Random inspection report
Care homes for older people
Name: Address: Lyme Valley House Care Home 115 London Road Newcastle under Lyme Staffordshire ST5 7HL one star adequate service 09/06/2009 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: Denise Clark Date: 2 7 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Lyme Valley House Care Home 115 London Road Newcastle under Lyme Staffordshire ST5 7HL 01782633407 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ravinder Singh Thiara Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 26 Number of places (if applicable): Under 65 Over 65 0 26 0 dementia old age, not falling within any other category physical disability Conditions of registration: 26 0 26 Age: Dementia (DE) age 55 and above Physical Disability (PD) age 55 and above The maximum number of service users who can be accommodated is: 26 The registered person may provide the following category of service only: Care Home Only (Code PC); 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 (OP) 26 Dementia (DE) 26 Physical disability (PD) 26 Date of last inspection 0 1 0 9 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Lyme Valley House Care Home is a large, Victorian house that has been extended to provide accommodation for a total of 26 people who were elderly; ten may have physical disabilities of whom two may be a minimum of 55 years on admission; ten may have dementia care needs; two may have mental health needs and be a minimum of 60 years on admission. The home is situated on a corner plot, fronting the main A34 road. There are small gardens to the front and side of the property. To the rear there is a large secure, paved patio area with raised flowerbeds; there are also car-parking facilities on site. Lyme Valley House is situated on the A34 dual carriageway and close to the market town of Newcastle-under-Lyme with its wide range of amenities and communal facilities. The A34 road is a main public transport route with access to a wide area. Communal facilities consist of three lounges, a quiet lounge (used by some as a dining area), a large, attractive heated conservatory and dining room. There are three assisted bathrooms and nine separate toilets. There is a laundry, large kitchen and office on the ground floor. The upper floor is accessed via a shaft lift, stair chair lift and staircase. There is an additional staircase that is used by staff only. Gardens are well maintained with mature planting and patio area with garden furniture and parasols for the benefit of people who use the service and their visitors. It is recommended that anyone interested in the home should contact Lyme Valley directly to find out current fees and request a Service Users Guide. It is understood that where accommodation and care needs are publicly funded the home asks for a top up of fees and people will need to clarify this prior to admission. Care Homes for Older People Page 3 of 9 What we found:
The purpose of this visit was to check compliance with the statutory requirement notice issued on 25th September 2009, with a deadline for compliance of 9th October 2009. We looked at arrangements for the recording, safekeeping and administration of medicines and found that the requirements in the notice had been met. We looked at the homes arrangements for storing medicines. Medicines were kept in two medicine trolleys which were secured to the wall in a hallway. Eye drops were kept in the kitchen fridge and controlled drugs were stored in a safe. We saw evidence that a medicine fridge and controlled drugs cupboard have been ordered. The manager told us that she hopes to be able to adapt the present accomodation to create a room for medicine storage. We watched medicines being administered at lunchtime: We saw that medicines were prepared for one person at a time and the medication record was signed after each administration. However, we noted that the medication record was left on the medicine trolley in the hall and not carried with the medicine to the persons side. When painkillers, prescribed to be taken as required, were given to people a second sheet was filled in and the reason for administration was recorded. Another medicine, prescribed to be taken when required for agitation, was being given regularly at night. There was no written guidance (protocol) to help staff decide when and whether the medicine should be given. We also saw that eye drops and an inhaler were administered to people in the dining room. These people consented to receive their medication but we did not see any record in their care plans saying they had chosen to be given their medicine in a communal area rather than in their own rooms. Medicine charts were left unattended in the hallway at the end of the medicine round. The manager told us that she had assessed the ability of all staff who administer medicines to carry out this task safely. One member of staff confirmed that the manager had watched her giving medicines recently. We counted a sample of tablets and found that the quantities matched the homes records. We saw that medicine charts were completed correctly. Two people were administering their own inhalers. There was no record in their care plans to say that these people were able to use inhalers correctly and safely. We visited one of these two people in their room. We found that the persons inhalers were unlabelled, and that there was no lockable facility for storing medicines in the room. We also found that a gel prescribed for another person was labelled use as directed, with no information as to how often and how much gel should be applied. The home had contacted the doctor to find out. What the care home does well: What they could do better:
There was no written guidance (protocols) to help staff decide when and whether painkillers and other medicines prescribed to be taken when required should be given. We also saw that eye drops and an inhaler were administered to people in the dining room.
Care Homes for Older People Page 4 of 9 There were no records in these peoples care plans to show they had chosen to be given their medicines in a communal area. The ability of people to administer their own medicines, including inhalers, safely was not assessed and documented. There was nowhere for medicines to be locked away in the room of one person who administered and stored their own inhalers. 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 £ 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 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 Risk assesments and written 15/01/2010 protocols must be in place to cover all areas of medication practice, including self administration and the administration of when required medication To promote the health and welfare of people using the service 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 A lockable storage facility should be provided for people who self-medicate to store their medicines, including inhalers Medicine charts and other personal information should not be left unattended in a communal area Staff should ensure that peoples privacy and dignity is respected when administering medicines such as eye drops, inhalers and creams. The pharmacy should be asked to label all medicines,
Page 7 of 9 2 3 9 9 4 9 Care Homes for Older People 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 including inhalers, with full dosage instructions 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. 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 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!
