are required in the communal areas This is to help ensure the comfort and safety of the residents 30/09/2009 5 24 16 Residents require new 19/10/2009 furniture and fittings for their private rooms This will help to ensure residents live in private accommodation to assure their comfort and privacy 6 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 30/09/2009 7 29 17 Staff must be recruited safely This will help to ensure the ongoing protection of people who use the service 19/10/2009 8 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 7 of 11 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 Effective systems must be 12/11/2009 put in place to ensure that prescriptions and instructions from medical professionals are properly recorded and followed so that administration errors do not arise. This will help make sure medicines are handled safely. 2 9 18 Effective systems must be 12/11/2009 put in place to ensure that staff responsible for the administration of medication are competent to do so safely. This will help make sure they have the necessary skills to do it safely. 3 9 13 Effective systems must be 12/11/2009 put in place to ensure that all medication received into the home and any medication administered, disposed of or returned to the pharmacy is
Page 8 of 11 Care Homes for Older People 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 recorded This is important so all medicines can be fully accounted for. 4 9 13 There must be a legally compliant controlled drugs cupboard available in the home. This will help prevent mishandling and misuse. 5 9 13 Effective systems must be put in place to ensure that any service user who selfmedicates is assessed to ensure they can do it safely. This is important so that people receive the right amount of support to do it safely. 6 9 13 Effective systems must be 12/11/2009 put in place to ensure that any medication administered by care staff or self administered is properly recorded, and any nonadministration is accounted for. This will help make sure medicines are handled safely. 7 9 13 Effective systems must be put in place for the recording, handling, safekeeping, safe administration and disposal of medicines received into 12/11/2009 12/11/2009 09/01/2010 Care Homes for Older People Page 9 of 11 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 the care home. This is important to help make sure medicines are handled safely. 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 The manager should carry out regular audits of the medicines and regular formal checks on staff competency to help make sure medicines are handled safely by properly skilled staff. Care Homes for Older People Page 10 of 11 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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!
