Inspection on 21/01/10 for Waterside Care Centre

This inspection was carried out on 21st 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 but made no statutory requirements on the home.

Other inspections for this house

Waterside Care Centre 26/11/09

Waterside Care Centre 24/08/09

Waterside Care Centre 02/03/09

Extracts from inspection reports are licensed from CQC, this page was updated on 11/04/2010.

Random inspection report Care homes for older people Name: Address: Waterside Care Centre Waterside Care Centre Leigh Sinton Malvern Worcestershire WR13 5EQ zero star poor service 10/09/2009 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: Morag Ross Date: 2 1 0 1 2 0 1 0 Information about the care home Name of care home: Address: Waterside Care Centre Waterside Care Centre Leigh Sinton Malvern Worcestershire WR13 5EQ 01886833706 01886832882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Minster Care Management Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 46 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 46 The maximum number of service users to be accommodated is 46 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: Dementia (DE) 46 Date of last inspection Brief description of the care home This is a purpose built two storey home situated in the village of Leigh Sinton, near Malvern. It provides nursing care on a permanent and respite basis for up to 46 older adults who have dementia and may also have some physical disabilities. All bedrooms Care Homes for Older People Page 2 of 9 2 6 1 1 2 0 0 9 Brief description of the care home are single occupancy and have ensuite facilities. There is a choice of well furnished seating areas. Bathing facilities are available on each floor offering a choice of a bath or shower. Aids and adaptations are available so that people requiring assistance can receive it safely. There is a passenger lift so that people can access all parts of the home and there is a secure garden to the rear of the premises that is accessible to people with limited mobility. At the front of the building is a car park providing off road parking for staff and visitors. The home has a no smoking policy. There is a bus route to Leigh Sinton and the home is within walking distance of the local shops. In the reception area there is a range of information for people living in the home and their visitors to access about the home . A copy of the inspection report should now be added to that information.The home has a range of fees and the manager should be contacted for up to date information about what these are. Care Homes for Older People Page 3 of 9 What we found: The pharmacist inspector visited the home on 21st January 2010 to check the management and control of medicines within the service. An unannounced inspection on 26th November 2009 had identified that medication management systems needed to be improved and a Statutory Requirement Notice (SRN) was served. We received an improvement plan dated 21st December 2009, which listed improvements the service had made to medication practices. The purpose of this inspection was to check compliance with the SRN. We arrived at 11.10am and stayed until 2:30pm. We looked at the medicine records and some care plans. We spoke to one member of staff, the Project Manager and the Acting Manager. The Project Manager explained that changes had been made to medicine management and that the service was working hard to ensure medicine was handled safely. We looked at how the home was storing peoples medication and found that there had been an improvement since the previous inspection. The medicine trolleys were neat and tidy and we found it easy to locate peoples medication. We found that there was improved stock control of peoples medication. However, we saw that some medication was not always stored correctly. For example, we saw in the upstairs medication trolley a bottle of prescribed eye drops for a person stored next to an ointment to be used externally, which increases the risk of contamination between medication for external use and medication to be put into the eyes. We discussed this with the Acting Manager. Overall, storage of peoples medication had improved, which reduced the risk of a medicine error. We looked at the medication administration record (MAR) charts and overall found that they were documented with a signature for administration or a reason was recorded if medication was not given. For example, we looked at the MAR chart for a person prescribed medicine for Parkinsons Disease. The medicine was prescribed to be given six times a day. We saw that there were records of the medicine being given at regular intervals six times a day as prescribed. We checked the amount of tablets available in the home in order to determine whether medication had been given as prescribed. We found that the amount of tablets that had been removed from the container matched with the records of receipt and the amount of tablets recorded as given. We saw a separate record for this medicine, which staff were also recording to ensure it was given six times a day. We were shown records of checks that had been made on all of the persons medication, which showed that their medicine was being given as prescribed. This means that there were improved arrangements in place to ensure that medication is administered as directed by the prescriber to the person it was prescribed, labelled and supplied for. We found that other medication records were generally up to date. For example, we saw current records for the receipt and disposal of medication. The date of opening of boxes and bottles of medicines were usually recorded and balances of medication were carried forward from old records to new records.We found that counts and checks made on the majority of medication was accurate, which showed that people who live in the service were being given medication as prescribed by a medical practitioner. For example, we saw that one person was to be given a tablet for the prevention of osteoporosis once a Care Homes for Older People Page 4 of 9 month on the same day before breakfast. We wanted to check that this medicine was being given as prescribed. We looked at the MAR chart and saw that the tablet was signed as given once a month at 7:00 am before breakfast. Overall,the medication records helped to ensure there was a clear audit trail of medication. Prescribed medication was not always available to administer according to the directions of a doctor. For example, we saw a MAR chart for a person for a tablet to be given once at night to reduce cholesterol. We saw that the MAR chart had been documented with a code o/s for five days from 11th January 2010 to 15th January 2010. The code o/s was not defined on the MAR chart but previous records showed this as out of stock. We saw that a record TO FOLLOW had been handwritten onto the MAR chart in red pen but there was no signature. A member of staff informed us that there were problems with the service receiving medication from the supplying pharmacy and that the pharmacy had written TO FOLLOW onto the MAR chart. The Project manager informed us that there had been disruptions in receiving normal medication deliveries due to severe weather conditions. Heavy snow fall had prevented the delivery driver from the pharmacy getting to the home. We acknowledged these explanations and discussed the need for the service to keep written records when medication is not available and to keep the prescriber informed. We looked at three peoples individual care plans with regard to their healthcare and prescribed medication. The first care plan was for a person who was prescribed a tablet for anxiety and agitation. We found it included information from healthcare professionals about changes made to the persons tablet to help with their anxiety. The second care plan we looked at was for a person prescribed medicine to reduce cholesterol and also medicine for constipation. Both medicines had not been available to give for five days. The care plan did not include information about the reason why the medicines were not available and there was no record that the prescribing doctor had been informed. The third care plan was for a person who was prescribed a tablet to help treat depression. The MAR chart had been changed on several ocassions with different doses. We spoke to a member of staff who told us that the Consultant had changed the doses. The care plan recorded that the person was being given the tablet for depression and records showed that there had been changes made by the Consultant. This means that overall information relating to medication was documented in the care plans but the information was not always easy to find. We gave feedback to the Acting Manager and Project Manager about the outcome of the inspection and informed them that the requirements relating to medication had been met. What the care home does well: What they could do better: The service should ensure that medicines for external use, such as creams and ointments, are stored separately from medicines for internal use including eye preparations. This is to ensure people are not at risk of harm. Care Homes for Older People Page 5 of 9 Care plans relating to medication should be kept up to date and ensure that information is easy to locate. This is to ensure that peoples health and welfare needs relating to medication are available and recorded. 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 9 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 12 When a person is discharged 27/11/2009 from hospital the manager of the home and or the deisgnated person must ensure that a reassessment of the persons identified needs are completed prior to them returning to the home. This will ensure that staff are confident in meeting peoples needs so that their health and safety is not placed at risk. Not fully assessed at this inspection visit but will be focused upon when we next inspect the home. This will ensure that staff are able to meet a persons health needs with confidence so that people are not at risk. Care Homes for Older People Page 7 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 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 service should ensure that medication prescribed for external use is stored separately from medication for internal use. The service should ensure that information relating to peoples medication, including any changes, is easy to locate in their individual plans of care. 2 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. © 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 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. 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