Inspection on 07/06/10 for Meadow Lodge Care Home
Also see our care home review for Meadow Lodge Care Home for more information
This inspection was carried out on 7th June 2010.
CQC found this care home to be providing an Poor 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.
Random inspection report
Care homes for older people
Name: Address: Meadow Lodge Care Home 445 Hagley Road Edgbaston Birmingham West Midlands B17 8BL zero star poor service 24/09/2009 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: Debby Railton Date: 0 7 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Meadow Lodge Care Home 445 Hagley Road Edgbaston Birmingham West Midlands B17 8BL 01214202004 01212468279 info@meadowlodgecarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Coseley Systems Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 22 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) 22 Date of last inspection Brief description of the care home Meadow Lodge is situated on the Hagley Road a short distance from Bearwood shopping centre. Bearwood has a variety of facilities including banks and public houses, shops and a library. Public transport into the City Centre is available directly
Care Homes for Older People Page 2 of 9 0 4 0 2 2 0 1 0 Brief description of the care home outside of the home. The home was originally two dwellings and has been converted to provide accommodation for up to 22 older people. The home has four shared and fourteen single bedrooms. The home has two lounges and two dining areas. Shower and toilet facilities are provided on the first and ground floors. On the first floor there are two bathrooms with bath seat lifts. There is a stair lift in the home. To the rear of the home there is a large garden that people living in the home can use. To the front of the home is a forecourt that provides some car parking. The home has a ramped access available. The service user guide/welcome pack states that the fees at the home are per regional Social Service/Council body contracts and the fee for people who are paying privately is 365 pounds per week. Care Homes for Older People Page 3 of 9 What we found:
The pharmacist inspection lasted four and a half hours. The reason for the inspection was to check compliance with the two requirements left at the last key inspection on 17th March 2010 regarding the poor medicine management in the home. These two requirements were both breached at this inspection. Due to the serious nature of the breaches further enforcement action will take place. Failure to meet the Regulations may result in prosecution. The owner and senior care assistant were present throughout the inspection and one care assistant who administered medicines was also spoken with. Three peoples medicines were looked at, together with their Medicines Administration Record (MAR) charts. Other records relating to medicines were also inspected. All the medicines were kept in a medicine trolley used to transport the medicines to the people who lived on the ground floor. Some medicines that were no longer needed were kept in a cabinet awaiting return to the pharmacy for destruction. The home had installed their own auditing system. This was a time consuming lengthy system of counting all the medicines in the trolley and comparing these with the MAR chart . This took place on a weekly basis. It could not identify who was responsible for any of the errors found. Two errors were identified during this home audit undertaken by the owner and senior care assistant. Audits by the pharmacist inspector from the Commission showed that medicines had not been administered as prescribed. Some medicines had been recorded as administered when they had not been. Others were unaccounted for. Incorrect doses of medicines had been administered and not as the doctor prescribed. Staff admitted administering one strength of medicine but recording they had administered another strength. It was not possible to ascertain exactly what medicines had been administered in some instances. This is of serious concern. One medicine had been recorded as not administered as there was none available. Audits indicated that they should have been enough on the premise but the medicine was not administered for four doses whilst a new supply was obtained. All medicines must be available for administration at all times and systems should be in place to ensure they are ordered and dispensed in time to ensure a continuous supply. Residents were allowed to self administer some of their medicines but no risk assessments had been undertaken and no compliance checks had been documented to demonstrate that they could safely take their medicines as prescribed. Staff still signed the MAR chart that they had offered one medicine even when they had not. This is of serious concern as records did not reflect actual practice. There was no formal system of recording medicines received from the hospital. It could not be confirmed exactly what the new prescribed dose was for two medicines for one person recently discharged from hospital. Staff had failed to follow their homes medicine procedures and policies for checking in medicines. Staff did not always record external
Care Homes for Older People Page 4 of 9 healthcare professional advice or other communication accurately or in a consistent place. Staff had recorded three different doses for one medicine and none could be confirmed for accuracy. 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 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 The medicine chart must 17/04/2010 record the current drug regime as prescribed by the clinician. It must be referred to before the preparation of the service users medicines and be signed directly after the transaction and accurately record what has occurred. This is to ensure that the right medicine is administered to the right service user at the right time and at the right dose as prescribed and records must reflect practice 2 9 13 All medication dose regimes 17/04/2010 must be clearly written on the medicine chart, checked by a second member of staff for accuracy. This is to ensure that the staff have clear directions to follow. 3 26 13 Practices in the home should 30/04/2010 follow good infection control policies. This will ensure that that cross infection is minimised. 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 A quality assurance system 29/06/2010 must be installed to assess individual staff competence in their handling of medicines. Appropriate action must be taken when these indicate that medicines are not administered as prescribed and records do not reflect practice. This is to ensure that individual staff practice is assessed on a regular basis to ensure that the medicines are administered as prescribed 2 9 12 All medicines must be available for administration at all times. This is to ensure that all service users have their medicines as the doctor prescribed. 29/06/2010 3 9 13 All service users that wish to 29/06/2010 self administer their own medicines must be risk assessed as able to do so
Page 7 of 9 Care Homes for Older People 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 and regular compliance checks undertaken and documented to confirm that they take the medicines as prescribed. This is to ensure that they can and do handle their medicines 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 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!
