Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Milbanke HFE Station Road Kirkham Lancashire PR4 2HA The quality rating for this care home is: The rating was made on: one star adequate 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: Simon Hill Date: 1 5 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Milbanke HFE Station Road Kirkham Lancashire PR4 2HA 01772684836 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Lancashire County Care Services care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability 15 1 0 7 Over 65 0 0 21 0 Conditions of registration: The home is registered for a maximum of 44 service users to Include:-: upto 21 service users in the category OP (Old Age not falling into any other category) upto 7 service users in the category PD (Physical Disability) upto 15 service users in the category DE (Dementia) up to 1 service user in the category MD (Mental Disorder) Service users in the physical disability category may only be accommodated in the 7 bedded rehabilitation unit, which must not accommodate any service user under the age of 55 years. Date of last inspection Brief description of the care home Care Homes for Older People Page 2 of 8 Milbanke Care Home provides high quality accommodation for a range of people with different needs and requirements. The home is currently separated into three different self contained units two of which provide accommodation for older people and the other is for people assessed as requiring specialist dementia care. In addition, the building houses a designated, separately run day care centre and office accommodation. Milbanke Care Home is located in a convenient location close to the main shopping centre of the town and local amenities. The accommodation is purpose built, arranged over two floors and offers individual bedroom accommodation to all residents some of which are provided with an en-suite facility. Each individual unit also has a large lounge/dining room that is bright, airy and comfortable and a smaller quiet lounge. Newly refurbished bathroom/shower and toilet facilities are conveniently located and provided with aids to promote independence. A passenger lift is provided for ease of access throughout the home. Care Homes for Older People Page 3 of 8 What we found:
We visited the home because previous inspections had found some serious shortfalls in the way medicines were handled. The visit was carried out by a pharmacist inspector and lasted four hours. The new acting manager, the area manager, three care staff and one resident were spoken with. We gave detailed feedback to the area manager at the end of the visit. Although improvements were found in most areas of medicines handling we continued to find some shortfalls that need to be addressed to make sure medicines are handled safely. We found continued improvements in the way medicines records and stock were organised. However, as on our last visit, it was the first day of a new medicines cycle and we again found the new supplies of medicines had not been properly organised so not all medicines were available when staff were trying to give them that morning, this meant that some medicines were not given at the right time and some were completely missed. Three people missed their blood pressure tablets because they had not been put on the trolley and another persons record did not have their pain relief medicines written on them so they were not given. Another person who was prescribed a regular laxative also missed it on the morning of the visit because it had not been written onto the current medicines record. Missing medicines can seriously affect a persons health and wellbeing. Records of medicines given to people showed good improvements and when a record had not been completed the manager was trying to do something about it to help prevent it happening again. We checked a sample of medicines stock against the records and found most medicines added up right showing they had been given to people correctly. However, we continued to find occasional mistakes that showed some medicines contained in packets had been missed. One person missed their pain relief tablets five times in the last three weeks and another missed their anti-cancer medicine twice in the last month. Missing medicines can seriously affect a persons health and wellbeing. Records of medicines receipt and disposal showed continued improvement and it was now possible to account for all medicines contained in traditional packets and bottles. Having accurate records helps managers carry out checks to show that medicines are being handled correctly. We looked at a sample of care plans and records and found good improvements about how when required medicines were to be given. We saw this with medicines used for anxiety and for pain relief and gave some further advice to review these regularly to make sure they are kept up to date. Having clear written plans helps make sure people get their medicines when they need them. We looked at how a person was supported when they looked after their own medicines. The paperwork had now been updated and a formal risk assessment had been carried out. A detailed care plan had been written and this had been reviewed every month to make sure the right amount amount of support was being given to this person. Care Homes for Older People Page 4 of 8 We checked how controlled drugs (medicines that can be misused) were stored and recorded. A new suitable cupboard had been obtained and this had been properly attached to the wall. A new special register was used for record keeping and this was being used correctly. Secure storage and witnessed records help prevent controlled drugs being misused. We looked at how medicines were checked and audited. We saw evidence of informal checks being carried out throughout the month and we saw more formal recorded audits carried out weekly. We gave further advice to the area manager on how to improve these to make sure they were finding all mistakes. Efficient recorded checks of the medicines help make sure medicines are handled 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 8 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 1 4(1)(2) The Statement of Purpose 30/09/2008 must be revised and updated and made available to all interested parties. (Not assessed at this inspection) 2 7 15 All residents must have an accurate, holistic and up to date plan of care that is regularly reviewed and amended as required. (Not assessed at this visit previous timescale 31/08/08). 09/09/2008 Care Homes for Older People Page 6 of 8 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 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 7 of 8 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 8 of 8 - 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!
