Care Home: Broadoak Manor Nursing Home

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What the care home does well A policy is in place for the use of Homely Remedies enabling people to receive prompt treatment for minor ailments without a prescription. Regular medicines audits are carried out to help ensure medicines are safely handled and that should any shortfalls arise, they can be promptly identified and addressed. What the care home could do better: Work is ongoing to help bring about improvement in the handling of external preparations such as creams, but some action could be taken more quickly to better support and evidence their correct use, as prescribed. The homes procedures for ordering medicines outside the main monthly delivery should be reviewed to help reduce the risk that doses may be missed whilst waiting for the next delivery. Random inspection report Care homes for older people Name: Address: Broadoak Manor Nursing Home Mulcrow Close Parr St Helens Merseyside WA9 1HB two star good service 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: Stephanie West Date: 2 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Broadoak Manor Nursing Home Mulcrow Close Parr St Helens Merseyside WA9 1HB 01744615626 01744615301 Telephone number: Fax number: Email address: Provider web address: www.bupa.com Name of registered provider(s): Name of registered manager (if applicable) BUPA Care Homes (CFHCare) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 120 Number of places (if applicable): Under 65 Over 65 0 120 dementia old age, not falling within any other category Conditions of registration: 120 0 The maximum number of service users who can be accommodated is: 120 The registered person may provide the following category/ies 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 Dementia - Code DE Date of last inspection Care Homes for Older People Page 2 of 8 Brief description of the care home Broad oak Manor Nursing Home is owned and run by BUPA. An interim manager is in post at the present time, due to the previous manager moving to another service within the BUPA organisation in December 2009. The home is situated in the St. Helens area, and is close to local shops and road links. The home is a modern, purpose built facility and is registered to provide accomodation for 120 people. It is split across the site into four separate units, three of which admit elderly people with general care needs and one [Havanagh] cares for elderly people with dementia. These units are named Stapley, Ashton, Ravenhead and Havanagh. Each unit has a designated Senior Nurse who has day-to-day responsibility for the provision of care. The fees for the service are currently between £451.72 and £733.36, depending on individual needs. Care Homes for Older People Page 3 of 8 What we found: This visit was carried out to look at the arrangements for the safe handling of medication following a report a concern about Controlled Drugs handling. The visit lasted approximately six hours and involved discussing the handling of medication with senior staff, and examination of medicines stock, records and storage arrangements in the Stapley and Havanagh houses. At the end of the inspection feedback was given to members of the management team. Overall we found that although there were some areas for improvement, generally suitable arrangements were in place for handling peoples medicines. Managers at the home carried out regular audits of medicines handling to help ensure that medicines are handled safely and that should any shortfalls be identified, they can be promptly addressed. Managers explained that the homes procedures for handling external preparations; such as creams, had been reviewed and that they had begun staff training in order to bring about improvement in the way they were managed. During this visit we saw that there were some shortfalls in the handling of external preparations. There were some old, or otherwise unwanted creams in stock and on occasion their use was not supported and evidenced by clear record keeping. In some cases the supporting information about the use creams needed to be updated to show when and where they may be needed. Although it will take time to implement the new procedures for handling external preparations some action for example, to improve stock control, could happen more quickly. We looked at medicines administration in the Stapley and Havanagh Houses. All medicines, with the exception of some external preparations, were administered by qualified nurses. The homes medication policy was available for reference and provided written guidance in the handling of medicines at the home. We found that records of medicines handling were generally clearly completed helping to support and evidence the safe administration of medication. Homely Remedies were kept enabling people to receive prompt treatment for minor ailments without a prescription. We looked at how information within peoples care plans supported medicines administration. We found that there was generally information in place about the use of medicines prescribed when required helping to ensure consistency in their use, when needed. But, we found some inconsistency in recording advice from healthcare professionals. Records were mostly clearly made and followed-up, helping to ensure any changes were promptly addressed, but on occasion entries could not be found to support changes to peoples medicines. This meant it was not always possible to evidence (track) these medication changes. A record viewed agreed that one of the people living at the home could have their medication given covertly (in food). Although covert administration was not currently being used there should be more information about how decisions to administer medicines covertly are made and reviewed. There should be clear guidance for staff about how this is carried out to help ensure that peoples best interests are protected. We looked at medicines stocks and storage. We found that all medicines including Controlled Drugs were safely locked away reducing the risk of mishandling or misuse. We found that generally sufficient stocks of medication were maintained to enable continuity Care Homes for Older People Page 4 of 8 of treatment. But, were concerned that where medicines needed to be ordered outside the main monthly order there was a risk that doses may be missed because there were none left to give. It was of concern that records showing the application of eye drops for one person had been marked as unavailable for several days, this should have been followed-up more quickly. Procedures for re-ordering medicines outside the main monthly delivery should be reviewed to help ensure they are effective. 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 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 12 12 The provision of therapeutic 01/05/2008 activities for residents with dementia must be developed with greater consistency and input. [Last requirement date 01/03/07 not met, not assessed at this visit] 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 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 homes procedures for ordering medicines outside the main monthly delivery should be reviewed to help reduce the risk that doses may be missed whilst waiting for the next delivery. Managers should look to improve the handling of external preparations alongside the staff training programme. 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. 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