Care Home: Harefield Road, 156

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What the care home does well Medication was well organized and recording of receipts and administration were accurate. An audit of medication supplied in their original containers supported this. New staff received medication training from the pharmacist supplier as part of their induction and their practice was supervised for 4 medication rounds before they were signed as competent. The home had addressed the error by allocating two members of staff to medication administration so that another check was in place to ensure that the right medicine was given to the right person. What the care home could do better: The homes needs to further ensure that medication is given as per the homes policy and not to the wrong person. In addition to supervised administration the home should also ensure that the selection and preparation process is also supervised and not interrupted. Part of the manager audits should also be to randomly check that all staff are administering medication professionally and in line with the homes procedures. Random inspection report Care homes for adults (18-65 years) Name: Address: Harefield Road, 156 Harefield Road, 156 Uxbridge Middlesex UB8 1PP two star good service 21/09/2009 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: Jane Shaw Date: 1 6 0 2 2 0 1 0 Information about the care home Name of care home: Address: Harefield Road, 156 Harefield Road, 156 Uxbridge Middlesex UB8 1PP 01895254803 01895254803 hm156harefield@ealing.org.uk www.supportforliving.org.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) : Support for Living care home 4 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Conditions of registration: 4 4 The maximum number of service users who can be accommodated is: 4 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 need on admission to the home are wtihin the following categories: Learning Disability - Code LD Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 156 Harefield Road is home to four men with learning disabilities and/or mental health needs. The home is owned by Notting Hill Housing Association and the service is managed by Support for Living (formerly Ealing Consortium) which is a not-for-profit organisation. The house is on a busy road and there are shops within fifteen minutes walking distance. The nearest large shopping centre is at Uxbridge and the premises Care Homes for Adults (18-65 years) Page 2 of 8 2 1 0 9 2 0 0 9 Brief description of the care home are close to the A40. There are four single bedrooms, a bathroom and a separate toilet on the first floor. The home does not have a lift. The toilet and shower on the ground floor are generally used by the staff. The main lounge is on the ground floor and is also used for meals. The former dining room has been divided and provides a separate sitting area for residents who smoke, which leads to the garden. The ground floor also has a kitchen and a utility room. There are two offices on the top floor, one of which is used as the staff sleeping in room. There is a large garden to the rear, partly paved, and parking to the front of the house. The current staff team is the Manager, Deputy Manager and seven support workers. There is a minimum of two staff on duty from 8am to 8pm, with one staff sleeping in at night. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: This Pharmacist Inspection was to review the safe handling of medication following reports received regarding three medication errors. We looked at the storage of medication and noticed that storage was well organized and secure in lockable wall mounted medicines cupboards. Lotions and creams for one resident were kept in a separate cupboard. We noticed that the keys for the medicines cupboard were left on the top of the desk when the office was unattended. We looked at the Medication Administration Records . The current cycle started on 21/1/2010 and there were no omissions in records of receipts or administration. If a resident went on leave or to hospital or refused medication an appropriate endorsement was used to explain the reason why. We counted 6 medicines supplied in the original packs to see if records were accurate. All could be reconciled. We noticed coloured named medicine pots in the sink awaiting cleaning. We discussed the recent medication error and asked the care worker to demonstrate how they administered the medicines. We observed the practice and saw that medication was selected individually, placed in the named pot and checked before taking to the individual resident in their room downstairs. We were told that administration was person centered and given in the morning according to the time of rising and morning pattern of the resident. We saw that when a resident went on leave for a few days that the pharmacist provided a separate labeled supply for the family to give. 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 4 of 8 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 19 18 The Registered Providers 30/11/2009 must ensure that the training for epilepsy is provided for those staff for whom a refresher course is due. To ensure that all staff have current training on this topic. 2 19 12 The Registered Providers 31/10/2009 must ensure that the guidance for epilepsy for the residents is current. To ensure that all staff are fully aware of the current guide lines for assisting residents with medical needs. 3 23 13 The Registered Providers 31/10/2009 must ensure that all incidents which may involving safeguarding issues are reported to the appropriate organisation as soon as possible after the incident. To ensure that all issues are investigated and the appropriate action is taken to protect people. 4 24 23 The Registered Providers must ensure that all of the outstanding repairs are 30/11/2009 Care Homes for Adults (18-65 years) Page 5 of 8 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 carried out. To ensure that repairs are carried out and any hazards to health, safety and hygiene are eliminated. 5 30 16 The Registered Providers 30/11/2009 must ensure that the first floor toilet flooring is suitable to maintain hygiene. To ensure that the smell of urine can be eliminated and the toilet kept clean and fresh. 6 33 18 The Registered Providers must have a system for regularly reviewing the staff rota to ensure that single staff cover remains suitable to meet the needs of the residents. To ensure that residents and staff are supported. 7 34 18 The Registered Providers 31/10/2009 must ensure that all of the information required to be held for permanent and agency staff currently working is in the home for inspection, is complete and is up-to-date. To ensure that people are protected by robust recruitment practices. 31/10/2009 Care Homes for Adults (18-65 years) 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 1 20 13 The key to the medicines cupboards must be kept securely by the person in charge at all times. This is to ensure that medicines do not fall into the wrong hands. 01/03/2010 2 20 13 That the managers ensure by 01/03/2010 regular spot checks that all staff are following the homes procedures in safe administration . This is to protect the residents from harm. 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 Care Homes for Adults (18-65 years) 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 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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