Care Home: Holmwood House

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What the care home does well Records are kept of the receipt, administration and disposal of medicines. Safe and secure storage is available for medicines, including controlled drugs, which need additional security. Safe practice is used for the administration of medicines. What the care home could do better: Records must be made of all medicines given by staff including creams and ointments. If a regular medicine is not given a reason for this must be recorded.This is to ensure that people are given their medicines as prescribed by the doctor. Medicines which have been prescribed for one person can only be given to the person whose name is on the label. They must not be used as a stock of medicine for the home. This is to ensure that people receive the correct medicines. It is recommended that staff request that medicines are reviewed at suitable intervals and that a record of any review is made in each person`s care file. This is to make sure that people receive appropriate medicines. It is recommended that a minimum/maximum thermometer is obtained for monitoring the temperature of the medicine fridge. This is to ensure that the temperature remains within the safe range for storing medicine. Random inspection report Care homes for older people Name: Address: Holmwood House Channels Hill Westbury On Trym Bristol BS9 3EU two star good service 22/07/2009 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: Sue Fuller Date: 1 9 1 0 2 0 0 9 Information about the care home Name of care home: Address: Holmwood House Channels Hill Westbury On Trym Bristol BS9 3EU 01179500810 01179508070 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) : Mr Ghassan Al-Jibouri care home 41 Number of places (if applicable): Under 65 Over 65 41 old age, not falling within any other category Conditions of registration: 0 41 Patients over 50 years of age sickness, injury and infirmity Manager must be a RN on part 1 or 12 of the NMC Register Staffing Notice dated 10/07/1998 applies Date of last inspection Brief description of the care home Holmwood House is registered to provide nursing care for up to forty-one people who are fifty years and over. The Home is a period style property, located in its own grounds, surrounded by residential housing and near to the local shopping centre. There are local shops, public houses and restaurants located within walking distance of the home. There are single and double rooms located on all three floors and a lift provides access to all floors. The home is near to major roads and bus routes. The mission statement describing the aims of the Home was displayed in the entrance hall. People who want to know about Holmwood House are able to find out about the home, Care Homes for Older People Page 2 of 9 2 2 0 7 2 0 0 9 Brief description of the care home the services and facilities it has to offer by requesting a copy of the homes brochure or information pack. This will detail the range of weekly fees and say what additional charges may be made. Care Homes for Older People Page 3 of 9 What we found: During this inspection we looked at the handling of medicines in the home. Outstanding requirements from the last key inspection concerning other areas were not looked at and are still listed at the end of the report. Many of the people living in the home are registered with one doctor who visits the home weekly and when needed. Other peoples doctors visit the home when asked by staff. Records confirmed that people are seen by their doctor. Medicines are supplied by the pharmacy using a monthly blister pack system. The manager commented to us that in the past she saw and could check prescriptions before they were sent to the pharmacy to be dispensed. This would be good practice to continue because it can help to ensure that the correct medicines are available for people living in the home. It can also help to prevent waste caused by receiving medicines which are not needed. Staff told us that none of the people living in the home is able to look after their own medicines so all are looked after and given by nursing staff. We saw some medicines given in the morning and at lunchtime. Medicines are safely transported around the home and suitable procedures are used to safely give medicines. The pharmacy provides printed medicines administration record sheets each month for staff to complete when they have given medicines. We noticed very few gaps in these records generally. However we saw that one person prescribed two different creams had a record of them being received into the home but no record of whether they had been used. One carer had written in the persons care notes that cream had been applied on one occasion, but we saw no other record of their use. Two other people are prescribed medicines to be given four times a day but there were very few records of the night time dose being given. Records must be made of all medicines given by staff, including creams and ointments. If regular medicines are not given a reason for this must be recorded. This is to ensure that medicines have been given as prescribed. We saw that one person had three items on their administration record which had not been used. Staff told us that these were not prescribed for the individuals use but had been supplied to cover emergency use for any person living in the home who might need them following recent flu vaccinations. Medicines which are prescribed for an individual can only be given to that person. Alternative arrangements need to be made if a stock of medicine is required in the home. We saw that printed information was available to ensure that nurses knew the correct dose of a medicine that needs to be carefully monitored. This helps to ensure that the correct dose is given. Records are kept of the receipt of medicines. Arrangements are in place for the safe disposal of unwanted medicines, suitable records are kept. We looked at three peoples care plans to see what information is kept about their Care Homes for Older People Page 4 of 9 medicines in addition to that on the medicines administration record sheets. We saw that a record has not been kept of the medicines people are taking when they first come into the home. The manager told us that there is a space on the pre-admission assessment form but this did not include important information about the dosage instructions or strength of the medicines. Action should be taken to address this. We also saw that there was no information to indicate that people living in the home have their medicines reviewed by their doctor at regular intervals. It is important that medicines are reviewed regularly and records kept of the outcome to ensure that people receive appropriate medicines at all times. Medicines are stored safely and securely. Suitable storage and records are available for controlled drugs, which need more secure storage. A medicine fridge is available, it is recommended that a minimum/maximum thermometer is obtained and used to record temperatures more accurately. A medicine trolley is used to carry medicines safely around the home. 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 9 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 12 12 The registered provider must 22/10/2009 make arrangements for appropriate and meaningful activities to be offered. This is so that peoples social and recreational, cultural and religious needs are met. This requirements is being made for a second time. 2 33 26 The registered person must ensure that records in respect of visits made by their representative are available for inspection. This is so that we know how the service is being monitored by the provider and what actions are being taken to ensure good standards 22/08/2009 Care Homes for Older People Page 6 of 9 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 9 13 The registered person must 16/11/2009 ensure that records are made of all medicines given by staff including creams and ointments. If a regular medicine is not given a reason for this must be recorded. This is to ensure that people are given their medicines as prescribed by the doctor. The registered person must 01/12/2009 ensure that medicines which have been prescribed for one person are only used for that person. They must not be used as a stock of medicine for the home. This is to ensure that people receive the correct medicines, that have been prescribed for them. 2 9 13 Care Homes for Older People Page 7 of 9 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 request that medicines are reviewed at suitable intervals and that a record of any review is made in each persons care file. This is to make sure that people receive appropriate medicines. It is recommended that a minimum/maximum thermometer is obtained for monitoring the temperature of the medicine fridge. This is to ensure that the temperature remains within the safe range for storing medicine. 2 9 Care Homes for Older People Page 8 of 9 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. 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