This inspection was carried out on 12th January 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. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: The Grange Nursing Home 72 Upper Northam Road Hedge End Southampton Hampshire SO30 4EB 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: Geraldine Yates Date: 1 2 0 1 2 0 1 0 Information about the care home
Name of care home: Address: The Grange Nursing Home 72 Upper Northam Road Hedge End Southampton Hampshire SO30 4EB 01489790177 Telephone number: Fax number: Email address: Provider web address: carolynr@tgnh.co.uk Name of registered provider(s): Mr Roy Clive Northover,Mrs Heather Northover,Mrs Angela Louise Northover Name of registered manager (if applicable) Mrs Carolyn Sarah Ryves Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Conditions of registration: The maximum number of service users to be accommodated is 63. The registered person may provide the following category/ies of service only: Care home only - (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 (OP) Physical disability (PD) Dementia (DE) Date of last inspection
Care Homes for Older People Page 2 of 8 care home 63 Over 65 0 63 0 0 0 0 Brief description of the care home The Grange is a care home providing personal care and nursing care for up to 63 people over the age of 65 years and who may also have a physical disability or have a terminal illness. The Grange is owned by three partners and is a family business. It is located in Hedge End a large village close to the edge of the city of Southampton and there is easy access to motorway links. The home is close to shops and other community amenities. The establishment was purpose built and opened in 1991. It is a three storey building that has a large open communal lounge dining room on the ground floor and another two lounge diner areas on the first floor and lower ground floor. There are 2 passenger lifts that provide access to the first floor. There is a large well maintained garden with a patio area that is accessible to people living in the home. The home has a website and people interested in living there or staying for a short respite stay are provided with a brochure containing information about the service that it provides and are encouraged to visit. Care Homes for Older People Page 3 of 8 What we found:
This inspection was a specialist pharmacist inspection to look at the handling of medicines in the home following concerns raised at the key inspection. We looked at the storage of medicines, records kept in the home and talked to the manager and lead nurse on duty. We looked in detail at the records for nine people living in the home. People who use this service had their medicines given to them by registered nurses. The manager informed us that, since the key inspection of 23 November 2009, all of the nurses have been assessed by a community matron to ensure that they follow safe practices when giving people their medicines. The manager also informed us that only the nurses are now involved in giving medicines to people and that the care staff no longer handle medicines. No one living in the home was looking after and taking their own medicines when we visited. The manager was aware of the need to review the policies and procedures on the safe handling of medicines. As new systems had been introduced in late December 2009 she was waiting for these to become fully implemented and any issues resolved before writing new procedures. Medication administration records and supplies were looked at on all three units. Clear records were kept to show when people were given their medicines. These records together with records of medicines received into the home and any stock balances brought forward from one recording chart to the next showed that most people get their medicines correctly. However we did see that one person, whose records and medicine supplies we checked, had been given more medicine than had been prescribed on nine consecutive days. Whilst it is acknowledged that the doctor visited this person on the day we visited the home and increased the dose this none the less represents a serious error. The manager has been undertaking monthly audits of medication to identify and deal with any problems. During the feedback at this inspection she suggested that she would be doing these weekly now so that any issues could be identified and dealt with more promptly. We would strongly support this as the service must be able to identify any problems that may occur in a timely manor. Some of the people whose records we looked at were prescribed medicines to be given only when needed, PRN medicines. Information was available in the care plans which described when the medicines were to be given to some of these people but it was not available for others. Clear guidance must be provided to the staff on when such medicines are to be given and when they are not so that people receive their medicines in a way that meets their needs at all times. Medicines on the units were stored securely so as to protect the people who use the service. Medicines requiring cool storage were kept in locked refrigerators and daily temperature records were kept. These showed them to be operating within the correct temperature range and so the medicines would be fit for use. Each unit had a Controlled Drugs cupboard to provide extra security to these medicines. Additional records were kept of the usage of Controlled Drugs and sedative medicines so as to readily detect any loss.
Care Homes for Older People Page 4 of 8 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 8 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 3 14 Pre admission assessments must be carried out on all prospective residents by a suitably trained person. Residents will be confident that their assessed needs are known and that they can be met if they live at the service. 31/12/2009 2 9 13 Systems must be put in place to ensure medications are given as prescribed. Medications must be given as prescribed so that residents receive their medications safely. 14/12/2009 Care Homes for Older People Page 6 of 8 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 Systems must be put in place to ensure medicines are given as prescribed. Medications must be given as prescribed so that residents receive their medications safely. 11/02/2010 2 9 13 Clear guidance must be provided to staff stating when medicines prescribed to be given only when needed are to be given to people. So that people receive their medicines in a way that meets their needs. 25/02/2010 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 7 of 8 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. Care Homes for Older People Page 8 of 8 - 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!
