Random inspection report
Care homes for adults (18-65 years)
Name: Address: Quince House 77 Adeyfield Road Hemel Hempstead Herts HP2 5DZ two star good service 08/04/2009 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: Derek Brown Date: 0 1 1 2 2 0 0 9 Information about the care home
Name of care home: Address: Quince House 77 Adeyfield Road Hemel Hempstead Herts HP2 5DZ 01442248316 01582840023 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) : Complete Care Services Limited care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 6 0 8 0 4 2 0 0 9 Quince House is a house in Adeyfield Road in Hemel Hempstead. It looks like all the other houses in the road. Six people live at the home. There is a train station near the home. There are also lots of different bus routes. This means that the people who live at the home can get around easily. Everybody who lives at the home has their own bedroom. Nobody has to share a room. Everyone shares the lounge, dining room and kitchen. The accommodation charges for Homeoaks are from £1650 to £1950 per week. Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home The Statement of Purpose and the Service Users Guide tell people about the home. The manager will give a copy the CSCI inspection report to people who want to see it. Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
The purpose of this inspection by pharmacist inspector was to examine the practices and procedures for the safe use, handling and recording of medicines following information received by the Commission. We looked at medication storage, medication records, talked to staff and looked at staff training records. Medication is stored securely for the protection of residents in a cupboard on the first floor of the home. Keys to this cupboard are kept in an unlocked drawer in the kitchen marked keys only. This is not an appropriate level of security for keys to medication storage as medicines may then be accessible to unauthorised people. The temperature of the cupboard used to store medicines is recorded regularly and at an acceptable level to ensure the quality of medicines in use. We looked at the medication and medication records for all 6 of the current residents. We found some problems with these records, including, but not limited to: Gaps in the records giving no indication whether medication had been administered or not; The same letter code (H) used to record that medication has been omitted because a person is either at home or in hospital so giving a confusing record; Medication omitted as supplies had run out; Medication not given in line with prescribed instructions; No record of the receipt of medicines, or of the stock balance left over to a new recording period, so it is difficult to account for medicines in use. We were also told that there was a practice of returning unused medicines at the end of each month. This is unnecessary, wasteful and has resulted in people running out of medication. We looked at the training records for staff who are authorised to give medicines to people and found that there a number of people who were giving medication but there was no documented evidence that they had been trained and assessed that they are competent to do so. What the care home does well: What they could do better:
Practices and procedures for the safe handling, recording and administration of medicines must improve to safeguard residents and demonstrate that they receive their medicines as prescribed.
Care Homes for Adults (18-65 years) Page 4 of 10 Staff authorised to administer medicines must be trained and assessed that they are competent to do so. 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 Adults (18-65 years) Page 5 of 10 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 6 12 Measures must be put in place to ensure that residents are involved in planning the support that they need, and monitoring their progress. The care plans and risk assessments contain appropriate information on personal and health care needs, but there is little indication of the involvement of each person in setting up and reviewing their care plan in accordance with the principles and practice of person centred planning. 31/08/2009 2 24 13 A risk assessment must be 08/07/2009 implemented to ensure that there is no risk to the people in the home from the hot surfaces of radiators. The people who live in the home should be confident that all parts of the home are free from possible risks to their health and safety. 3 24 13 Running water temperatures 22/04/2009 of all baths and showers need to be regulated to close to 43 degrees Centigrade in order to avoid the risk of
Page 6 of 10 Care Homes for Adults (18-65 years) 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 scalding. Until this is completed, measures must be put in place to ensure that no-one in the home is at risk of scalding from the high water temperatures. The temperatures of all water outlets, and especially baths and showers, must be tested on a regular basis to make sure that they remain at a safe level. The people who live in the home should be confident that all parts of the home are free from possible risks to their health and safety. 4 33 18 The staffing rotas show that 08/08/2009 some staff work very long hours. The registered person must ensure that sufficient staff are employed in the home in order to comply with the Working Time Regulations. People who work excessively long hours may be too tired to provide a good quality of care for the people who live in the home, and there is a risk of errors due to poor concentration. Care Homes for Adults (18-65 years) Page 7 of 10 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 20 13 There must be sufficient 31/12/2009 supplies of medicines held in the home for the continued treatment of people. This will ensure they receive their medication as prescribed. 2 20 18 Staff authorised to administer medicines must be trained and assessed as competent to do so. This will protect people from harm. 31/01/2010 3 20 13 Keys to medicines storage cupboards must be kept on the person of the person in charge. This will prevent unauthorised access to medicines. 31/12/2009 4 20 13 Records made of the receipt and administration of medicines must be clear, accurate and complete and include the balance of any 31/12/2009 Care Homes for Adults (18-65 years) Page 8 of 10 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 remaining medication carried forward to a new recording period. This will account for all medicines in use and demonstrate that people receive their medicines as prescribed. 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 20 It is unnecessary and wasteful to return unused medication at the end of each month so this practice should be reconsidered. Care Homes for Adults (18-65 years) Page 9 of 10 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 Adults (18-65 years) 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 Adults (18-65 years) Page 10 of 10 - 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!
