Random inspection report
Care homes for older people
Name: Address: Manor Hall Borough Lane Eastbourne East Sussex BN20 8BB one star adequate service 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: Suni Chotai Date: 1 2 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Manor Hall Borough Lane Eastbourne East Sussex BN20 8BB 01323-722665 01323647804 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): South Coast Nursing Homes Limited The registered provider is responsible for running the service care home 44 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 44 0 old age, not falling within any other category physical disability Conditions of registration: 0 44 The maximum number of service users to be accommodated is 44. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability - (PD) Old age, not falling within any category - (OP) Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Manor Hall is registered to provide nursing care for up to forty-four residents, and is situated in a residential area of Eastbourne, close to local amenities and public transport with an attractive park nearby. A considerable amount of work has been done to convert two buildings into this large care home, while still retaining many of its original features. A stair lift and two shaft lifts enable residents to access all parts of the home. There are two lounges one in each side of the building. The larger lounge has a dining area and is also used for activities. To the front of the home is a small patio area accessible through the main lounge, and there is an enclosed patio area between the main building and the rear extension. There is some parking at the rear of the building, which is accessible at the side of the home. The current rate of fees can be obtained from the home. Care Homes for Older People Page 3 of 9 What we found:
Suni Chotai, Pharmacist from CQC visited the home for a random inspection to look at medicine management in the home. There had been a recent medicine error resulting in a hospital admission which was being investigated separately. Our visit was to ensure that people in the service receive their medicines safely and as intended by their doctor. We conducted this inspection by looking at storage facilities for medicines, ordering systems for medicines and how medicines are given to people. We also looked at records and care plans relating to medicines. We spoke to five members of staff and we watched some of the lunch time medicines being given to people. We looked at all Medicine Administration Record [MAR] charts for the current cycle. We looked at three care plans to further check individual medicine management guidance for staff. There are two medicine trolleys which are used to take medicines to people. There is a fridge for medicine which is kept at the correct temperature and there are two medicine storage areas to lock medicine safely. Some bedrooms have individual medicine storage cupboards. For medicine which are controlled and have further storage and recording requirements by law, we found the systems to allow safe management and complies with the law. The homes system allows for staff to record medicine received and disposed. We found the home to have adequate facilities to handle and store medicine safely. With regards to record keeping, we found that the home was not completing records as per the homes policy on some occasions. We saw examples where, if the medicine is prescribed as a variable dose, the actual amount given was not always recorded on the MAR chart. There were some Gaps on the MAR chart where we should see either a signature of the person who gave the medicine or a reason recorded for not giving the medicine. On checking further we found that, for some of the medicines, the medicine had been given but the record not completed. The home has an audit sheet to check on these gaps and are striving to improve record keeping using this audit sheet. Gaps on the MAR chart means we cannot be sure that the medicine was given. We saw two British National Formulary [BNF] from 2004 and 2008. This is a reference book giving medicine information and is considered too old to give current medicine information. The home must keep current medicine information for reference. Care plans did not have individual guidance for staff to give medicines to be given only when needed for consistency. For one person there was information that they will take their medicine by themselves. There was no Care plan on this which should include a risk assessment for safety and welfare of the resident. Some people were being given medicine at 6:00 a.m. in the morning. This was questioned and we were told that the people wake up early and this was their choice. This information was not recorded in the care plans viewed. What the care home does well: What they could do better:
Care Homes for Older People Page 4 of 9 The record keeping around medicine use should be completed and accurate to give a clear picture of treatment given. The resident should be included in drawing up a careplan on use of medicines which are to be taken only when needed. 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 7 15 Care plans to be up to date 16/05/2008 and under regular review, with the involvement of residents and/or relatives, to protect residents. Care plans to be up to date 31/03/2010 and reflect the specific need of the residents, with regular reviews, and evidence of the involvement of residents and/or relatives. To ensure that the needs of the residents can be identified and met. 2 7 15 3 27 18 Staffing levels to be reviewed 31/03/2010 and appropriate changes made to ensure that the individual nees of the residents are met. To ensure the home can meet the individual needs of the residents. 4 33 24 The current quality assrance 31/03/2010 and monitoring system to be reviewed and developed. To ensure the home can meet the needs of the people living there. 5 33 26 The resonsible person to visit 31/03/2010
Page 6 of 9 Care Homes for Older People 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 the home, review the services and facilities, and produce a written report. To ensure the service offered and the environment is appropriate to meet the needs of the people living there. Care Homes for Older People Page 7 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 To have records around medicines which accurate, true and completed. So that there is a detailed record of treatment given. 30/04/2010 2 9 13 To have a risk assessment for any medicines managed by the resident. To protect people from harm 31/05/2010 3 9 13 To have individual detailed care plans on medicines which are to be taken only when needed. So that there is consistency and personallised care 31/05/2010 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!
