Care Home: Howbury House

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What the care home does well We saw good documentation of medicine records and checks made on peoples medicines. This means that peoples healthcare requirements relating to medicines management were being met. The previous requirements for medicines from the previous inspection had been met. What the care home could do better: The service should ensure that all medicine records accurately record what medicines have been given to people. In particular for medicines prescribed as `one or two` to ensure records accurately reflect what has been given. This will ensure the health and welfare of the person is safeguarded. The service should ensure that external medicine preparations are stored separately from medicines for internal use. This is to prevent any contamination between external and internal medicines. Random inspection report Care homes for older people Name: Address: Howbury House Pickersleigh Grove Malvern Worcestershire WR14 2LU 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: Morag Ross Date: 1 2 0 5 2 0 1 0 Information about the care home Name of care home: Address: Howbury House Pickersleigh Grove Malvern Worcestershire WR14 2LU 01684571750 01684571753 Telephone number: Fax number: Email address: Provider web address: www.worcestershire.gov.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Ann Creese Type of registration: Number of places registered: Conditions of registration: Category(ies) : Worcestershire County Council Home Care Services (DCA) care home 32 Number of places (if applicable): Under 65 Over 65 0 32 dementia old age, not falling within any other category Conditions of registration: 32 0 The maximum number of service users who can be accommodated is: 32 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 (OP) 32 Dementia (DE) 32 Date of last inspection Care Homes for Older People Page 2 of 8 Brief description of the care home Howbury House is a large, single storey building located in a residential area a short distance from the main road that runs through Malvern Link. There is easy access to public transport and shops. The premises have attractive gardens including enclosed gardens and sitting areas. There is a large, open field on the one side of the premises that allows pleasant views of the Malvern Hills. The premises are owned and operated by Worcestershire County Council. The premises are designated as a resource centre and are currently registered to provide personal care for a maximum of 32 older people. People are accommodated in single bedrooms in units. The units have their own communal bathroom and toilet facilities, a combined lounge and dining area and the shared use of a small, domestic kitchen. A service is provided on two units for 17 people who require intermediate care. The maximum length of stay is normally six weeks. A third unit provides seven respite places for people. A fourth unit called the Lodge provides respite for up to six people with dementia. There are also emergency or transitional places. Although the permanent residential care service has been phased out, one person continues to reside on the premises permanently. The purpose of the resource centre is to work closely with families and in partnership with healthcare and other professionals in order to provide a flexible service that is responsive to the needs of local people while maximising the resources available. Care Homes for Older People Page 3 of 8 What we found: The pharmacist inspector visited the home on 12th May 2010 to check the management of medicines within the service and found that there was an overall improvement in the management and control of medication. We spoke to one member of staff, the Deputy Manager and three people who live in the service. We saw that all medication was stored securely in locked cupboard in each persons bedroom. We saw that peoples medication were stored neatly and easy to locate. We saw that external preparations such as creams or ointments were not always stored separately from peoples internal medicines. We discussed this with the Deputy Manager during our inspection. However, our overall finding was that medication storage was safe and therefore the people who live in the service are protected from harm. We looked at three peoples medication administration record (MAR) charts and overall found that they were well documented with a signature for administration or a reason was recorded if medication was not given. We saw that the times of administering medicines were clearly highlighted on the MAR charts with clear directions recorded for the administration of medicines that needed to be given at special times. For example,we saw that one person was to be given a tablet once a week before breakfast. There were clear directions available for staff to follow to ensure the medicine was given according to the prescribers instructions. This ensured that staff knew when to give medicines. Two members of staff checked the medicine records for accuracy and detailed the reason for any changes directly onto the MAR chart. This helped to ensure that accurate medicine records were available for people living in the home. For example, we looked at the medicine records for a person who had recently been admitted to the home. The person had been prescribed eight medicines. We found all of the medicines were accurately recorded and had been signed as given on the MAR chart. We were informed that the person had not brought in any medicnes and the service had to obtain an emergency prescription in order to ensure the person had their prescribed medicines. This means that the service made sure that the person was protected from harm. Medicines which were prescribed as one or two to be given were not always clearly recorded by staff. For example, we saw one person was prescribed a painkiller to be given as one or two four times a day, however the records did not document how many tablets were given each time. This was highlighted to the Deputy Manager who agreed to discuss a system of recording accurate medicine records with all trained staff. This means that it was not always clear how many tablets had been given to a person. We found that other medication records were generally up to date. We saw that written information from a GP relating to peoples medicines, such as changes to a dose, were kept next to their MAR chart for staff to refer to. we saw that all relevant medicine information was easily available for staff to refer to in order that the person was given their prescribed medicines. These records helped to ensure there was a clear audit trail of medication. We found that counts and checks made on medication were accurate, which showed that people who live in the service were being given medication as prescribed by a medical practitioner. Care Homes for Older People Page 4 of 8 People who were assessed as able to look after their own medicines were given the opportunity to be independant. For example, we spoke to one person who looked after their own medicines in their room. They were very happy looking after their medicines and knew what each one was for. The person had been risk assessed as able to look after their medicines safely. This means that people were able to live independently within the service and were also protected from harm by regular checks. 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 service should ensure that medicnes for external use are stored seprately from medicines for internal use and prevent the possibility of contamination. This is to ensure that people are protected from harm. The service should ensure that systems are in place to record the amount of tablets given to a person when the directions are for a variable does. This is to ensure that medicine records are accurate. 2 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. 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