Inspection on 07/12/09 for Mapleford

This inspection was carried out on 7th December 2009.

CQC found this care home to be providing an Adequate 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

Mapleford 10/02/10

Mapleford 01/10/09

Mapleford 09/06/09

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Random inspection report Care homes for older people Name: Address: Mapleford Bolton Avenue Accrington Lancs BB5 6HN 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: Simon Hill Date: 0 7 1 2 2 0 0 9 Information about the care home Name of care home: Address: Mapleford Bolton Avenue Accrington Lancs BB5 6HN 01254871255 01254231768 mapleford@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Julie Hammond Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mapleford (Nursing Home) Ltd care home 54 Number of places (if applicable): Under 65 Over 65 54 54 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 54 54 The registered person may provide the following categories of service only: Care home 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: Mental Disorder, excluding learning disabilities or dementia - Code MD, Dementia - Code DE. Maximum number of service users who can be accommodated is: 54 Date of last inspection Brief description of the care home Mapleford is a purpose built care home set in its own grounds. It is situated in a residential area of Huncoat close to shops and a Church. It is on a bus route to the town of Accrington which is about 2 miles away. Care Homes for Older People Page 2 of 10 0 9 0 6 2 0 0 9 Brief description of the care home Mapleford provides 24 hour nursing and personal care for up 54 people suffering from dementia or mental health problems. Accommodation is provided in mostly single rooms and 7 double rooms. Some of the bedrooms have en-suite facilities. There are 3 lounges each with with a dining area. A passenger lift facilitates access to all areas of the home. The current fess charged at Mapleford are £430.50 - £1093.01 per week. A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. Care Homes for Older People Page 3 of 10 What we found: We carried out this visit to check how medicines were being handled because we found some shortfalls on our previous two visits that meant some people were being placed at unnecessary risk. The visit was carried out by a Pharmacist Inspector and lasted approximately five hours. Overall we found some improvements in the recording and giving of medicines but we saw some unsafe practice that could lead to serious mistakes when giving medicines to people. Records of medicines received into the home, given to people and disposed of were usually signed and up to date. However, we found some recent mistakes that showed some staff were not always following the correct procedures when giving and signing for medicines. One medicine was not signed as given for 11 out of the last 14 days for the lunchtime dose even though our stock checks showed it had probably been given. We saw two medicines that should be given before food were wrongly given after food because staff had not followed the written instructions. When we arrived at the home we saw some unsafe practice in that a number of medicines were pre-prepared in advance of giving them out. We saw eleven pots containing various medicines on a small tray that was then carried around the home to give to people. This is not safe because medicines could be easily mixed up and given to the wrong person. We also saw that all the medicines were signed in advance of people actually taking them so it was not a true record. The registered manager agreed that the practice of secondary dispensing medicines and signing for medicines in advance of people taking them was not safe. We found that controlled drugs (medicines that can be misused) were not always given in a safe way. On the day of the visit two controlled drugs for one person were signed for in advance of the person taking them and two staff did not properly witness them being administered. This is poor practice that not only increases the chances of mistakes but could also lead to mishandling and misuse. The manager agreed that this was not good practice and that the nursing staff concerned had not followed the correct procedures. We carried out some detailed checks of the stocks and found the majority of medicines had been given correctly. Managers carried out regular checks and these had identified some mistakes and action had been taken to help prevent them happening again. However, we found creams and external medicines were not well recorded. There was no information about whether creams were being currently used and care plans contained no information about how to use them. Most cream records had not been signed so we could not be sure they were being used properly. The manager showed us some new paperwork that had been developed and she began updating the care plans during our visit. We looked at a sample of care plans for medicines handling and related health issues. We found some good information about how to use peoples when required medicines and these were reviewed regularly. However, we found important information missing from some peoples care plans. One person who often refused their medicines had no care plan about how this was to be managed and one member of staff said they sometimes put the medicines in his porridge to make it easier for him to take, the manager agreed that this was not good practice. This same person suffered from epileptic seizures but no care plan was in place about how to manage them. We asked two different staff about what they Care Homes for Older People Page 4 of 10 would do if this person had a seizure and one of them said they did not feel they had the skills to administer the prescribed medication. The manager agreed that there should be a care plan and wrote one immediately. She also said she would make sure all staff had been trained and had the competency to manage seizures safely. 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 5 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 7 15 Care plans must accurately identify and address all the care needs of each person using the service. This will ensure that all the nurses and care workers will know what they need to do in order to fully meet the needs of each person using the service. 31/07/2009 2 8 13 Risk assessments for falls, 31/07/2009 nutrition and the development of pressure sores must be completed for each person using the service. This will ensure that risks are identified and effectively managed. 3 9 13 Records of medicines received into the home and given to people must be clear, accurate and complete. This will make sure all medicines can be fully accounted for. 31/07/2009 4 19 13 Storerooms must be kept locked. 31/07/2009 Care Homes for Older People Page 6 of 10 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 This will prevent people using the service from being injured if they mistakenly enter these rooms. 5 22 13 Nurse calls must be accessible to people using the service in their bedrooms. This will enable people using the service to ask for help when needed. 6 26 16 The unpleasant odour in several bedrooms must be eliminated. This will ensure people using those rooms live in a homely and comfortable environment. 31/07/2009 28/08/2009 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 8 13 Effective systems must be put in place to monitor the safety of medication practices. This will help make sure medicines are handled safely. 24/01/2010 2 9 13 Effective arrangements must 24/01/2010 be put in place at the home to ensure medication is administered to service users in exact accordance with the prescribers directions. This will help make sure peoples health and wellbeing is protected. 3 9 13 Effective arrangements must 24/01/2010 be put in place at the home to ensure medication administration practices are safe and do not put services users at risk from for example secondary potting of medication. This will help make sure medicines are handled 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 safely. 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. 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