Random inspection report
Care homes for older people
Name: Address: Lakeland View Nursing & Residential Home 220-224 Heysham Road Morecambe Lancashire LA3 1NL two star good service 08/05/2008 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: Lesley Plant Date: 2 1 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Lakeland View Nursing & Residential Home 220-224 Heysham Road Morecambe Lancashire LA3 1NL 01524410917 01524833216 lakev@gotadsl.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Bernadette Ann Wallbank Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Frank George Gregory Nicholls care home 33 Number of places (if applicable): Under 65 Over 65 0 33 dementia old age, not falling within any other category Conditions of registration: 33 0 The registered person may provide the following category of service only: Care home with nursing - Code N. 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, Dementia - Code DE. The maximum number of service users who can be accommodated is: 33. Date of last inspection Brief description of the care home Lakeland View is registered with the Commission to provide nursing and residential care for older people and for people with dementia. The maximum number of people who can be accommodated is 33.
Care Homes for Older People Page 2 of 9 0 4 0 6 2 0 0 9 Brief description of the care home The home is located in the Heysham Road area of Morecambe, close to bus routes and shops. Lakeland View has three floors and there is a passenger lift in place. There is parking space and a small garden area to the front of the building, with a patio to the rear of the dining room. The home provides a range of communal living rooms including two main lounges, a small conservatory, a separate lounge for those people who smoke and a large airy dining room. There is a Statement of Purpose, Service Users Guide and Information Pack that is given to all prospective residents; this is a set of written information that tells you about the care service that is offered and what the resident can expect if he or she decides to live at the home. The home is owned by Mr Frank Nicholls and the registered manager is Mrs Bernadette Wallbank. Details of the current fees can be obtained by contacting the home. Care Homes for Older People Page 3 of 9 What we found:
This visit was carried out in response to a letter of concern which had been received by the CQC. This information raised potential issues regarding the management of medication and the management of some employees. We were accompanied by two representatives from North Lancashire Primary Care Trust, including a pharmacist and a representative from the local authority. Eleven members of staff were spoken to and the pharmacist examined medication, associated records and the systems in place for the storage, administration and disposal of medication. Some staff spoken to raised concerns about proposed changes to the rota and shift system and did not appear to know the reasons for these changes. Some staff also stated that they found the owner difficult to approach, that the response they would receive varied from day to day and that the owner did not always respond appropriately or professionally when dealing with staff. This was discussed with the registered provider who explained that changes to the shift system were being made in order to better meet the needs of those living at the home. The registered provider did not accept that their approach with staff could be seen as inappropriate or unprofessional. It was also evident that many staff had worked at the home for many years and their was nothing to suggest that that those living at Lakeland View were not getting a good standard of care and support. The management of medication was discussed with staff, the majority of whom said that they were not aware of any problems in this area. No member of staff spoken to had directly witnessed the registered provider mismanaging medication. The registered provider explained that although he has access to the medication kept at the home, he rarely administers medication and when does so, correct procedures are followed. The audit by the pharmacist from the Primary Care Trust raised a number of concerns and identified improvements to be made. The registered manager is currently not on duty at the home. The home was previously registered under the name of the owner, who acted as a sole trader. The ownership of the home has changed to that of a limited company, which has registration implications for the CQC. What the care home does well: What they could do better:
This inspection visit was carried out to look into specific areas of service provision and did not look at other areas. Although requirements made at previous inspections were not assessed during this visit, the registered provider did confirm that these had been attended to.
Care Homes for Older People Page 4 of 9 The registered provider and registered manager must maintain good personal and professional relationships with each other and with staff. It is important that as well as receiving information regarding the reasoning behind proposed changes to shift patterns, staff have opportunity to air their views and discuss with the owner any implications they feel these changes may have. The registered provider must inform the CQC in writing about the temporary management changes at the home and provide details of the interim management arrangements, ensuring that satisfactory management support is in place. The registered provider must apply to the CQC to register the home as being owned by a limited company. The audit by the pharmacist from the Primary Care Trust raised a number of concerns and identified improvements to be made. There needs to be tighter recording of stock and administration of all medications. When a medication is refused or wasted, then this should be clearly recorded. The medication administration sheets could be clearer. On some records it was difficult to distinguish the difference between an initial confirming administration and the letter H, which denotes the patient was in hospital. Records should be kept of any medication taken into hospital and any medication brought back from hospital into the home. Where medication is prescribed as one or two tablets as required, the medication administration record should show how many tablets have been administered. The home should consider keeping a running balance of codeine stock due to the potential for abuse. The room where the medication was stored was very warm. Staff advised this was made worse by the room being directly over the laundry. A thermometer in the room read 28 degrees; however some medication must not be stored above 25 degrees. This problem should be addressed. Some of the medication boxes were full for some individuals, posing a risk that medication could fall into neighbouring boxes. A lot of service users were receiving paracetamol and codeine, instead of co-codamol. The nurses spoken to did not know if this was a request from the GP, the home or the pharmacy. The reasoning for this needs to be explored. There needs to be an audit trail for the Controlled Drug cupboard key. There should be consideration of a change in ordering and processes to cut down on waste medication. These improvements will help to ensure that a clear audit trail can be made of all medication and that medication is stored, administered and disposed of appropriately. The registered provider must ensure that there are robust arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. 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 19 23 All parts of the home must be reasonably furnished and decorated. Staff must not commence duty until all the necessary checks have taken place. (previous timescale of 07/08/06 not met) The Registered Person must comply with all conditions of registration. To fail to do so would be an offence under the Care Standards Act 2000. 30/09/2008 2 29 19 31/05/2008 3 31 43 12/06/2009 4 38 13 Cleaning products must be safely stored. 31/05/2008 Care Homes for Older People Page 6 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 1 9 13 The registered provider must 12/07/2010 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. To protect the health and welfare of service users. 2 31 39 The registered provider must 01/08/2010 apply to the CQC to register the home as being owned by a limited company. In order for the home to be appropriately registered with the CQC. 3 31 12 The registered provider and registered manager must maintain good personal and professional relationships with each other, service users and staff. This will help all concerned to function as a team and promote a pleasant atmosphere at the home. 12/07/2010 Care Homes for Older People Page 7 of 9 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 4 31 39 The registered provider must 12/07/2010 inform the CQC in writing about the temporary management changes at the home and provide details of the interim management arrangements, ensuring that satisfactory management support is in place. In order that the CQC has up to date information about the management of the home. 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!
