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 3 0 2 2 0 1 0 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 1 1 2 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 reason for this inspection by a pharmacist inspector was to assess progress towards meeting the requirements made following the inspection on 1/12/09. We have also received information alleging inappropriate security for medicines, particularly controlled drugs, which resulted in the unauthorised people gaining access to medicines. Following the inspection on 1/12/09, we received a response from the provider indicating what actions had been taken to meet the requirements and that they had been met by the given timescales. On arrival at the home we saw that they keys to the medication storage cupboard are still stored in a drawer in the kitchen area, but that this drawer is now locked and they key kept on the person of the shift leader. So the requirement we made about this has been met. We also made a requirement that there must be sufficient supplies of medicines held in the home for the continued treatment of residents. We looked at the medication records over the previous 2 months and talked with staff. We found that there were no recorded omissions due to the unavailability of medicines and this was confirmed by staff we spoke with. We therefore consider this requirement had been met. On our last inspection in December 2009 we found that the records made when medicines were given to people were inaccurate, incomplete and did not permit an audit trail of medicines in use. On this inspection we saw that the the records made when medicines are given to people have improved and demonstrate that people receive the medicines prescribed for them. But for one person we saw that the record had been completed with the code letter H which, according to the key for the codes at the foot of the form indicated that the resident was in hospital. However we were informed that the resident was actually at home during this period. The response from the provider stated that The letter O has now been adopted to indicate any other reasons [for omission]... such as service user on home leave. This has therefore not been implemented by all staff and the record of the medication administration is inaccurate. We also found that there is no record of the balance of any surplus stock carried forward to a new recording period and in one case it was difficult to assess whether the medication records were accurate as we could not accurately assess the quantity of medication used. The requirement has therefore not been met in full, but, taking a reasonable view of the improvements made, we have carried forward the requirement with a new timescale for action. We also made a requirement that staff authorised to administer medicines must be trained and assessed as competent to do so. We were told that a training session had been held on 18/12/09 for all staff but no documentary evidence could be provided to support this, such as certificates of attendance or an attendance list to show which staff had attended. We were also told that staff had not been assessed as to their competence to administer medication safely. We found, on looking at the medication adminstration records that one person had not been given their medication as staff had forgot to administer. This has not been reported to the Commission under Regulation 37 of the Care Homes Regulations 2001 and brings into question staff competence to administer medication safely. This requirement has therefore not been met, but given that some
Care Homes for Adults (18-65 years) Page 4 of 10 training has been provided we have carried forward this requirement with a new agreed timescale. We did not find any medication left unattended and the home does not have any controlled drugs, nor has any person been prescribed controlled drugs during the previous 3 months. We therefore cannot uphold the concern raised that people have had unauthorised access to medicines. On inspection of the medication records we noted that one person was prescribed medication on a when required basis but that the records made when medicines are given show the medication given regularly. We were told that the medication for this person is now needed on a regular basis. Such changes or variations to prescribed instructions must be discussed with the prescriber so that instructions for the use of medicines reflect the persons needs following a medical assessment. We have not made a requirement about this on this occasion and expect this to be managed by the home. We made a recommendation about the unnecessary and wasteful disposal of unused medication at the end of each month. We did not find, on this inspection, any such unnecessary disposal of medication so this recommendation has been implemented. 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 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. Not assessed on this inspection. 31/08/2009 2 20 18 Staff authorised to administer medicines must be trained and assessed as competent to do so. This will protect people from harm. This requirement has not been fully met by the given timescale of 31/01/2010. 28/02/2010 3 20 13 Records made of the receipt and administration of 28/02/2010 Care Homes for Adults (18-65 years) Page 6 of 10 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 medicines must be clear, accurate and complete and include the balance of any 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. This requirement has not been fully met by the given timescale of 31/12/2009. 4 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. Not assessed on this inspection. 5 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
Care Homes for Adults (18-65 years) Page 7 of 10 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 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. Not assessed on this inspection. Care Homes for Adults (18-65 years) Page 8 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 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 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!
