Random inspection report
Care homes for older people
Name: Address: Nazareth House 118 Harlestone Road Northampton Northants NN5 6AD zero star poor service 06/04/2009 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: Naveeda Knopp Date: 3 0 1 0 2 0 0 9 Information about the care home
Name of care home: Address: Nazareth House 118 Harlestone Road Northampton Northants NN5 6AD 01604751385 01604580435 sheila@naznptn.plus.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Congregation of the Sisters of Nazareth care home 50 Number of places (if applicable): Under 65 Over 65 50 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 50 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 - Code OP Date of last inspection Brief description of the care home Nazareth House is a care home providing personal care for Older People, it is a large home located on the outskirts of Northampton. The home has been established for many years and is run by The Congregation of the Sisters of Nazareth who also offer a comprehensive range of spiritual support and guidance to meet the individual religious needs and preferences of people living within the home. Mass and The Rosary are
Care Homes for Older People Page 2 of 9 0 6 0 4 2 0 0 9 Brief description of the care home celebrated on a daily basis, in the Church which is attached to the home . Accommodation is provided over the ground and first floor, with access to the first floor being via a passenger lift, the ground floor provides all the communal amenities, along with bedroom and bathing facilities, whilst the first floor provides additional bathing facilities and bedrooms. Bedrooms in some instances include an en-suite facility, some of these being added recently. Nazareth House has a large and very well maintained garden, with mature trees, shrubs and plants and benefits from a large water fountain. Information about Nazareth House is provided in the form of a Service Users Guide and a Statement of Purpose. The Manager provided information on the day of the site visit with regards to fees. Fees range from £469.00 to £539.00 per week; the fee charged is dependent upon the specification and amenities of the personal accommodation. Care Homes for Older People Page 3 of 9 What we found:
The home currently does not have a registered manager but a new manager is due to start in November 2009. A Sister was allocated as a Regional Support Manager to the home by the owners. One of the team leaders has recently been given the role of trainer to manage and oversee the medication training programme to the relevant staff. All medicines including those that by law needed to be kept under tighter control where stored appropriately and securely. There was a fridge designated for medicines that required cold storage. Ten controlled drugs (medicines that are legally required to be stored and handled in a more secure manner) audits carried out showed all the doses had been accounted for. For one person who was prescribed a pain relief patch that is also classified as a controlled drug, the GP instructions had not been followed regarding how often this patch was to be applied. Instead of changing this patch every two days the medication record and other documentation indicated it was being refreshed every three days.The senior lead on duty also verbally confirmed that the patch is changed every third day. This meant that the prescribers instruction had not been followed and that this person may have not had sufficient pain relief. After speaking to this person it was established that there is not always complete pain control but she was stating the patch could be changed every two days to her recollection. During a period of observation of a medication round on one of the two wings, it was seen that the procedure followed was safe and the carer treated people with respect and dignity. She also checked with individuals whether they needed their pain relief if it was prescribed on a when required basis. A person living at the house stated he was very happy living at the house and how they deal with his medicines. He said he would see a GP instantly when he needs to. A second person was spoken to while they were resting in their room. She stated that she had no ointment for a few days for her bottom that then caused a problem. She said she saw a doctor only a few days ago. She also said sometimes you have to look at night to find the right one to ask. The medicine accounting processes for non controlled drugs at the home was poor. This prevented complete audit trails to be carried out confidently and indicated that there was no accurate record of what and how much of a medicines was in the home for individuals living at the home. Two of these medicines that we were able to audit showed up anomolies. Some people at the home were managing some or all of their own medicines. This was not happening within a suitable risk management framework hence this was potentially detrimental to individuals health.No relevant or useful information was seen in the corressponding care plans of these self- medicators relating to health conditions and medication. Problems were seen with the handling of medicines with a short in use date. As dates where not always marked on such products there was increased risk that an out of date medicines could be used. The home were accounting for medicines that were being returned to the supplying Pharmacy.But the method used by staff to collect and store individual doses not taken is not appropriate.
Care Homes for Older People Page 4 of 9 A programme of training for staff handling medication was well underway. This was being delivered by an external training company and the supplying Pharmacist. In addition a set of internal briefings had been started which included Deprevation of libertys, Medication handling in Care Homes and Good Practise Guide on Self - Administration. The medication policy on the request from a previous inspection had been updated but it could not be confirmed that all relevant staff had seen this revised version. 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 29 19 The registered person must ensure all people working in the home have the appropriate checks in place. This is to ensure the safety of people in the home. This was not assessed during the Pharmacist inspection on the 30/10/2009 16/10/2009 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 All people who selfadminister their own medication , the home must ensure that this is occurring within a suitable risk managed framework. This is prevent any decline in peoples health. 25/12/2009 2 9 13 The home must ensure that 25/12/2009 accurate records are made to account for all medicines kept on the premises for all people living or staying at the home. This is to safeguard the health and welfare of all people living at the home. All people living at the home 25/12/2009 must have their medicines administered in accordance to the Prescribers instructions This is to safeguard the health and welfare of people living at the home. 3 9 13 Care Homes for Older People Page 7 of 9 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 2 3 4 9 9 9 9 The management could ensure compliance to medication procedures by carrying out regular audits. It can be useful to keep a copy of signatures used on medication records for the staff who give out medication. All relevant staff should see and follow the most up to date medication policy. The home could keep a medication profile in individuals care plan. 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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!
