Care Home: Hampton Road, 20

What the care home does well The manager was keen to improve practice and had sought additional training in the safe handling of medicines. She observed some staff practice to ensure that they administered the medicines in a safe manner. What the care home could do better: The medicine management must improve to safeguard the health and well being of the people who live in the home. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Hampton Road, 20 Hampton Road, 20 Erdington Birmingham West Midlands B23 7JJ 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 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: Debby Railton Date: 2 9 0 4 2 0 0 9 Information about the care home Name of care home: Address: Hampton Road, 20 Hampton Road, 20 Erdington Birmingham West Midlands B23 7JJ 01213776601 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) : Coventry and Warwickshire Partnership Trust care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 4 That named service user over 65 years can be accommodated and cared for. The home can provide care and accommodation for 4 service users under 65 for reasons of learning disability. Date of last inspection Brief description of the care home The registered provider changed in October 2006 from North Warwickshire NHS Trust to Coventry and Warwickshire Partnership Trust. Hampton Road is situated in a cul de sac in the Erdington area of Birmingham. The home provides care and accommodation to four adults aged between 18 and 65 years with a learning disability and additional needs including behaviours that can challenge. At the time of the fieldwork three people were living at the home and one person had commenced introductory visits. Shops, pubs, restaurants and places of worship are within walking distance. Public transport systems are also located close to the home. There are two bedrooms Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home on the ground floor and a bathroom and separate shower room. There are two bedrooms on the first floor and a bathroom and separate toilet facility. There is a spacious lounge, dining room and kitchen. There is ramped access to the front of the home. Ground floor hallways and doorways are sufficiently wide to provide access to wheelchair users, however there is no passenger lift therefore the first floor is not accessible to people that cannot use stairs. The rear garden is spacious and has no level changes. Consultation with people who live at 20 Hampton Road takes the form of regular observations and detailed care and support plans that identify and review likes and dislikes. Advocacy services are promoted. Previous inspection reports are available in the hallway of the Home for people to read. Because a Service User Guide was not available at the time of the inspection we are not able to confirm the present fees charged by the Home, therefore the reader may wish to contact the Home directly for more information. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: The pharmacist inspection lasted just over two hours. Two people, who lived in the home, medication was looked at together with their Medicine Administration Record (MAR) charts, care plans and other records. All feedback was given to the manager Emma Faulkner who was very pro-active throughout the inspection. The home do not see the prescriptions before they are dispensed, so they do not check them or make a copy of them to check the medicines and MAR charts received for accuracy. This was to be addressed for the next cycle of medicines due into the home. Not all quantities of medicines received were recorded on the MAR chart so it was difficult to audit exactly what the care staff had administered and whether they had accurately recorded what they had done. Where they had been recorded, audits indicated that some medicines had not been administered as the doctor prescribed. In one instance five tablets were missing and there was no explanation why. Medicines were on the premise available to administer but there was no record of them anywhere, so it was not possible to demonstrate when they had been administered. Some medicines were available to administer that were no longer prescribed and these had not been removed from the premise. One medicine had been crossed off the MAR chart even though it was still currently prescribed and available to administer. Protocols were available for staff to follow for medicines prescribed to administered when required but these had not been updated when the medication had been altered, so the information was meaningless in some instances. Some prescribed medication had no supporting protocols detailing their use for staff to adhere to, to ensure they are only administered when required as the doctor intended. It was noted that two medicines prescribed to be administered when required had been administered routinely on a daily basis. One medicine had been purchased as a homely remedy but there was no supporting protocol detailing when staff should administer it or a record of when it had been administered. The care plans and other records held all the information received about dose changes from the doctor or psychiatrist but these had not always been used to accurately check the medication received. Information surrounding the persons mental health was very good but the care plans lacked information about their other clinical conditions. Without such information staff would be unable to fully support the peoples medical conditions. Medicines were stored in a locked cabinet, which was situated by the main hall of the building. Staff prepared the medication next to the cabinet and then took it to the person. This increases the risk of error as there would be nowhere to put the medication safely if an emergency occurred. Individual cabinets which could be installed in each bedroom was discussed with the original cabinet being used to store any surplus medication delivered that month. The medication could be safely prepared and administered in the privacy of the individual persons room. Currently there was no quality assurance system in place to check individual staff competence in the safe handling of medication. The manager though had observed the Care Homes for Adults (18-65 years) Page 4 of 10 medication round for about half the staff and identified and addressed shortfalls in practice seen. Further training has been sought with the new pharmacy in addition to the yearly training provided by the health trust. 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 Adults (18-65 years) Page 5 of 10 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 Adults (18-65 years) Page 6 of 10 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 19 12 The registered manager 15/06/2009 must ensure that the service users care plans detail their clinical conditions and are regularly updated This is to ensure that the health care needs of the service users are fully met. 2 20 13 A system must be installed 15/06/2009 to check the prescription prior to dispensing and to check the dispensed medication and the medicine charts against the prescription for accuracy. All discrepancies must be addressed with the healthcare professional. This is to ensure that all medicines are administered as prescribed at all times 3 20 13 The home must review 15/06/2009 where it stores medication to administer to service users. This is to ensure that all mediction can be securely Care Homes for Adults (18-65 years) Page 7 of 10 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 held in the event of an emergency 4 20 13 All medicines received and 15/06/2009 held on the premise must be recorded. Their quantities and any balances carried over from previous cycles must be recorded. This is enable audits to take place to demonstrate the medicines are administered as prescribed and their is a record of all medication on the premises A quality assurance system 15/06/2009 must be installed to assess individual staff competence in their handling of medicines. Appropriate action must be taken when these indicate that medicines are not administered as prescribed and records do not reflect practice. This is to ensure that individual staff practice is assessed on a regular basis and appropriate action is taken if audits indicate that staff do not administer the medicines as prescribed. The medicine chart must 15/06/2009 record the current drug regime as prescribed by the clinician. It must be referred to before the preparation of the service users medicines and be signed directly after the transaction and accurately record what has Page 8 of 10 5 20 13 6 20 13 Care Homes for Adults (18-65 years) 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 occurred. This is to ensure that the right medicine is administered to the right service user at the right time and at the right dose as prescribed and records reflect practice 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 20 It is recommended that all homely remedies have a supporting protocol detailing their use, that is checked by a doctor or pharmacist, for staff to administer them against. Care Homes for Adults (18-65 years) Page 9 of 10 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 Adults (18-65 years) 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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