Latest Inspection
This is the latest available inspection report for this service, carried out on 8th July 2010. CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Hugh Myddelton House.
What the care home does well Medication was stored in accordance with legal requirements and medication records provided for audit to indicate that medication was administered to residents according to prescribing directions. Air conditioning was provided to ensure the correct storagetemperature was maintained. Medication records included comprehensive details of each resident together with a medication profile with information where further decision is required, for example, "when required". What the care home could do better: Insulin that was in use requires storage at room temperature in accordance with the directions. The correct usage of the medicine fridges integrated thermometers and monitoring of the temperatures should be reviewed. Some medication records should be endorsed to improve the clarity of use. Random inspection report
Care homes for older people
Name: Address: Hugh Myddelton House 25 Old Farm Avenue Southgate London N14 5QR 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: Lawrie Allum Date: 0 8 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Hugh Myddelton House 25 Old Farm Avenue Southgate London N14 5QR 02088864099 02088829824 helen.matthews@barchester.com www.barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 47 Number of places (if applicable): Under 65 Over 65 38 0 old age, not falling within any other category physical disability Conditions of registration: 0 18 Service users should not be admitted where the primary need is that they are sensory impaired and/or are terminally ill. The home must not admit service users who are in need of acute care, that requires intensive medical management. The second floor will be known as the YPD (Young Physically Disabled) Unit. This floor is to provide care for nine service users of either sex aged between eighteen and under sixty five with a physical disability, some of whom may have a sensory impairment (SI) ; be terminally ill (TI) and in need of nursing care. The second floor will only accommodate up to nine service users of either sex aged between eighteen and sixty five with a physical disability and in need of nursing care.
Care Homes for Older People Page 2 of 9 There will be a total of eighteen YPD service users Date of last inspection Brief description of the care home Hugh Myddelton House is a care home owned and managed by Barchester Healthcare Ltd and registered to provide nursing care for up to forty-seven people. The home provides nursing care to up to thirty-eight people over the age of sixty, and up to eighteen people with physical disabilities aged between sixteen and sixty-five. The service is provided in a purpose built building which provides modern facilities for people. All of the bedrooms are single rooms and have en suite facilities. There are five communal areas as well as a dining room. There are communal areas on each of the floors including two large areas on the ground and first floor. Bedrooms are provided on the ground, first and second floor and all three floors are served by two shaft lifts. There is a pleasant garden area to the side of the home. The home is located in a quiet residential area of Southgate close to shops, amenities and transport links. The stated aim of the home is to create circumstances in which residents can maintain their dignity, identity and independence and also to provide an environment for individuals that supports their physical and mental well being. Weekly fees to the home as of May 2009 are GBP850 - GBP1300 depending on need. Extra charges are made for hairdressing, chiropody and newspapers. Current CQC inspection reports are available from the managers office or from the CQC website www.cqc.org.uk. Care Homes for Older People Page 3 of 9 What we found:
Each of the three floors of the home had a dedicated room for the storage of medicines. Medicines were dispensed by Boots Pharmacy using the Boots monitored dosage system and printed medicines administration record (MAR) charts provided. The current cycle of repeat dispensing MAR charts started on 21/06/2010 for residents on all three floors. Medical requirements for the homes residents were served by one local GP practice. At the time of the inspection there were 22 of the 38 places for older people occupied and 14 of the 18 places for young physically disabled people occupied. Since the reported medication errors that occurred on 28/04/2010 and 21/06/2010, all staff handling medication at the home had undergone training and assessment by the homes deputy manager following Barchesters competency assessment. The middle floor included storage for Controlled Drugs (CD) for all three floors. CD records were correct and currently no residents on the ground floor were prescribed CDs. Medication requiring cold storage was kept in locked, dedicate fridges located in the medication storage rooms on the ground and middle floors of the home. The fridge on the middle floor contained insulin that was currently in use for residents on the middle and top floors of the home. This insulin should be stored at room temperature once in use and used within the in-use time limit, which in this case was 4 weeks. Whilst the multi-dose insulin container included the date of first use this was not included for the penfill insulins. According to the prescribed insulin dosages the containers should be fully used within the time limit if all doses were consecutively administered, however, if there was a break in administration then this may not be the case, for example, if a resident was away from the home for a period in hospital. The medicine fridge temperature monitoring records were recorded as fractions of a degree Celsius when the integrated thermometers readings were in whole degrees. Staff were therefore recording temperatures of less than 1 degree Celsius without taking any remedial action when the minimum for medicines storage is 2 degrees Celsius. Both fridges were within the required range of 2 to 8 degrees Celsius. The temperature records for the fridge on the ground floor indicated the same maximum/minimum records since 22/06/2010. This appeared to be due to a problem with resetting the thermometer after taking the daily readings. A resident on the middle floor had several wound dressings included on their medicine administration record (MAR) charts and not all were in use. To provide clarity for all staff it is advised to indicate those dressings which had been discontinued by the visiting tissue viability nurse. A medicine requiring handling precautions, finasteride, was in use on the middle floor. To ensure safe handling this precaution should be included on the MAR chart and on the container. The nurse on duty for that floor was aware of the precautions required. What the care home does well:
Medication was stored in accordance with legal requirements and medication records provided for audit to indicate that medication was administered to residents according to prescribing directions. Air conditioning was provided to ensure the correct storage
Care Homes for Older People Page 4 of 9 temperature was maintained. Medication records included comprehensive details of each resident together with a medication profile with information where further decision is required, for example, when required. 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 9 13(2) The registered person must 22/06/2009 ensure that there is increased monitoring of gaps in the recording on medication administration records, and that no residents miss out on medication prescribed to them due to pharmacy provider issues, to ensure that peoples medication needs are met safely. The registered person must 17/07/2009 ensure that daily records for people living at the home include greater detail of health and social care provided, including staff support to provide social and intellectual stimulation e.g. chatting with or reading to people, assisting them to listen to the radio or access books, to evidence that they are receiving holistic support. (Previous timescales of 22/02/08 and 18/07/08 not met). The registered person must ensure that informal concerns expressed by people living at the home or 03/07/2009 2 12 16(2mn) 3 16 22 Care Homes for Older People Page 6 of 9 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 their relatives/ representatives, are recorded alongside evidence that they are addressed swiftly. Recent concerns raised regarding practicalities of feeding an identified resident, giving tablets to people with swallowing difficulties, and confidence in nurses abilities to address concerns raised, must be addressed swiftly, to ensure that the views and interests of people living at the home are taken into account. 4 27 18(1a) The registered person must 17/07/2009 ensure that the number of care staff on duty in each part of the home, is reviewed to ensure that people living at the home are provided with high quality care and attention at all times, and particularly at night. The registered person must 17/07/2009 ensure that all care and nursing staff receive individual supervision sessions at least six times annually, to ensure that they work in line with best practice in the interests of people living at the home. 5 36 18(2) Care Homes for Older People Page 7 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 It is required to store insulin that is currently in use at room temperature. To meet the licensed storage indication for insulin administration. 05/08/2010 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 To ensure the correct medicine fridge temperatures are recorded by resetting the integrated fridge maximum/minimum thermometer after readings are recorded. To provide additional information on medicine administration record (MAR) charts to ensure the safety and clarity of use, for example, handling precautions for finasteride, indicating which wound dressings are discontinued by the tissue viability nurse. To record the date each insulin container is first used to ensure usage does not extend beyond the in-use time limit. 2 9 3 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. 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 9 of 9 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
