Care Home: Chilterns Manor

What the care home does well Clear records are kept of the medicines that are to be given and that have been given to people who use the service. Staff were able to demonstrate that they give medicines following the appropriate procedures. What the care home could do better: Controlled Drugs must be stored in the new Controlled Drugs cupboard once it has been correctly fixed to a solid wall in order to comply with the law. When people look after their own medicines the risks of this to themselves and to other people should be assessed and minimised. Random inspection report Care homes for older people Name: Address: Chilterns Manor Northern Heights Bourne End Buckinghamshire SL8 5LE one star adequate service 16/01/2009 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: Geraldine Yates Date: 1 6 0 6 2 0 0 9 Information about the care home Name of care home: Address: Chilterns Manor Northern Heights Bourne End Buckinghamshire SL8 5LE 01628528676 01628527735 chilternsmanor@centurioncare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Centurion Health Care Ltd care home 22 Number of places (if applicable): Under 65 Over 65 0 22 dementia old age, not falling within any other category Conditions of registration: 22 0 The maximum number of service users to be accommodated is 22. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Chiltern Manor provides residential care and accommodation for 22 older people. The registered provider is Centurion Health Care Ltd. The home is traditionally furnished and decorated to a high specification set in its own landscaped grounds, and has car parking facilities for approximately twelve to fifteen vehicles. Care Homes for Older People Page 2 of 9 1 6 0 1 2 0 0 9 Brief description of the care home There are 18 single bedrooms, and 2 double rooms over three floors, that can be accessed by stair lifts, most rooms have en-suite facilities, and those that don?t have a wash hand basin; double rooms are single or kin share only. The home is situated at the end of a private road, adjacent to open farmland. Chiltern Manor has a Statement of Purpose and Service Users Guide available on application to the home. Information CSCI received 18/01/08/ confirms that weekly fees start from 375 pounds to 850 pounds. Care Homes for Older People Page 3 of 9 What we found: This inspection was a specialist pharmacist inspection to look at the handling of medicines in the home. We looked at the storage of medicines, records kept in the home, policies and procedures and talked to staff. All three floor were visited and the records of 7 people were looked at in detail. People who use this service are supported to be as independent as possible. If people wish to and are able to look after any of their own medicines they are supported to do this. When we visited most people who were prescribed medication needed support from the staff. The only medicines being looked after by residents were low risk items such as inhalers and creams. When people looked after these medicines the risks that this activity might poss to other people and how they could be minimised had not been assessed. This is an area that should be developed. We did not see any medicines being given to people but the staff on duty described to us how they would do this. They described safe and appropriate procedures. Written policies and procedures are available to provide guidance to staff. The procedures lacked the detail necessary to enable medicines to be handled consistently by all staff. This could lead to staff following inconsistent practices. Clear records were kept of medicines coming into the home, medicines leaving the home and medicines that were given to people. These together with the medicines supplies showed us that people get their medicine correctly. Clear records were kept of all medicines given to people. If a medicine was not given this was recorded together with the reason why. When medicines were prescribed to be given at a variable dose, such as one or two tablets, then the actual dose given was recorded. There were no gaps or other discrepancies on the medication administration record charts that we looked at. When it was necessary to make additional entries on the record charts supplied by the pharmacy these were done accurately. It is however good practice to have these entries checked by a second carer to ensure that they are accurate and people get their medicines correctly. When people are prescribed medicines to be given only when needed there was information in the care plans informing staff as to when these medicines should be given. The medication administration records showed that people were being offered these medicines and when they were given. Peoples allergies to medicines were recorded on their medication profiles and their admission information but not always on their medication administration record charts. Allergies must be recorded accurately and consistently so as to prevent someone being given a medicine that they are allergic to. All medicines were stored securely so as to protect the people who use the service. Medicines requiring cool storage were kept in a secure refrigerator and daily temperature records were kept. These showed it to be operating within the correct temperature range and so the medicines would be fit for use. Medicines liable to misuse, called Controlled Drugs, were stored in a locked cash box in the drug trolley. A new cupboard has been bought in which to store Controlled Drugs. Care Homes for Older People Page 4 of 9 This cupboard will comply with the law once it has been correctly fixed to a solid wall. Additional records were kept of the use of Controlled Drugs so as to readily detect any loss. 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 1 4 Review and ammend the 31/03/2009 information within the statement of purpose and service users guide to ensure that people are provided with up to date information including that listed under schedule 1 of the care homes regulations 2001 Regulation 4(1) of the Care Homes Regulations 2001 requires that: The registered person shall compile in relation to the care home a written statement (in these regulations referred to as the statement of purpose) which shall consist of - a) a statement as to the aims and objectives of the care home; b) a statement as to the facilities and services which are to be provided by the registered person for service users and c) a statement as to the matters listed in Schedule 1. 2 9 13. (2) The registered provider must 17/04/2008 ensure a controlled drugs cupboard, which complies with the misuse of Drugs (safe custody) Regulation 1973 is provided for the secure storage of any 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 Controlled Drugs, which are prescribed for people who use the service. 3 31 8 The registered person must 30/04/2009 ensure to recruit and register an individual to manage the care home. Regulation 8 (1)(a)(b) of the Care Homes Regulations 2001 requires that: (1) The registered provider shall appoint an individual to manage the care home where- (a) there is no registered manager in respect of the care home; and (b) the registered provider - (i) is an organisation or partnership; (ii) is not a fit person to manage a care home; or (iii) is not, or does not intend to be, in full-time day to day charge of the care home. 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 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 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. 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