This inspection was carried out on 18th January 2010.
CQC has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
Random inspection report
Care homes for older people
Name: Address: Wykenhurst Residential Home 17-19 Baggallay Street Hereford Herefordshire HR4 0DZ new service which has yet to be given a quality rating 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: Morag Ross Date: 1 8 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Wykenhurst Residential Home 17-19 Baggallay Street Hereford Herefordshire HR4 0DZ 01432278435 01432344705 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) July V11 Ltd T/A Wykenhurst Residential Home Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 27 Number of places (if applicable): Under 65 Over 65 0 0 0 27 0 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: That service users are over 45 years of age 27 0 27 0 27 That the maximum number of service users accommodated be no more than 24 people That there be no further service users admitted to Wykenhurst
Care Homes for Older People Page 2 of 8 The registered person may provide the following categories of service only Care Home only Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories Mental Disorder Code MD maximum number of places 27 Physical disability Code PD maximum number of places 27 Old age, not falling within any other category Code OP maximum number of places 27 Dementia Code DE maximum number of places 27 Date of last inspection Brief description of the care home Wykenhurst is registered to accommodate up to twenty-seven adults who may require care due to a wide range of care needs. These can include (for those over 65 years) general frailty associated with increasing age, physical disabilities or mental health issues. People aged under 65 years who have care needs arising from their mental health may also be accommodated as well as one younger person with a physical disability. The home consists of adjacent Victorian period houses that have been converted to one property. It is located in one of the original residential areas of Hereford and is within easy reach of the city centre. There are also local facilities e.g. shops, church and public house in close proximity and it is on a main bus route. There is a shaft lift for access. There are sitting rooms, a separate dining room, a hairdressing room and a reasonably sized, accessible and secure garden. The schedule of fees is available from the home. Additional charges are made for hairdressing, chiropody, dry cleaning, toiletries and newspapers (2 papers are provided each day for general use). Care Homes for Older People Page 3 of 8 What we found:
The pharmacist inspector visited the home on 18th January 2010 to check the management and control of medicines within the service. Although Wykenhurst has recently been registered with the Commission as a new service, we have a high level of concern about the quality of this service and risks to people using it. At the last key inspection before the change in registration, the service was rated as a zero star (poor service). The providers then failed to comply with seven statutory requirement notices and there are several on-going safeguarding investigations. For these reasons, the company has been registered with conditions applied, as listed above. We will be carrying out a full inspection of this service soon, but because of the risks which we had identified at previous inspections, we carried out an unannounced inspection focused on the areas of highest risk. We arrived at 11.20am and stayed until 2:10pm. We looked at the medicine records, some care plans and medicine storage. We spoke to two people who live in the home, one member of staff, the Deputy Manager and the Manager. The Manager explained that changes had been made to medicine management including changing pharmacy supplier and that they were currently updating peoples care plans with regard to medication. The Manager told us that the service was working hard to ensure medicine was handled safely. We looked at the medication administration record (MAR) charts and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We saw that some of the MAR charts were slightly confusing, particularly for medication to be given when required. The service was documenting when medication was not required and countersigning this record. Whilst we acknowledge that the record was accurate it is important to ensure that the record is clear. We discussed this with the Manager and Deputy Manager. The Deputy Manager informed us that checks are also made on the records to ensure that they are correct and up to date, however this was not documented. This means that there were improved arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labelled and supplied for. We found that other medication records were generally up to date. For example, we saw current records for the receipt and disposal of medication. The date of opening of boxes and bottles of medicines were usually recorded and balances of medication were carried forward from old records to new records.We found that counts and checks made on the majority of medication was accurate, which showed that people who live in the service were being given medication as prescribed by a medical practitioner. Overall,the medication records helped to ensure there was a clear audit trail of medication. We spoke to two people who live in the home. One person looked after their own medication and told us that they were very happy with this arrangement. We looked at their individual care plan and saw that there was a detailed Medication Risk Assessment available dated December 2009. It was detailed, comprehensive and person centred. The second person we spoke to was independent and understood what their medicines were prescribed for. One of the medicines was a tablet to be given when required for anxiety
Care Homes for Older People Page 4 of 8 and agitation. The person told us exactly when it should be given and that they would request it when they felt anxious.We looked at the persons MAR chart and saw that the tablet had been given ocassionally at 5pm. We looked at the persons individual care plan and saw that there was a Care Plan Monitoring document which explained that the tablet had been requested by the person recently. There was no protocol available which explained about the persons individual behaviour requirements or under what circumstances the tablet should be given, however we were told by the Manager and Deputy Manager that this was due to be completed very soon. The person also told us about an injection they received from a clinic every month.The injection was not documented on the current MAR chart and we could not find reference to it in the persons care plan, which means that not all relevant information about the persons healthcare requirements were recorded.We discussed this with the Manager and Deputy Manager. We saw that one person had recently been prescribed three new medicines. We saw that the MAR chart had been handwritten with a double checking system in place to ensure the information was correctly recorded. We looked at the persons individual care plan and saw a Medication risk Assessment dated December 2009, however it had not been updated to include the three new medicines. We spoke to the Manager and deputy Manager who told us that the medicines had recently been started and that the care plan would be updated. We gave feedback to the Manager and Deputy Manager. Overall we found that there was an improvement in medicine management by the service, which ensured that medicines were being given safely to people who live in the service. 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 8 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 6 of 8 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 1 9 13 Regulation 13(2). To make 26/02/2010 arrangements to ensure that care plans include detailed information and instructions for staff in respect of the administration and management of medicines, including the reasons to give medicines on a when required basis and what constitutes needed for a named person. To ensure staff know when and how to give the medication. 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 7 of 8 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 8 of 8 - 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!
