Inspection on 19/05/09 for Hollin Bank House

This inspection was carried out on 19th May 2009.

CQC found this care home to be providing an Adequate 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

Hollin Bank House 19/05/08

Hollin Bank House 04/09/07

Hollin Bank House 21/08/06

Hollin Bank House 17/03/06

Hollin Bank House 03/11/05

Hollin Bank House 01/03/05

Hollin Bank House 21/06/04

Hollin Bank House 02/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

Key inspection report CARE HOMES FOR OLDER PEOPLE Hollin Bank House Blackburn Road Oswaldtwistle Lancashire BB5 4PE Lead Inspector Mrs Susan Hargreaves Key Unannounced Inspection 19th May 2009 09:30 DS0000009433.V375397.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollin Bank House Address Blackburn Road Oswaldtwistle Lancashire BB5 4PE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01254 236841 01254 236841 ray.pullinger@yahoo.co.uk Mr Raymond John Pullinger Mrs Sylvia Pullinger Manager post vacant Care Home 14 Category(ies) of Dementia - over 65 years of age (1), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (1), Old age, not falling within any other category (11) Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. In annexe 2 the number of service users in each category is 11 OP, 1 MD(E) 1 MD and 1 DE(E) 19th May 2008 Date of last inspection Brief Description of the Service: Hollin Bank House offers 24-hour personal care for up to 14 people. The service has been registered as a care home, providing care for over 20 years, by the same registered owners. The home is a detached property set in a residential area approximately one quarter of a mile from Oswaldtwistle town centre. The home is close to a main road that is serviced by public transport. Accommodation is provided in single or twin-bedded rooms. A stair lift facilitates access to all areas of the home. Communal lounges and dining room are located on the ground floor. The current fees charged at Hollin Bank House are £405 per week. Additional charges are payable for hairdressing dry-cleaning and personal items. A copy of the statement of purpose and service user guide is available on request. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. A key or main unannounced inspection, which included a visit to the home, was conducted at Hollin Bank House on 7 May 2009. As part of the inspection process we looked at all the information we have received about Hollin Bank House since the last key inspection which took place on 13 May 2008. This included a random inspection on 9 July 2008 when we were accompanied by an environmental health officer to monitor compliance with the requirements made about moving and handling procedures at the last key inspection. A random inspection was carried out by a pharmacist inspector on 12 September 2008 to look at arrangements for handling medication and to follow-up concerns raised at the previous inspection. Information about these inspections can be obtained from Hollin Bank House or www.cqc.org.uk The manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical information about the service. Five completed surveys were returned from people who use the service and one from a member of staff. At the time of this visit twelve people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty, people who use the service and their visitors. Discussions also took place with the manager and deputy manager regarding issues raised during the inspection. What the service does well: People who use the service were treated with respect and personal care was carried out in private. One person said, “The staff are great, I’ve no grumbles.” Another person said, “The staff are good, they do everything I need them to do.” One visitor said, “Mum is quite happy here. The staff are fine.” Another visitor said, “It’s a nice place, I can come anytime and they give me a cup of tea.” Training for all members of staff was encouraged. More than three quarters of the care workers had had National Vocational Qualifications at level 2 or above. The member of staff who completed the survey stated that they were given Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 6 training which kept them up to date and enabled them to meet the individual needs of people using the service. All the people asked said the daily routine was flexible and they could get up and go to bed when they wanted. What has improved since the last inspection? What they could do better: All care plans should include clear directions for staff to follow to ensure they know exactly what they need to do in order to fully meet the needs of people using the service. Action must be taken to ensure that medication is managed correctly. There must be a complete and accurate record of all medicines received into the home. All containers of medication should be dated when they are opened. The amount of medication left over from the previous month should be recorded on the new medication administration record. This will ensure medication is managed correctly and also enable accurate stock checks to be made. To ensure that the correct amount of medication is given at the right time a medication administration record should be in place for each person using the service who has been prescribed medication. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 7 To ensure the doctors instructions are followed and people receive the correct dose of their medication at the right time medication should only be given to people from the containers they have been dispensed in by the pharmacist. It is important that people are given their medication as prescribed by the doctor. When the dose or time of administration is changed there should be written evidence that this has been done by the doctor. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. To ensure medication is managed correctly a system must be put in place to regularly check all aspects of the management of medication including staff competence. A wider range of leisure activities should be offered regularly to enable more of the people using the service to have a fulfilling lifestyle. To help prevent the spread of infection from one person to another paper towels should be made available in communal toilets. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the health and social care needs of each person using the service. EVIDENCE: A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. These supply information about the care and facilities provided at the home. A senior member of staff visited people who were considering using the service in hospital or their own home before admission. The purpose of this visit is to Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 10 assess the persons health and personal care needs to ensure they can be met at the home. We looked at the care records of a person who recently came to live at the home. These records included a pre-admission assessment. This assessment provided important information for the development of their care plan. People who were considering using the service or their relatives received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were cared for in a manner which promoted their privacy and dignity. Deficiencies in the management of medication could affect the health and wellbeing of some people. EVIDENCE: We looked at the individual care plans of two people who use the service. These plans identified the health and social care needs of each person. Some of these plans provided clear directions for staff to follow to ensure their individual needs were met in the way they preferred. For example the care plan for one person explained exactly what staff needed to do in order to ensure this person was comfortable and felt safe at night. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 12 However, some areas of the care plans lacked clear guidance for staff to follow especially about the prevention of pressure sores. One care plan provided information about how pressure sores developed. This read more like a training manual rather than giving specific guidance for staff to follow stating exactly what they needed to do in order to prevent that person from developing pressure sores. Another care plan stated the person should sit on a pressure relieving cushion without indicating which type or if in fact one was in use. Despite the deficiencies in the care planning process there was no evidence to suggest that people were not receiving the care that they needed. Discussion with two people using the service confirmed that they were happy with their care and staff treated them well. Appropriate risk assessments including ones for falls, nutrition and the development of pressure sores were in place. Some guidance for staff to follow about how to manage identified risks was also included in the care plans. The care plan for one person stated their weight needed to be monitored but did not indicate how often this was to be done. However, the records did indicate that this person had started to gain weight. Care plans and risk assessments were reviewed monthly to make sure they were still relevant. Where possible the people using the service or their relatives were involved in care planning and signed the care plan to indicate their agreement with the care provided. There were records of the involvement of GP’s and other healthcare professionals including the chiropodist, dentist, district nurse and social workers in the care of people who use the service. Medication was stored correctly and administered by members of staff who had received training in the management of medication. We looked at records of the management of medication and found that although a record of the receipt of medication was usually made this did not include the amount. However, a record of the amount of medication brought into the home when one person was admitted had not been made. An up to date medication administration record was not in place for this person. Moreover, the medication was not in the container it had been dispensed in by the pharmacist and therefore instructions about the dose and frequency of administration were not available. There was also no evidence to suggest that the person’s GP had been contacted to check the dose and if in fact this medication had been prescribed. Giving people their medication only from the containers they were dispensed in and checking with the GP what medication has been prescribed would ensure they receive the correct medication. We checked a sample of medication records and stock but found it difficult to account for some medication. This was because medication was not dated on Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 13 opening and the amount of medication left over from the previous month was not recorded on the new medication administration records. Keeping detailed and accurate records help prevent the mishandling of medication. Written guidance for staff to follow about when individual people using the service needed to be given medication that was prescribed ‘when required’ were not available. One person was prescribed a tranquiliser to be given when required but there were no instructions for staff to follow about the symptoms this person might display when they needed this medication. Having clear written instructions for the administration of when required medication ensures people are given their medication only when they need it. It was evident from one of the medication administration records that a medication initially given at 10pm had been changed to 12noon. The manager said the GP had given this instruction verbally over the telephone but there was no documentary evidence to support this. Another medication prescribed to be given three times a day was usually given twice a day and a hand written instruction on the medication administration record stated the medication was to be given as requested only. Again there was no written evidence that this had been changed on the instruction of the GP. We looked at the records of how medication was checked by the deputy manager. Although this was done regularly it did not cover all aspects of the management of medication. The deputy manager was advised to further develop this system and to ensure it also included staff competence. Personal care was given in the privacy of the person’s own room or the bathroom. Members of staff were observed attending to people in a polite and friendly manner. One person said, “The staff are great, they look after me.” Five people using the service completed a survey and all stated that they always received the care and support they needed. One member of staff explained in detail how they promoted privacy and dignity for all people using the service and considered this to be an important part of their care. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s choices were respected and the range of leisure activities provided met the needs of most people. Meals were wholesome and appetising and people enjoyed them. EVIDENCE: People using the service were encouraged to pursue their own interests and hobbies. One person liked knitting and said, “They get wool for me when I want it.” Another person liked reading magazines and doing puzzles. A member of staff explained that one person regularly attended the local Inskip Club. However, one person was asked what she did all day and replied “Just sit here” She also said that activities were organised sometimes but if they were organised more often she would join in. One care worker explained that all members of staff were responsible for organising activities. These included, watching television, chatting, manicures, playing cards and dominoes. Outside entertainers sometimes visited the home. Five of the six people who completed Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 15 the survey indicated that there were always activities arranged that they could take part and one person put sometimes. Local clergy regularly visited the home and offered communion to people who wished to practice their faith in that way. People using the service and members of staff said that visitors were welcomed into the home at any time and offered refreshments. One visitor said, “I can come any time and they give me a cup of tea.” The daily routine was flexible in order to meet the needs and preference of people using the service. All the people asked said they could choose when to get up and go to bed. One person said, “You can do as you want, get up and go to bed when you want.” The meal served at lunchtime looked wholesome and appetising. Lunch was unhurried allowing people time to chat and enjoy their meal. All the people asked said the food was good and they enjoyed their meals. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints were taken seriously and investigated. Members of staff had the training necessary to ensure people who use the service were protected from abuse. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the statement of purpose and service user guide. The six people who completed the survey stated that they knew how to make a complaint. The manager explained that one complaint had been investigated since the last key inspection and the issues raised were discussed at a staff meeting. A record of the discussions that took place at this meeting was seen. No complaints have been made directly to the Commission. Policies and procedures about safeguarding vulnerable adults were in place. Discussion with two members of staff confirmed that they had received training in safeguarding vulnerable adults. They both said they would report any concerns to the manager immediately. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provided a comfortable and homely environment for people who use the service. EVIDENCE: A tour of the premises confirmed that the home was clean, tidy and generally well maintained. This provided a safe and comfortable place for people using the service to live. The five people who completed the survey all stated that the home was always clean and fresh. One person wrote on the survey, ‘It’s a good place. Always clean and tidy.’ Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 18 People who use the service were encouraged to bring personal item for their bedrooms to make them more homely. These included ornaments, photographs and pictures for the walls. The ground and gardens were well kept and accessible to people using the service if they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitably equipped laundry room ensures clothes are washed promptly and returned to people using the service. Gloves and plastic aprons were available for members of staff to use in order to protect themselves and people using the service from infection. However, paper towels were not available for staff and people using the service in the toilet on the first floor and ground floor. Terry hand towels had been placed in these areas. Using communal towels increases the risk of spreading infection from one person to another. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Members of staff were encouraged to acquire the skills and knowledge necessary in order to meet the needs of people who use the service. Recruitment procedures were thorough. EVIDENCE: The duty rota provided details about the grades and number of staff on duty for each shift. Five people who use the service completed the survey and in answer to the question are staff available when you need them four indicated always and one usually. We looked at the file of one member of staff appointed since the last inspection. This file indicated that all the required information had been obtained before this member of staff had started working at the home. These included two written references and a Criminal Records Bureau check. These checks ensure people who use the service are protected from the employment of unsuitable staff. Discussion with the manager and members of staff confirmed that training was encouraged. This included moving and handling, management of medication, Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 20 basic food hygiene, health and safety, first aid and fire safety. In addition to this more than half of the care workers had National Vocational Qualifications at level 2 or above in health and social care. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a competent manager and the views of people using the service are considered when decisions about the care and facilities provided at the home are made. EVIDENCE: The manager is a registered nurse with many years experience of managing a care home. He maintains an up to date knowledge of current practice by attending relevant seminars and reading articles from a variety of care publications. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 22 Discussion with the manager confirmed that he was committed to quality assurance and has achieved the nationally accredited Investors in People Award. The people using the service and their relatives were asked to give their views about the home by completing satisfaction questionnaires. The last one was done in March this year and two completed one had been returned to the manager. People using the service and their relatives were also encouraged to express their views about the home at regular meetings. We looked at the minutes of the meeting held in March. These stated that leisure activities and meals were discussed. The Annual Quality Assurance Assessment stated that as a result of listening to the views of people using the service the menus were reviewed regularly in order to meet their individual tastes. Several people using the service had a small amount of money kept at the home to pay for hairdressing and other personal needs. To ensure this was managed safely records of all transactions were kept. We checked two of these during the visit and found them to be up to date and accurate. Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place for people to live and work. Fire alarms and emergency lighting were tested weekly. An up to date fire risk assessment was in place and the care plan for each person using the service included a fire evacuation plan. We looked at records of the routine servicing of equipment. These included an up to date electrical installation certificate and evidence that the testing of small electrical appliances was carried out annually. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. OP9 Standard Regulation 17(1)(a) Schedule 3 (i) Requirement A record of the receipt including the amount of all medication must be kept in order to audit medicines and evidence whether they are given correctly. Outstanding from previous inspection timescale of 31/10/08 not met 2. OP9 13(2) A medication administration 12/06/09 record must be in place for each person using the service who has been prescribed medication. This will ensure the correct amount of medication is given at the right time. To ensure medication is managed correctly a system must be put in place to regularly audit all aspects of the management of medication including staff competence. Outstanding from 2 previous inspections - Timescale 27/06/08 and 31/10/08 not met. Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 25 Timescale for action 12/06/09 3. OP9 24(1) 26/06/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations All care plans should include clear directions for staff to follow to ensure they know exactly what they need to do in order to fully meet the needs of people using the service. All containers of medication should be dated when they are opened. The amount of medication left over from the previous month should be recorded on the new medication administration record. This will ensure medication is managed correctly and also enable accurate checks to be made. When the amount of prescribed medication or the time of administration is changed evidence that this change has been made by a doctor should be available. Medication should only be given to people from the containers they have been dispensed in by the pharmacist. This ensures that the doctor’s instructions are followed and the correct dose is given at the right time. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. A wider range of leisure activities should be offered regularly to enable more of the people using the service to have a fulfilling lifestyle. Paper towels should be made available in communal toilets. This will help to prevent the spread of infection from one person to another. 2. OP9 3 OP9 4 OP9 5 OP9 6 OP12 7 OP26 Hollin Bank House DS0000009433.V375397.R01.S.doc Version 5.2 Page 26 Care Quality Commission North West Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: 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. 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