Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: The Glade 32 Lancaster Road Southport Merseyside PR8 2LE The quality rating for this care home is: The rating was made on: one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Simon Hill Date: 1 8 1 2 2 0 0 8 Information about the care home
Name of care home: Address: The Glade 32 Lancaster Road Southport Merseyside PR8 2LE 01704566699 01704566698 Noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Susan Jackson,Mr David Winston Jackson care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 25 Conditions of registration: The registered person may provide the following category of service only: Care home only - Code PC 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 - Code OP The maximum number of service users who can be accommodated is: 25 Date of last inspection Brief description of the care home The Glade is an older property that has been converted into a care home and is registered to provide personal care and support for up to 25 older people. It is situated in a leafy part of Southport close to public transport and within easy reach of the amenities that serve the area. The home provides accommodation over four floors and has lift access. The communal space contains one large dining room and one large sitting room. Toileting and bathing facilities are located throughout. The home has had adaptations such as handrails, hoists, specialist bathing facilities and ramps to suit the Care Homes for Older People
Page 2 of 10 needs of the residents. There is a call-bell system throughout the home. The front garden is accessible via a ramp and suitable garden furniture is available for the residents and their visitors. The Glade is part of a small group of homes privately owned by Mr and Mrs Jackson. Weekly fees range from £379-£480. Care Homes for Older People Page 3 of 10 What we found:
We visited the home because the manager had told us about a mistake that had happened when giving and recording medicines. The visit was carried out by a pharmacist inspector. It lasted four hours and involved speaking with the acting manager and two residents. We checked a sample of medicines stocks, medicines records and care plans. We gave detailed feedback to the acting manager at the end of the visit and to both of the owners by phone the following day. Overall we found some poor practice when handling medicines that could seriously affect the health and wellbeing of people who live in the home. When we arrived at the home the acting manager said she had given all the medicines out that morning except for one resident but on checking the records we saw that none of them had been signed. This is poor practice as failing to sign and check the records at the time of giving medicines can lead to serious mistakes and medicines being missed. We also noted numerous missing signatures for the previous days medicines. The acting manager said that she had not given and recorded the medicines properly because she was very busy and this was the quickest way to do it. We saw an example of very poor record keeping when a tablet that is only given weekly was signed for wrongly on eight consecutive days, we could not confirm if it had been given because there was no clear stock control system. When we checked a further sample of records and stock we found it very difficult to account for medicines, so we could not be sure they had been given to people correctly. There was no obvious system of stock control because stock was not properly carried forward at the beginning of each month. Of the medicines that we could check we found several that did not add up showing they had been missed. One person missed a steroid tablet three times in the last 10 days and a medicine to treat stomach ulcers twice in the last 11 days. This same person ran out of stock of three of their medicines for several days because staff had not reordered it in time. Missing medicines can seriously affect a persons health and wellbeing. We looked at the times medicines were given and found the records did not always state the correct time to take the medicine in relation to food intake. The acting manager confirmed that at least three people were being given a medicine with food instead of before, this medicine should have been given at least 30 minutes before food to prevent serious side effects. We saw some recorded stock checks but we saw no formal audits of the whole medicines handling system. Mistakes were not being found and acted upon to help prevent them happening again. We gave some advice both to the acting manager and the owner on how to develop this. We looked at a sample of care plans and records to check if medicines were properly reflected in them. There was no formal system for recording information about how when required medicines were to be given and we saw two people taking when required medicines for anxiety but there was no information about how and when they should be given. Having clear written care plans helps make sure people get their medicines when they need them. We checked how controlled drugs (medicines that can be misused) were handled. A Care Homes for Older People Page 4 of 10 suitable cupboard was used for storage but this was not properly attached to the wall so it was not fully secure. A special register was used for record keeping and this was usually completed correctly. Having good arrangements for the handling of controlled drugs helps prevent them being mishandled and misused. We looked at how medicines were stored and found them to be secure but disorganised, the acting manager said she was trying to sort them out but she had been too busy. A fridge was used for medicines requiring cold storage but this was too warm when we checked it and a urine sample was found stored next to some insulin, this is unhygienic and could cause serious infections. The temperature of the fridge had not been checked for over a week so staff did not know it was too warm. Storing medicines at the wrong temperature can spoil them. We looked at how people were supported to look after their own medicines. People were encouraged and helped to do this and we spoke with one person who seemed to be managing their medicines safely. However the paperwork to support this was not up to date. Suitable risk assessments and care plans had not been written for two people and although a risk assessment had been done for another person their was no care plan to say how this person was to be supported. Having good care plans that are regularly reviewed helps make sure people receive the right amount of support to manage their medicines safely. We looked at how staff were trained to handle medicines safely. All staff have attended formal medicines training sessions and we saw some evidence of this. The acting manager said all staff were watched and supervised until they were deemed competent but we saw no formal records of this and on the day of our visit we saw some poor practice when giving and recording medicines. Regular recorded competency checks on staff help make sure they have the necessary skills to handle medicines safely. What the care home does well: What they could do better:
Medicines must be given to people correctly as prescribed because receiving medicines at the wrong dose, wrong time or not at all can seriously affect their health and wellbeing. Staff must be competent and have the necessary skills to handle medicines safely so that the health and wellbeing of people who live in the home is protected. Efficient recorded audits (checks) of the medicines must be carried out to make sure staff are competent and to make sure medicines are handled safely. Accurate records of medicines received, given to people and disposed of must be made so that all medicines can be fully accounted for. Paperwork must be up to date for people that look after their own medicines to help make sure they receive the right amount of support to do it safely. Care Homes for Older People Page 5 of 10 Controlled drugs must be stored in a cupboard that meets the requirements of the law to help prevent mishandling and misuse. Medicines must be stored at the right temperature to help prevent them being spoilt. 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 £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 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, 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 Medicines must be stored at the right temperature. This will stop them being spoilt. 19/01/2009 2 9 13 An efficent system of checking and auditing medicines must be in place. This will make sure medicines are handled safely and make sure staff have the necessary skills. 19/01/2009 3 9 13 Accurate records of 19/01/2009 medicines received, given to people and disposed of must be made. This will help make sure medicines can be fully accounted for. 4 9 13 Staff must be competent and 19/01/2009 have the necessary skills to handle medicines safely. This will help make sure people have their medicines administered correctly. 5 9 13 Medicines must be given to people correctly as 19/01/2009 Care Homes for Older People Page 8 of 10 prescribed Receiving medicines at the wrong dose, wrong time or not at all can seriously affect a persons health and wellbeing 6 9 13 For people that are looking after their own medicines a risk assessment and care plan must made. This will help make sure people receive the right amount of support. 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 19/01/2009 1 9 A care plan for when required medicines should be written and used to make sure they are given to people correctly. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
