Inspection on 15/10/09 for Sunrise Operations Edgbaston Ltd (Assisted Living)

This inspection was carried out on 15th October 2009.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sunrise Operations Edgbaston Ltd... 27/04/10

Sunrise Operations Edgbaston Ltd... 24/03/10

Sunrise Operations Edgbaston Ltd... 19/01/10

Sunrise Operations Edgbaston Ltd... 07/09/09

Sunrise Operations Edgbaston Ltd... 29/04/09

Sunrise Operations Edgbaston Ltd... 29/10/08

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Random inspection report Care homes for older people Name: Address: Sunrise Operations Edgbaston Ltd (Assisted Living) 5 Church Road Edgbaston Birmingham B15 3SH one star adequate service 29/04/2009 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: Debby Railton Date: 1 5 1 0 2 0 0 9 Information about the care home Name of care home: Address: Sunrise Operations Edgbaston Ltd (Assisted Living) 5 Church Road Edgbaston Birmingham B15 3SH 01214551100 01214556689 Telephone number: Fax number: Email address: Provider web address: www.sunrise-care.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sunrise Operations Edgbaston Limited care home 68 Number of places (if applicable): Under 65 Over 65 68 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 68. 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 (OP) 68 Date of last inspection Brief description of the care home Sunrise Senior Living Edgbaston offers a purpose built care home for older people who require varied levels of support with day to day living (Assisted Living), nursing care and residential care. People can choose to live in the home for a short or long term stay. Care Homes for Older People Page 2 of 10 0 7 0 9 2 0 0 9 Brief description of the care home Sunrise Assisted Living is registered to provide assisted living care with nursing for up to 68 older people. Assisted living care is provided on the ground and first floor of the premises. The home offers spacious accommodation within bedroom suites of varying sizes and layouts. Each suite provides a bedroom, living area and en suite facilities, which has a level floor access shower or a bath. Two separate spa baths are available for communal use. The home offers a luxurious, beautifully furnished and well maintained environment for people to live in. Two passenger lifts and staircase provides access to all floors in the home. There is a large lounge, restaurant style dining room and a well maintained kitchen. A charge is made for the bedroom suite accommodation £140 - £240 per day. An additional charge is made for a care package these prices range from £19 to £66.50 per day. Each additional hour of care is charged at £19. Additional charges are made for ironing services, care staff escort, chiropody, medication administration and weekly furniture rental. Care Homes for Older People Page 3 of 10 What we found: The pharmacist inspection lasted three hours. Six peoples medication was looked at together with their Medicine Administration Record (MAR) charts and care plans. The nurse in charge of ordering medication and assessing the medicine management in the home was present throughout the inspection. All medicines were now correctly stored and a new locked cupboard to securely hold discontinued medicines was in use. Medicines from the reminiscence unit were now no longer kept in the assisted living unit. Currently two medication trolleys were used to store the current medicines for administration. These were kept in the air conditioned medication room. At the time of the inspection it was not policy to use the trolley to transport the medicines to the people in the home. The nurse prepared the medicines in the medication room and placed them in open pots and then walked through the home to the person to adminsiter them to. There would be nowhere to securely hold these medicines if an emergency occurred. Following a discussion after the inspection, we, the commission, were assured that this practice would cease and the trolley would be used to transport the medicines through the home. This practice was later observed. All controlled drugs (CD) were stored in compliance with current regulations and CD records correctly recorded. All the prescriptions were seen prior to dispensing and used to check the medicines and MAR charts received into the home. The quantity of all the medicines received had been recorded enabling audits to take place. Some poor practice was seen. The practice nurse had visited the home and prescribed a medicine for a clinical condition. This had been dispensed but then placed in the medicine cupboard and not administered as there was no record of it on the MAR chart. This was very poor practice and resulted in the person not receiving their prescribed medication, so the clinical condition remained untreated for seven days. A new person had come to live in the home and no checks had been made with the doctor to confirm her current medicine regime. Three medicines were not available to administer despite her underlying clinical condition warranting her taking them. No supply had been sought to administer or reasons why they were not available to administer. As a result two requirements left at the last inspection had not been met. Two boxes of medicines were found in the trolley that had been discontinued. These had not been recorded on the MAR chart but left in the trolley ready for administration. If they had been administered together it would have placed the person at risk of an overdose as they both contained the same active ingredient. It could not be demonstrated whether any had been administered or not. This had not been recognized despite regular audits. These were promptly removed from the trolley. A robust quality assurance system had been installed to assess the practice of staff administering and recording medication. This had improved the practice in the home overall and the majority of medicines were administered as prescribed and records reflected practice. A few errors were seen , for example some medicines had been signed as administered when they had not been and one gap was seen and the reason for non Care Homes for Older People Page 4 of 10 administration not recorded. Overall though vast improvement was seen compared to the last pharmacist inspection in September 2009 and some of the errors seen had already been identified and appropriate action taken to address the issues. People are still encouraged to self administer their own medication. A disclaimer is signed by the person that if any errors occur they are at fault. The home has a duty of care to ensure that the people do take their medicines safely. The risk assessment undertaken by Sunrise stated that monthly audits would be carried out. There was no evidence of this. There was no current list of medicines received into the home and it was impossible to check whether the person took their medicines correctly. One box of antibiotics was seen in one persons room that had been dispensed in June 2009. Only 9 of the course of 21 capsules had been taken. Staff were totally unaware of this medication. Other medicines that were no longer needed were also seen and staff had no idea what the current drug regime of the person was, despite the assessment stating that monthly audits were to take place. It could not be demonstrated that the people took their medicines safely or that the home had an up to date list of medicines currently in the home. This breached the requirement left at the last inspection. The care plans surrounding medicines were poor. Not all the peoples clinical conditions were known. Without such information staff could not fully support their health care needs. It was difficult for staff to know if therapeutic testing as advised by the doctor or practice nurse had been undertaken as the care plans did not detail who did the tests or where the results were documented. All information must be available to enable the staff to fully support the health care needs of the people who use the service. 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 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 13 The medicine chart must 03/10/2009 record the quantity of medicines received and the date. It must be referred to before the preparation of the service users medicines and be signed directly after the transaction and accurately record what has occurred. This is to ensure that the right medicine is administered to the right service user at the right time and at the right dose as prescribed and records must reflect practice 2 9 13 All service users must be risk 03/10/2009 assessed as able to self administer their own medication and a MAR chart written to record these prescribed medicines. Regular compliance checks must be undertaken and documented and further support offered if necessary. This is to ensure that they can handle their medication safely 3 9 12 Staff must ensure that 03/10/2009 prescriptions are ordered and dispensed in time to ensure a Page 6 of 10 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 continuous supply of medicines are available to administer This is to maintain the health and wellbeing of the service user 4 18 13 All allegations and incidences 31/05/2009 of abuse must be taken seriously by making sure that a timely and informed investigation can take place if appropriate. This will make sure that people feel confident that they are protected from the risk of abuse while living in the home. 5 27 18 Staffing levels must be 31/07/2009 reviewed to make sure that sufficient numbers are on duty at all times. This must include reviewing the times when care staff are involved in housekeeping, waitressing and laundry tasks. This will make sure that care hours for people living in the home are not depleted while staff undertake non care duties. 6 28 18 Work is needed to increase 31/07/2009 the number of care staff with a NVQ level 2 qualification or equivalent in care. This will make sure that people living in the home are cared for by competent and Care Homes for Older People Page 7 of 10 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 qualified staff. 7 37 37 Systems must be put into 29/05/2009 place to ensure that we are informed about incidents and accidents affecting the health, safety and wellbeing of people living in the home. This must include making us aware of any incidence of suspected or alleged abuse. This will help to make sure that people living in the home are protected from the risk of harm. Care Homes for Older People Page 8 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 7 15 The care plans must include information to support the service users clinical needs This is to ensure their health and welfare 15/11/2009 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 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. 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. 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