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Inspection on 15/12/09 for Park Hills Nursing Home

Also see our care home review for Park Hills Nursing Home for more information

This inspection was carried out on 15th December 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We found no significant examples of good practice when handling medicines.

What the care home could do better:

Medicines must be given to people correctly `as prescribed` and accurate records must be kept to help make sure medicines are handled safely. Controlled drugs must be stored securely according to the law.

Random inspection report Care homes for older people Name: Address: Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ zero star poor service 16/09/2009 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: Simon Hill Date: 1 5 1 2 2 0 0 9 Information about the care home Name of care home: Address: Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ 01616246671 F/P01616246671 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) : Ms Barbara Rogers care home 17 Number of places (if applicable): Under 65 Over 65 17 0 old age, not falling within any other category physical disability Conditions of registration: 0 17 The registered person may provide the following category of service only: Care home with nursing - Code N 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 Physical disability - Code PD The maximum number of service users who can be accommodated is: 17 Date of last inspection Brief description of the care home Park Hills Nursing Home provides 24 hour nursing care and accommodation for up to 17 people over the age of 65 years. Mrs Barbara Rogers is the registered owner and manager of the home. 1 6 0 9 2 0 0 9 Care Homes for Older People Page 2 of 11 Brief description of the care home The home is situated approximately one mile from Oldham town centre and is reasonably close to local amenities such as shops, pubs and local schools. Bus services are also available close by. The home is a Victorian property that has been extended at the rear. Entrance to the home is by a purpose built ramp at the side of the building. Well-maintained gardens are available outside the property. The home provides 17 single bedrooms, on both the ground and first floor and the majority of these are south facing. A passenger lift and other aids, such as hoists are available. There are three bathrooms. On the ground floor there is a choice of a large lounge/dining room or a smaller quiet lounge. A copy of the homes last inspection report was available from the main entrance area of the home. The weekly fees ranged from £445.65 to £490.00 dependent on the package of care required. Further details regarding fees and other information about the home are available from the manager. No additional charges are currently made. Care Homes for Older People Page 3 of 11 What we found: We carried out this visit to check how medicines were being handled because we found serious shortfalls on our last visit that meant some people were being placed at unnecessary risk. The visit was carried out by a Pharmacist Inspector and lasted approximately four hours. Overall we found some improvements in the recording and giving of medicines but we still found mistakes that were placing the health and wellbeing of people at unnecessary risk. Records of medicines received into the home, given to people and disposed of were usually signed and up to date. However, we found recent mistakes that showed some staff were not always following the correct procedures when giving and signing for medicines. We found several gaps on the current medicines records and silly mistakes that meant the records were not accurate. We saw two medicines that should be given before food were wrongly given after food because staff had not followed the written instructions even though we had highlighted this issue at the last visit. We found that when medicines were not given, for example, if they were refused, a clear explanation was not always recorded. We found one medicine that was to supposed to be given every other day was signed as given on three consecutive days on one occasion and two on another. Inaccurate records can lead to serious mistakes that can affect peoples health and wellbeing. We looked at how controlled drugs (medicines that can be misused) were being handled and found some shortfalls. A strong pain relief patch was replaced three days which could have caused the person to suffer pain. This was a serious concern because we had found this problem at our last visit. The controlled drug cupboard had been attached to the wall but it was still not compliant with the law so we gave some more advice about how to put it right. Controlled drugs must be handled safely to help prevent and mishandling and misuse. We carried out some detailed checks of the stocks and found medicines contained in the special system supplied by the pharmacy (this makes giving and preparing medicines simple and easy to do) were usually given correctly. However, medicines contained in bottles and packets were difficult to audit and check because stock had not been properly carried forward at the beginning of the new medicines cycle. Liquid medicines were particularly difficult to check so we gave some advice about how to make this easier to do. We found nutritional food supplements were not clearly recorded because the staff member giving them was not always the person signing the record so we could not be sure the record was a genuine one. We found some improvements in the general organisation of the medicines such as all old stock had now been removed and accurate records of medicines being disposed of were now made. We saw no real improvement in the way medicines and staff competence were audited and checked. There were no recorded audits and staff were not formally observed giving and recording medicines so problems were not being found and rectified by the managers. Given the continued mistakes it was evident that some staff need to have their competency formally assessed to make sure they have the necessary skills to handle medicines safely. Care Homes for Older People Page 4 of 11 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 11 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 7 15 Care plans must always 12/10/2009 clearly detail all the needs and support requirements of people who use the service and how those needs are to be met These needs must be regularly reviewed, and the outcomes recorded, in the light of changing needs of individuals and the advice of health care professionals, to form a daily working tool for staff. This is necessary to ensure that staff are consistently aware of the current needs of people, so that their support of each individual is always based on complete and up to date information to enable them to fully safeguard people. 2 8 13 The healthcare needs of 12/10/2009 people, including nutritional needs, tissue viability needs and moving and handling needs, must always be based on the current expert advice of health care professionals and care plan records must always contain enough up to date information for staff about what dressings/ equipment is being used and Page 6 of 11 Care Homes for Older People 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 how it should be used/ maintained. In addition, a full and detailed assessment of risks to each individual must always be completed, recorded and kept under review. This is necessary in order that people always receive care and support which maintains their health and wellbeing and safeguards them from harm. 3 9 13 Medicines must be given to people as prescribed This is important because receiving medicines at the wrong dose, wrong time or not at all can seriously affect their health and wellbeing. 4 9 13 Accurate records of all medicines received into the home, given to people and disposed of must be kept. This will help make sure all medicines can be fully accounted for. 5 9 13 Controlled drugs must be stored in a cupboard that meets the requirements of the law. This will help prevent mishandling and misuse. 6 18 13 Robust procedures and appropriate staff training in, and understanding of, the 12/10/2009 20/01/2010 20/11/2009 20/11/2009 Care Homes for Older People Page 7 of 11 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 protection of vulnerable adults from abuse must be in place. This is necessary in order that the policies and practices of the home ensure that people are safeguarded from harm. 7 19 23 The manager must ensure that the premises consistently meets the fire departments required standards. This is necessary in order that people are consistently protected from the risk of fire. 8 29 19 The manager must make sure that a detailed employment history and appropriate references are consistently taken. This is necessary to ensure that people who use the service are supported by staff who are being vetted to ensure the protection of people. 9 29 19 That a POVA First Check is 18/09/2009 obtained for all staff, for whom a CRB check is not yet in place. Appropriate and timely POVA First and CRB checks must be in place for all staff who are working with vulnerable people in order that people Care Homes for Older People Page 8 of 11 12/10/2009 12/10/2009 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 are safeguarded from harm and poor practice. Care Homes for Older People Page 9 of 11 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 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 10 of 11 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). 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