This inspection was carried out on 1st December 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 7 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 Victoria Residential Home Thursby Road Burnley Lancashire BB10 3AU one star adequate service 07/10/2009 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: Maggy Howells Date: 0 1 1 2 2 0 0 9 Information about the care home
Name of care home: Address: The Victoria Residential Home Thursby Road Burnley Lancashire BB10 3AU 01282416475 01282441447 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Victoria Care Homes Limited care home 41 Number of places (if applicable): Under 65 Over 65 0 41 dementia old age, not falling within any other category Conditions of registration: 41 0 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. Dementia - Code DE. The maximum number of service users who can be accommodated is: 41. Date of last inspection Brief description of the care home The Victoria Residential Home is registered to provide accommodation and personal care for 23 Older People and 18 Older People with a Dementia. The home is a converted hospital with a spacious layout. It is located approximately 2 miles from Burnley town centre and there is a main bus route nearby. There are car-parking facilities at the front of the home and there is a public park directly opposite.
Care Homes for Older People Page 2 of 12 0 7 1 0 2 0 0 9 Brief description of the care home Accommodation is provided in 30 single bedrooms and 5 double bedrooms on three floors. There is a passenger lift linking the floors. Seventeen of the single bedrooms and one double room have ensuite facilities comprising of a toilet and wash hand basin. The home is split into three units and is staffed accordingly. The ground floor is known as the Thursby Unit and provides personal care for older people. The first floor provides personal care for older people who have a dementia and this part of the home is known as the Butterworth Unit. There were no residents accommodated on the second floor. At the time of the inspection (January 2010) the scale of charges ranged from £366.00 to £412.00. Additional charges were made for hairdressing and chiropody. Information was made available to prospective residents in the form of a statement of purpose and service users guide. The service users guide was usually given to relatives and/or prospective residents on viewing the home or at the point of assessment. Previous inspection reports can be viewed in the home or downloaded free of charge from the Commissions website at www.cqc.org.uk Care Homes for Older People Page 3 of 12 What we found:
We carried out this visit to make sure medicines were being handled safely. The visit was carried out by a pharmacist inspector and it lasted approximately six hours. When we arrived at the home the manager was not present, so we spoke to the deputy manager as well as other staff involved in handling medicines. We checked medicines records, stock and storage areas on both units and at the end of the visit we took some photographs of the records and storage areas because we found serious shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. We found numerous old medicines, dressings and other prescription items that were no longer used, out of date or belonged to people that no longer lived in the home. We found eye drops and insulin in the fridge on the residential unit even though the fridge was not working as there was no electrical supply to it. We were told that all staff knew this fridge was not working and that only the fridge in the dementia unit was to be used, but this clearly was not the case in practice. Medicines deteriorate and spoil when they are not kept at the correct temperature and this can make them ineffective and dangerous to use. Both medicines storage rooms were dirty and we found loose tablets on the floor in one room. We found that the pots used for giving out medicines were dirty and contaminated with powder from tablets. One medicine cupboard had a broken lock and contained tablets that could not be accounted for. Another cupboard contained items such as cigarettes and cosmetics and we also found money belonging to one person living at the home that had not been accounted for. This is unsafe and unhygienic. We tried to account for a sample of the medicines but found this very difficult because there was no clear system of stock control in place. Medicines were not always properly recorded when received into the home and records of medicines disposed of were inaccurate and incomplete. Medicines were not recorded when carried over each month so it was not possible to know how much stock was being held in the home. In the few cases where it was possible to account for medicines we could see that they had not always been given correctly, with some medicines having been signed for, but not actually given and some medicines missing. We found that people were not always given their medication at the correct time in relation to food and drink, for example one persons medicine stated that it was to be taken during the evening meal, but it was actually being given before breakfast. Other medicines that needed to be taken before food in order to work properly were only being given after meals. We also saw examples where medicines had not been given, but no explanation had been recorded. It was of serious concern that some doses of paracetamol (a painkiller) and antibiotics (to treat infections) were given too close together, this is very dangerous The health and welfare of people living in this home is at serious risk of harm when they are not given their medicines correctly. It was of serious concern that Controlled Drugs (strong medicines that may be misused) were not stored securely in a cabinet meeting current legislation. We looked at the Controlled Drugs register and found that the times of administration were inaccurate and disposal of these medicines had not been recorded. Failure to keep these medicines
Care Homes for Older People Page 4 of 12 safely and maintain accurate records is dangerous and places people at unnecessary risk.We found the records of creams and nutritional supplements were not always complete so we could not be sure they were being used properly. We saw a note from a district nurse asking staff to use Hydromol cream on a residents legs, but there was no supply of this on the trolley or in the cupboards and no mention of it on the persons medication administration records. This meant that it was impossible to whether or not these directions had been followed. The health and well being of people living in the home is at risk of harm if medicines, including creams and nutritional supplements are not used correctly and healthcare professionals instructions are not followed. Dressings were generally not recorded on peoples medication records meaning that the home did not have a full record of each persons current treatment. The system for checking record sheets from one cycle to the next was not robust enough to identify changes or mistakes made by the doctor or pharmacy. This had resulted in one person being given incorrect medication for a number of doses. Some people chose to look after their own creams, inhalers and other items and some creams used by staff were also stored in peoples bedrooms. There were no risk assessments available to show that these practices were safe and no records of any checks made to ensure that people were using their medicines correctly. People are at risk if staff do not store medicines properly or support them to use their medicines correctly. We looked at staff training records and found that not all staff currently responsible for handling medicines had been trained to do so. Some staff had been trained over five years ago and there was no evidence that this had been updated. Current guidelines for safe handling and administration of medicines were not available. There was no evidence that any staff had undertaken competence checks to ensure that they were capable of performing their duties safely. Staff are more likely to make mistakes when they are poorly trained and not kept up to date with current guidance. We looked at how the medicines were audited (checked) and found no formal systems in place. The mistakes we found and the general poor organisation of the medicines had not been identified by the manager and action was not being taken to make the necessary improvements. The competence of the current staff is of serious concern because of the poor practice in the administration, record keeping and storage of medicines that we saw. What the care home does well: What they could do better:
Medicines must be given to people only as prescribed because receiving medicines at the wrong time, wrong dose or not at all can seriously harm a persons health and wellbeing. There must be accurate records of all medicines received into the home, given to people and disposed of so that all medicines can be fully accounted for. Controlled drugs must be stored in a cabinet that meets the requirements of the law to help prevent mishandling and misuse of these powerful medicines.
Care Homes for Older People Page 5 of 12 Medicines must be properly disposed of when no longer required or past their expiry date to help make sure they are not misused. Medicines must be stored at the correct temperature so that they do not spoil and remain safe to use. There must be a robust system of auditing (checking) medicines so that weaknesses are identified and action taken to make improvements where necessary. Medicines must only be handled by appropriately trained staff who have undergone effective competency checks to ensure they can perform these duties safely. 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 12 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 7 15 The residents and/or their representatives must be consulted about the development and review of their care plan. This is to ensure the residents have the opportunity to influence the individual service they receive. 30/11/2009 2 9 13 All information from 28/10/2009 prescription labels must be recorded on the medication administration record and all controlled drugs must be accounted for. This is to ensure the residents are given their medication in line with the prescribers instructions and a clear audit path can be maintained of drugs handled in the home. 3 12 16 The activities on the dementia care unit must be structured to meet the residents individual needs and preferences. This is to ensure the residents live in a stimulating environment. 30/11/2009 Care Homes for Older People Page 7 of 12 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 4 30 18 All staff must complete specialist training courses including managing challenging behaviour and supporting people with a dementia in line with the needs of the residents. This is to ensure the residents needs are met. 26/02/2010 Care Homes for Older People Page 8 of 12 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 There must be a robust system of auditing (checking) medicines so that weaknesses are identified and action taken to make improvements where necessary. 31/12/2009 2 9 13 Medicines must be properly disposed of when no longer required or past their expiry date to help make sure they are not misused. 31/12/2009 to help make sure they are not misused. 3 9 13 Medicines must be stored at the correct temperature so that they do not spoil and remain safe to use. 4 9 13 Medicines must only be handled by appropriately trained staff who have undergone effective competency checks 31/12/2009 31/12/2009 Care Homes for Older People Page 9 of 12 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 to ensure they can perform these duties safely. 5 9 13 There must be accurate 31/12/2009 records of all medicines received into the home, given to people and disposed of so that all medicines can be fully accounted for. 6 9 13 Controlled drugs must be stored in a cabinet that meets the requirements of the law to help prevent mishandling and misuse of these powerful medicines. 7 9 13 Medicines must be given to 31/12/2009 people only as prescribed because receiving medicines at the wrong time, wrong dose or not at all can seriously harm a persons health and wellbeing. 31/12/2009 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 Risk assessments should be completed to ensure that creams, medicines and and dressings are only stored in peoples rooms where it safe to do so. Risk assessments must be completed for people wishing to Care Homes for Older People Page 10 of 12 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 look after some or all of their own medicines (including creams) to ensure that this is safe and that people receive the support they need to store and use their medicines properly. Care Homes for Older People Page 11 of 12 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 12 of 12 - 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!
