Random inspection report
Care homes for older people
Name: Address: White Lodge & St Helens House 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR 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: Sue Fuller Date: 2 9 1 2 2 0 0 9 Information about the care home
Name of care home: Address: White Lodge & St Helens House 15-17 Boscombe Spa Road Bournemouth Dorset BH5 1AR 01202395822 01202569587 wl-office@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Christine Higginson,Mr John Higginson,Mrs Karen Frances Watt,Mr Peter John Higginson,Mrs Carolin care home 54 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 54 old age, not falling within any other category Conditions of registration: 0 One named person (as known to the CSCI) under the age of 65 may be accommodated to receive care. Date of last inspection Brief description of the care home White Lodge and St Helens House are adjoining properties with an extension that links them on each level. The home is registered to accommodate fifty-four residents in the old age category. All residents have single bedrooms. The home is on sloping land and has four floors; lower ground, ground, first and second. There is a passenger lift. There are pleasant well-maintained gardens at the rear of the property, but access is limited by a steep path and steps. 1 0 0 9 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home The fees for the home range from £380 to £500 per week. Up to date details of fees can be obtained from the home. Care Homes for Older People Page 3 of 9 What we found:
The pharmacist inspector carried out this inspection and looked at medication handling in the home. We (the Care Quality Commission) began the inspection by asking staff about progress with the items relating to medicines included in the recent action plan provided to the Care Quality Commission. We were told that the registered providers were doing regular audits of controlled drugs. These are medicines that require more secure storage and recording in a controlled drugs register. We did not see any record of these audits. However a check of these medicines confirmed that records were up to date and correct and that improvements had been made to the way these records were kept. This helps to show that these medicines have been looked after safely. Three members of staff have received medicines training. We were told that arrangements had been made for a pharmacist to come and provide training for another six members of staff later in January. We were also told that one of the registered providers is intending to start doing competency assessments for staff involved with giving medicines. This helps to protect the health of people living in the home by ensuring that staff are able to give medicines safely. The manager told us that he is reviewing the medicines policy and that this was almost complete. He offered to send a completed copy to CQC. A pharmacist from Bournemouth and Poole PCT visited the home in December and provided some advice to the home. This person was seen by one of the registered providers and a carer but no information about the advice given was available at the time of this inspection. Staff confirmed that all the people living in the home had their medicines reviewed by their general practitioner (GP). We saw three peoples care plans confirming this. However no information about the result of the review, or any changes made, had been recorded. This means that staff cannot check that any changes have been carried forward and the correct medicines are supplied. We were told that the home are reviewing the pharmacy service they currently use. They have taken action to make sure that staff can check the prescriptions when they receive medicines. This means that they can check that the correct medicines have been supplied. At present medicines are supplied by a local pharmacy using a monthly blister pack system. None of the people living in the home looks after their own medicines, all the medicines are looked after and given by staff. Staff should ensure that anyone moving to the home is given the choice to look after their own medicines, if they wish to and it is safe for them to do so. Suitable lockable storage is available so that medicines can be kept securely. Staff have recently obtained a second medicines trolley. This has meant that medicines can be given by two members of staff at the same time. Staff told us that this had significantly
Care Homes for Older People Page 4 of 9 reduced the time needed to give the medicines. This means that people receive their medicines at a more suitable time, particularly in the mornings. We saw some medicines being given at lunchtime. Medicines were given appropriately and records made as the medicines were taken. When people were prescribed tablets for pain relief, we saw staff asking if they needed them. The pharmacy provides printed medicines administration record sheets for staff to complete when they have given medicines. Handwritten additions to the records had been signed, dated and checked. This is good practice to reduce the risk of mistakes. We saw that the majority of records had been completed fully. We saw two gaps in the administration records. The tablets were missing from the blister packs, staff did not know why the record had not been signed. Staff have dated the packs of medicines supplied in standard boxes so that it is possible to audit the stock and check it has been given as recorded.We checked three packs of medicine and saw that they agreed with the administration record. We noted that several people are prescribed medicines with a variable dose but staff do not always record the amount they have given. This means that it is not clear how much medicine the person has received. Action must be taken to ensure that the amount given is always clear. Many people living in the home are prescribed creams and ointments. A new system has been introduced and these are now recorded separately by the carers who are applying them. We looked in two peoples care plans and saw that the records kept were not accurate or complete. They had often been ticked rather than signed by the carer and did not always agree with the information printed on the medicines administration record sheet. Action is needed to make sure that these records are accurate, are signed by the person applying the medicine and demonstrate that the medicine has been used as prescribed by the doctor. Records are kept of the medicines received into the home and of the disposal of unwanted medicines. This means that there is an audit trail of the medicines used in the home. We looked at four peoples care plans to see what information they contained to help carers give medicines safely. We found very little information about medicines. One person is prescribed a sedative medicines daily, as directed it is always given at night but there was no information about its use in the care plan. Another persons medicine administration record showed that they often refused to have their eye drops at night but there was no information about any action which may have been taken to address this or to inform the persons doctor. One person had been in hospital but the daily record did not mention their return to the home. None of the files looked at contained information about the persons current medicines, medicines they were taking when they moved to the home or the results of recent medicine reviews. Staff explained that they were currently changing their care files and improving them. One person, whose file had been changed, did have information about the way they were given one of their medicines including a care plan and risk assessment. Care Homes for Older People Page 5 of 9 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 6 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 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 1 9 13 Accurate records must be made of all medicines given by staff. All medicines must be given as prescribed. This refers to application of creams and ointments. This is to ensure that topical medicines are given as prescribed. 26/01/2010 2 9 13 If the dose of medicine is variable, a record must be made of the amount given. This is so that it is clear how much medicine has been administered. 26/01/2010 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 Staff should ensure that relevant information is available in peoples care plans to help staff give medicines safely. The outcome of medicine reviews should be recorded to ensure that medicines are given correctly.
Page 8 of 9 Care Homes for Older People 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. 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!
