Random inspection report
Care homes for older people
Name: Address: Nazareth House 162 East End Road East Finchley London N2 0RU three star excellent 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: Ffion Simmons Date: 1 0 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Nazareth House 162 East End Road East Finchley London N2 0RU 02088831104 02084443691 anne.fenlon@nazarethcare.com www.sistersofnazareth.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anne Fenlon Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Congregation of the Sisters of Nazareth care home 84 Number of places (if applicable): Under 65 Over 65 84 old age, not falling within any other category Conditions of registration: 0 Fifteen specified service users who have dementia may remain accommodated in the home. The home must advise the regulating authority at such times as any of the specified service users vacate the home. Date of last inspection Brief description of the care home Nazareth House is a long established residential care home providing a home for eighty-nine people over the age of 65. It is owned and operated by a Roman Catholic order of nuns, The Congregation of the Sisters of Nazareth who are the registered providers. There is a very strong Catholic ethos in the home, including a chapel where
Care Homes for Older People Page 2 of 10 Brief description of the care home Mass is celebrated daily. People from other religious and cultural groups are also accommodated and assisted with religious observance and to maintain contact with their community groups. Nazareth House is a large home split into a number of annexes named after Saints. There are a number of bedrooms with en-suite facilities, but those bedrooms without en-suite facilities have communal facilities close by. The home, with its spacious grounds, offers peace and tranquillity and it is ideally situated close to shops, post office and local transport. The home is light and airy with spacious corridors and has appropriate adaptations and equipment for people with mobility problems. The staff are allocated to work on the same unit so that the residents receive consistent care from the same staff. Each unit has a separate dining area and lounge. The cost of placements is £620 to £682 per week. Additional cost are for hairdressing, chiropody and nail care. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. Following Inspecting for better lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Older People Page 3 of 10 What we found:
The random inspection took place over 7 hours on the 10th June 2010. This random inspection focused mainly on the homes management of medication. During the visit we audited the medication and talked to staff and some visitors. The medication administration records (MAR) of twelve residents were checked during this visit. No pictures appeared with the MAR charts for identifying the resident, which is a breach of the homes medication policy. This was discussed with the Manager who acknowledged that this needs to be done and is on the agenda to be done. Of the twelve MAR charts seen, only one of the charts outlined in a resident had any allergies. Allergies must be noted on the MAR chart, where no allergies are known, this should be recorded on the MAR chart as per the homes medication policy. There were some gaps in recording of medication administered to residents with no signatures for administration or endorsements to indicate why the medication might not have been given. The home uses the local chemist and we noted that the home receives some medication in blister packs, but some medication were loose and not blistered and we audited some of these loose medication. We were concerned to note that when we audited some of the medication, that the balances were incorrect when checked against the MAR sheets, which suggested that medication had been signed as given but remained in the packs. Some of these drugs include calcium supplements, drugs affecting bone metabolism (alendronic acid), diuretics for the cardiovascular system (frusemide), drugs used in parkinsonism and related disorders (co-careldopa), antiplatelet drugs (aspirin), Central nervous system, Antiepileptic drugs (phenobarbital and Carbemazepine) and pain relief drugs (paracetamol, co-codamol and ibuprofen). Failure to give medicine as prescribed can put residents at risk of harm and can affect their health and well-being and their quality of life. Out of the 12 residents tracked there were errors noted in the administration and/or recording of medication for 10 of these residents. This means that a high percentage of residents were not receiving their medication as prescribed. We could not see evidence that staff are regularly auditing the medication in the home, to ensure residents are receiving their medication as prescribed. We noted also that senior staff had secondary dispensed medication from containers dispensed by the pharmacist into dosset boxes for three residents. This is not considered safe practice, as it can lead to errors and mix-ups and carers are unable to check against the original label. What the care home does well:
Staff were monitoring the room temperature where medication was stored including the fridges. The storage of medication was secure and well organised. We noticed that a residents was able to retain their independence and self medicate and risk assessment for self medication was in use. Residents who were prescribed Warfarin had their blood monitored regularly and the result was kept with the Medication Administration Record
Care Homes for Older People Page 4 of 10 (MAR) for reference. The dose was correctly transcribed to the MAR. Residents benefit from living in a nice environment, which is kept clean,tidy and well maintained. Visitors spoken with during the inspection were very complimentary about the staff and the standards of care offered. Staff were very kind and accommodating and assisted fully in the inspection. A number of staff have worked in the home for a long time and commented that they enjoyed working there. We received a number of questionnaires providing feedback about the service. One of the questionnaires expressed the familys gratitude for the care given to their relative. When we asked what the home does well, a resident commented providing a home from home. It does very well in all departments. Staff commented that they felt the home did well in compiling detailed care plans, offer training (paid) and it endeavours to provide excellent care. Staff went on to saythe home is doing the best that could be expected of a service of its kind. 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 9 13(2) Staff must sign for all medication that is administered. 30/09/2007 Care Homes for Older People Page 6 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 13 9 Ensure recent photographs of 14/07/2010 service users are available with the Medication Administration Records to promote the safe identification of service users. To ensure the safe identification of service users. 2 13 9 Ensure that service users are 14/07/2010 administered their medication as prescribed. To ensure their health and well-being are protected. 3 13 9 Ensure the service 14/07/2010 implements a safe system of administering service users medications and desists from the practice of secondary dispensing. To ensure that medication is administered safely. 4 13 9 Ensure that only staff that are suitably skilled and 14/07/2010 Care Homes for Older People Page 7 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 competent handle and administer medication. This is so that service users receive their medication safely and by a competent person. 5 13 9 Put a system in place to 14/07/2010 ensure medication administration records (MAR) accurately reflect whether any medication was administered, refused, or refused and destroyed and if there was non administration of medication for any other reason, the reason for the non administration is recorded. This is to ensure that accurate records are maintained and that service users receive their medication as prescribed. 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 Robust systems should be put in place to audit balances of loose medication to ensure balances are correct and to ensure residents are receiving their medication as prescribed. Allergies should be noted on the MAR chart, where no allergies are known, this should be recorded on the MAR chart as per the homes medication policy. 2 9 Care Homes for Older People Page 8 of 10 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 3 9 The home should record minimum and maximum temperatures of the fridge as well as the actual. 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. 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 10 of 10 - 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!
