Care Home: Harriet`s

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What the care home does well Since the last inspection the service had worked to improve the way medicines are managed. Procedures for managing stocks of medication had been reviewed so that medicines did not run out. What the care home could do better: Records for administration of medication had improved. However there were still errors that meant that residents did not always get the correct treatment and changes to medication were not managed properly. The training and assessment of competencies of staff in the safe handling of medication needs to be completed so that they follow safe practices to keep residents safe. Random inspection report Care homes for older people Name: Address: Harriet`s 119 Main Street Distington Workington Cumbria CA14 5TA 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: Angela Branch Date: 2 0 0 7 2 0 1 0 Information about the care home Name of care home: Address: Harriet`s 119 Main Street Distington Workington Cumbria CA14 5TA 01946831166 01946834373 harriets@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Healthcare (Focus) Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 41 Number of places (if applicable): Under 65 Over 65 0 41 dementia old age, not falling within any other category Conditions of registration: 41 0 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: Old age, not falling within any other category - Code OP (maximum number of places: 41) Dementia - Code DE (maximum number of places: 41) The maximum number of service users who may be accommodated is 41. Date of last inspection 2 7 0 4 2 0 1 0 Care Homes for Older People Page 2 of 11 Brief description of the care home Harriets is a purpose built home situated in the village of Distington, midway between Workington and Whitehaven. The home has been open for a number of years but is now owned by Southern Cross Healthcare. The Southern Cross group of companies operate a number of care and nursing homes throughout Britain. The home is registered to care for older adults or people who need care because they suffer from dementia. Further information may be accessed from the home or via the Southern Cross website Care Homes for Older People Page 3 of 11 What we found: The pharmacist inspector examined the handling of medication by looking at relevant documents, storage and meeting with the support manager. The reason for the visit was to follow-up requirements made at the last pharmacy inspection on 27 April 2010. The inspection took five and a half hours. Feedback was given to the support manager at the end of the inspection. Overall we found that whilst there were some improvements in the way medicines were managed we still had concerns about errors that we found that could place the health and well-being of residents at risk. Of four requirements made at the last inspection, three remain unmet. We looked at records for receipt, administration and disposal of medication. We found that these had improved. However, whilst administration records were generally well completed when medicines were given to residents, there were still areas that needed further improvement. We saw a medication that had been stopped by the hospital that remained on the record and continued to be administered for nine days up to and including the inspection. There was no evidence that this had been restarted intentionally. We were particularly concerned about this as we had recently been informed of a very similar incident and were disappointed that this had not been managed properly to prevent it happening again. These errors could cause harm by exposing residents to medication that is not prescribed and not appropriate. We checked records for administration that were sometimes unclear, for example for a blood-thinning medicine. This medication is very hazardous if mistakes in administration are made. The records were unclear for the dose given. It is important that administration records are clear and accurate to prevent errors that could cause harm. We counted a sample of medicines and compared them with records. Most of these added up to show that the medicines could be accounted for. The home had also reviewed the way it orders and monitors stocks of medicines. This meant that medicines did not run out. Whilst some input by health care professionals and outcomes were well recorded, others were not. Sometimes information was recorded in different places in the residents files so that it was difficult to track changes to medication. It is advisable to have a consistent way of recording this information so that it is clear. We checked medicines liable to misuse, called controlled drugs, and these were in order. The home had recently received a visit from the supplying pharmacist to check and advise on medicines management. It had also done internal checks, or audits, of medication to identify problems that need to be managed to keep residents safe. Since the last inspection some staff had received training in the safe handling of medication and the support manager said that this was to be repeated for other staff shortly. We were told that a process of review of staff competencies in the handling of medication had been started however we were not able to see records relating to this. The manager must ensure that the process of training and regular monitoring of competencies in the safe handling of medication is completed to show that staff follow safe practices to keep residents safe from medication errors. Care Homes for Older People Page 4 of 11 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 11 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 3 14 Full assesments must be 18/06/2010 carried out prior to admission of any new service user. This must be done by an appropriately trained person. This must be done to lessen the risk of inappropriate admissions that may lead to people being accommodated who do not need lengthy stays in residential care. 2 7 15 Care plans must be completed accurately after consultation with individual service users. This must be done so that people in the service receive suitable levels of care and support that reflect their needs and wishes. 18/06/2010 3 8 12 Suitable arrangements must 18/06/2010 be made to ensure that residents receive appropriate health care at all times. This must include nutritional planning. This must be done so that people receive good health care support and have appropriate nutrition. Care Homes for Older People Page 6 of 11 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 4 9 13 Medicines must be given in the prescribed dosage. This must be done to ensure that residents receive safe and effective treatment. 01/06/2010 5 9 19 All staff who administer 01/06/2010 medication and perform health care tasks must be suitably trained and must be assessed as competent in the tasks. This must be done so that staff can deliver health care tasks in a safe and appropriate manner. 6 9 13 All records for receipt, administration and disposal of medication must be accurate and free from errors. This must be done to protect residents from mistakes that could cause harm to their health and well-being. 01/06/2010 7 27 18 Southern Cross must ensure 18/06/2010 that there are enough qualified, competent and experienced staff on duty at all times. This must be done to meet the care needs of people who live in the service. 8 29 19 The registered provider must 18/06/2010 ensure that staff do not have access to vulnerable people before all background checks Page 7 of 11 Care Homes for Older People 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 are in place. This must be done to ensure that only staff who have suitable backgrounds are employed to work in the home. 9 30 18 All staff in the service must receive a full induction and attend the manadatory training set out by the company and must also attend training suitable to their job role. This must be done to lessen risk to staff and residents and to ensure that staff deliver appropriate care and services to vulnerable people. 10 38 13 The arrangements for 18/06/2010 moving and handling both people and objects must be reviewed. Appropriate training must be given and staff involved must have their competence checked by a person trained to do so. This must be done to keep people safe and comfortable when being moved and to ensure good health and safety practices are in place. 11 38 23 The systems in place for delivering fire instructions and fire drills must be reviewed. This must be done to ensure Care Homes for Older People Page 8 of 11 18/06/2010 18/06/2010 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 that staff receive drills and instructions that allow them to deal with a fire situation. Care Homes for Older People Page 9 of 11 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 there is a consistent way of recording input from health care professionals so that changes to treatments can be tracked easily. Care Homes for Older People Page 10 of 11 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. 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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