Care Home: Alexandra House

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What the care home does well Care plans and supporting paperwork contained detailed information about medicines and the health issues they were prescribed for. This helps make sure the health wellbeing of people is protected. What the care home could do better: Medicines must be given at the right time to help make sure they work properly. The handling of liquid medicines needs to be improved so they can be fully accounted for to show they are being given to people correctly. Random inspection report Care homes for older people Name: Address: Alexandra House 2 - 4 Lord Street Southport Merseyside PR8 1QD three star excellent service 20/01/2009 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: Simon Hill Date: 0 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Alexandra House 2 - 4 Lord Street Southport Merseyside PR8 1QD 01704543715 01704543828 jan.habeck@ben.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Habeck Type of registration: Number of places registered: Conditions of registration: Category(ies) : BEN - Motor & Allied Trades Benevolent Fund care home 56 Number of places (if applicable): Under 65 Over 65 56 0 old age, not falling within any other category physical disability Conditions of registration: 0 6 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. Physical disability - Code PD (maximum number of places: 6). The maximum number of service users who can be accommodated is:56 Date of last inspection 2 0 0 1 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home Alexandra House (BEN - Motor and Allied Trades Benevolent Fund) is a registered care home run by a charitable organisation. The registered manager is Mrs Jan Habeck. The home provides fifty six places for nursing and personal (residential) care for residents. Included in this number the home can accommodate up to six young physically disabled. Respite/day care is offered for up to six non-residents a week. The home is situated in the town centre close to local amenities. Alexandra House is a large building and consists of two units. The nursing unit has twenty eight beds (including six for the young physically disabled); the unit for personal (residential) care has twenty eight beds. The five beds on the ground floor accommodate residents who require general nursing. The home has fifty two single rooms and two double rooms; none of the rooms are en-suite. Two rooms on the top floor are small flats and residents accommodated in these rooms receive minimal personal care. All areas of the home are accessible by the use of a lift, chair lift and stairs. The home has suitably adapted bathrooms and a very good standard of equipment to assist those who are less independent. A call system with an alarm facility operates throughout the building and the home is subject to an ongoing programme of maintenance and redecoration. The charge for accommodation ranges from 750 pounds a week for nursing care and 440 pounds a week for residential care. Care Homes for Older People Page 3 of 8 What we found: We carried out this visit to look at how medicines were being handled because the manager had told us about two recent mistakes. We checked a sample of medicines stocks, medicines records and care plans. Overall we found some improvements are needed to help make sure medicines are always given and recorded properly. We found medicines stock to be well organised, records were clearly presented and spare stock was stored securely in clean and tidy rooms. Records of medicines received into the home and given to people were usually signed and up to date. Ordering and recording procedures were efficient and most medicines could be easily accounted for. We saw good information about the use of when required medicines and care plans contained detailed information about specific medicines and the health issues they were prescribed for. However, we found records of medicines disposed of were not always clearly made and we could not account for one medicine that had recently been discontinued. We also found excessive amounts of stock were disposed of unnecessarily instead of carrying them forward to the new monthly medicines cycle. We gave some detailed advice about how to improve the procedures for medicines disposal so checking and auditing them could be made simpler and more efficient. We carried out some detailed checks on the current stocks and records and found regularly prescribed medicines were usually being given correctly. However, we found liquids medicines difficult to audit because they were not always dated on opening and some of our checks raised concerns about whether they had been measured and given to people properly. On the day of our visit one person was given another persons liquid medicine, although this was the same medicine, this showed staff were not always following the correct procedures whilst preparing and giving medicines. We gave some detailed advice to the manager about how to audit liquid medicines so they can be properly accounted for. We also saw one medicine signed for in advance of it being given, this is not good practice because the records should always be signed after a person has taken their medicine and not before. We looked at the times medicines were given to people and found those that needed to be given before food were often wrongly given afterwards because the medicines rounds had not been properly organised. Giving people medicines at the wrong time, wrong dose or not at all can seriously affect their health and wellbeing. We checked how controlled drugs (medicines that can be misused) were handled. We found they were securely stored in suitable cupboards but advised the manager to check one of them was properly fixed to the wall because we could not be sure it met the requirements of the law. We checked the current stocks of several controlled drugs and found these were correct and all records were properly witnessed. We gave some advice about how to improve the recording of medicines used in a syringe driver (a special pump that injects medicines over several hours) to help make the records clearer and to prevent any mistakes. We looked at how external medicines such as creams were given and recorded. We found some good care plans about how to use creams properly and these were being reviewed regularly. However, on the residential unit we found one cream was being signed for even though it was not being applied and had not been for some time. We also found some Care Homes for Older People Page 4 of 8 creams were not always properly signed for so we could not be sure they were being used correctly. We gave some general advice about how to make the necessary improvements so the records show that creams are being used as prescribed. We looked at how staff were trained to handle medicines. All had received certificated medicines training and their competency was formally assessed. However, we highlighted several issues during our visit that showed some staff were not always following the correct procedures for giving medicines safely. We discussed these specific issues with the manager and gave some advice about developing these assessments further and to include a more thorough observation and recording of staff administering medicines. We saw regular checks and audits carried out by the managers to help make sure medicines were handled safely but these had not identified the some of the issues we had found so we advised the manager to review and develop these further. Regular training, efficient audits and formal competency checks help make sure medicines are handled safely by suitably skilled staff. 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 8 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 8 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 Medicines must be 10/05/2010 administered to people correctly. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 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 assessment of staff competency in giving and recording medicines should be reviewed to help make sure medicines are given to people in the safest way. Procedures for the disposal of medicines should be improved to help prevent mishandling or misuse. Care Homes for Older People Page 7 of 8 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. 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