Random inspection report
Care homes for older people
Name: Address: St Michael`s View St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP zero star poor service 01/03/2010 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: Michael Earnshaw Date: 0 2 0 6 2 0 1 0 Information about the care home
Name of care home: Address: St Michael`s View St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP 01914551215 01914551238 stmichaels@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sonia Pharoah Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne Homes Ltd care home 64 Number of places (if applicable): Under 65 Over 65 0 31 0 dementia old age, not falling within any other category physical disability Conditions of registration: 33 0 2 The maximum number of service users who can be accommodated is: 64 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 - Code OP, maximum number of places 31 Dementia Code DE, maximum number of places 33 Physical Disability - Code PD, maximum number of places 2 Date of last inspection 0 1 0 3 2 0 1 0 Care Homes for Older People Page 2 of 9 Brief description of the care home St Michaels View Care home is owned by the Southern Cross, which was first registered in November 1994 and now accommodates 32 older people of mix gender for general nursing care and another 32 persons with mental ill health, 2 of who may also have a physical disability. The home does not provide intermediate care services. It is situated in a residential area and convenient for the town centre of South Shields. It is close to local train and bus transport. The coast, shopping outlets, local theatres and social amenities are close by. The local shops and a post office are within easy walking distance of the care home. St Michaels View is a modern single storey care home, custom designed and built to provide facilities and services in 2 distinct separate units. There are in total 4 lounges, 2 dining areas and bedrooms with en-suite facilities. There are 2 internal courtyards both with wheel-chair access. The home is decorated and furnished to a good standard, and in keeping with the age, character and style of the building. Care Homes for Older People Page 3 of 9 What we found:
This inspection was carried out to check compliance with two Statutory Requirement Notices (SRNs) issued on 6 May 2010 that the Care Quality Commission sent to the provider following the previous inspection carried out on 21 April 2010. These SRNs concerned arrangements in the home for maintaining supplies of medication and the recording and safe administration of medicines. A pharmacist inspector spent seven hours in the home looking at medication records and care plans, and speaking to the manager and senior care staff. The outcome is as follows; We found no evidence that people living in the home did not receive their medication as prescribed because supplies were not available. A system recently introduced into the home to record the quantity of medication remaining after each administration is helping staff identify medication which needs to be re-ordered before supplies run out. In addition, regular medication counts are undertaken by senior staff in the home and a full audit trail is maintained for the ordering, receipt and disposal of all medication. This good practice helps to make sure that accurate and complete medication records are maintained and helps to prevent the home running out of prescribed medication. Regular checks of the Medication Administration Records(MARs) are now carried out to ensure that all entries are complete and fully recorded. This has led to a significant improvement in reducing the number of gaps on the MARs seen during the last inspection. We noted no significant gaps on MARs where administration had not been recorded or a non-administration code entered on the MARs, other than in relation to one resident prescribed daily Strontium sachets. There were gaps on four consecutive days but daily entries on the stock balance record, and a count of the sachets remaining, confirmed that all doses of Strontium had been administered, but not recorded on the MAR. Appropriate codes for the non- administration of medicines were recorded on MARs, with additional explanations as to why medication had not been given documented on the reverse side of the MAR. We noted that a person out on social leave did not receive a 6pm dose of Tegretol Retard on one occasion and there is no procedure in the home to enable medication to be taken out of the home with the resident or carer. We counted a sample of medications and compared the amount of medication remaining with the quantities supplied and the number of doses recorded. Although the majority of counts confirmed that medication had been given as prescribed we noted a few small discrepancies, on the Cleadon Unit, where the medication remaining did not match up with the medication records. A number of residents were prescribed Insulin and regular recording of blood glucose, in line with the relevant persons care plan, was fully documented on each persons diabetic/urine record sheets which were kept with the MARs. This means that staff have ready access to a diabetics recent blood glucose results when managing that persons dietary intake and Insulin requirement. Considerable progress has been made since the last inspection to ensure that medication care plans are in place for people with special medication administration needs. Written
Care Homes for Older People Page 4 of 9 guidance was attached to the individual MARs for people with swallowing difficulties where the use of thickening agents is required, and for people prescribed medication to be taken when required. Similar detailed medication care plans were also in place for a person receiving medication disguised with food and drink, and a person receiving all their medication via a Percutaneous Endoscopic Gastrostomy tube. Entries in the relevant care plan confirmed that appropriate professional advice had been obtained when preparing this medication guidance. We looked at the list of signatures of staff authorised to administer medication in the home. Updated documentation has recently been introduced to deal with the frequent use of agency staff and signature records on both the Cleadon and Marsden Units were up to date and complete. We therefore found that the medication requirements made in the Statutory Requirement Notices issued on 6 May 2010 were met at the time of this inspection. The remaining outstanding requirements listed in this report were not assessed as part of this visit. 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 5 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 18 18 All grades of staff must complete safeguarding training which links into the Local Authority Procedural Framework. This will ensure people living in the home are protected from harm. 07/05/2010 2 30 18 Undertake a comprehensive 31/07/2010 review of the training provided to current staff at the home and produce an accurate record of all training provided to individual members of staff. Produce an assessment of training needs for each member of staff to identify the training needed to enable each member of staff to meet service users health and welfare needs. Ensure that as a minimum each member of staff receives training in Understanding Dementia,Managing challenging behaviour,Safeguarding Adults, Mental Capacity Act and Deprivation of Liberties. Ensure that all nurses with responsibility for Care Homes for Older People Page 6 of 9 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 administering medication are trained to do so. Put in place effective arrangements to ensure that all newly employed and current staff receive structured induction training that as a minimum includes, Moving and Handling training, Fire safety training, Safeguarding adults, Health and safety training and Food Hygiene. Ensure there are sufficient staff employed at the home that are trained in first aid so that there is at all times a minimum of one person on duty who has received first aid training. This is to ensure that the staff receive training appropriate to their work in order to meet the health and welfare needs of the service users accommodated at the home. Care Homes for Older People Page 7 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 Weekly Bisphosphonates, such as Alendronic Acid and Risedronate, should be given at a different time from all other medication. A pharmacist should be contacted for advice if necessary. The system of frequent checks of MARs and maintaining running stock balances should be maintained, particularly in view of the regular changes in agency staff handling medication in the home. A procedure for dealing with medication when people go out on social leave should be written, communicated to staff and included in the homes medicines policy. 2 9 3 9 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. © 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 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!
