Care Home: Dorset House

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What the care home does well All medicines were administered by two staff working together and checking each other to make sure that there were no medication errors or omissions. What the care home could do better: Medicines procedures could give more detailed guidance for staff on some aspects of handling medicines in the home. Medicines with a limited use once opened should be marked with the date of opening. All handwritten entries on MARs should be made in block capital letters if they cannot be printed by the pharmacy and should be checked and witnessed by a second person. Random inspection report Care homes for older people Name: Address: Dorset House Off Station Road Wallsend Tyne & Wear NE28 8EN two star good service 03/09/2008 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: Michael Earnshaw Date: 2 1 0 7 2 0 1 0 Information about the care home Name of care home: Address: Dorset House Off Station Road Wallsend Tyne & Wear NE28 8EN 01916437750 01912007155 anne.steel@northtyneside.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elizabeth Anne Steele Type of registration: Number of places registered: Conditions of registration: Category(ies) : North Tyneside Council care home 41 Number of places (if applicable): Under 65 Over 65 0 20 dementia old age, not falling within any other category Conditions of registration: 21 0 The maximum number of service users who can be accommodated is: 41 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places: 21 Old age, not falling within any other category Code OP, maximum number of places: 20 Date of last inspection 0 3 0 9 2 0 0 8 Care Homes for Older People Page 2 of 8 Brief description of the care home Dorset House Resource Centre is a North Tyneside Council service registered to provide up to 41 places for older people with a range of needs. The centre is a single storey building situated in a residential area of Wallsend. A bus route, pub, and local shops are within easy walking distance. Off street parking is available. The centre consists of four units all of which have their own lounge and dining area, bathing facilities and laundry. The Oakwood unit offers a total of 21 short break beds for people with a diagnosis of dementia. The Kensington unit has 11 places for older people who need respite care and the Sandringham unit provides nine rehabilitation beds where service users follow a comprehensive reablement programme. In addition, 20 day care places are provided seven days a week for people with dementia. The fees paid by people using the service vary according to their individual financial circumstances. The Council carries out an assessment to determine peoples eligibility to access its services and receive financial support. Information about how peoples financial circumstances will be assessed is included in the homes service user guide and statement of purpose. A copy of the most recent inspection report is available on request at Dorset House. Care Homes for Older People Page 3 of 8 What we found: The reason for this visit was to carry out a pharmacist inspection to check that medicines were being handled safely within the service. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at significant risk or harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. A pharmacist spent four hours in the home and the inspection involved looking at medicines storage, the current medication administration records, and the policies and procedures relating to the handling of medicines in the home. We also spoke to several staff handling medication and to two assistant managers on duty. During the visit we gave verbal feedback to the assistant mangers. The outcome is as follows: Medicines were well managed in the home, by appropriately trained staff, and records were accurate and complete. We identified some areas where small improvements could be made to the handling of medicines in the home. All medicines were securely stored and within the temperature range recommended by the manufacturer. The current medication administration records (MARs) were looked at and a sample of medicines counted and checked against the medication records. There were no gaps on the MARs and no discrepancies between stocks of medication remaining and the administration records. This indicates that people living in the home get their medication correctly as prescribed. Details of prescribed medicines were handwritten onto the MARs and occasionally it was difficult to read because block capital letters had not been used. In addition, not all handwritten entries had been checked and countersigned by a second person to confirm that the entries were correct and complete. We found that occasionally some MAR sheets were not individually numbered to alert staff to the number of medication sheets currently in use for an individual service user. Numbering MARs 1 of 1, 1 of 2, or 2 of 2 for example, helps confirm that all the medication records for a service user are together and complete. Photographs of each service user were located with the MARs to assist in correctly identifying people when administering medicines. We found a bottle of Xalatan eye drops in the medicines fridge which did not have a date of opening on the bottle. This means that there is a risk that medicines with a short use once opened may be used beyond the date recommended by the manufacturer and may not be safe to use. The medicines policy and procedures could be improved to include more detailed Care Homes for Older People Page 4 of 8 guidance for staff. For example, there was little or no guidance on making handwritten entries on MARs, managing medicines for people who self- administer, checking medication on admission and, re-ordering supplies. The controlled drug cupboard appeared to meet safe custody regulations and there were no discrepancies between controlled drug stock, entries in the controlled drug register and entries on the MARs. All entries in the register were fully signed and witnessed. Having secure storage and properly witnessed records helps prevent the misuse and mishandling of controlled drugs. Audit of medication was regularly carried out and staff handling medicines had received appropriate training on the safe handling of medication. A programme of refresher training was underway at the time of the inspection. Having regular medication audit and thorough assessments of staff competency help make sure that medicines are handled safely by suitably trained staff. Requirements made following the last key inspection have not been included in this report. 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 £ 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 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 2 3 4 9 9 9 9 All handwritten entries on MARs should be checked and signed by a second person to confirm accuracy. The containers of medicines with a short life once opened should be marked with the date of opening. MARs should be consecutively numbered for each service user. The medicines policy should be updated to include guidance for staff on all aspects of handling medicines in the home. Copies of the medicines policy and a copy of the current edition of the British National Formulary should be kept with the medicines trolley on each floor. Hand written entries on MARs should be made in block capital letters to make them easier to read. 5 9 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. 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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