Care Home: Hazel Bank Residential Home

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What the care home does well The acting manager has made improvements to the way medication is handled since the last pharmacist inspection. Records for receipt, administration and disposal of medication are more accurate and protect residents from errors, and show clearly the treatment received by them. There were good records of communications with health care professionals and changes to treatment occuring as a result. What the care home could do better: The acting manager should continue to improve care plans for the management of medication and health related issues so residents receive well managed support and care to keep them well. The acting manager should also ensure that staff are vigilant of unexpected changes to medication and follow these up with residents` doctors so that they receive the correct treatment. There should be robust procedures in place for managing the disposal of medicines liable to misuse, called controlled drugs, so that they can always be accounted for. All staff should receive training in the safe administration of medication and be assessed as competent in the task before they assume responsibility for it. Random inspection report Care homes for older people Name: Address: Hazel Bank Residential Home Yanwath Penrith Cumbria CA10 2LF one star adequate service 01/07/2009 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: Angela Branch Date: 1 0 0 8 2 0 1 0 Information about the care home Name of care home: Address: Hazel Bank Residential Home Yanwath Penrith Cumbria CA10 2LF 01768840021 01768840031 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Number One Care Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 21 Number of places (if applicable): Under 65 Over 65 21 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 21. The registered person may provide the following categories of service only: Care Home - 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) Date of last inspection Brief description of the care home Hazel Bank is a care home registered to provide care and accomodation for older adults. Hazel Bank is a Victorian house that had been adapted and converted for its use as a care home but has kept many of the original features of the house. There is access to all floors in Hazelbank using the stairs and the passenger lift. Care Homes for Older People Page 2 of 8 0 1 0 7 2 0 0 9 Brief description of the care home The home is in the small rural hamlet of Yanwath about 5 miles from Penrith and has large gardens with trees, a garden folly, lawn areas and a car parking area. Fees payable at the home are from four hundred and twenty two pounds a week at the time of the site visit. There are additional charges for hairdressing, outings and personal transport, newspapers and magazines and personal toiletries. The home makes information about its services available through its service user guide and statement of purpose and these are available in the home and a copy of the last report. Care Homes for Older People Page 3 of 8 What we found: The pharmacist inspector examined the handling of medicines by looking at relevant records, storage and meeting with the acting manager Jacqueline McGough. The reason for the visit was to follow-up requirements made at the last pharmacist inspection on 25 May 2010. The inspection took three hours. Feedback was given to the acting manager during and at the end of the visit. Overall we found that the handling of medication had improved, reducing the risk to residents from medication errors. Two requirements made at the last inspection regarding medication were met and work had been done towards meeting the third requirement regarding care planning. There were seven residents living at the home at the time of the inspection. The records for receipt, administration and disposal of medicines for these residents had improved so that the treatment that they received was clear. We saw a few mistakes on the administration records that were corrected at a later time. Staff should continue to take care to make accurate records at the time of medicines administration. We saw good records of communications with health care professionals such as GPs. This meant that changes to medication were easily tracked and checked for accuracy. We saw that GPs also signed medication changes on the medicines administration records and this is an example of good practice as it gives further confirmation of the new instructions. We checked a sample of care plans. Overall there were improvements in the quality of these. However, there was still work to be done to make sure that all care plans provide clear guidance for managing health and medication so that staff deliver care that is safe, appropriate and consistent. The acting manager showed us new ideas for improving care plans. We recommend that when these are reviewed that they provide person-centered and individualised plans of care to improve health and quality of life for residents. The home had recently changed its registration status from providing nursing care to providing personal care only. This means that the medicines administration task was being done by carers instead of nurses. We discussed training in safe administration of medicines and competency checks of carers with the acting manager. We were concerned that there was not a trained member of staff on duty at night who had been shown to be competent in the task. Medicines records showed that some medication, such as when required pain-killers, were administered during the night by untrained staff. The acting manager said that staff had started training in safe admnistration of medicines however, she should ensure that they are also competent in the task before they assume responsibility for it to ensure the safety of residents. We checked medicines liable to misuse, called controlled drugs. We did a stock check that was in order. We saw that some controlled drugs had been returned to the pharmacy for disposal. However, the records of this had been signed by one staff member only and there was no witness. Although the acting manager said that they had a receipt from the pharmacy this could not be found. The acting manager should make sure that there are robust procedures in place for managing the disposal of controlled drugs to ensure a complete audit trail so that these medicines can be accounted for at all times. Medicines storage had improved. We were concerned that one resident had two similar, but different, eye drops, one received following their discharge from hospital and a Care Homes for Older People Page 4 of 8 follow-on supply from the pharmacy. Staff had not checked the unexpected change in medication with the residents GP so that it was not clear which treatment was appropriate. There should be arrangements in place to check for unexpected changes to medication. The acting manager had been in post for approximately six weeks. In this short time she had made improvements to the way medicines were handled and further improvements were planned. She had started a series of checks, or audits, of medication so that concerns could be identified and managed to protect residents from medication errors. 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 The acting manager should ensure there are robust procedures in place for managing the disposal of medicines liable to misuse, called controlled drugs, so that they can always be accounted for. The acting manager should ensure that staff are vigilant of unexpected changes to medication and follow these up with residents doctors so that they receive the correct treatment. The acting manager should continue to improve care plans for the management of medication and health related issues so residents receive well managed support and care to keep them well. The acting manager should ensure that all staff receive training in the safe administration of medication and be assessed as competent in the task before they assume responsibility for it. 2 9 3 9 4 9 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. 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. Care Homes for Older People Page 8 of 8 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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