Key inspection report
Care homes for older people
Name: Address: Stanton Lodge Nursing & Residential Home Millfield Avenue Shiremoor Tyne & Wear NE27 0LE The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Mary Blake
Date: 2 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People
Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home
Name of care home: Address: Stanton Lodge Nursing & Residential Home Millfield Avenue Shiremoor Tyne & Wear NE27 0LE 01912522919 01912535017 stanton.lodge@fshc.co.uk www.fshc.co.uk Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) care home 72 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) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Three named service users are under pensionable age. No further admissions of under pensionable age service users must take place without prior agreement of the Commission for Social Care Inspection Date of last inspection Brief description of the care home Stanton Lodge is a purpose built 72 bed care home. All the accommodation is on ground floor level and all the bedrooms have en-suite facilities. The home is situated in a residential area and is close to local amenities and public transport. There are two units within the home each offering a different category of care, one provides for older people requiring personal care or personal care with nursing and the other provides care for 21 younger physically disabled people. There are lounges and dining rooms on each unit and there is a smoking lounge. All units have specialist baths, showers and disabled toilets. There are enclosed garden areas, which are wheelchair accessible, and Care Homes for Older People
Page 4 of 28 Over 65 51 0 0 21 Brief description of the care home there are car-parking facilities. Fee rates vary on an individual basis and are available from the home. This fee includes the nursing care element without specialist equipment. Further information about the home is available in the service user guide, which contains the statement of purpose and previous inspection reports. This is kept in the reception area of the home. Care Homes for Older People Page 5 of 28 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward in this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. An unannounced visit was made by a Regulatory Inspector and a Pharmacy Inspector on the 26th January 2010. The manager was present throughout the inspection. Before the visit we looked at information we have received since the last random Care Homes for Older People
Page 6 of 28 inspection in November 2009. We looked at how the service dealt with any complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of people who use the service, their relatives, staff and other professionals. We also looked at how the service had responded to recent enforcement action taken by the Commission that included the issuing of three legal notices with regard to the health and welfare of people living at the home, care planning and the management of medications at the home. During the visit we talked with people who use the service, relatives, staff and the manager, we looked at information about the people who use the service and how well their needs are met and looked at other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for and looked around the building/parts of the building to make sure it was clean, safe and comfortable. We also checked what improvements had been made since the last visit. We told the manager and provider representatives what we found. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? There had been improvement in the consistency and amount of information which was recorded in the care plans and the standard of care planning on the older persons unit was satisfactory, we found evidence that individual peoples care plans were maintained, updated, reviewed and revised in order to accurately reflect their health and welfare needs. Care Homes for Older People Page 8 of 28 There was an improvement in the recording of wounds and pressure sores within care records and it was easier to identify whether wound dressings were being changed as needed. There had been improvements to pressure area care with evidence of healed wounds and of good liaison with the tissue viability nurse. We found that the individual health needs of people who use the service were now being consistently met. Proper and prompt provision had now been made for their care and treatment. We found examples where the quality of recording was improved and information was up to date. The recorded information was consistent and important details found within the daily reports had been included within individual peoples care plans. Various assessment tools were in place such as nutrition, pressure sore risk, moving and handling and dependency and these had now been consistently completed, reviewed and updated. People who use the service and their families are now involved with their care plans. Individual care plans had been evaluated and where necessary updated on a monthly basis and these now accurately reflected the changing needs of the people who use the service. Risk assessments had now been accurately completed and actions recorded to help minimise risks such as weight loss. Nutritional assessments and care plans were in place for people where risks had been identified and the records of actions taken was now consistent. We found that several people were being nursed on pressure relieving mattresses which were now set correctly and their use was now detailed within individual care plans. The majority of people were up and in the lounges. Staff reported that some people got up on alternative days and staff now understood why this was happening and felt there was improved direction from the nurses. The ordering, storage and recording of medicines is now well managed and well maintained. People who use the service said their choice about how they spent their day had improved and that they now received hot drinks with their meal and regular drinks outside of mealtimes. A range of developing social activities takes place both within and outside of the home and this gives people who use the service the opportunity to meet, mix and socialise with others. The home has undergone refurbishment and redecoration to a good standard and now provides comfortable and pleasant surroundings for people who use the service. Individual bedrooms are well furnished and have ensuite facilities. Bathrooms and showers are of a good standard with a number of assisted facilities to enable people Care Homes for Older People
Page 9 of 28 who use the service to feel more comfortable and supported to enjoy this time. The communal areas have been redecorated and used for a range of social events. We observed that staff were kind and caring towards people who use the service. They said that they were now receiving the direction and support they needed and felt more able to provide people with the support and care that they needed. There were sufficient numbers of suitably qualified nurses working in the care home to meet peoples nursing care needs and provide full support to and supervision of the carers. The dependency levels of the current people who use the service had been reviewed and additional care staff were in place on the older persons unit, staff were clearly under less pressure and told us that they felt better supported and more able to meet peoples personal care needs. There was evidence of management planning within the home and there was improved leadership on the older persons unit where the atmosphere was calm and staff felt they had clear direction. It was evident from the views of staff, relatives and people who use the service that the improvement in consistent leadership had led to improvement in care delivery and this was now evident within the care plans. What they could do better: Regular audit of the whole medication system would help ensure that all staff closely follow the homes medicines policy and good practice guidance. Staff must sign and date handwritten entries they make on MARs. Each entry must be checked by a second person to reduce the risk of error when copying information. Additional guidance on the administration of anticoagulants and medicines prescribed to be taken as required should be kept with MARs to support staff at the time of medicines administration. Stocks of controlled drugs should be checked regularly and a record of the check made in the controlled drug register this will help identify if a medication error or omission occurs. A list of staff authorised to administer medicines, together with their specimen signatures and initials, should be kept in each MAR file. This will help identify who was involved in administration if a medication error or omission occurs. Additional guidance should be provided with the MAR charts to assist staff in deciding when medication prescribed to be taken as required should be offered to people. The medication disposal records should include a signature and date to confirm that the listed medicines have been removed from the home. To ensure that people who use the service receive wholesome, nutritious and well Care Homes for Older People
Page 10 of 28 prepared meals at all mealtimes. The programme of planned training in safeguarding of vulnerable adults and first aid must be completed as this will help protect people who use the service. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 11 of 28 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 12 of 28 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service know how their needs will be met prior to admission to the home. Evidence: There have been no new admissions to the older persons unit as the provider has invoked a voluntary embargo until the service improves. Planned respite has continued within the younger adults unit without any issues. Previous preadmission processes and documentation had been satisfactory. Care Homes for Older People Page 13 of 28 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are consulted about and enabled to participate in decisions about their lives. Their privacy and dignity are protected, their holistic needs are met. Regular audits of the whole medication system would ensure that staff follow the homes policies and procedures. Evidence: Information which was recorded in the care plans had been maintained, updated, reviewed and revised on an individual basis and in order to accurately reflect their health and welfare needs. Three care plans were looked at in detail. The recorded information was consistent and details found within the daily reports had been incorporated into plans. Various assessment tools were in place such as nutrition, pressure sore risk, moving and handling and dependency. These had been consistently completed, reviewed and updated when indicated to accurately reflected the changing needs of the people who use the service. Risk assessments had been completed and actions recorded to help minimise risks such as weight loss.
Care Homes for Older People Page 14 of 28 Evidence: There was sufficient information about why and what types of pressure relieving mattresses were in place and information on their setting in relation to peoples body weights. There was evidence of good links with the tissue viability nurse. Nutritional assessments and care plans were in place for people where risks had been identified. The records of actions taken had was consistent with good practice. Links are established with local GP and supporting health professionals and people who use the service were receiving support for opticians, chiropodists, dentist and aural health support. Occupational therapist and physiotherapist support was available and people who use the service had accessed dietary advice and support. The process for ordering and checking prescriptions, and the receiving of medication into the home, is well managed and records are maintained. This ensures that all required medication is ordered, dispensed and received in time for the start of the next cycle of treatment. All medication was securely stored and within the appropriate temperature range recommended by the manufacturer. Liquid medicines, and other medicines with a short use once opened, were labelled with the date of first opening. This ensures medicines are not used beyond the date recommended by the manufacturer. Medication administration records for each unit were looked at, including a sample from the previous month. No gaps were identified in the records, appropriate non administration codes had been used and no discrepancies were found between the quantities of medication received, the number of doses recorded on the MARs and the quantities of medication remaining. Handwritten entries on MARs were not always signed by a second person to confirm accuracy and occasionally, there was no signature or date for the person making the initial entry. Controlled drugs were stored appropriately. There were no discrepancies between entries in the controlled drug register, entries on the MARs and the quantities of controlled drug held in the home. Daily and weekly audit of the MARs is currently undertaken to ensure that staff complete medication records accurately and to identify any medication problems promptly. This is good practice and we saw examples where medication queries had been identified by staff and subsequently promptly resolved. Audit of the whole medication system, however, to include for example, storage conditions and the Care Homes for Older People Page 15 of 28 Evidence: recording of controlled drugs and medicines sent for disposal, is not regularly undertaken. This would ensure that staff are following the homes policies in relation to medication at all times. A programme of additional medication training has been introduced to reinforce standards of good practice and the providers policy on the administration of medicines. It was observed that staff were treating people who use the service with kindness and respect throughout the day and this was confirmed by service users and their families. Staff were respecting individual choices and dignity. Care Homes for Older People Page 16 of 28 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are enabled to participate in appropriate activities of their choice and to maintain relationships with friends and family. Evidence: People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. going to the cinema, to the pub, eating out, shopping etc. The home had recently had a Burns Night with traditional food and Scottish dancers and this had been thoroughly enjoyed. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting individual wishes. Staff support people who use the service to maintain existing friend and social relationships.
Care Homes for Older People Page 17 of 28 Evidence: Staff seek permission prior to entering individual rooms and were communicating well with people who use the service. People who use the service were observed to move freely around the home. People who use the service have been involved in a recent review of menus and as a result of this menus and mealtimes had been changed. However the regular chef was not on duty on the day of inspection and the meal served at lunchtime was not the one detailed on the menu. The food being served at lunch time was not of a satisfactory standard, the spam fritters were over cooked and very greasy, this was commented upon by people who use the service they are always greasy dont really like the main choice at lunch but I usually have a nice salad. Alternatives were available and were well presented and people said these were good. People who use the service and staff commented that the food is generally good but often let down by lunchtimes dont really want things like hot dogs. People were observed having a leisurely lunch in a relaxed and social setting with good staff support evident. Peoples nutritional needs were observed to be identified and actively managed with input from the dietician as needed. Care Homes for Older People Page 18 of 28 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are managed satisfactorily. People who use the service are safeguarded. Evidence: The home ensures that people who use the service and their relatives are aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken and recorded. The complaints procedure is displayed in the home and available to individuals and their families. People who use the service and their relatives spoken to know how and who to complain to and were confident that their concerns would be dealt with. There are extensive means to obtain views of service users and their families. There have been four recorded complaints dealt with internally. The manager was aware of the need to protect people who may not be able to make individual decisions. They have a good understanding of the mental capacity and deprivation of liberty legislations and the implications of this. Staff have undertaken training on the Protection of Vulnerable Adults but this needs updating and further training is planned. Staff were aware of the whistle blowing policy and said they felt able to raise concerns if necessary. The manager was aware of the need to protect all people who use the service. Safeguarding issues had been appropriately managed and reported.
Care Homes for Older People Page 19 of 28 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well decorated, maintained, clean and comfortable. Evidence: The home is furnished and decorated to a good standard and provides comfortable and pleasant surroundings for people who use the service. Individual bedrooms are well furnished with ensuite facilities and was evidence that people had personalised their room. Aids and adaptations are available to assist people to move freely and independently around the home. Bathrooms and showers are of a good standard with a number of assisted facilities to enable people who use the service to feel more comfortable and supported to enjoy this time. The communal areas are well decorated and used for a range of social events. The home is clean and free from offensive odours. Care Homes for Older People Page 20 of 28 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well staffed with a skilled, consistent and trained staff team giving security to people who use the service. Staff recruitment and training records were clear and contained all relevant information. The thorough vetting process helps protect people who use the service. Evidence: The home is currently only partially occupied. with twenty service users on the older person unit and thirteen service users on the younger adults unit. There were sufficient numbers of suitably qualified nurses working in the care home to meet the full needs of people who use the service and to provide support and supervision to the carers. The manager stated that the dependency levels of the current people who use the service had been reviewed and additional care staff were in place on the older persons unit. Staff were clearly under less pressure and told us that they felt better supported and more able to meet peoples personal care needs. The staff have a good understanding of the individual needs of people who use the service, who were very complimentary about the staff. Staff have undertaken National Vocational Training in Care at level two or above as well as additional training,
Care Homes for Older People Page 21 of 28 Evidence: ensuring people who use the service receive care from a skilled and knowledgeable staff team. Four recruitment files across all roles and including a new starter were well documented and all appropriate checks in place. Staff have undertaken mandatory training but there were shortages for staff completing safeguarding of vulnerable adults updates and first aid training. The provider has submitted an action plan outlining how this training issue will be met. Staff have continued to undertake training and spoke of using this knowledge in their practice. It was observed that staff were treating people who use the service with kindness and respect throughout the day and this was confirmed by service users and their families. Staff were respecting individual choice, privacy and dignity. Care Homes for Older People Page 22 of 28 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a home that is well run and managed. Evidence: The registered manager is an experienced nurse and manager and is only responsible for Stanton Lodge. A peripatetic manager in a supporting role remains in place for the interim. A deputy manager and nurse have now been appointed and are working on the older person unit and a unit leader (nurse) has been appointed and is working on the younger adult unit. Recruitment for qualified nurses continues. The manager has introduced systems to enable people who use the service, relatives, staff and supporting health professionals to voice their views. Regular meetings had been held for people who use the service, relatives and staff to discuss and review practices and the running of the home. The people who use the service and staff made positive comment about the manager
Care Homes for Older People Page 23 of 28 Evidence: and staff team. They gave examples of improved practices and of the staff team taking time to listen and respond to any concerns they may have. The providers quality assurance and audit systems have been reviewed and are a comprehensive document covering areas such as medication, home manager audit and catering. Monthly provider visits are undertaken. The accident records are well documented with manager and provider overview and analysis, evidence of risk assessment update, contact with the fall risk team and risk management strategies put in place. Accident and risks assessment are appropriately documented with good links established with the local health team. All records were well organised, easy to access and up to date. Procedural policies are available to staff in the office and other areas. There was evidence of management planning within the home and there was improved leadership on the older persons unit where the atmosphere was calm and staff felt they had clear direction. Throughout the visit senior management were present, co-operative and acknowledged our findings. It was evident from the views of staff, relatives and people who use the service that the improvement in consistent leadership had led to an improvement in care delivery and this was now evident within the care plans. Fire and other system testing had been undertaken at the recommended timescales and systems established for maintenance to be undertaken when necessary. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 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, Care Homes 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 9 13 Staff must sign and date handwritten entries they make on MARs. Each entry must be checked by a second person to reduce the risk of error when copying information. To reduce the risk of error when copying information and ensure safety of people who use the service. 19/03/2010 2 9 13 A regular audit of the whole 19/03/2010 medication system must be undertaken regularly to help ensure staff are closely following the homes medicines policy. To ensure that staff follow the homes medicines policy and ensure the safety of people who use the service. Care Homes for Older People Page 26 of 28 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 The medication disposal records should include a signature and date to confirm that the listed medicines have been removed from the home. Additional guidance should be provided with the MAR charts to assist staff in deciding when medication prescribed to be taken as required should be offered to people. A list of staff authorised to administer medicines, together with their specimen signatures and initials, should be kept in each MAR file. This will help identify who was involved in administration if a medication error or omission occurs Stocks of controlled drugs should be checked regularly and a record of the check made in the controlled drug register. The written instructions provided by the anticoagulant clinic should be kept attached to the MAR chart of persons receiving anticoagulant treatment. This makes sure that staff have accurate and up to date guidance on the dose of anticoagulant to administer. To review the lunchtime meals to ensure that people who use the service receive wholesome, nutritious and well prepared food. Ensure that all staff complete training in safeguarding of vulnerable adults updates and first aid as this will help protect people who use the service. 2 9 3 9 4 5 9 9 6 15 7 30 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!
