Care Home: Cranham

What the care home does well The focus of this inspection was to look at areas where concerns had been raised. Because of this we did not look at all aspects of the service and may therefore not have identified some positive things about the home. We saw that staff maintain accurate recordings of the administration of medication. What the care home could do better: The home does not make sure that care plans are kept up to date. This means that staff may not have the information they need to provide the care that is required. The home does not keep accurate records of fluid intake, where this has been identified as something which is required. This means that people may be at risk of not having enough fluid to maintain hydration. Stocks of medication are not rotated, and the home keeps much more medication than it needs to. The home needs to make sure that medication is disposed of as soon as it becomes out of date. This will protect the people living at the home from receiving medication which could place them at risk of harm. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Cranham 226 Cranham Drive Worcester Worcestershire WR4 9PH three star excellent 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 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: Sarah Blake Date: 0 9 0 3 2 0 0 9 Information about the care home Name of care home: Address: Cranham 226 Cranham Drive Worcester Worcestershire WR4 9PH 01905455474 01905759006 cranham@heart-of-england.co.uk www.heart-of-england.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) : Heart of England Housing and Care Limited care home 45 Number of places (if applicable): Under 65 Over 65 45 45 45 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 Cranham is a purpose built home located in the Warndon area of Worcester city, close to local shops and a bus route. The accommodation is divided into five separate units providing bedrooms and communal lounges, dining areas and kitchenettes. These are all on ground floor level. There are no en-suite toilet facilities in any of the bedrooms. Communal toilet and bathroom facilities are provided. Wheelchair access to some rooms is difficult as doorways do not have a clear opening of 800mm and the rooms are not spacious. The gardens are well kept and accessible to the residents. The home provides a residential care and respite service for up to forty-five older Care Homes for Older People Page 2 of 9 Brief description of the care home people who may have physical disabilities and/or mental health needs. Information regarding the home is available in the Statement of Purpose, Service Users Guide and inspection reports that are available in the reception area, and copies are provided for all prospective residents and on request. Care Homes for Older People Page 3 of 9 What we found: We carried out this inspection because we, the commission, had received a complaint about the standard of care provided by the home. The home had also informed us of some recent errors in the administration of medication. We made an unannounced visit to the home, and spent time observing how care is provided and managed. We also looked at the homes procedures for managing medication. We saw that one person, who is at risk of dehydration, was having their fluid intake and output recorded on a chart. The chart showed that on one day, the person had only been offered fluids four times within twenty-four hours. On another day, according to the chart, fluids had only been offered three times in twenty-four hours. It is not possible to see from the records how much fluid the person is having. If it has been decided that a persons fluid intake should be monitored, then it is important that all staff complete the chart accurately. We spoke to staff, who told us that they regularly offer fluids to the person. We saw that the person appeared to be well hydrated. We saw that one person is now being cared for in bed, as they are very ill. The care plans did not give any information about important aspects of their care, such as the need for measures to prevent pressure sores, information about how to assist them to mobilise, and information about their continence needs. We saw that medication which has been supplied but is not yet in use was stored in two secure cupboards. There was medication in the cupboard which had been dispensed more than six months previously and had not been used. Medication which is not needed should be returned to the pharmacy. The dates on the boxes of some medication showed that the home is not rotating stock in accordance with good practice guidelines. We saw that the home was currently using a box of medication dispensed in July 2008, and the cupboard contained five more boxes of this medication. We saw that a bottle of eye drops, which was still in use, had been opened in November 2008. The bottle clearly stated discard remainder one month after opening. The manager immediately removed the bottle for return to the pharmacy. We checked the records which show when medication has been administered, and these were accurate and complete. What the care home does well: What they could do better: Care Homes for Older People Page 4 of 9 The home does not make sure that care plans are kept up to date. This means that staff may not have the information they need to provide the care that is required. The home does not keep accurate records of fluid intake, where this has been identified as something which is required. This means that people may be at risk of not having enough fluid to maintain hydration. Stocks of medication are not rotated, and the home keeps much more medication than it needs to. The home needs to make sure that medication is disposed of as soon as it becomes out of date. This will protect the people living at the home from receiving medication which could place them at risk of harm. 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 £ 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 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 7 14 (2)(a)(b) You must ensure 16/04/2009 that assessments of peoples needs are kept under review, and revised as circumstances change. This is so that people can be sure that their needs will be met. 2 7 15 (1)(2) You must ensure that 16/04/2009 care plans are sufficiently detailed to enable staff to understand and meet the health and personal care needs of people who use the service. This is so that people can receive the care that they need. 3 8 12 12(1)(a) Where peoples fluid 16/04/2009 intake is being monitored, you must ensure that records are up to date and accurately reflect the current situation. This is so that people are not put at risk of dehydration. 4 9 13 13 (2) You must ensure that 16/04/2009 Page 7 of 9 Care Homes for Older People 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 medication is not used when it has passed its disposal date. This is to ensure that people are not put at risk by unsafe practices. 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 You should ensure that there are effective arrangements in place to monitor stock levels of medication. This is so that people can be sure that the home has adequate stocks of medication. Care Homes for Older People Page 8 of 9 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. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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