Random inspection report
Care homes for older people
Name: Address: Haylands 93 Crofts Bank Road Urmston Manchester M41 0US one star adequate service 12/06/2009 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: 1 5 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Haylands 93 Crofts Bank Road Urmston Manchester M41 0US 01617483185 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Stacey Jayne Niven Type of registration: Number of places registered: Conditions of registration: Category(ies) : Urmston Housing Society care home 24 Number of places (if applicable): Under 65 Over 65 24 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: Male. 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: 24. Date of last inspection Brief description of the care home Haylands home for retired gentlemen is registered to accommodate a maximum of twenty-four service users who require personal care by reason of old age. The home is situated within walking distance of Urmston town centre with public transport routes close by. The building is a large detached Victorian house with well-maintained
Care Homes for Older People Page 2 of 9 2 6 0 8 2 0 0 9 Brief description of the care home enclosed gardens. There is off road parking at the front of the property. There are fourteen single rooms and five twin bedded rooms. Two of the single rooms have ensuite facilities and there are toilets and bathrooms on each floor. A stairlift provides access to all floors and there are additional toilet facilities on the ground floor with disabled access. The fees for accommodation are 250 pounds per week and the fees include all meals, laundry, domiciliary chiropody and entertainment. Additional costs include hairdressing, dry cleaning and telephone calls. Care Homes for Older People Page 3 of 9 What we found:
We carried out this visit because three previous inspections had found concerns about the way medicines were being handled. The visit was carried out by a pharmacist inspector who checked medicines stock and medicines records. Overall we found some improvements but still found shortfalls that were placing the health and wellbeing of people who live in the home at unnecessary risk. We found the records of medicines received into the home were not always accurate because they were not properly dated. Records of medicines given to people were usually signed correctly but when medicines were omitted, for example if they were refused, then clear reasons were not always recorded. We found medicines that were returned to the pharmacy when they were no longer required were not always recorded properly because they were not dated and in some cases not recorded at all. Having accurate records of medicines helps make sure they can be fully accounted for to show they are being handled safely. There was no clear system of medicines stock control so it was not always possible to check whether medicines were being given to people correctly. The home used a specially dispensed system, provided by the pharmacy, to help give medicines in a more organised way but the design of the system was not the best one for use in a care home because it was difficult to identify individual tablets. We raised this issue at our last visit and although the manager had made some progress the system was still making it difficult for staff to give medicines safely. The manager told us a new pharmacy was to be used shortly and they were to supply a more suitable system. Medicines that could not be packed into the special system were supplied in packets and bottles but these could not always be easily accounted for because they were not carried forward properly at the beginning of each new medicines cycle. Our checks of these medicines found some had occasionally been missed including medicines used for blood pressure, iron deficiency and depression. We also found one medicine that several people were taking for stomach acid problems was not being given correctly before food because staff had not followed the instructions on the label. Missing medicines or giving them at the wrong time can seriously affect a persons health and wellbeing. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We looked at how two people were supported to look after some of their own medicines. One of them had a clear plan and risk assessment about how they were to be supported but the other person had no information. 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. We looked at how when required medicines were handled and found very little information about how and when to use them. One person that was prescribed a strong medicine for anxiety had no information about how to use it so there was a risk that it might not be given properly. We found creams were poorly handled because the records of them being applied were not always signed and there was no information about how to use them. We also found several creams insecurely stored in peoples rooms so there was a risk of them being mishandled. Care Homes for Older People Page 4 of 9 We checked how controlled drugs (medicines that can be misused) were handled. There was no suitable cupboard to store them in even though we raised this issue at our last visit. The manager said a new cupboard had been been ordered but they were still waiting for it to be delivered. A special register was used for recording controlled drugs receipt, administration and disposal and these were usually properly witnessed. However, several recent entries had not been properly completed when they had been returned the pharmacy for destruction so the register showed several controlled drugs were still being held by the home even though they had been disposed of. Having secure storage and accurate records help prevent the misuse and mishandling of controlled drugs. Care staff that handled medicines had all received some certificated training in the past and we saw some evidence of staff competence now being formally assessed. However, these competency assessments still need to be improved because we saw several examples of poor practice such as records being completed incorrectly, a carer touching a medicine with their hand when preparing it and very poor handling of creams. We found no improvements for the auditing (checking of medicines) so mistakes were not being found and improvements were not being made. Competency assessments and regular auditing 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 9 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 Medicines must be given to service users as prescribed. Because receiving medicines at the wrong dose, wrong time or not at all can seriously affect their health and wellbeing. 01/09/2009 2 9 13 (2) The registered manager 31/07/2008 must make sure that medication administration procedures are carried out in a safe and appropriate manner thereby ensuring that service users receive the right medication. There must be effective systems in place to audit medication. To help make sure that medicines are handled safely and to make sure that people who live in the home are kept safe. 14/09/2009 3 9 13 4 9 13 All medicines must be stored 01/09/2009 safely and securely. Medicines must be stored safely and at the correct temperatures so they can not be mishandled and so that Care Homes for Older People Page 6 of 9 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 they work properly. Provision for the storage of medicines under the in accordance with the Misuse of Drugs (Safe Custody regulations) must be made. 5 9 13 Clear and accurate records of 01/09/2009 medicines received into, administered and disposed of by the home must be maintained. So that medicines can be fully accounted for to prevent mishandling and to show that they are being given correctly so service users health is not at risk form harm 6 19 23 The registered person must make sure that the building complies with fire safety regulations at all times and cease wedging doors open. In order to minimse the risk of smoke inhalation and the spread of fire in the event of a fire emergency. 23/07/2009 Care Homes for Older People Page 7 of 9 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 8 of 9 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 9 of 9 - 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!
