This inspection was carried out on 8th June 2010.
CQC found this care home to be providing an Adequate 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for adults (18-65 years)
Name: Address: Richmond Mews Nursing Home Richmond Terrace Shelton Stoke-on-Trent Staffordshire ST1 4ND one star adequate 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: Elaine Bray Date: 0 8 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Richmond Mews Nursing Home Richmond Terrace Shelton Stoke-on-Trent Staffordshire ST1 4ND 01782222310 01782209800 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Angela B Warrilow Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shelton Care Limited care home 48 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 48 The maximum number of service users who can be accommodated is: 48 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: Learning disability (LD) 48 Date of last inspection Brief description of the care home Richmond Mews consists of seven flats that surround a central courtyard as well as an additional semi-independent unit, situated across the road from the home and an eight-bedded bungalow, located across the main car park. Each flat is self-contained in
Care Homes for Adults (18-65 years) Page 2 of 8 Brief description of the care home that they each can accommodate between one or up to eight service users, have their own kitchen, bathrooms, lounges and dining room. All of the flats have single bedrooms with 15 of those having en-suite facilities. The home has a central laundry. Each flat, apart from the semi-independent unit, provides both nursing and personal care for young people who have a learning disability. The semi-independent unit provides personal care and support. The service provides care and accommodation for service users who have a learning disability, and may have varying degrees of behavioural problems, a physical disability or mental health issues. Each flat on the main site has its own enclosed garden area. There is a car park to the side of the property. Richmond Mews is situated within a residential area of Stoke on Trent that is close to Hanley town centre and all local amenities. Service users are able to access day facilities at Regent College, part of the Richmond Care Homes Ltd and the newly established Networks group. Weekly fees range from GBP333.00 to GBP2,962, and are subject to annual review. Care Homes for Adults (18-65 years) Page 3 of 8 What we found:
We carried out a specialist pharmacist inspection to see if medicines were being managed safely. We looked closely at a sample of ten residents medicines and medicine records. We also looked at facilities available and spoke with staff that help residents to have their medicines. Residents live in groups of up to eight in seperate flats. The flats we visited each had a strong metal medicine cupboard to store medicines securely. Where possible, residents medicines were supplied in a calendar pack. Other medicines were supplied in standard containers. Each resident had a designated space in the cupboard. Many had baskets to segregate their medicines from others. Staff were anxious about including medicated creams. In a small domestic environment, provided the containers close securely and are handled hygeinically, this would be acceptable. We looked at the residents medicine records. There was a form, provided by the pharmacy, that staff used to record all medicines given to residents. It was also used to record the receipt of medicines. There was a seperate sheet to record medicines disposed of in the bin provided by the waste contractor. The medicines delivered in the main orders were recorded received, but those that arrived in-between (dose changes or antibiotic courses) were frequently missed. There were only a very few gaps in the administration records. There was a seperate chart to explain why medicines (like pain-killers), given when needed rather than at regular times, were used. The disposal records were loose in a folder and not in date order making them difficult to follow. When the audit trail is clear and complete it is easy to show that residents have had their medicines correctly. eg. two residents had courses of penicillin antibiotic. One had a correct audit trail where every dose was accounted for. The other had no receipt record so it was not clear if the administration record showed the correct number of doses. Recently the medicines have been delivered in two installments. The records did not show this. The audit trail would be clearer if the amount of the medicines, not in the calendar pack, was recorded at the beginning of each new sheet. One resident started to have a hay fever medicine. There was no receipt record because there was medicine remaining from a previous attack. This was not recorded. All the above shows that staff are making entries in the boxes, but the entries do not always show a complete audit trail describing exactly all the medicines use. There was a bottle of a liquid medicine used only occasionally for side effects of another medicine. The pharmacy had stuck the dispensing label over the expiry date. Another bottle of liquid medicine had no dispensing label. Staff had hand-written the residents name and its open expiry date on the container. What the care home does well: What they could do better:
The audit trail of medicines received, given/not given and put for waste could be done better and stored in a more organised way so that it is possible to prove that residents
Care Homes for Adults (18-65 years) Page 4 of 8 are having their medicines safely. When there are problems with medicines received, staff should contact the pharmacy to remedy the situation. 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 8 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 23 12 The provider must ensure that referrals are made under the Mental Capacity Act, to ensure that peoples wishes listened to and acted upon. 16/01/2010 Care Homes for Adults (18-65 years) Page 6 of 8 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 Ensure that the medicines and their records are reconciled at suitable intervals to confirm their accuracy. To show that medicines have been given correctly 10/07/2010 2 20 13 Ensure that if there are problems with medicines received, the pharmacy is informed immediately To ensure residents medicines are safe to use. 10/07/2010 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 7 of 8 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 8 of 8 - 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!
