Random inspection report
Care homes for older people
Name: Address: Perth House Care Home Athlone Close Chaddesden Derby DE21 4BP zero star poor service 16/06/2009 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: Denise Clark Date: 1 0 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Perth House Care Home Athlone Close Chaddesden Derby DE21 4BP 01332717550 01332717550 kevinjowett@derby.gov.uk Derby.gov.uk 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) : Derby City Council care home 39 Number of places (if applicable): Under 65 Over 65 39 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 1 6 0 6 2 0 0 9 Perth House is situated within a residential area of Derby city. It is registered to provide residential care for 39 Older People, although following the refurbishment there are only 36 beds available. All bedrooms are single and are provided across two floors, which are connected by a shaft lift and staircase. A variety of communal areas are provided. The service provides places for up to 10 people for intermediate care. This is to support people to regain their independence, with a view to returning home. There are also up to 4 short-term care beds. This accommodation is on the ground floor. Long-term residents accommodation is on the first floor. All areas of the care home are accessible to people living at the home and seating is provided in the Homes garden. There is parking available for visitors. Fees are calculated by the assessment and collection section in Social Services and are based on capital and any regular income. At the time of inspection the fees were between £108.10 - £350 per week.
Care Homes for Older People Page 2 of 12 Brief description of the care home Further information regarding the fees can be obtained by contacting the Registered Manager at Perth House or through your local Social Services office. Inspection reports by the Care Quality Commission are available at the service. Care Homes for Older People Page 3 of 12 What we found:
We watched medicines being administered at lunchtime and saw that people were approached in a friendly, courteous manner. Medicines were handled in a hygienic way. People prescribed eye drops or inhalers were asked if they wished to be given these medicines in the privacy of their rooms. However, the person administering medicines left each persons tablets or capsules in a pot by their plate on the dining table, and signed the administration record before the person took their medication. Inhalers were not stored safely inside the locked medicine trolley during the medicine round. We observed that an inhaler belonging to a person who was self-medicating had been left unattended on a coffee table in the lounge. We spoke to another person who looked after their own medicines. This person did not have anywhere to lock their medicines in their room. We saw an assessment of this persons ability to take medicines without help in their care plan. This person told us they were unhappy about the way one member of staff had spoken to them, and because they had not been assisted to have a bath in the past four days. We found that medicine charts were satisfactorily completed, except that there was no information as to whether a person had an allergy to certain medicines. We saw that one medicine had been labelled take as directed by the pharmacy and that a discontinued medicine had been printed on one persons chart. Records of the disposal of medicines were kept but the book was full and a new book was required. Records of controlled drugs were kept in a separate register. The return of controlled drugs to people going home was not always clearly recorded. We also found that a discrepancy of one tablet in the controlled drugs register had not been investigated. The cupboard in which controlled drugs were being stored did not meet legal requirements. We saw that a fridge used to store medicines was not locked, and the temperature of the fridge was not monitored. We found that medicines for two people staying at the home for a short time were inadequately packed and labelled in a compliance device and multidose pack. These people had brought their medicines into the home with them. We saw that a good system had been introduced for the handling, recording and storage of creams that were applied when people were helped to wash and dress. We found that all the staff who administer medicines at night had recently attended medicines training. The assistant manager on duty told us that he had attended training earlier that year. What the care home does well: What they could do better:
Medicines are not always securely stored. People are put at risk by the practice of leaving
Care Homes for Older People Page 4 of 12 each persons medicines by their plate at the dining table. Records in the controlled drugs register are insufficient to provide an audit trail of controlled drugs entering and leaving the home. 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 12 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 3 14 Each person must receive an 31/07/2009 up-to-date assessment of their needs, with a copy provided to the home, before they are admitted. This assessment must be kept under review and revised if there are any change of circumstances. This is so that everyone can be assured that the persons needs can be met at the home. 2 7 15 There must be an up-to-date 31/07/2009 plan of care available for each individual. This must be available for care staff to read and follow. This is to ensure that care staff are aware of the action that needs to be taken so that each persons health, personal and social care needs are met. 3 9 13 Any person who has been 30/06/2009 assessed as safe to self administer their medication must have a written risk assessment and must keep their medication secure at all times. Care Homes for Older People Page 6 of 12 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 to ensure the health and safety of people living at the home. 4 9 13 There must be safe systems 30/06/2009 for the recording, handling, safekeeping and safe administration of medicines received into the care home. This is to ensure the health and safety of people living at the home. 5 18 Regulation 18 All members of staff working 30/09/2009 (1) c at Perth House must receive training in safeguarding adults procedures. This is so that people living at the care home are protected from abuse. Previous timescale was 31 December 2008. This has not been met. A time extension has been given. If this extended timescale to meet this requirement is not met, enforcement action will be considered. 6 19 23 Fire doors must not be 30/06/2009 propped open. There must be a safe system for allowing individuals independent access to their bedrooms, whilst preventing the risk of spread of fire. This should be done in consultation with the fire service. This is to ensure that there is
Care Homes for Older People Page 7 of 12 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 a safe fire system that does not affect individuals independence. 7 19 23 There must be a risk 10/07/2009 assessment completed concerning the smoke room. This is to ensure that the room is being used safely. 8 30 18 All staff and managers must receive training appropriate to the work that they are to perform. This includes refresher training in moving and handling, first aid and six monthly fire training for night staff. This is to ensure that all managers and staff have upto-date information and knowledge to assist them in their duties so that people are protected. 9 36 18 The registered person must ensure that people working at the care home are appropriately supervised. This is to ensure that care staff receive adequate guidance, support and opportunities to discuss their development in order to assist them in their work. 10 37 37 The registered person must 30/06/2009 give notice in writing to the Commission without delay of the occurrence of the death of any service user, the
Page 8 of 12 30/09/2009 28/08/2009 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 outbreak of any infectious disease, any serious injury or illness, any theft, burglary or accident, allegation of misconduct, or any event in the care home which adversely affects the wellbeing or safety of any service users. This is a requirement under the Care Standards Act 2000 11 37 17 All confidential records concerning staff and service users must be kept securely in the care home. This is to ensure that the home meets the Data Protection Act as well as confidentiality and privacy of people at the home. 30/06/2009 Care Homes for Older People Page 9 of 12 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 belonging to 30/09/2009 people who self-medicate must be securely stored. to ensure the safety and well being of people living in the home People must be observed taking their medication before the medicine administration record is signed to ensure the safety and well being of people living in the home 30/09/2009 2 9 13 3 9 13 Controlled drugs must be stored in a cupboard that complies with the Misuse of Drugs (Safe Custody) regulations for security reasons and to meet legal requirements 30/10/2009 4 9 13 Accurate records of the use 30/09/2009 of controlled drugs must be kept and any discrepancies in stock balances must be
Page 10 of 12 Care Homes for Older People 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 promptly investigated and reported. for security reasons and to meet legal requirements 5 9 13 Medicines must only be 30/09/2009 administered if packed and labelled in accordance with Royal Pharmaceutical Society of Great Britain guidance. to ensure the safety and well being of people living in the home 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 9 9 Any known allergies or the wording none known should be recorded on medication administration records Managers should liaise with the community pharmacy to ensure that discontinued medicines are not printed on MARs and that all medicines are labelled with full dosage instructions The medicine refrigerator should be locked and the temperature should be monitored over a 24 hour period by a minimum, maximum thermometer. A daily temperature record should be kept. 3 9 Care Homes for Older People Page 11 of 12 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 12 of 12 - 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!
