This inspection was carried out on 19th January 2010.
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.
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 9 0 1 2 0 1 0 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 11 1 5 1 0 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 11 What we found:
The pharmacist inspection lasted three hours. Six peoples medicines were looked at together with their Medicine Administration Record (MAR) charts and care plans. The lead nurse on duty was present during the inspection. Four requirements regarding medicines had been left at the last pharmacist inspection on 15th October 2009. Due to the poor medicine management seen at that inspection a warning letter was also issued. It was found at this inspection one of the requirements regarding medication had been met and three had not been complied with. One further requirement was left at this inspection. Due to the non-compliance of the regulations the home has been referred to the enforcement team within the commission so further enforcement action can be taken. The home stores the medicines in two medicine trolleys, which are kept in a dedicated medication room. The temperature is controlled to store the medicine at the correct temperature. A controlled drug cabinet has also been installed and secured correctly to comply with current regulations. Medicines requiring refrigeration are stored in a dedicated refrigerator. Medicines that are no longer needed are stored in a locked cupboard in the office. The manager has installed a quality assurance system to assess staff competence in the safe handling of medicines. Whilst this has improved the overall standard of medicine management, serious errors were still found during the inspection. The home sees all the prescriptions before they are dispensed and a copy is taken to check the dispensed medicine and MAR chart received into the home. The quantity of all medicines received is now recorded on the MAR charts enabling audits to take place to confirm they have been administered as prescribed. Audits indicated that not all the medicines had been administered as prescribed despite the homes internal audits being undertaken. Medicines had been signed as administered when they had not been. Gaps were seen. These medicines had either been administered but not signed as such or not administered and the reason for non administration not recorded. Some medicines were unaccounted for and it could not be demonstrated why they were missing. The practice nurse had recently increased the dose of one medicine, as recorded in the external healthcare professional visit record. This information had not been recorded on the MAR chart nor the information relayed to the person, resulting in only half the prescribed dose being administered. As this medicine was prescribed to treat high blood pressure and the dose was increased to reduce his blood pressure further, this is of serious concern. The care plans also recorded that the practice nurse had reduced the dose of a laxative from three times a day to twice a day. Again staff had failed to record this information on the MAR chart resulting in the person was taking the medicine at the old dose. One medicine was recorded on the MAR chart to be given at a dose of three tablets each
Care Homes for Older People Page 4 of 11 day. A newly dispensed box of tablets was found in the medicine trolley. The dose had been changed to one tablet twice a day, and one tablet had been administered from this box. The old container of the tablets had been placed in the returns medicine cabinet. A dose of two tablets had been dispensed for each day in this container to be administered but the records recorded that three had been administered. This indicated incomplete recording and a failure to follow safe procedures for medicine administration. This is of serious concern. People are encouraged to self administer their own medicines. The home now risk assesses people that wish to handle their own medicines to ascertain whether the person can safely do so. Compliance checks are undertaken when the person is willing to let the staff do so. Whilst a system to check compliance had been installed staff had failed to act on the information found following the checks, even when they indicated that the person did not take the medicines as prescribed, hence the outstanding requirement had not been met. The staff did not calculate the actual amount of tablets that should have been left after a certain period of time so the information collected by counting the tablets left in the medicine boxes was not used to actually assess whether the person did safely take their medicines. Further compliance checks were to be undertaken to ensure that the people do take their medicines as prescribed and to offer further help if necessary. One person had recently been discharged from hospital. The prescription recorded a reduced amount of medicine to treat epilepsy. Staff were still administering the higher dose and had not checked with either the hospital or the doctor to confirm which dose was correct. One medicine had been recorded on the discharge sheet following a hospital visit that had not been dispensed as it was assumed that the persons own supply would be used. This medicine had not been recorded on the MAR chart and no supply was available for administration. The staff had failed to record the correct information on the MAR chart and investigate any discrepancies. The care plans detailing the persons clinical conditions were poor. One person had a medicine prescribed to treat scabies. There was no care plan relating to her care to ensure that the infectious skin condition was treated correctly and to prevent infection of other residents and staff. What the care home does well: What they could do better:
The home does not act on the information supplied from the hospital or other external healthcare professionals resulting in the people not being administered the most recent dose of medicine in all instances. Whilst they do assess some people who wish to self administer their own medicines the system does not highlight if they have done so correctly, so they do not offer further support if needed.
Care Homes for Older People Page 5 of 11 Despite regular audits staff are still failing to administer the medicines as prescribed and records do not reflect practice in all instances, indicating that staff do not follow safe procedures for medicine administration at all times. 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 11 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 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 2 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 3 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. Care Homes for Older People Page 7 of 11 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 is to ensure that they can handle their medication safely 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 qualified staff. 7 37 37 Systems must be put into place to ensure that we are 29/05/2009 Care Homes for Older People Page 8 of 11 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 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 9 of 11 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 All dose regimes must be 20/02/2010 clearly written on the medicine chart and checked by a second member of staff for accuracy. They must record the most current medicine regime prescribed. This is to ensure that the staff have clear, up to date and accurate directions to follow. 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 10 of 11 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 11 of 11 - 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!
