Inspection on 07/09/09 for Sunrise Operations Edgbaston Ltd (Assisted Living)

This inspection was carried out on 7th September 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 6 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... 15/10/09

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 15/11/2009.

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: 0 7 0 9 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 11 2 9 0 4 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 took two hours. Nine peoples medication was looked at together with the Medicine Administration Record (MAR) charts. Two nurses were spoken with, one of whom was responsible for checking in all the medicines for the current cycle. The reason for the pharmacist inspection was due to a reported error of over ordering and missing medication. The home now has a dedicated medication room. This had an air conditioning system installed so all the medicines were stored at the correct temperature. Medicines requiring refrigeration were kept in a dedicated locked medicine refrigerator. Most of the medicines are no longer stored in the individual residents rooms but in a medication trolley. This is used to store and transport the medicines to the individual people. People who self administer their medicines keep their own supply in their room. Medicines that are no longer needed are removed from the trolley and kept in the office in open boxes and bags. Anyone gaining access to the room would have access to these medicines within. This is of concern as all medicines must be securely held at all times. Systems have now been installed to check the prescriptions prior to dispensing and to check the MAR charts and medicines received into the home. The quantity of all medicines had been recorded and any balances of medicines from previous cycles for the current cycle which started on the day of the inspection. These had not been recorded for all medicines from the previous 28 day cycle. The home had begun to undertake audits to assess whether the nursing staff are administering medicines correctly as the doctor prescribed. These indicated that there was a 37 per cent error rate. The audits were not refined enough to identify individual staff practice, so it would not be possible to address the individual training needs or to take further action if necessary. It was found that many medicines had not been administered as prescribed. Staff had recorded they had administered medicines when they had not. This indicates that they are not reading the MAR chart before the preparation of medicines and inaccurately recording exactly what medicines they have administered. This is of serious concern. Gaps were also seen on the MAR chart. It could not be demonstrated exactly what had occurred, whether medicines had been administered and not recorded as such or not administered and the reasons for non-administration not recorded. Some medicines were unaccounted for, again with no explanation. Hand written MAR charts were poor. One MAR chart was not dated so the information recorded would be meaningless in the future. The quantities of medicines received into the home had not been recorded so it was difficult to demonstrate they had been administered as prescribed and records reflected practice. Medicines had not been ordered in time so one resident went without prescribed medication for seven days whilst a new supply was sought. This is of serious concern as nursing staff should be aware when a prescription needs to be ordered to ensure a Care Homes for Older People Page 4 of 11 continuous supply. All entries in the Controlled Drug register had been accurately recorded, but as no balances carried over from previous cycles had been recorded on the MAR chart these did not match. For good medicine management both balances should tally. On further investigation of the reported error to the Commission, the nurse in charge said that 14 capsules were missing but on reviewing the MAR chart 17 were unaccounted for. An open pot of tablets was found in the boxes awaiting return to the pharmacy. The nurse on duty recognized them as being sent down from the reminiscence unit on the second floor. As this has a separate registration no medicines from that unit should be on the assisted living unit. The people who live in the home are encouraged to self medicate their own medicines. The nurse on duty confirmed that there were no MAR charts for some of these people. No compliance checks could be undertaken to ensure that these people take them as the doctor intended. Without such information no support plan can be put in place to fully support these people. In addition the home must account for all the medicines received into the home and record in detail what they are. This was raised at a previous pharmacist inspection and has not been fully addressed. 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 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 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. 2 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. 3 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 6 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 qualified staff. 4 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 7 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 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 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 Care Homes for Older People Page 8 of 11 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 reflect practice 3 9 13 All medicines must be held in 03/10/2009 a locked facility at all times. This includes medicines awaiting return to the pharmacy for destruction This is to ensure the safety of the service users at all times 4 9 13 A quality assurance system 03/10/2009 must be installed to assess individual staff competence in their handling of medicines. Appropriate action must be taken when these indicate that medicines are not administered as prescribed and records do not reflect practice. This is to ensure that individual nursing staff practice is assessed on a regular basis and appropriate action is taken if audits indicate that nurses do not administer the medicines as prescribed. Only medicines prescribed and dispensed for the assisted living unit must be kept on the registered premise. This is to ensure a full audit trail of all the prescribed and dispensed medicines can be maintained and all medicines can be accounted for 03/10/2009 5 9 13 Care Homes for Older People Page 9 of 11 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 6 9 12 Staff must ensure that 03/10/2009 prescriptions are ordered and dispensed in time to ensure a continuous supply of medicines are available to administer This is to maintain the health and wellbeing of the service user 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). 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