Care Home: Byron Court

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What the care home does well Regular medication audits will be completed to help ensure that should any shortfalls arise they can be promptly addressed. What the care home could do better: Procedures for ordering medication outside the main monthly order need to be reviewed to help ensure that adequate stocks of medication are maintained to enable continuity of treatment. Records showing the administration of sip feeds and external preparations, such as creams, need further improvement to better support and evidence their correct use as prescribed. Random inspection report Care homes for older people Name: Address: Byron Court Gower Street Bootle Liverpool Merseyside L20 4PY two star good service 21/01/2010 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 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: Byron Court Gower Street Bootle Liverpool Merseyside L20 4PY 01519220398 01519335687 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mary George Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 52 Number of places (if applicable): Under 65 Over 65 0 44 dementia old age, not falling within any other category Conditions of registration: 8 0 The maximum number of people who can be accommodated is : 52 The registered person may provide the following category/ies of service only: Care Home with nursing - Code N To people 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 (44) Dementia - Code DE (8) Date of last inspection 2 1 0 1 2 0 1 0 Care Homes for Older People Page 2 of 9 Brief description of the care home Byron Court is a purpose built care home registered for the care of a maximum of 52 Residents. The Home provides care to older persons, male and female, over retirement age that require nursing care. Byron Court is owned by a private organisation. Accommodation is situated over three floors and there are three lounges and one dining room. An enclosed lounge is available for those people who wish to smoke. There are landscaped gardens to the front of the establishment that are easily accessed. There are 47 bedrooms comprising of 42 single rooms and 5 double rooms. None of the rooms have en-suite facilities. Byron Court is situated off a main road in the Bootle area, opposite some small local shops. Public transport is easily accessible. The fee rate for accommodation is as follows: Residential rate of 383 pounds a week to the dementia nursing rate of 531 pounds a week. Care Homes for Older People Page 3 of 9 What we found: The purpose of this visit was to look at action taken to improve medicines handling in order to address concerns identified at our previous visit and to meet with current requirements. This visit focused on medicines handling, other areas were not examined on this occasion. We looked at care documentation within the home and the medication systems that were in place. We spoke with new manager and nursing staff responsible for medicines handling. At the end of the visit feedback was given to the provider (owner) and the manager. Overall we found that action was being taken to bring about improvement in medicines handling, although there were some areas that remain to be addressed to better support and evidence the safe handling of medication. We looked at medicines administration. Since our previous visit written assessments had been completed where people chose to self-administer medication. One person we spoke with managed their own medicines and was happy with the arrangements in place to support them with this. But the information within peoples care plans could be usefully expanded to provide clearer guidance to staff about any support people may need with their medicines. As seen at our previous visit, we found that where medicines were prescribed when required there was a lack of supporting information about their use. This needs to be addressed to help ensure consistency in their use, when needed. The homes medicines policy was being reviewed by the new manager with consideration given to the arrangements for handling homely remedies. We looked at a sample of medicines stocks and records. We found that the medicines administration records were generally clearly and accurately competed enabling medicines both in the monitored dosage system and in boxes and bottles to be accounted for (tracked). The home had introduced a new system for handling and recording external preparations e.g. creams, but this had been less successful. Although it was evident that creams were in use this was not supported by good record keeping and on occasion old or otherwise unwanted creams had not been promptly put for disposal. This meant it was not always possible to tell if creams had been used correctly. Similarly, we found a lack of supporting information within peoples care plans about the use of prescribed nutritional supplements (sip feeds) that meant it was difficult to evidence their use as prescribed. We were concerned to find occasional examples where records showed people had missed doses of medication because there was none left to give. We saw that this was most likely to occur over a weekend. The homes procedures for ordering medicines outside the main monthly order need to be reviewed to help reduce this risk. We found that all medicines including Controlled Drugs were safely locked away helping to reduce the risk of mishandling or misuse. At our previous visit we were concerned to see that on two occasions there had been a delay in changing a pain-reliving patch for one person. It was of concern that this had occurred on another occasion since our previous visit, although the most recent records showed they had been changed correctly. These errors need to be investigated to reduce the risk of re-occurrence. It is important that the patches are changed on time to help ensure pain is well managed. The new manager had carried out an initial assessment of medicines handling and had planned regular medicines audits to help ensure that should any weaknesses arise they will be promptly identified and addressed. Care Homes for Older People Page 4 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 5 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 9 13 Medication must be given as prescribed. Medication records must be completely, clearly and accurately maintained to support and evidence the safe administration of medication. 19/04/2010 2 19 13 The registered person must 19/04/2010 carry out a risk assessment on access to staircases for people living at the home and must carry out any necessary works in line with managing these. This must be carried out in conjunction with advice from the Fire department. To ensure the health, safety and wellbeing of people living at the home. 3 19 16 Work must be carried out to improve the overall environment. This must include decoration and refurbishment of bedrooms. This will ensure residents live in pleasant surroundings that are well maintained. 21/03/2010 4 26 16 All areas of the home must 19/04/2010 be maintained to a clean and Page 6 of 9 Care Homes for Older People 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 hygenic standard. To ensure the health, safety and wellbeing of people lviving at the home and ensure people are provided with a clean home environment. 5 26 23 The standard of cleanliness in the building must be improved. Bathrooms, bedrooms and communal areas must be kept clean. This will ensure good standards of hygiene for the residents. 6 38 18 Staff require training in safe working practices. This will help to ensure they have the skills and knowledge to undertake their work safely. 02/03/2010 21/02/2010 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 The homes procedures for 21/06/2010 ordering medicines outside the main monthly order need to be reviewed to help ensure adequate stocks of medication are maintained to allow continuity of treatment. 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 Where medicines are prescribed when required there should be individual information about when they may be needed and how this need may be made known. Where people chose to self-administer medication there should be clear written information about any support they may need to do so safely. 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. 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