This inspection was carried out on 19th October 2009.
CQC found this care home to be providing an Excellent 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Park Hills Nursing Home 199 Chamber Road Oldham Lancashire OL8 4DJ 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: Simon Hill Date: 1 9 1 0 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. 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 make sure medicines were being handled safely because concerns were found on our last inspection. The visit was carried out by a pharmacist inspector and it lasted six hours. We checked medicines records and medicines stock and at the end of the visit we took some photocopies of the records because we found serious shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. When we arrived at the home the senior nurse on duty said that the morning medicines had all been given out from approximately 7am, about one hour before breakfast. When we checked the medicines records we found numerous medicines that needed to be given after food were signed as given before food at 7am. The medicines records did not highlight any special warnings and medicines were not being given to people at the best time to fit into their normal daily routine. We found medicines stock was poorly organised, numerous medicines were not labelled and some were not in their original packets so we could not be sure who they were prescribed for. When we tried to account for a sample of the medicines we found this impossible because there was no clear system of stock control in place. Medicines were not always properly recorded when received into the home and no records of medicines disposed of had been made for over a year. Medicines were not recorded when carried over each month so it was not possible to know how much stock was being held in the home. Of serious concern was the routine practice of mixing different supplies of the same medicine together, this is very dangerous and can lead to serious mistakes. We found numerous old medicines for people that no longer lived in the home. One medicine we found was eight years out of date and was not labelled and another persons injections had not been properly disposed of even though they had died over a year ago. We found old scruffy eye drops in the fridge that were not prescribed to anyone in the home and the fridge temperature was not being checked to make sure it was correct. We also saw one liquid medicine being given to a person that was two days out of date. We found a very dirty tablet crusher that had fresh powder in it along with old crusty powder, the nurse on duty said she did not know who was having their tablets crushed and we found no evidence of this in the records we looked at at. We found the records of creams and nutritional supplements were not always complete so we could not be sure they were being used properly. Medicines stock was being shared between residents even though this is against the law and we found some medicines were not being recorded as given even though they were in stock and appeared to be in use. We also found several examples of medicines being out of stock for a number of days, this showed the ordering system was not well organised. We saw some old oxygen cylinders in the store room but the nurse on duty said nobody was prescribed them, these should not be kept as stock and should only be used for the person they are prescribed for. We checked how controlled drugs (medicines that can be misused) were handled. The cupboard used for storing them did not meet the requirements of the law because it was not properly attached to the wall. A special register was used for making records and
Care Homes for Older People Page 4 of 11 these were usually properly witnessed. We found one controlled drug had not been given to a person correctly on two occasions because staff had forgotten to give it to them which could have caused them to suffer pain. We looked at how the medicines were checked and audited and found no formal systems in place. The mistakes we found and the general poor organisation of the medicines had not been identified by the manager and action was not being taken to make the necessary improvements. The competence of the current nursing staff is a serious concern because we found poor practice in the administration, the record keeping and storage of medicines. 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 18 13 Robust procedures and 12/10/2009 appropriate staff training in, and understanding of, the 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. 4 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. 5 29 19 The manager must make sure that a detailed employment history and appropriate references are consistently taken. 12/10/2009 12/10/2009 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 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. 6 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 are safeguarded from harm and poor practice. Care Homes for Older People Page 8 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 1 9 13 Medicines must be properly labelled at all times and should not be shared between people. This is important to help make sure they are safely handled. 20/11/2009 2 9 13 Controlled drugs must be stored in a cupboard that meets the requirements of the law. This will help prevent mishandling and misuse. 20/01/2010 3 9 12 Medicines must be properly disposed of when no longer required and should only be used when they are within their expiry date. This will help make sure they are handled safely. 20/11/2009 4 9 13 Accurate records of all medicines received into the home, given to people and disposed of must be kept. 20/11/2009 Care Homes for Older People Page 9 of 11 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 This will help make sure all medicines can be fully accounted for. 5 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. 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 20/11/2009 1 9 Suitable procedures for the auditing of medicines and checking of staff competence should be put in place to help make sure medicines are handled safely by adequately skilled staff. 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). 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 11 of 11 - 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!
