Care Home: Holy Cross Priory Nursing Unit

What the care home does well The last key inspection was completed on the 3 November 2008 and this confirmed an overall `good` rating for the home, and that the records relating to medicine handling were `full and accurate`. This random inspection confirmed that suitable medicine policies and procedures are in place, and that the registered nurses working in the home take full responsibility for all medicine administration. Training records also demonstrated that the registered nurses were receiving training provided by the home on the handling and use of medicines. The home has a well equipped medicines room which provides very good storage arrangements for all medicines, which includes a mobile drugs trolley, a fridge for those medicines that need cold storage, and a secure controlled drug cupboard. A controlled drug register is used to record any controlled drugs that come into the home. Practice seen during the random inspection confirmed that staff administer medicines directly from the drugs trolley in accordance with the homes procedures. Medicine records examined were found to be full and accurate. The general staffing arrangements in the home were discussed and confirmed to be of a good level with a good ratio of trained nurses on duty throughout the day. What the care home could do better: Although staff training on the whole is well developed care staff involved in the administration of medicines need to have clear training that identifies their specific role and responsibilities. This should include reference to the homes policies and procedures. A reference book used for up to date information on all medicines needs to be replaced with a more up to date version. Although the manager provides regular staff supervision and staff meetings are held where practice in the home is discussed and reviewed. There is no system in place to review staff competencies, or to monitor if staff are following the home`s procedures. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Holy Cross Priory Nursing Unit Cross In Hand Heathfield East Sussex TN21 0TS two star good service 03/11/2008 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: Melanie Freeman Date: 2 3 0 3 2 0 0 9 Information about the care home Name of care home: Address: Holy Cross Priory Nursing Unit Cross In Hand Heathfield East Sussex TN21 0TS 01435863764 01435866707 holycrossnursingunit@tiscali.co.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) : The Grace and Compassion Benedictines 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 to be accommodated is 21 The registered person may provide the following categories of service only: Care home with Nursing(N) to service users of the following gender: Either: Whose primary need on admission to the home are within the following categories:Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Holy Cross Priory Nursing Unit is a purpose built extension to The Priory residential care home. It is owned by the Grace and Compassion Benedictine Society (Charitable Trust) and run by the Benedictine Sisters of our Lady Grace and Compassion, which is a Catholic order. It is situated in Cross-in-Hand, approximately three miles from Heathfield town. The Care Homes for Older People Page 2 of 9 0 3 1 1 2 0 0 8 Brief description of the care home unit is attached by a corridor to The Priory and is staffed and run as a completely separate home apart from the shared laundry and main kitchen. The residents enjoy a lounge and separate dining area, they can also use the facilities of The Priory if they wish. On site is a hairdressing room as well as a chapel. There are extensive attractive gardens that are accessible to residents and used when the weather permits. The Holy Cross Nursing Unit is registered to provide general nursing care for 21 residents and admits residents who are either privately funded or funded by Social Services. The homes fees as from 01 April 2008 are 560 pounds per person per week. Additional costs are charged for chiropody, hairdressing newspapers, magazines and toiletries. The homes literature states that one of its main aims is to provide the highest standard of care for every person living here at the home, their family and carers. Care Homes for Older People Page 3 of 9 What we found: This random inspection was completed on the Monday 23 March 2009 and included an unannounced visit to the home by Andrea Leverett regional manager, and Melanie Freeman regulatory inspector. The visit lasted approximately one and a half hours and was facilitated by sister Benidicta the registered manager. This inspection was completed following receipt of information confirming a serious drug error involving the handling of a controlled drug. The Commission needed to satisfy its self that suitable arrangements have been put in place in the home to ensure that all controlled drugs are stored, recorded and administered in a safe way. As a registered nursing home all medicines in the home are administered by a registered nurse. Following arrival and explanation of the inspection visit to the manager she was asked to provide a copy of the homes policy and procedure on medicines. This was duly supplied and included clear procedures for the safe handling of controlled drugs. The home has a good sized medicines room that was found to be clean and well organised and contained a suitable controlled drug cupboard. The contents of this was checked and cross referenced with the controlled drug register, and was found to be accurate. In addition the medicines fridge was checked and it was noted that its contents were suitably labeled and stored. It was however noted that the BNF used for reference and up to date information on all medicines was dated March 2007. The controlled drug register recorded which registered nurse administered the drug and the second nurse or carer who witnessed the administration. The registered manager, and the homes procedure, confirmed that all staff involved in the administration process of any medicine must be suitably trained. The training records examined identified that not all care staff involved in the administration process of controlled drugs had received training on the handling and use of medicines. When asked the registered manager confirmed that she believed that the homes procedure in respect of medicine administration is being adhered to, and any recording errors or gaps are highlighted and followed up. There is however no system to review staff competency or to observe staff practice, although staff do receive regular supervision and staff meetings are held where practice is reviewed. What the care home does well: The last key inspection was completed on the 3 November 2008 and this confirmed an overall good rating for the home, and that the records relating to medicine handling were full and accurate. This random inspection confirmed that suitable medicine policies and procedures are in place, and that the registered nurses working in the home take full responsibility for all medicine administration. Training records also demonstrated that the registered nurses were receiving training provided by the home on the handling and use of medicines. The home has a well equipped medicines room which provides very good storage arrangements for all medicines, which includes a mobile drugs trolley, a fridge for Care Homes for Older People Page 4 of 9 those medicines that need cold storage, and a secure controlled drug cupboard. A controlled drug register is used to record any controlled drugs that come into the home. Practice seen during the random inspection confirmed that staff administer medicines directly from the drugs trolley in accordance with the homes procedures. Medicine records examined were found to be full and accurate. The general staffing arrangements in the home were discussed and confirmed to be of a good level with a good ratio of trained nurses on duty throughout the day. 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 £ 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 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 30 18 All staff must receive training 01/05/2009 appropriate to the work they are to perform. This will ensure staff who are involved in the administration of medicines are fully aware of their specific roles and responsibilities, and follow the homes procedures. 2 33 24 Further quality systems need 01/05/2009 to be established to ensure staff are maintaining high standards of practice. This will ensure that staff understand and adhere to the homes policies and procedures, and ensure best practice is followed at all times. 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 That a more up to date reference book on medicines is sourced for the homes use. Care Homes for Older People Page 8 of 9 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 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 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. 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