Care Home: Gosmore Nursing & Care Centre

What the care home does well During the site visit, it was noted that the majority of the residents were in the lounges. They seemed relaxed and comfortable. Some residents seemed sleepy but all were alert as lunchtime approached. The activity co-ordinator was busy attending to individuals in the two lounges with help from the care workers. Members of staff were ready to help individuals to the dining room for lunch. Some residents preferred their lunch in the lounge/diner. Residents spoken to gave positive feedback about the care and service provided. What the care home could do better: In view of the recent medication error, we recommend that staff have regular refresher courses on the recording. handling, safekeeping, safe administration and safe disposal of medicines received into the home. This will ensure that residents are not unduly expose to risk. It would be safer if the bin used for the disposal of medicines has a closed up lid that can only open one-way to ensure that no one can get access to the discarded medicines once they are in the bin. This will ensure the safe disposal of all medicines. Random inspection report Care homes for older people Name: Address: Gosmore Nursing & Care Centre Hitchin Road Gosmore Hertfordshire SG4 7QH 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: Yoke-Lan Jackson Date: 0 4 1 1 2 0 0 9 Information about the care home Name of care home: Address: Gosmore Nursing & Care Centre Hitchin Road Gosmore Hertfordshire SG4 7QH 01462454925 01462453991 gosmore@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamhealth Limited (wholly owned subsidiary of Four Seasons Health Care Limited) care home 70 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 70 25 old age, not falling within any other category physical disability Conditions of registration: 0 0 This home may accommodate 25 older people with physical disability who require personal care. This home may accommodate 70 older people in need of nursing care. This home may accommodate one named service users who have a diagnosis of dementia. This condition will be revoked should the service users permanently leave the home. Date of last inspection Brief description of the care home Gosmore is a care home providing personal and nursing care and accommodation for 70 older people. It is owned and managed by Tamhealth Limited, which is a member of Care Homes for Older People Page 2 of 8 Brief description of the care home the Four Seasons Health Care group. The home is set in extensive grounds on the outskirts of Hitchin, a short drive from the main shopping centre and the local amenities. Stevenage is five miles away from the home. Gosmore Nursing Home was opened in 1999 and accommodation for service users is offered in both the original and newer wings of the building. The majority of the homes bedrooms are for single accommodation but there are some double rooms. Twenty-seven of the rooms have en-suite facilities. There are three lounges on the ground floor, one being a large conservatory. There is a large dining area and a hairdressing room. The home is set in attractive grounds which is accessible to all residents. The home charges £550 - £800 per week. Further information can be obtained from the Statement of Purpose and the Service User Guide. A copy of the most recent CQC inspection report should be available in the home. Care Homes for Older People Page 3 of 8 What we found: A random inspection was conducted on 04/11/2009 following concerns raised about the care practice, record keeping and in view of recent medication errors made. At the time of the visit the deputy manager was present. The registered home manager was not on site till later in the afternoon. However, the regional manager was present. During the inspection we examined some written care plans and daily records kept. We observed the administration of medication. We spoke to some of the people who live in the home and interviewed some members of staff. Three written care plans were examined. The care plans reflected the care needs of each resident. We case-tracked the written notes for a resident on total bed rest and who is doubly incontinent. The resident has no pressure sore and needed incontinent pads day and night. There are a number of record charts kept in the room. The deputy manager explained the purpose of each chart and form used for the daily recording. These forms include a Food and Fluid chart, a Turning Chart and a Supervision Form with dates and times printed on it. Each member of staff who attends to the resident has to record the task and time for each task. The resident is checked regularly to ensure that their nursing care and personal care needs are being met. On the day of the site visit, this resident seemed comfortable lying on a profiling bed with an air mattress. The resident appeared peaceful and well cared for. The deputy manager explained to us the new corporate Care and Health Assessment Profile (CHAP) booklet which forms part of the written care plan and it is in use for each resident. The aim of using such a profile is to ensure continuous assessment commencing with the pre-admission assessment that is carried out prior to admission of the resident. The nurse assigned to the resident carries out a monthly assessment of their care needs and any changes in their care needs are reflected in the CHAP. The care plans seen were detailed and informative and were kept up to date. Relevant risk assessment forms were seen in the care plan folders examined. A detailed care plan ensures that those who are looking after the residents have the required information to deliver the personal, social and healthcare needs of the people living in the home. During the site visit we observed a nurse shadowing the deputy manager during medicine administration in one of the two units. The deputy manager later showed the same nurse how to record and dispose of the medicines that needed to be returned to the pharmacy. It was noted that each unit has a medication trolley which was secured to the wall when not in use. All medicines currently in use are kept in the locked trolley. The home uses the monitored dosage system for each resident. All individual medicine containers and boxes have the opening date clearly written on them. The nurses interviewed explained the procedure of administration and how to update the Medication Administration Record (MAR) Charts. The MAR charts examined were correctly signed. It was noted that all stock medicines are kept in the medication storage room, which has the correct room temperature of below 25 degrees. The bin used for the disposal of medicines has an open lid and it was placed on the floor within the lockable storage room. The manager said that the bin will be kept in a locked cupboard as soon as the Care Homes for Older People Page 4 of 8 maintenance man has erected one in the storage room. The regional manager confirmed that this will be sorted out within the next few days. The deputy manager confirmed that as a result of the recent medication errors all nurses have had a refresher course on the recording, handling, safekeeping, safe administration and safe disposal of medicines received into the home. All the nurses spoken to confirmed that they have had training and that the second training date is 10/11/2009. 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 9 It is recommended that staff have regular refresher courses on the recording. handling, safekeeping, safe administration and safe disposal of medicines received into the home. This will ensure that residents are not unduly expose to risk. 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. 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