Inspection on 20/10/09 for The Hawthorns

This inspection was carried out on 20th October 2009.

CQC found this care home to be providing an Good 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.

Other inspections for this house

The Hawthorns 10/06/09

The Hawthorns 27/06/07

Similar services:

The Highlands

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Random inspection report Care homes for older people Name: Address: The Hawthorns O`Neill Drive North Blunts Peterlee Durham SR8 5UQ two star good 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: Janet Long Date: 2 0 1 0 2 0 0 9 Information about the care home Name of care home: Address: The Hawthorns O`Neill Drive North Blunts Peterlee Durham SR8 5UQ 01915871251 01915866779 Telephone number: Fax number: Email address: Provider web address: www.barchester.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 105 Number of places (if applicable): Under 65 Over 65 0 0 49 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 30 6 0 75 The maximum number of service users who can be accommodated is: 105 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 - Code OP, maximum number of places: 49 Dementia - Code DE, maximum number of places: 30 Mental disorder, excluding learning disability or dementia - Code MD, maximum number of places: 6 Physical disability Code PD, maximum number of places: 75 Care Homes for Older People Page 2 of 9 Date of last inspection Brief description of the care home The Hawthorns Care Home was opened in 1996. It is situated on the outskirts of Peterlee, adjacent to the community hospital and is conveniently located for access to all local amenities. Barchester Healthcare became the owners of the home in 2006. The company changed to Barchester Healthcare Limited in February 2007. This is the first inspection since Barchester Healthcare Limited came into being. The home is a two-storey building that is serviced by passenger lifts. There are three separate units within the service. The general unit for older persons, which caters for people with predominantly nursing needs, is located on two floors. The mental health unit is located on the ground floor and caters in the main for people with dementia. The rehabilitation unit is for people between the ages of 18 and 65 years who require help to maximise their independence. This unit is also located on two floors and the people accommodated upstairs generally have intensive nursing needs. There are a mixture of single and double rooms within the home, some of which have en suite facilities. There are sufficient and suitable additional bathrooms and toilets located throughout the home. Each unit also has a range of sitting and dining areas available. The garden areas are accessible and pleasant. Car parking facilities are available at both the front and rear of the building. Care Homes for Older People Page 3 of 9 What we found: This pharmacist inspection lasted 8 hours and was carried out to follow up medication concerns identified at the last Key Inspection in June 2009 and a series of safeguarding notifications since then. During the visit we examined medication policy and procedure, the current medication administration record( MAR) charts,and the medication ordering, storage and handling arrangements. A copy of the prescription is kept and a book was available to record medicines received and those returned and destroyed. Medicines were supplied from two community pharmacies and a hospital pharmacy and all medicines were supplied in original packaging. The recording of medicine administration is poor; there were a number of gaps on the MAR charts. To demonstrate that people are getting the medication as prescribed the MAR chart should record each administration. MAR charts were all handwritten and there were transcription errors. There was also no facility on the MAR chart to record differing doses for a drug therefore these appear as separate entries even though they may be administered from a single container, this had led to problems with stock control and also with the incorrect dose being given. The quantity of medicine received into the home and brought forward each month could not be clearly recorded on the MAR and this made audit very difficult. On the day of the visit medication was out of stock for a number of people on several units and for two people on the same unit the same medication had been out of stock on two consecutive months. It is important to make sure that the quantity of medication is regularly checked so that a prescription can be ordered in plenty of time to prevent people being without. Medication for two people on one unit had not been given because the person was asleep at the morning medicine administration round on a number of days, no action had been take to give this once daily medication at a different time of day. The MAR charts were contained in a ring binder file and the holes had in many cases torn and obscured records of administration. There was a list of signatures of staff signing MAR charts. Medicines are stored securely either in locked trolley or locked cupboards. The temperature of the medicine storage area in one unit was not monitored and although fridge and room temperatures were regularly monitored in the other units some records of fridge temperature had been made outside those recommended by the manufacturer and no action had been taken. The date of opening was not always added to medicines with limited use once open this means there is a risk that the medication may be used beyond the date recommended by the manufacturer and may not be safe to administer. All controlled drugs cupboards had records which balanced with the stock available. Medication administration was observed on three units on one of these units best practise was not always followed and feedback was given to the member of staff at the time and the manager on the day. A single supply of some medication was used to administer doses of medicine to more than one person. What the care home does well: MAR charts all had a photograph of the person and any allergies recorded. There was also a risk assessment for administration of medicines via an enteral tube however some of Care Homes for Older People Page 4 of 9 these did not reflect current medication. 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 Medication must only be administered from the containers supplied by the pharmacy this will reduce the risk of mistakes 31/12/2009 2 9 12 The home must ensure that 31/12/2009 there is an effective system in place to request, obtain and retain adequate supplies of prescribed medicines so that they can be given as and when prscribed This will make sure that people are not without prescribed medication 3 9 13 Medication must be given as prescribed and a record made at the time it is given This will make sure that people receive their medication correctly and the treatment of their medical condition is not affected. 31/12/2009 Care Homes for Older People Page 7 of 9 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 The temperature of the medication rooms and fridges should be regularly monitored and action should be taken is the measured temperature falls outside manufacturers recommendation. A system should be in place to record all medication received in to the home and medication carried over from the previous month. This helps confirm that medication is being given as preascribed and when checking stock levels. Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information is recorded and people receive their medication as prescribed. 2 9 3 9 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. 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