This inspection was carried out on 4th August 2009.
CQC found this care home to be providing an Good 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: 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: 0 4 0 8 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 11 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 11 What we found:
The reason for the visit initially was to check on the management of Controlled Drugs held by the home. It had been reported in a letter to the Commission that Controlled Drugs were going missing and the home was failing to report the matter. We found on the day of the visit that all Controlled Drugs were accounted for and the report of Controlled Drugs going missing may have related to an incident when a carer in the home signed for the receipt of some Controlled Drugs which had never left the Pharmacy. While examining the Controlled Drug records we found that one of the people who was using the service had not received a dose of their pain control medicine on three separate occasions yet the Medicine Administration Records (MAR) indicated that on two of these occasions the medicine had been administered. On the third occasion the MAR chart indicated that the medicine had not been administered because it was not required. This medicine had not been prescribed on a when required basis and the nursing staff on duty testified that this person would have required the pain control. We found evidence that the nursing staff were completing the Controlled Drugs register before the administration of the Controlled Drugs had taken place. We found a number of problems with the medication records being kept by the home. We found that the home was not always accurately recording the receipt of medication entering the home. We found that some 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 examined a number of MAR charts and found that they were not robust enough to demonstrate that the home had administered the medication as prescribed. An audit of these MAR charts found some medicines to be missing for example we found that 21 antibiotic capsules had been dispensed and 6 of these tablets had been administered. We expected therefore to find 15 capsules remaining but in fact we only found 12 capsules present. We also found that the audit appeared to show medicines were not being administered even though the MAR charts were being signed for example we found that 60 laxative tablets had been dispensed and the MAR chart showed that 4 tablets had been administered. We therefore expected to find 56 tablets remaining but in fact we found that there were still 60 tablets still in the box. This could mean that the nursing staff were signing the MAR charts but not actually administering the medication. It was also admitted that due to the lack of space in the mobile drug trolley the nursing staff were sharing prescribed medicines between people who were using the service. The sharing of prescribed medicines between people who live in the home contravenes the Medicines Act of 1968 and must be addressed as a priority. We found that the care plans were poor for containing information about the administration of medicines. We found that the service was reliant on using the hospital notes for all queries relating to medicines. We found that when a person left the home or went back into hospital these notes were returned to the hospital so the home did not have their own fully independent record of the persons stay with them. As a consequence we found little or no information about how and when medicines prescribed on a when required basis should be administered. We found no evidence that clarification had been sought with the prescriber about medicines that had been prescribed with a variable
Care Homes for Older People Page 4 of 11 dose. We found very little information about the reasons for the administration of the medication and where appropriate the length of treatment in particular the administration of medicated creams.We found that there was no information about administering medicines through a PEG tube to one of the people who was using the service. On the subject of security and storage of medicines we found that the medicines were regularly being stored in a room that was too hot to comply with the manufacturers requirements. The room temperature was regularly being measured at above 25 degrees centigrade which was the maximum temperature specified by most manufacturers. 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. We found that medicated creams were being insecurely stored in the rooms of people who used the service. We also found that the lock to the mobile drug trolley had been broken and as a result during the administration rounds medicines were available to unauthorized persons in the home. We found that carers were applying medicated creams and ointments without any form of training on the safe handling of medicines. We found that the home did not have an ongoing assessment programme to ensure that the staff that were administering any forms of treatment were administering these treatments safely and in accordance with the homes policies and procedures. In light of some of the issues identified during the inspection the assessment of the staffs competency to administer these treatments safely must be carried out as a matter of urgency. What the care home does well: What they could do better:
The service needs to ensure that the administration records can demonstrate that the people who are using the service are having their medicines administered as prescribed. The service needs to ensure that the service has there own care plans which will have all the information about 1) why a medicine was prescribed 2) about why a medicine was discontinued and 3) on how to administer when required medicines safely. We found that there was no information about administering medicines through a PEG tube to one of the people who was using the service. The home must ensure that all medicines are stored securely and at the correct temperature. The home must ensure that the administration practices do not place people at risk. The home must ensure that the staff administering medication to the people who use the service are safe and competent to do so. Care Homes for Older People Page 5 of 11 The service must ensure that medication is administered only to the person it was prescribed labelled and supplied for. 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 6 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 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 2 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 7 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 Regulation 13(2) The 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. 13/09/2009 2 9 13 Regulation 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe 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 13/09/2009 Care Homes for Older People Page 8 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 policies and procedures to ensure that individuals receive their medication safely and correctly. 3 9 13 Regulation 13(2) The 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. 4 9 13 Regulation 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe 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
Care Homes for Older People Page 9 of 11 13/09/2009 13/09/2009 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 prescriber to meet individual health needs. 5 9 13 Regulation 13(2) The 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. 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 13/09/2009 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!
