Care Home: Elmhurst

What the care home does well The home carries out regular stock checks of medication and checks of the accuracy of the records made when medicines are given to people and this provides a good account of medicines in use. Training provided for staff on the safe use and recording of medicines is of a good standard. The requirement made on the last inspection for staff to have training on safer administration of medicines has therefore been met. Most medication is stored securely for the protection of residents and when medication requires special storage requirements, such requirements are followed and ensures residents receive medication of suitable quality. What the care home could do better: Medicines, including creams must never be left in communal areas and accessible to people they are not prescribed for. All medicines must be locked away when not in use. Records made when medicines are given to people must be more accurate to protect residents and demonstrate that residents receive the medicines prescribed for them. The records made of the medication fridge temperatures was sometimes inaccurate and no action had been taken to investigate or correct these entries. Hand-written changes or additions to printed medication records should be signed and dated by the person making the entry and should be checked by a second person who should also sign the record. Random inspection report Care homes for older people Name: Address: Elmhurst Windhill Bishops Stortford Hertfordshire CM23 2NF two star good 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 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: Derek Brown Date: 0 4 0 6 2 0 0 9 Information about the care home Name of care home: Address: Elmhurst Windhill Bishops Stortford Hertfordshire CM23 2NF 01279713100 01279713161 Telephone number: Fax number: Email address: Provider web address: www.quantumcare.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Quantum Care Limited care home 61 Number of places (if applicable): Under 65 Over 65 61 61 61 dementia learning disability old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 1 0 0 Operated by Quantum Care Limited, a not for profit organisation, Elmhurst is a care home providing accommodation and personal care for up to 61 elderly people. The home, purpose-built in the late 1990s, is divided into four separate units (one specialising in dementia care) and offers all single bedrooms with en-suite facilities and spacious communal areas in each unit. Elmhurst is situated within walking distance of Bishops Stortford town centre with its mainline railway station and a wide range of shops and other amenities. There is car parking space in front of the building, but as this is shared with a day centre next to the home it can often be full. Elmhursts weekly charges range from £420 to £675 per week. (Correct at April 2008) Additional Care Homes for Older People Page 2 of 9 Brief description of the care home charges apply for personal toiletries, newspapers, hairdressing, chiropody and private dentistry. Quantum Care have a comprehensive Personal Guide which provides very clear information about fees and services and includes contact details for the Commission for Social Care Inspection (CSCI). Copies of the latest inspection report are also made available. Care Homes for Older People Page 3 of 9 What we found: This inspection by a pharmacist inspector was to assess practices and procedures for the safe storage, use, recording and administration of medicines following incidents which had been reported to the Commission. We also assessed progress towards meeting the requirement for training on medication made at the last key inspection on 14th April 2008. We looked at medication storage and medication records for a total of 22 people on all four units of the home. We also looked around the home and spoke with staff. We looked at training records for staff authorised to give people their medicines. The majority of medicines are stored securely for the protection of residents in a room which is temperature controlled to maintain the quality of medicines in use. Temperature records are kept and indicate that the temperature is well below the recommended maximum for medication storage. The temperature of the fridge used to store medicines was also recorded and this shows it is kept at the right temperatures but the record was sometimes inaccurate. Additionally only the current temperature is recorded, not the maximum or minimum the fridge has reached, despite the homes own policy which states Fridge temperatures should be monitored daily using a maximum/minimum thermometer. On a tour of the home we found some creams kept in communal toilet and bathroom areas on Sunflower unit which could be accessed by the residents they were not prescribed for. The home carries out regular stock checks of medication and checks of the accuracy of the records made when medicines are given to people and this provides a good account of medicines in use. Training provided for staff on the safe use and recording of medicines is of a good standard and we saw records of such training. The requirement made on the last inspection for staff to have training on safer administration of medicines has therefore been met. Other aspects of this requirement relating to training in infection control and the protection of vulnerable adults was not assessed on this inspection. We found some problems with the records made when medicines are given to people, this includes: when medicines are given in variable doses e.g one or two tablets the actual quantity given is not always recorded and so this could result in people receiving too much or too little medication. When medication is given at a different time to that printed on the medication record form, the actual time it is given is not recorded accurately, this could result in people being given medicines that shouldnt be given together, too close together. The remaining stock balances for two medicines did not agree with what should have been left if the records made were accurate. One person was prescribed medication on a when required basis but the records showed it was given regularly at tea-time and at night. There was no guidance for staff in the residents care plan of what this medication is used for or how and when it should be used. Daily records did not show any justification for the use of this medication. A previous requirement that care plans must contain clear detail as to what actions care workers need to take to ensure each persons Care Homes for Older People Page 4 of 9 needs in respect of his/her health and well being has therefore not been met. Hand-written changes to medication records do not always indicate who made the entry and when and they are not signed as checked by a second person. 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 7 15 Care plans must contain 30/09/2008 clear detail as to what actions care workers need to take to ensure each persons needs in respect of his/her health and well being are to be met. Previous timescale of 31/07/2008 not met. 2 18 18 The person in charge must 31/07/2008 make sure that care workers receive training to keep people safe. Specifically refers to the Protection of Vulnerable Adults and the control of infection. Previous requirement referred to medication training and this aspect has been met. Other aspects of this requirement not inspected on this occasion. 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 9 13 All medicines must be stored 30/06/2009 securely when not in use. This will protect residents by ensuring they are not accessed by people they are not prescribed for. 2 9 13 Records made when 30/06/2009 medicines are given to people must be accurate and complete. This will demonstrate that people receive the medicines prescribed for them and ensure medicines are given correctly. 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 Hand-written changes or additions to printed medication records should be signed and dated by the person making the entry and should be checked by a second person who should also sign the record. Care Homes for Older People Page 7 of 9 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 2 9 The medication refrigerator temperature should be monitored and recorded using a maximum/minimum thermometer, the record should include the current temperature, the maximum and minimum reached and it should then be reset for the next recording period. 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. 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