Care Home: Katherine House Rest Home

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What the care home does well The purpose of this inspection was to follow up requirements and recommendations relating to medicines made during the previous inspection. What the care home could do better: Further improvement are needed to the medicines administration records so that complete and accurate records are kept of all medicines given by staff. If medicines are prescribed regularly but are not given a reason for this must be recorded. Applications of creams and ointments by staff must be recorded. This requirement has been repeated from the last inspection. Action should be taken to ensure that additional information about the safe use of a medicine prescribed for one person is available in the home. So that staff can look after this person. Random inspection report Care homes for older people Name: Address: Katherine House Rest Home Cote House Lane New Cote Rest Home Westbury On Trym Bristol BS9 3UW 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: Sue Fuller Date: 0 5 0 7 2 0 1 0 Information about the care home Name of care home: Address: Katherine House Rest Home Cote House Lane New Cote Rest Home Westbury On Trym Bristol BS9 3UW 01179873540 01179873631 acollins@merchantventurers.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ann Collins Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Cote Charity care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 40 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 category: Old age, not falling within any other category - Code OP, maximum number of places: 40 Date of last inspection Brief description of the care home Katherine House Rest Home is managed by The Cote Charity and is registered by us to provide personal care to forty people, both men and women, aged 65 years and over. The home is set in secluded grounds a short distance from Durdham Downs in Bristol. Care Homes for Older People Page 2 of 10 0 2 0 2 2 0 1 0 Brief description of the care home Katherine House is purpose built and was opened in December 2009 with the people transferring to the new building from an older building on the same site. Previously the home was called New Cote Rest Home. The home is accessible with rooms split over two levels with a lift to the first floor. All bedrooms are single and have an ensuite. Katherine House is situated close to major bus routes and amenities. The City Centre is also a short distance away. The homes aims to provide a good, affordable, accessible care and services for elderly people. There vision of the future is to build on their current high standards of care maintaining a flexible, holistic and care for life programme respecting the independent lifestyle of elderly people. The range of fees is currently £404.96 to £550.45 per week and extra charges are made for chiropody, hairdressing, and toiletries. Care Homes for Older People Page 3 of 10 What we found: The pharmacist inspector carried out this inspection to review the progress that had been made in improving the safe handling of medicines in the home, following the last inspection. We (the Care Quality Commission) spoke to a senior carer on duty who is involved with looking after medicines in the home and to the registered manager. We looked at the arrangements for storing medicines and the records kept of how medicines have been given. We saw some medicines being given at lunchtime and spoke to two people who have their medicines looked after by staff. We saw that improvements had been made to the storing of medicines so they are more secure. Some improvement was also seen in the records of medicines given by staff but further action is needed to ensure that records are complete and accurate. Some people are able to look after creams and ointments prescribed for them but staff look after and give out most of the medicines. We saw staff give some medicines at lunch-time using a safe method. The pharmacy provides printed medicines administration record (mar) sheets each month, for staff to complete when they give medicines. We spoke to two people living in the home who told us that they were happy with how staff looked after their medicines. At the time of the inspection a new supply of medicines had just been started so we also looked at the previous months mar sheets. We saw that several items which had been handwritten on to the mar sheets had not been signed and dated by the person making the addition and had not been checked by a second person. This is recommended as good practice to reduce the risk of mistakes being made which can lead to medicines being given incorrectly. We saw that there were several gaps in the mar sheets particularly for creams and ointments. It was not clear whether these medicines had been given or not. The record for one persons cream to be used three times a day was only signed twice daily. Another person prescribed a cream to be used two or three times a day had two days with no signatures and three days with only one signature. Staff told us that these creams and ointments are kept, and used, in peoples rooms and sometimes the administration record sheets are not signed. We saw one persons mar sheet included a number of different creams and there was no record of which were in current use. This person told us that they just used one cream and applied it themselves. We saw a pot of cream in one persons room had a different persons name on the label. Prescribed medicines belong to the person whose name is on the label and should only be used for that person. Staff must make a record of any creams and ointments they apply to show that they have been used as prescribed. Records should also show which items people look after themselves and which are in current use. We also saw occasional gaps with other medicines. One person had gaps in the administration record for one medicine five times during the month and on one day none Care Homes for Older People Page 4 of 10 of their morning medicines had been signed as given. Another person is prescribed an inhaler to be given twice daily but the administration record showed it was given once daily. Staff said this was because the person did not wish to have the afternoon dose. Another person prescribed a medicine for pain relief four times a day had no record of it having been given and 12 records of it having been refused over the month. If medicines are prescribed regularly a record must be made of when they are given or applied. If they are not given the reason must always be recorded. Any changes to the dosage instructions must be discussed and agreed with the prescriber so that the prescription can be amended. We saw that one person is prescribed a medicine which needs special monitoring. No specific information about this medicine was available in the home and we explained to staff where this information could be found. It is important this information is available to help staff look after this person. Secure storage is available for medicines. Suitable storage is available for controlled drugs which need additional security. The purpose of this inspection was to look at the handling of medicines. We did not look at the action taken to meet other requirements and recommendations so these have remained in this report. 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 10 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 3 14 The registered manager must ensure that individuals are reassessed in respect of the move to Katherine House. Ensuring the information is current and updates the plan of care. 30/03/2010 2 6 15 For care plans and risk assessments to be updated to reflect changing needs. Ensuring care needs are being met, improve communication and ensure an open and transparent service is being provided. 30/04/2010 3 9 13 The registered manager 09/02/2010 must ensure that medicines are administered as prescribed and that accurate records are kept of all medicines given by staff. If a regular medicine is not given a reason must be recorded. This is to ensure that medicines are administered safely and that peoples health is protected. 4 26 24 Ensure the home is free from 18/02/2010 odour. Investigate and take acton to address the odour in Page 6 of 10 Care Homes for Older People 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 a ground floor toilet. Ensuring the home is free from odour. 5 30 18 To ensure that all new staff complete an induction with records maintained. Ensuring staff have the knowledge and the skills to complete their role. 6 38 13 For staff to receive manual handling training with records being maintained. Ensuring people are safe and protected from harm. 7 38 23 A plan must be devised 09/02/2010 demonstrating that fire drills will be completed with all staff within the next seven days and fire training within the next month. To protect peoples health in the event of a fire. 18/03/2010 11/03/2010 Care Homes for Older People Page 7 of 10 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 manager 02/08/2010 must ensure that medicines are administered as prescribed and that accurate records are kept of all medicines given by staff. If a regular medicine is not given a reason must be recorded. This is a repeated requirement. This is to ensure that medicines are administered safely and that peoples health is protected. 2 9 13 Action should be taken to 02/08/2010 ensure that additional information about the safe use of a medicine prescribed for one person is available in the home. To help staff look after this person Care Homes for Older People Page 8 of 10 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 Handwritten additions to the medicines administration record sheet should be signed, dated and checked by a second person to reduce the risk of mistakes being made, which could lead to medicines being given incorrectly. Care Homes for Older People Page 9 of 10 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. 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