Random inspection report
Care homes for older people
Name: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ two star good service 25/08/2009 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: Jane Poole Date: 2 9 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ 01935474520 01935432380 cmbw@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Christopher Michael Bruce Wharton care home 14 Number of places (if applicable): Under 65 Over 65 14 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who may be accommodated is 14. The registered person may provide the following category 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 category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Latimer Lodge Residential Home is part of a continuing care complex that includes Tyndale Nursing Home, which provides nursing care and Coverdale Court, which is a sheltered housing complex. All businesses are run entirely independently but come together to share resources, interests and activities.
Care Homes for Older People Page 2 of 10 2 5 0 8 2 0 0 9 Brief description of the care home Latimer Lodge Residential Home is a fourteen-bed care home providing personal care for older people. It is situated close to the centre of Yeovil. It stands in its own gardens, in close proximity to Tyndale Nursing Home and Coverdale Court. There is good access for frail people and wheelchair users, including pleasant garden areas. Car parking is available. Communal rooms and some bedrooms are located on the ground floor with further bedrooms on the first floor, some of which are very spacious. A passenger lift is available. Care Homes for Older People Page 3 of 10 What we found:
This random inspection was carried out in response to concerns raised on behalf of a person who had a short stay at Latimer Lodge. The concern was that the medication returned to the service user after their stay showed that they had not received all medication prescribed during their stay. We, the Commission, visited the home and looked at Medication Administration Records (MARs) for people living at the home and the person who had had a respite stay. We also looked at the care plan for the person who had stayed at the home. The home uses a monitored dosage system with printed MARs for permanent residents. The recording on these MARs matched the medication held for each person in all but one instance where there was a one tablet discrepancy. The MAR for the person who had stayed on respite was hand written and had not been checked and signed by a second person. One medication was dispensed in a box of 56 tablets and the other was dispensed in 4 Dossett boxes. The MAR chart did not state the number of tablets received into the home or the number returned to the service user. The dispensing pharmacist was contacted by phone and they confirmed that the dossett boxes had contained a total of 23 morning doses of medication and 24 evening doses. The MAR chart showed that 12 morning doses and 12 evening doses had been signed for as being given. This should have meant that 11 morning doses and 12 evening doses were returned to the service user after their stay. 15 morning doses and 15 evening doses were returned meaning that on 7 occasions medication had been signed for but not given. One medication was dispensed separately in a box containing 56 tablets but again this was not recorded on the MAR chart. Instructions on the box, and the hospital discharge summary, stated that the medication should be given twice daily. The hand written entry on the MAR stated once daily and as this had not been checked by a second person, in line with good practice guidelines, it meant that the entry had not been corrected and the person did not receive this evening medication on all 12 nights of their stay. Although the Dossett boxes are clearly marked with days of the week, so that it can be clearly seen which have been used, the home did not follow this pattern and appear to have given the medication from random days. This meant that any medication not given was not immediately noticed and there is no clear audit trail to identify which staff had signed the sheet without giving the medication. During the persons stay concerns were raised about their poor food and fluid intake. The doctor was contacted and liquid supplements were prescribed. These were not recorded on the MAR and there was no evidence in the care plan to say that they had been given.
Care Homes for Older People Page 4 of 10 The running records show that on two occasions the person was assisted to take a GTN spray, again this was not recorded on the MAR as a prescribed medication. Running records written by care staff showed that the person did not choose to socialise and spent much of their time in their bedroom. The care plan showed that after the first night of their stay the person had preferred to sleep in an arm chair and a pressure relieving cushion had been put in place. In the running records it is unclear whether the person had spent each night in their chair or in the bed. 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
Care Homes for Older People Page 5 of 10 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 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 (2)Medication must be 26/09/2009 administered in line with the instructions on the Medication Administration Records. To ensure that people receive the prescribed dosage and that its effectiveness can be monitored. 2 29 19 (1) schedule 2. No staff should begin work in the home until two written references have been received. To minimise the risk s of abuse to people who live at the home. 31/08/2009 3 31 18 (1) The registered person must keep the management arrangements under review. To ensure that at all times there are clear lines of responsibility and accountability. 31/12/2009 Care Homes for Older People Page 7 of 10 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 (2) The registered person must ensure that a suitable system is in place for the audit of medicines and that regular audits are carried out. To ensure that all medication is accounted for and given as prescribed. 09/04/2010 2 9 18 (1) The registered person must ensure that all staff who administer medication are competent in this area and their competency is regularly assessed. To minimise the risks of mistakes in the administration of medication. 09/04/2010 3 9 13 (2) The registered person must ensure that there are safe and robust systems in place for the recording and administration of medications, including medicines for temporary residents. 09/04/2010 Care Homes for Older People Page 8 of 10 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 To ensure that people receive medications as prescribed. 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 9 of 10 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 10 of 10 - 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!
