Care Home: Lady Elsie Finney House Home for Older People

What the care home does well Regular weekly checks of the medicines are carried out to help make sure they are handled safely. What the care home could do better: Liquid medicines must be given to people correctly `as prescribed` so their health and wellbeing is maintained. When medicines are not taken by people a clear reason must be recorded so that medicines can be properly accounted for. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Lady Elsie Finney House Home for Older People Cottam Avenue Cottam Preston PR2 3XH one star adequate 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 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: Simon Hill Date: 0 5 0 3 2 0 0 9 Information about the care home Name of care home: Address: Lady Elsie Finney House Home for Older People Cottam Avenue Cottam Preston PR2 3XH 01772721072 01772721073 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) : Lancashire County Care Services care home 45 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 45 The registered person may provide the following categories of service only. Care home with nursing - code N, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Dementia - Code DE The maximum number of people who can be accommodated is: 45 Date of last inspection Brief description of the care home Lady Elsie Finney House is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 45 people who have Dementia. The purpose built home is divided into three separate units, each with an open plan lounge and dining room. All accommodation at the home is provided on a single room basis and all bedrooms have en-suite facilities. In addition, there are ample numbers of well equipped bathrooms for the residents use. Care Homes for Older People Page 2 of 8 Brief description of the care home The home has been designed to provide easy access for people with limited mobility and there is a passenger lift to enable residents to access the first floor accommodation. The provider of the home is Lancashire County Care Services, a direct services organisation who operate a number of care homes in the area. Care is provided on a 24 hour basis including waking watch care throughout the night. The majority of carers employed at the home hold National Vocational Qualifications in care, at level 2 or above. At the time of our inspection we were advised that fees for care and accommodation range from £394 - £411 and are assessed in accordance with peoples individual needs. All this information and more can be found in the Service User Guide which is available on request from the home. Care Homes for Older People Page 3 of 8 What we found: We visited the home because our last visit found some shortfalls in the way medicines were handled. The visit was carried out by a pharmacist inspector. It lasted five hours hours and involved speaking with the manager, three carers and the area manager. We checked a sample of medicines stocks, medicines records and care plans and observed some of the morning medicines being given to people. Although we found some improvements in the handling of medicines we continued to find mistakes, notably with liquid medicines and record keeping, that could place the health and wellbeing of people who live in the home at risk. We found medicines stock and records to be well organised. Current and spare stock was stored securely in clean and tidy rooms and special secure trolleys were used to transport medicines safely around the home. A simple system of stock control had been developed that made checking the medicines easy to do. When we checked the records of medicines given we found they were usually signed and up to date. Adequate stocks of medicines were kept in the home and records of receipt and disposal were usually accurate and complete. However, our checks showed that if people were asleep when the medicines were being given out staff did not always go back later to give them and so sometimes they were missed completely. We also found it difficult to fully account for all medicines because when people did not take them, for example, if they refused, a clear reason was not recorded. We found the stocks of some liquid medicines did not add up showing they had either been measured out wrong or had been completely missed. The manager said his checks had found similar mistakes and he had spoken with staff about it but there continued to be problems with these medicines. Missing medicines without good reason can seriously affect a persons health and wellbeing. We observed medicines being given to people in an organised way during and just after breakfast. However, one person had their eye drops put in their eyes at the breakfast table, this is not good practice as it is unhygienic and does not respect a persons privacy and dignity. We looked at the times medicines were given to people and these were now better organised, any medicines that needed to be given before food were now clearly highlighted on the records and staff confirmed this when we spoke with them. Giving medicines at the right time helps make sure they work properly. The manager carried out weekly recorded checks to help make sure staff were giving and recording medicines correctly. Recent checks had found similar mistakes to our findings and the manager said action was being taken to help prevent them happening again. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We saw some good information about how when required medicines such as painkillers and sprays for angina were to be given, although some of these had not been reviewed for several months and so there was a risk that they would not be up to date. Having up to date clear written care plans helps make sure people get their medicines when they need them. Care Homes for Older People Page 4 of 8 We looked at how staff were trained to handle medicines safely. All staff have attended formal medicines training as part of their standard training. The area manager said a new competency assessment system was being developed that would include the manager watching staff give people their medicines. Regular competency checks on staff help make sure they have the necessary skills to handle medicines safely. 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 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 38 13 (4) (a) In relation to the use of 10/09/2008 kettles and cleaning fluids, it must be ensured that staff are fully aware of and fully comply with risk assessments. 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 1 9 13 Liquid medicines must be given to people as prescribed. This is important to help maintain the health and wellbeing of people who live in the home. This is an element of a previous requirement that has not been met. 10/04/2009 2 9 13 When medicines are not taken by people a clear reason must be recorded. This is important so that medicines can be fully accounted for. 10/04/2009 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 Care Homes for Older People Page 7 of 8 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. 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