Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Margaret House 221 Manchester Road Burnley Lancashire BB11 4HN The quality rating for this care home is: The rating was made on: two star good service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Stephanie West Date: 1 7 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Margaret House 221 Manchester Road Burnley Lancashire BB11 4HN 01282423804 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Gordon Fell care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia 11 11 Over 65 0 0 Conditions of registration: The registered person may provide the following category/ies 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: Dementia Code DE (maximum number of places: 11) Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places: 11) The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief description of the care home Margaret House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for 11 people, whose main care needs are mental health difficulties. Mr Fell the owner manages the home on a day-to-day basis. The home is located in a residential area of Burnley and is adjacent to Scott Park. There are pleasant accessible garden areas to the front and sides with a lawn area to the side Care Homes for Older People Page 2 of 9 and rear of the home. A bus stops outside the home, on route to the town centre. Accommodation offered is in single rooms, fitted with an emergency call system. Information about the service is available from the home for potential residents in a Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £502:50 and £602:50. Residents are responsible for purchasing optional extras such as hairdressing, and private chiropody. Care Homes for Older People Page 3 of 9 What we found:
The home was randomly selected for a visit to look at the arrangements for handling medication. The visit lasted approximately two and a half hours and involved discussing the handling of medication with senior staff, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the owner. Overall, we found that medication was mostly well managed but there were some areas that could be improved to help ensure people are best protected. We looked at how medicines were administered. Care was taken to ensure that any special instructions such as before food were followed and there was some flexibility in the times that medicines were administered for example, if people chose to stay up later in the evening. Where people needed medicines outside the normal medication rounds staff were careful to ensure medicines were given at the right time. Where people were prescribed medicines when required we found written information for staff providing guidance about when they may be needed, and how this need may be made known. Staff explained that one persons capsules were opened-up as they found them hard to swallow but information about this was not written down. It is important that checks are made with the prescriber and recorded to help ensure the best and safest arrangements are made. Home remedies (non-prescribed medicines that can be purchased from a chemist shop) are not kept at the home but we saw two examples where they had been given. If non-prescribed medicines are used a clear policy and procedure describing their safe use needs to be implemented. Residents were able to look after and take their own medicines if they wished to and were able, and this helped them to remain independent. One person had chosen to apply their own cream. They were happy with the arrangements in place and when asked, said they did not run out. But, written assessments had not been completed. The level of support provided by staff to help ensure safe self-administration should be recorded and reviewed at regular intervals. Similarly, arrangements need to be assessed and recorded when medicines are supplied for people to take when away from the home. We looked at medication recorded keeping and found that overall records for the receipt and administration of medicines were clearly maintained. Most medicines were supplied in a monitored dosage system; this was used correctly helping to ensure medicines are administered as prescribed. However, where medicines were supplied in traditional containers (e.g. boxes and bottles) it was not possible to track (account for) their safe handling. This was partially because some medicines were not kept in the original pharmacy-labelled container but instead the loose foils were banded together. And additionally because, where stocks of medicines were carried forward to the next month, the qualities were not shown on the new paperwork. Medicines should normally be safely stored in and administered from the original pharmacy-labelled container. Medicines were safely locked away but the storage arrangements should be reviewed. We found that most medicines were kept in the central medicines cupboard, but some Care Homes for Older People Page 4 of 9 were also kept in another office. This made the stock control more difficult. Unusually one persons insulin was kept in a fridge in another persons own room. The home did not currently handle controlled drugs but should any be prescribed the home will need a legal controlled drugs cupboard, due to a change in law. All staff handling medication have completed certificated training. But, although medication guidance was available, there was no clear medication policy offering staff guidance about the handling of medicines at the service. This needs to be addressed to help ensure consistency in the handling of medication at the home. The supplying pharmacist carried out audits (checks) at the home but regular written in-house audits were not competed. Carrying out regular audits will help ensure that medicines are well managed and that should any weaknesses arise, that they would be promptly addressed. 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 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
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, Care Homes 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 Medicines must be normally 19/01/2009 kept in and administered from the original pharmacylabeled container and record keeping be such that the safe handling of medication can be accounted for. 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 Where medicines are self-administered or supplied for administration away from the home this should be assessed and the agreed arrangements documented, to help ensure people are supported in the best and safest way. A comprehensive medicines policy and procedure should be implemented providing staff clear written guidance about the safe handling of medicines at the service. Regular medicines audits should be completed to help ensure medicines are safely handled and that should any weaknesses be identified, that they will be quickly addressed. Where capsules are opened or if tablets are crushed, the prescribers advice should be sought and recorded to help Care Homes for Older People Page 7 of 9 ensure it is done in the best and safest way. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI 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!
