Inspection on 22/07/10 for Sun Hill

This inspection was carried out on 22nd July 2010.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sun Hill 26/05/10

Sun Hill 17/03/10

Sun Hill 11/03/10

Sun Hill 09/03/10

Sun Hill 13/05/08

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Random inspection report Care homes for older people Name: Address: Sun Hill 147 Manchester Road Burnley Lancashire BB11 4HT zero star poor 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: Maggy Howells Date: 2 2 0 7 2 0 1 0 Information about the care home Name of care home: Address: Sun Hill 147 Manchester Road Burnley Lancashire BB11 4HT 01282422500 01282434696 sun_hill_residential@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) S.J. Care Homes (Wallasey) Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 0 0 0 7 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 22 1 4 0 The maximum number of people who can be accommodated is: 22 The registered person may provide the following categories of service only; Care home only - code PC, to people 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: 7) Dementia Code DE Mental disorder, excluding learning disability or dementia - Code MD Care Homes for Older People Page 2 of 10 (maximum number of places: 4) Learning disability - Code LD (maximum number of places 1) Date of last inspection Brief description of the care home Sun Hill provides 24-hour care and accommodation to older people and older people who have a dementia or mental health problem. One person has a learning disability. The home is a large detached house, located on a main road close to Burnley town centre. There are good bus and rail links nearby. There is car parking at the front of the home and an enclosed garden/patio at the back. Car transport with staff escort is provided. There are two lounges and a dining room/lounge on the ground floor. Private single bedrooms and one double (most en-suite) are on the ground, first and second floors. There is a lift to the upstairs bedrooms. The home has an activities programme that includes movement to music, reminiscence, entertainers, dominoes, bingo and outings. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The current fees at the home are £386.00 to £435.00 covering all aspects of care, food and accommodation. 1 1 0 3 2 0 1 0 Care Homes for Older People Page 3 of 10 What we found: We visited the home because we had some concerns about the giving and recording of medicines at our last visit. This visit was carried out by a pharmacist inspector. It lasted approximately six hours and involved speaking with the manager, the responsible person, the operations manager and carers on duty. This was an unannounced visit, which meant that neither management nor staff knew we were going. We checked the medicines storage area, a sample of medicines stocks and medicines records. We gave detailed feedback to the manager, operations manager and responsible person at the end of the visit. Overall we found that there was some poor practice when handling, administering and recording medicines. This meant that health and wellbeing of people who live in the home was being put at unnecessary risk of harm. Policies and procedures for handling medicines within the home had only just been produced. These had not yet been shown to the staff. This meant that staff did not have clear instructions for handling medication within the care home. We looked at a sample of records and stock and found it very difficult to account for medicines. This meant that we could not be sure that medicines had been given to people correctly, or if the right amount of stock was left. There was no obvious system of stock control because stock was not properly recorded (carried forward) from one month to the next.When we looked at records, we found that not all medicines entering the home had been recorded. Records of medicines leaving the home were also incomplete. Records of all medicines received, administered by and leaving the home must be complete and accurate in order to account for all medicines. The medication administration records were generally preprinted by the supplying pharmacy, although some had been written by hand. The handwritten ones had not been double signed by two members of staff to show they had been thoroughly checked. We found that these contained lots of inaccuracies, for example the strength, dose and form of medicine was often missing. One record did not have the date or the name of the person written on. When the administration of medicines is not accurately recorded, people are at risk of being given the wrong amount of medicine (too much or too little). Mistakes are far more likely to happen when records are incomplete and inaccurate. Some people were prescribed medicines to be taken only when required e.g. painkillers. There was a clear system in place for recording detailed information about how and when these medicines were to be given, but this had not been completed in all cases. This information is vital in order to ensure that people be given their medicines consistently and correctly. It is important that this information is regularly reviewed and updated where necessary. One person had their tablets crushed before they were given. There was no specific instructions for staff to follow in order to do this safely. There was no mention of this practice in the persons care plan and no evidence that the safety of crushing these had been checked with the pharmacy or, in some cases, the prescriber. Crushing tablets can Care Homes for Older People Page 4 of 10 alter the way in which they are absorbed by the body, and in some cases can be dangerous. Some medicines have to be taken at specific times, for example an hour before food, in order to work properly. Whilst some medicines were clearly given an hour before breakfast, we could see no evidence that this was done at other times of the day. We saw medicines prescribed to be taken 30-60 minutes before food being given after lunch. People are unlikely to get the best from their medication if it is not given at the correct time in relation to food and drink. We looked at the storage of medicines and found that the service had an appropriate medication cupboard and trolley with the keys being held securely at all times. Some medications e.g.stocks of insulin, had to be kept in a fridge according to manufacturers guidance. There was no medication fridge available and the stock was being kept on the trolley. Medicines can spoil and become unfit for use if they are not kept at the correct temperature. Using spoiled medicines places the health and welfare of people living in the home at serious risk of harm. When we looked at a sample of stocks, we found that some peoples medication had been allowed to run out. This is unacceptable. the health and welfare of people living in this home is at serious risk of harm if they are not given their medication at the correct tine. People living in the home were not encouraged to look after their own medication. No risk assessments had been completed to assess whether people wished to manage their own medicines, or what support they may need in order to be able to do so safely. We asked the manager about audits (checks) that were carried out to assess how well medicines were managed within the home. She told us that she carried out checks, but there were no written records of this.This meant that mistakes were not being found and acted upon to help prevent them happening again. We gave some advice to the manager on how audits can be performed and how they help to maintain and improve standards. We looked at training and found that only senior carers who had been given medication training were authorised to handle medication. However, there was no evidence of a formal system for checking and recording the competence of care staff (including temporary staff) actually administering or recording medicines. Checking the competence of staff ensures they are safe to carry out their duties without supervision. Given the serious nature of our findings the competence of some staff is questionable. What the care home does well: What they could do better: All medication must be administered as prescribed, in order to protect the health and wellbeing of people who use this service. Medicines must be given at the correct time of day, particularly with regard to food and drink intake in order for medicines to work properly and/or reduce side effects. Care Homes for Older People Page 5 of 10 There must be complete and accurate records of all medication received, administered and disposed of by the service in order to account for all medicines. There must be a system for regularly auditing (checking) the standard of handling and recording medication within the service so that standards can be monitored and improved where necessary. 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 6 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 9 24 There should be an effective system in place to check medicines and staff competence. This will help to make sure people who live at the home are kept safe. 16/07/2010 2 9 13 Records of medication received into the home and given to people must be clear, accurate and complete. This will enable medicines to audited to make sure they are being given correctly. 16/07/2010 3 26 16 The unpleasant odour in several areas of the home must be addressed. This Will ensure people people using the service have a homely and pleasant place to live. 30/06/2010 Care Homes for Older People Page 7 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 1 9 13 There must be sufficient stocks of each persons medication available at all times so that people receive their medication as prescribed. 31/08/2010 2 9 13 Medication must be kept at 20/08/2010 the correct temperature, e.g. in a fridge, as recommended by manufacturers in order to prevent it from spoiling and becoming unsafe to use 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 13 If medication needs to be crushed and/or given covertly, then there should be detailed instructions for staff to follow in order to do this safely. Written permission should be obtained from the prescriber before giving any medicine in this way Two members of staff should thoughly check and sign Page 8 of 10 2 13 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 handwritten medication administration record charts in order to reduce the risk of errors being made. Care Homes for Older People 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 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. 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