Random inspection report
Care homes for older people
Name: Address: Rossmore Nursing Home Limited 68 Sunny Bank Spring Bank West Kingston upon Hull East Yorkshire HU3 1LQ 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: Date: 2 7 0 5 2 0 0 9 Information about the care home
Name of care home: Address: Rossmore Nursing Home Limited 68 Sunny Bank Spring Bank West Kingston upon Hull East Yorkshire HU3 1LQ 01482343504 Telephone number: Fax number: Email address: Provider web address: dnd@rossmorecare.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rossmore Nursing Home Limited care home 56 Number of places (if applicable): Under 65 Over 65 56 56 56 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 8 Registration includes twelve (12) stroke rehabilitation patients and 6 day places. Date of last inspection Brief description of the care home Rossmore Nursing and Residential Home is a two-storey building, which has been converted from a number of terraced houses for its present use. It is situated about a mile and a half from the centre of Hull in a quiet residential area overlooking the playing fields of Hymers College. There is a range of shops and pubs nearby. There are bus stops close to the home and the main train station is within walking distance. Car parking is available on the street outside the home. The home provides nursing and residential care to people over the age of 65 years for needs associated with physical
Care Homes for Older People Page 2 of 9 Brief description of the care home disabilities or dementia. The home also has a contract with Hull Primary Care Trust to provide a stroke rehabilitation service to eight people. The main unit has accommodation provided over two floors within single or shared rooms; one of the shared rooms has en-suite facilities. Access to the upper floor is available through the use of stairs or the passenger lift. The main unit has four assisted bathrooms and two shower rooms and the stroke unit has two shower rooms. Communal areas consist of a large lounge with doors into a dining room, which in turn leads into a small quiet room. Four shared bedrooms for the stroke unit are located at one end of the main unit and the communal areas are in a separate building. These consist of a lounge, rehabilitation kitchen, a therapies room and offices for health professionals. There is a small garden leading off from the quiet room on the main unit and a courtyard accessible for the stroke unit. Fees for the home range from 350.50 - 560 pounds per week plus a 10 pound top fee, which is determined on an individual basis. Additional charges include hairdressing, toiletries, newspapers and chiropody. Information regarding the services the home provides can be located in the service user guide and statement of purpose, both available from the managers office. Care Homes for Older People Page 3 of 9 What we found:
This pharmacist inspection visit lasted 5 hours and was carried out to follow up medication concerns identified at the last key inspection in April 2009. During this visit we examined the medication policy and procedures, the current medication administration record (MAR) charts, and the medication ordering, storage and handling arrangements. There are very few administration gaps on the MAR charts meaning that people living in the home can expect to receive their prescribed medicines correctly. There is now greater consistency in handwritten entries and changes made to medication. The quantities of medicines received into the home and brought forward each month are now clearly entered on each persons MAR chart making it easy to check whether sufficient quantities are always available. Loose additional medication labels supplied by one community pharmacy were destroyed during this visit in order to prevent inappropriate use leading to accidental medication errors. Medicines are stored securely either in locked trolleys or locked cupboards. The temperature of one medicine storage area was not checked or monitored so staff do not know that medicines in this area are stored correctly. Storing medicines at temperature and conditions recommended by the manufacturer means that staff will know medicines are safe to use when needed. Advice should also be taken on the general security of some storage areas to reduce the risk of loss, diversion or tampering. The revised medication procedures we were shown contain some inaccuracies and gaps, for example about medicines disposal and individual medication care plans. Clear medication procedures based on current professional guidance help staff to work consistently and may reduce the risk of medication error. Individual medication care plans which reflect the personal preferences and lifestyle choices of people living in the home are not available for most people. Such care plans reduce the likelihood of people refusing their medicines or of doses being missed. 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 4 of 9 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 8 12 Care staff must ensure that a 15/05/2009 specific residents health needs are met in relation to pain control management. This will ensure the resident remains as pain free as possible and health professionals instructions are carried out. 2 9 13 Staff administering 15/05/2009 medication must ensure that policies and procedures are adhered to. The potting up of medication is an unsafe practice. This will ensure the safe administration of medication and avoid mistakes and accidents happening. 3 9 13 The registered person must ensure that nurses only administer medication to services users that is prescribed for them by their GP. This will ensure service users health, safety and wellbeing are protected. 15/05/2009 4 9 13 A system must be in place to 15/05/2009 record the expiry dates of medication with limited use once opened.
Page 5 of 9 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 This makes sure medication is safe to administer by reducing the risk of contamination. 5 9 12 People must only receive 15/05/2009 medication that is prescribed for them on the bottle. The practice of mass dispensing from one bottle of lactulose is unsafe practice. This will ensure that peoples medication can be audited more accurately. 6 9 13 Stock control of medication 15/05/2009 must be managed more effectively to ensure there are always supplies on the premises and people recieve the medication that has been prescribed for them. This will ensure that the identified health needs are met. Care Homes for Older People Page 6 of 9 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 1 9 Individual medication care plans should be developed and agreed which reflect the personal preferences and expressed lifestyle choices of people living in the home. These care plans should be regularly reviewed in line with changes in peoples medication, health and wellbeing. Regular, monthly prescriptions should be seen before sending to the pharmacy. This makes sure a check can be made of any changes, that all the medicines required have been listed and prevents people from being without their medicines. The temperature in all medication storage areas should be monitored to ensure medicines are being stored correctly at temperatures recommended by the manufacturer. Staff will then know they are safe to use when needed. Consideration should be given to improving aspects of medication storage and security in order to reduce the risk of loss, diversion, or tampering. The medication policy and procedures should be updated in line with current professional guidance so that staff
Page 7 of 9 2 9 3 9 4 9 5 9 Care Homes for Older People 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 understand exactly what is expected of them. Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!
