Care Home: Byker Hall

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What the care home does well Comprehensive audit of the medication system is carried out regularly and this helps identify any medication problems promptly and helps confirm that staff are closely following the home`s medicines policy. What the care home could do better: Medicines for people who self-medicate should be stored in a locked drawer or cabinet in the bedroom and under the control of the individual. Regular risk assessments should be carried out to confirm that it is still safe and appropriate for the person to continue to self medicate. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Byker Hall Allendale Road Byker Newcastle Upon Tyne NE6 2SB The quality rating for this care home is: The rating was made on: zero star poor service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Michael Earnshaw Date: 0 6 0 1 2 0 0 9 Information about the care home Name of care home: Address: Byker Hall Allendale Road Byker Newcastle Upon Tyne NE6 2SB 01912240588 01912763080 Byker.Hall@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Tamaris Healthcare (England) Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability 0 5 Over 65 48 0 Conditions of registration: A maximum of 5 service users can be admitted in the category PD aged 50 years plus. Date of last inspection Brief description of the care home Byker Hall Care Home is purpose built and is situated in a residential area of Byker. The site is shared with another home owned by the same company. The Home is within easy reach of shops, public transport and all other amenities. Byker Hall provides general nursing care for up to 49 older people in single en-suite rooms. The home has communal lounges, dining rooms and smoking rooms on each floor. The laundry and kitchen areas are on the lower ground floor, from resident areas. All areas of the home are accessible and a passenger lift services all floors. Externally there is a garden and patio area and there is ample car parking. The home provides information about the service through the service user guide. A copy of the last inspection report Care Homes for Older People Page 2 of 8 from The Commission for Social Care Inspection is available in the entrance to the home. Care Homes for Older People Page 3 of 8 What we found: The reason for the visit was to undertake a pharmacist inspection of the service. The visit lasted 4.5 hours and involved looking at arrangements within the service that support the safe handling and administration of medicines. We looked at the medicines policy, medication records, storage, security and stock control. We also observed some medicines being administered and discussed the arrangements for training staff involved in the handling of medicines. We gave verbal feedback to the service deputy manager and the two nurses in charge. Morning medicines administration was observed on the first floor and was well managed and followed good practice guidance. Staff were not disturbed by colleagues and offered support and verbal encouragement to people taking medicines. People receiving nutritional supplements were asked what flavour of product they preferred that morning. The nurse put on disposable gloves when required to directly handle medication which prevents potential cross contamination and infection. There were no significant gaps on the medicine administration record (MAR) charts but the quantity of some medicines brought into the home when residents return from hospital is not always recorded. This means it is difficult to have a complete record of medication within the home and to check if medicines are being given as prescribed. However, we noted that two medicines for one person had been recorded as not available and consequently 5 doses of one medicine and 4 doses of the second medicine had not been given over a two day period. We were informed that night staff carry out a check on all the MAR charts to ensure that administration records are complete. A small number of handwritten entries on the MAR charts had not been countersigned by a second person to confirm their accuracy. We looked at the care plan of one person who was self medicating. Although a risk assessment had been initially completed there was no evidence of regular reassessment to demonstrate that it was still safe and appropriate for the person to continue self medicating. The medicines for this person were located in the bedroom but not within a locked drawer or cabinet and we were informed that this was the wish of the individual. This means that these medicines may be taken or tampered with by other people in the home. During the inspection we undertook an audit of a selection of medicines and checked the quantity of medicines received with the number of doses administered and the quantity of medicine remaining. There were only a few small discrepancies indicating that medicines are generally being given as prescribed. The storage and security of medicines within the home is good and there are detailed records of medicines ordered and received. Medicines for disposal are documented but the reason for disposal is not always entered in the appropriate column and the date of their removal and confirmation signature are not recorded. The controlled drug cupboard appears to meet safe custody regulations. There were no Care Homes for Older People Page 4 of 8 discrepancies between the entries in the controlled drug register, entries on the MAR charts and the quantity of controlled drug held in the home. There was no evidence of any regular controlled drug stock checks and two controlled drugs not used for more than six months had not been disposed of. 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 requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 19 23 The home must be well 01/12/2008 maintained and decorated to bring the home back to the required standard. Bathing facilities must be provided at adequate numbers for the resident numbers and their needs. Bedrooms must be maintained and furnished to satisfactory standards to meet the needs and comfort of the residents. 01/09/2008 2 21 16 3 24 16 01/10/2008 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, Care Homes 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 Locked storage facilities must 06/03/2009 be available for persons who self medicate To safeguard the health and welfare of people living in the home 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 A system should be in place to record all medication kept in the home and carried over from the previous month or brought into the home when a person returns from hospital. Staff should sign and date all handwritten entries they make on the MAR charts. Each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. Records for the disposal of medicines should include a date and signatures when removed from the home. Stocks of medication must be checked regularly and ordered in a timely fashion using a local pharmacy if necessary. Stocks of controlled drugs should be regularly checked and a record made in the controlled drug register. Page 7 of 8 2 9 3 4 9 9 5 9 Care Homes for Older People Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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