Random inspection report
Care homes for older people
Name: Address: Wall Hill Broad Street Leek Staffordshire ST13 5QA one star adequate service 15/06/2009 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: Ian Henderson Date: 1 8 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Wall Hill Broad Street Leek Staffordshire ST13 5QA 01538399807 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Jane Briand Type of registration: Number of places registered: Conditions of registration: Category(ies) : Wall Hill Care Home Limited care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Conditions of registration: 7 0 The maximum number of service users who can be accommodated is: 34 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 - maximum number of places 34 Dementia Code DE, maximum number of places 7 Date of last inspection 1 5 0 6 2 0 0 9 Care Homes for Older People Page 2 of 10 Brief description of the care home Wall Hill is registered to provide care and accommodation for 31 older people, 9 of whom may have needs associated with a physical disability, 9 of whom may have mental health needs and 4 whom may have dementia. The home is located close to the centre of the historic market town of Leek in the Staffordshire Moorlands. There is a wide range of community facilities, including shops, restaurants, pubs and other leisure amenities in the town. There is good access to local bus services. The home also has its own minibus which is a well used and popular facility. The home is a twostorey building that has undergone considerable refurbishment to meet the needs of people who use the service. A passenger lift allows easy access to the first floor. Of the 29 single bedrooms available, 26 have en-suite toilet facilities. There is one shared bedroom available. The environment is well maintained and decorated throughout. Attractive communal sitting areas are provided at Wall Hill, with large and small lounge areas with comfortable seating and a large and attractive dining room that opens onto the rear grounds and patio area. People interested in accommodation at Wall Hill are advised to contact the home direct to obtain information about current fees and availability. Care Homes for Older People Page 3 of 10 What we found:
The reason for the visit was to assess what progress the home had made in meeting the requirements made at the random inspection that took place on the 22nd October 2009. Following the inspection on the 22nd October 2009 five requirements were made in relation to the management of medicines. We found that there had been some improvements in the medication records being completed by the home. We found that the home was now recording the quantities of medicines received into the home. We found that the home had implemented a carry over system to take account of medicines that were being carried over from the previous administration cycle. However we found that the home was failing to fully complete this system as some medicines carried over from the previous month had been accounted for in the records and some had not. In particular we found that the quantities of anticoagulant tablets had not been carried over and accounted for in the records and as a consequence the auditing of these tablets to determine whether they had been administered as prescribed was not possible. It is particularly important that the home can audit this particular medicine as the doses can change frequently and can be quite complex. We also found that the home was not always recording the quantity administered for medicines that had been prescribed with a variable dose. We found a number gaps in the administration record and therefore the home could not demonstrate whether the medicine concerned had or had not been administered. We found that the information about medicines in the care plans still needed to be improved. We also found that a number of people were still continuing to hold and administer some of their medicines. We found that there was still no written assessment of the risks to either the people themselves or other people in the home associated with this activity. We also found that there was no monitoring programme in place to ensure that the people were administering the medication as prescribed by the doctor. We observed the lunchtime medicines round and found that the administration practices had improved. We found that the staff member was ensuring that medicines had been taken before the administration record was signed and the administration process moved to the next person. We found however the home could not demonstrate that all of their members of staff who were involved in the administration of medicines were competent to administer medicines accurately and safely. We found that the home had obtained a new fridge and were measuring the maximum and minimum temperatures on a daily basis. We examined the temperature records and found that the fridge was being maintained outside the accepted temperature range. We found that since the 4th January 2010 the home had been recording the minimum temperature at 4 degrees Celsius and the maximum temperature at 9 degrees Celsius. The home could therefore not demonstrate that the contents of the fridge were being stored appropriately. We found that the Controlled Drugs cabinet had been secured to the wall using the correct fittings and therefore was now meeting the requirements set out in the Misuse of Drugs (Safe Custody) (Amended) Regulations 2007. Care Homes for Older People Page 4 of 10 We found that the home had obtained a Controlled Drugs register. We found however that of the two people prescribed a Controlled Drug in the home the home was only recording the receipt and administration for one of them. We also found that the home was not fully completing the record of administration within the Controlled Drugs register for the one person that they were making a record for. We also found that where the home was making a record in the Controlled Drugs register they were failing to make a similar record on the medicine administration record [MAR] chart and visa versa. 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 10 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 Req. 15(1) The home shall 17/07/2009 prepare a written plan giving details as to how the persons needs in respect of his health and welfare are to be met. The plan should be reviewed regularly and at point of change. This will assure people who use the service that they will receive a person centred service for their individual needs. 2 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 22/01/2010 3 9 13 The service must ensure that 22/01/2010 medication is stored securely at the correct temperature recommended by the
Page 6 of 10 Care Homes for Older People 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 manufacturer. Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 4 9 18 To ensure that staff are suitably qualified, experienced and competent to safely administer medication before they administer medication to people who use the service. regulation 18(1)(a). The registered person shall ensure thats at all times suitably qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users 5 9 13 Appropriate information 22/01/2010 relating to medication must be kept for example in risk assessments and care plans to ensure that staff know how to use and monitor all medication including when required as directed and self administered medication so that all medication is administered safely correctly and as intended by the prescriber to meet individual health needs. 22/01/2010 Care Homes for Older People Page 7 of 10 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 Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. Care Homes for Older People Page 8 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, 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 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 9 of 10 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 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!
