This inspection was carried out on 7th December 2009.
CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 3 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 Green Nursing Home Wharf Road Kings Norton Birmingham West Midlands B30 3LN one star adequate service 31/07/2009 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 1 2 2 0 0 9 Information about the care home
Name of care home: Address: The Green Nursing Home Wharf Road Kings Norton Birmingham West Midlands B30 3LN 01214513002 01214863360 flintvaleltd@btconnect.com Flintvaleltd@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Flintvale Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 59 Number of places (if applicable): Under 65 Over 65 0 59 dementia old age, not falling within any other category Conditions of registration: 59 0 The maximum number of service users who can be accommodated is: 59 The registered person may provide the following category of service only: Care Home with Nursing (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) 59 Dementia (DE) 59 Date of last inspection 3 1 0 7 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home The Green is a purpose built facility, which offers nursing care for up to 59 older adults, who may also have dementia care needs. There is off road parking to the front of the property, which is sufficient for the home, and is situated close to bus links to the centre of Birmingham. There are a range of local shops and community facilities nearby. The home has a mixture of shared and single bedrooms, some of which have en-suite facilities, spread over the ground and first floors of the building. There are communal bathing, shower and toilet facilities on both floors to meet the needs of the people who live there. The building has basic adaptations for people with limited mobility, including two passenger lifts. Communal lounges are situated on the ground floor and the lounge doors open onto an enclosed garden with a water feature, which has wheelchair access. Laundry and kitchen services are located on the ground floor, as are the dining rooms. Fee rates for the home vary depending if the person is privately funded or funded by Social Care and Health. Charges vary, on the assessed banding and type of room chosen and a top up fee is payable. Current fee rates are available on request from the home. Hairdressing, chiropody, opticians and dentists visit the home, and are available for additional fees. Previous inspection reports and articles of interest are available inside the reception area of the home, for anyone who wishes to read them. Care Homes for Older People Page 3 of 9 What we found:
The pharmacist inspection lasted two and a half hours. The reason for the inspection was to check compliance with the outstanding requirements regarding medication. The two outstanding requirements had been met but three further more specific requirements and one recommendation were left . Seven peoples medicines were looked together with their medicine administration record (MAR) chart and care plans. Three nurses were spoken with and all feedback was given to the newly appointed manager and the operations manager. The home stored all the medicines in a dedicated medicine room. It was identified at the last inspection in July 2009 that it was too hot to safely store medicines. Again it was too hot as the temperature regularly went above 25C. In addition medicines requiring refrigeration were found in the medicine room, so were not stored in compliance with their product licenses either, so their stability could not be guaranteed. We were given assurance that an air conditioning system would be installed to control the temperature to store medicines below 25C at all times. Medicines for external use were kept in open boxes on top of the medicine trolleys. Anyone gaining access to the room would also have access to these medicines. All medicines should be held in a locked facility at all times. A further medicine trolley had been ordered to securely store all the medicines and the home was awaiting delivery. The home had installed a system to see all prescriptions before they are dispensed and used a copy of them to check the Medicine Administration Record (MAR) chart and medicines received into the home for accuracy. Copies were available for nursing staff to check throughout the 28 day cycle. Audits indicated that the medicines dispensed in blister packs, where the pharmacist dispenses one tablet per day in each blister, had been administered as prescribed and records reflected practice. Medicines dispensed in traditional bottles and boxes had not always been administered as prescribed. Medicines had been recorded as administered when they had not been or half the prescribed dose had been administered (one tablet not two as prescribed). This indicates that nursing staff are not reading the MAR chart before the administration of medicines and are not accurately recording what they have done. People new to the home bought in there medicines and staff in one instance had failed to count the medicines accurately and recorded the dispensing quantity. It therefore could not be demonstrated if these had been administered as prescribed. There was though information surrounding her current medicine regime in the care plans so these had been checked before administration to ensure the home were giving the current medicine regime as prescribed by the doctor. The care plans were good with respect to the clinical needs of the people. It was easy to identify why a medicine had been prescribed and why a dose had been changed. This would enable the nursing staff to fully support the clinical needs of the people they look after.
Care Homes for Older People Page 4 of 9 There are now protocols attached to the MAR charts detailing how and when to administer medicines for epilepsy. One nurse spoken with had a good knowledge of the medicines she administered but another nurse had almost no knowledge of what they were for. She was new to the home but was allowed to adminsiter medicines despite the management knowing she had training needs in this area. Currently the home had no quality assurance system to assess individual nursing staff competence and we, the commission, were given assurance that a robust system would be installed to confirm staff competence in the safe handling of medicines 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 9 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 6 of 9 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 medicines must be stored 08/01/2010 in compliance with their product licences. This is to ensure their stability 2 9 13 A quality assurance system must be installed to assess 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. 08/01/2010 3 9 13 All medicines must be stored 08/01/2010 in a locked facility at all times.
Page 7 of 9 Care Homes for Older People 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 This is to ensure that all medicines are safely held on the premise at all times. 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 1 9 It is advised that training is given to all nursing staff that do not know the indications and side effects of the medicines they handle Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!
