Inspection on 30/12/09 for Langdale View

This inspection was carried out on 30th December 2009.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langdale View 10/12/09

Langdale View 10/07/09

Langdale View 01/04/09

Langdale View 28/10/08

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/04/2010.

Random inspection report Care homes for older people Name: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB two star good service 01/04/2009 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: Mathias Foundling-Miah Date: 3 0 1 2 2 0 0 9 Information about the care home Name of care home: Address: Langdale View 590 Gypsy Lane Leicester Leicestershire LE5 0TB 01162762186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Lucinda Nicholls Type of registration: Number of places registered: Conditions of registration: Category(ies) : Yasmin Kassam,Neemat Kassam care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Conditions of registration: 34 0 The maximum number of service users who can be accommodated is: 34 The registered person may provide the following categories 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 fall within the following categories: Old Age not falling within any other category - Code OP . Dementia Code DE Date of last inspection 1 0 0 7 2 0 0 9 Care Homes for Older People Page 2 of 11 Brief description of the care home Langdale View is registered to accomodate 34 older people and is also registered to accomodate people with dementia and who need nursing care. The home is a converted older building on the outskirts of Leicester City. Accomodation is on three floors which can be accessed by a passenger lift. There are two lounges and a seperate dining room on the ground floor. Care Homes for Older People Page 3 of 11 What we found: Previous concerns were evidenced during a visit by Debbie Williams (Regulation Inspector) on a Key Inspection on 10th December 2009. The reason for the pharmacist Inspection visit on 30th December 2009 was due to concerns raised and regarding an incident involving a person wearing two controlled drug patches with one not being removed. The staff incorrectly believed it contained no further drug. The manager had left and the service was being run on agency nurses. The pharmacist Inspection visit on 30th December 2009 involved examination of medicines, storage facilities, medicine charts and records. We case tracked two people living in the service. Discussions took place with the Management Consultant, the Senior Agency Nurse in charge and Agency staff on duty, during the time of the inspection. Feedback was provided and the outcome of this inspection is as follows: This inspection has identified that there was a lack of policy and procedures particularly for care with nursing. Improvements could be made which includes the induction training of agency staff, monitoring and checking of medicines administered in the home. A management consultant has recently undertaken to manage the home and is currently overhauling the medication management system. During the Inspection we met the agency nurse in charge today, who informed us Just to let you know-my first day today here-from agency. This member of staff including other staff members had no prior induction training of this home. We were informed by the management consultancy that an external agency would provide three day induction training. This would be followed up by the home to provide geography induction of the home and then double up and shadow a senior clinical staff member. We observed that an authorised member of staff handled keys to the medicine units and medicine cupboards. The drug trolley was securely linked to the wall. There was a suitable locked controlled drugs (CD) cabinet in place. The medicine treatment room was being organized; we found neatly stored medicines and supplements. However we observed three oxygen cylinders were not stored safely and found unsecured without chains to prevent a risk of them falling. Recently a cupboard was replenished with dressings and preparations necessary for nursing care of people living in the service. The sample controlled drug (CD) balances (including patches) were correct and these reflected accurately in both the appropriate CD register and medicine chart. The CD cabinet and other storage cabinets were in a clean organised and a tidy state. Care Homes for Older People Page 4 of 11 During Inspection we observed some over stocking of medication including Insulin in the home. The home was informed to continue to improve this process and to segregate the Insulin into individual sealed containers as there was more than one insulin vial opened for people living in the service. We found that a person living in the service previously had a fall in May 2009 and fractured a bone. This was correctly reported to the commission. However there was no review of trips and falls risk assessment carried out by the home. This person wore varifocal lenses, had cataracts and was prescribed a sedative. The fridges contained several medicines including creams and Insulin, the majority with the date of opening. Majority of medicines were stored correctly in the fridge and in accordance with the manufacturers storage directions. However some creams and Insulin found in use do not require refrigeration. The staff were made aware to follow manufacturers storage temperature specification. We informed the staff that insulin if injected cold was painful. The medicine fridge in the treatment room needed defrosting, however the current temperature was recorded within the correct range. There was daily monitoring and recording of fridge temperature and the outside room temperature. However the policy incorrectly stated readings should be between 1-8. The home had no max-min thermometer which was suitable for storage of medicines. The failure to store medicines at the proper temperature could result in people in service receiving a treatment that is ineffective. Regular monitoring checks of medication administration were not made by the home to ensure that people living in the service received medicines correctly. We were informed that the Management Consultancy are installing a checking system to ensure that all the medicines are administered as prescribed at all times, to maintain the improved level of medicine management which was now taking place. The sample audits undertaken indicated that generally medicines were administered and staff followed instructions as the doctor prescribed. However we found a once weekly medication which was not administered at 7am and some variable doses did not always indicate whether one or two tablets were administered. During the inspection we observed the lunch-time medication round. We observed that staff by passed this once weekly medication on the medicine chart. They explained the reason that it was written by night staff on the 7am dose as out of stock. However on examining the drug trolley we found an unused full box of this medication which was immediately administered by staff during lunch-time. Medicines were hygienically taken out and straight into medicine pots. A glass of water was provided. Medicines were administered with a friendly patient approach. This was carried out with respect and in a dignified way. However the staff did not follow the manufacturers recommendation. Staff should have administered this medication half an hour before food or an empty stomach, preferably with the person living in the service standing up to properly take this medicine. A currently used bottle of eye drops was found in the fridge which we were informed by staff that they would administer this straight from the fridge into the persons eyes. They were not aware that this could now be kept at room temperature once opened. Staff were not fully aware of particular medicines with cautionary and advisory measures. Care Homes for Older People Page 5 of 11 The management consultancy have separated and discarded all previous medications found on the premises which have been separated form current medication and stored in a secure cabinet ready for disposal. However all medicines for disposal have not been recorded to ensure a clear audit trail. The home has made arrangements and were waiting collection from a registered disposal company. We found several large blue bags containing used medicine cassettes to be returned to the pharmacy. However these were not securely and separately stored away to reduce the risk of mal-administration of medicines. The home has not put a system in place to ensure medication administration competency including assessment of competency of medication management. The home lacks medication policies for staff and agency staff to safely and competently follow procedures necessary in this home. This could potentially compromise the health and welfare of people living in the home. The management consultant has informed us that they will dealing with this and updating the policies. 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 6 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 4 18 Staff must receive training in 30/10/2009 caring for people with dementia and the safe management of challenging behaviour. This is to ensure people have their needs met and are protected from harm. 2 18 13 Staff must receive training regarding safeguarding policies and procedures. This is to protect people living at the home from harm. 12/10/2009 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 A quality assurance system 28/02/2010 must be installed to assess all staff including agency staff competent in their handling of medicines. Appropriate action must be taken when these indicate that medicines are not administered as prescribe and records do not reflect practice, to ensure that all medicines are administered as prescribed and this can be demonstrated. To safeguard the health and welfare of people living in the home. The medicine policy must be 28/02/2010 reviewed to ensure that it reflects current practice and relevant to the nursing care at this home, including, Individual risk assessments for falls and trips; when required PRN medicines; administration of medicines Page 8 of 11 2 9 13 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 by specialised techniques including rectal administration, buccal midazolam, Insulin Injection, PEG feed, vaccines, anaphylaxis and oxygen. The signed policy date and the next review date must be recorded on the policy.The staff must receive training to adhere to it. To safeguard the health and welfare of people living in the home. 3 9 18 The Registered Manager 28/02/2010 must ensure all staff including night and agency staff responsible for medicines administration including invasive or specialised techniques has the necessary Induction, skills and training. In house training schemes must have a body of up to date knowledge in the subject of medicines to include medicines with cautionary and advisory measures including for example Insulin, patches, eye drops and once weekly medicine doses. To safeguard the health and welfare of people living in the home. Care Homes for Older People Page 9 of 11 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 To action secure storage of medicines to be returned and awaiting collection. Oxygen cylinders to be securely kept or chained to a wall to prevent a risk of them falling. The policies and procedures relating to the handling of medication should be reviewed and updated in line with the guidance from the Royal Pharmaceutical Society document The Handling of medicines in Social Care settings published 2007. 2 9 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!