Random inspection report
Care homes for older people
Name: Address: Probert Court Continuing Care Home Probert Road Oxley Wolverhampton West Midlands WV10 6UF two star good 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: Ian Henderson Date: 1 1 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Probert Court Continuing Care Home Probert Road Oxley Wolverhampton West Midlands WV10 6UF 01902444067 01902444068 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) : Heantun Care Housing Association Limited care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 25 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 (OP) 25 Date of last inspection Brief description of the care home Probert Court is a care home providing accommodation, personal and nursing care to 25 older people. It provides a service to people who have continuing care needs. The home has two designated respite care beds. It is owned by Heantun care Housing Assocation Ltd and people are generally admitted to the home direct from a hospital
Care Homes for Older People Page 2 of 13 0 4 0 8 2 0 0 9 Brief description of the care home setting with fees paid by the local Primary Care Trust. The home is situated in the Oxley area of Wolverhampton, a short distance away from local shops and amenities. The single storey building was purpose built, with twenty one single occupancy bedrooms and two double rooms. The communal areas inside the home are spacious and homely in character and the gardens are easily accessible for people. People can obtain information about this service from the home?s Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on CSCI?s website at www.csci.org.uk. Care Homes for Older People Page 3 of 13 What we found:
The reason for the visit was to establish what progress the service had made in meeting the requirements about the safe management of medicines made at an inspection on the 4th August 2009. In summary the medicines management systems within the home were still found to be poor and were not safeguarding those living in the home. As a consequence of a continued breach of the Care Homes Regulations 2001 with respect to the management of medicines a number of medication records were seized under the provision of the Police and Criminal Evidence Act 1984. We still found a number of problems with the medication records being kept by the home. We still found that the home was not always accurately recording the receipt of medication entering the home. We found that medication which had been carried over from previous months had not been accounted for in the records and therefore as a consequence the home did not know whether this medication was being used appropriately. We found that the Medicine Administration Record [MAR] charts were not robust enough to demonstrate that the home had administered the medication as prescribed. An audit of some MAR charts identified that some medicines had gone missing and the nursing staff did not know the whereabouts of these tablets. We also found that the audit appeared to show that some medicines were not being administered even though the MAR charts were being signed to indicate the medicines had been administered. We found further problems of a medicine being out of stock and the nursing staff administering a sub therapeutic dose of an antibiotic. We also found that a much needed course of steroid tablets had not been started as promptly as they should have been thus placing the individual at risk of further complications. We found that medicine that had been refused could not be accounted for and it was concluded that the nursing staff were discarding these medicines without making a record in the disposal register. At the previous inspection we found that Paracetamol tablets were being shared between people who used the service. We found at this inspection that the issue of the sharing of Paracetamol had ceased as each person prescribed Paracetamol now had their own individual supply. We found that the home had initiated their own care plans for the people who used the service and were less reliant on the hospital notes that were available to the nursing staff. We found that the home still needed to improve on the quality of information about medicines in the care plans. We also found that the home was failing to keep the temperature of the fridge within the accepted temperature range of between 2 and 8 degrees centigrade. As a consequence the home was advised to discard the insulin present in the fridge and seek new supplies. The home was also advised to seek advice from the manufacturers of the other medicines found within the fridge. We also found that some creams that did not required cold storage conditions were being stored in the fridge and one cream that did was not being stored in the fridge even though the pharmacy label clearly stated that it should be kept
Care Homes for Older People Page 4 of 13 in the fridge. We found that medicated creams and ointments were being stored securely in the treatment room. We found that due to the lack of permanent staff the manager had not been able to carry out any competency assessments on the handling and administering of medicines. We considered that the home could have better prepared the agency nursing staff on the systems within the home before they stated their shift. 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 13 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 Regulation 13(2) The 13/09/2009 registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The service must ensure that medication is administered only to the person it was prescribed labelled and supplied for. 2 9 13 Regulation 13(2) The 13/09/2009 registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. All medication including medicated creams must be stored securely and at the correct temperature recommended by the manufacturer. 3 9 13 Regulation 13(2) The 13/09/2009 registered person shall make arrangements for the recording, handling, safekeeping, safe
Page 6 of 13 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 administration and disposal of medicines received into the care home. Appropriate information relating to medication must be kept for example in the homes own risk assessments and care plans to ensure that staff know how to use and monitor all medication including as directed when required and self administered medication so that all medication is administered safely correctly and as intended by the prescriber to meet individual health needs. 4 9 13 Regulation 13(2) The 13/09/2009 registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Medicine records for the receipt administration and disposal of medication must be clear and accurate showing that people using the service have received medication as prescribed in order to ensure that these people are safeguarded. 5 9 13 Regulation 13(2) The 13/09/2009 registered person shall make arrangements for the recording, handling, safekeeping, safe
Page 7 of 13 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 administration and disposal of medicines received into the care home. Staff who handle medication must be trained and competent and their practice must follow current written policies and procedures to ensure that individuals receive their medication safely and correctly. 6 30 18 (1)(c) (i) The registered person must 01/09/2008 ensure that the induction programme meets the Skills for Care standards. This is to ensure that new staff are trained and competent to do their jobs 7 33 26 The registered person or a 01/09/2008 representative of the organisation must visit the home at least once a month and prepare a written report on the conduct of the care home. This is to demonstrate that the quality of the service is continually monitored, so that action can be taken to improve the home?s performance and improve outcomes for people. Care Homes for Older People Page 8 of 13 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 12 Put systems in place to request, obtain and retain adequate supplies of prescribed medications are available at all times to enable administrations to be carried out as and when prescribed. Regulation 12 [1] [a] and [b]. The registered person shall ensure that the care home is conducted so as [a] to promote and make proper provision for the health and welfare of service users [b] to make proper provision for the care and where appropriate treatment education and supervision of service users. 07/01/2010 2 9 12 To promote and make proper 07/01/2010 provision for the health and welfare of service users. Care Homes for Older People Page 9 of 13 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 Regulation 12 [1] [a] and [b]. The registered person shall ensure that the care home is conducted so as [a] to promote and make proper provision for the health and welfare of service users [b] to make proper provision for the care and where appropriate treatment education and supervision of service users. 3 9 13 Put in place an effective 07/01/2010 system to request, obtain, and retain adequate supplies of all prescribed medications so that they can be administered as and when prescribed. Regulation 13[2] The registgered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 4 9 13 Ensure that medication 07/01/2010 administration records are accurately maintained. That the reason for nonadministration are recorded by the timely entry of the appropriate code, or entry of
Page 10 of 13 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 the meaning of any such codes are clearly explained on each record. Regulation 13[2] The registgered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 5 9 13 Make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Regulation 13[2] The registgered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 6 9 13 Make arrangements to 07/01/2010 ensure that medication is stored at the correct temperature at all times and in accordance with manufacturers instructions to assure of their stability to be administered. Regulation 13[2] The registgered person shall make arrangements for the
Care Homes for Older People Page 11 of 13 07/01/2010 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 recording handling safekeeping safe administration and disposal of medicines received into the care 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 Care Homes for Older People Page 12 of 13 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 13 of 13 - 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!
