Care Home: Lakeland View Nursing & Residential Home

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What the care home does well Home Remedies as kept to enable people to have treatment for e.g. minor pain without needing a prescription from the doctor. What the care home could do better: Care needs to be taken to ensure that the home`s policies are consistently followed when handling people`s medicines. Prescribed medicine should only normally be administered from people`s own pharmacy labelled supplies. And, to help reduce the risk of mistakes, nursing staff should seek written confirmation of verbal advice to change people`s medicines Random inspection report Care homes for older people Name: Address: Lakeland View Nursing & Residential Home 220-224 Heysham Road Morecambe Lancashire LA3 1NL 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: Stephanie West Date: 2 2 0 7 2 0 1 0 Information about the care home Name of care home: Address: Lakeland View Nursing & Residential Home 220-224 Heysham Road Morecambe Lancashire LA3 1NL 01524410917 01524833216 lakev@gotadsl.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Bernadette Ann Wallbank Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Frank George Gregory Nicholls care home 33 Number of places (if applicable): Under 65 Over 65 0 33 dementia old age, not falling within any other category Conditions of registration: 33 0 The registered person may provide the following category of service only: Care home with nursing - Code N. 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 - Code OP, Dementia - Code DE. The maximum number of service users who can be accommodated is: 33. Date of last inspection Brief description of the care home Lakeland View is registered with the Commission to provide nursing and residential care for older people and for people with dementia. The maximum number of people who can be accommodated is 33. Care Homes for Older People Page 2 of 9 0 4 0 6 2 0 0 9 Brief description of the care home The home is located in the Heysham Road area of Morecambe, close to bus routes and shops. Lakeland View has three floors and there is a passenger lift in place. There is parking space and a small garden area to the front of the building, with a patio to the rear of the dining room. The home provides a range of communal living rooms including two main lounges, a small conservatory, a separate lounge for those people who smoke and a large airy dining room. There is a Statement of Purpose, Service Users Guide and Information Pack that is given to all prospective residents; this is a set of written information that tells you about the care service that is offered and what the resident can expect if he or she decides to live at the home. The home is owned by Mr Frank Nicholls and the registered manager is Mrs Bernadette Wallbank. Details of the current fees can be obtained by contacting the home. Care Homes for Older People Page 3 of 9 What we found: The purpose of this visit was to look at the homes arrangements for handling medication to look at how concerns identified at our previous visit had been addressed. This visit focused on medicines handling, other areas were not examined on this occasion. We looked at care documentation within the home and the medication systems that were in place. We spoke with owner manager and the nurses on duty. We found that overall suitable arrangements were in place for handling peoples medicines but to ensure people are best protected, care needs to be taken to ensure the homes medicines policies are consistently followed. We looked at medicines administration. All medicines were administered by qualified nurses. There was supporting individual information about medicines prescribed when required helping to ensure consistency in their use, when needed. And information about the use of prescribed creams showing why and where they may be needed. We saw that because many people took morning medicines some of these were not administered until quite late in the morning. But, the actual time these medicines were given was not recorded. This means that there was a risk that where doses of the same medicine were repeated throughout the day, they will be given too closely together. The times that medicines are administered needs to be monitored and recorded to reduce this risk. We were concerned to find that medicines were sometimes administered from supplies originally prescribed and labelled for other people, in these cases medicines handling could not be accounted for. Prescribed medicines should only normally be administered from peoples own labelled supplies, administering medicines from other peoples boxes increases the risk of mistakes. Arrangements were in place for the use of homely remedies, this benefits people at the service as they can receive treatment for conditions such as minor pain without delay. Records showing the receipt, administration and disposal of medication were generally up-to-date so medicines handling could be accounted for. But, there were some areas that could be improved to ensure the completeness and clarity of these records: When medicines were prescribed for example, one or two the actual dose given was not always recorded and on occasion the medicines administration records were signed when the medicines were prepared, not immediately after administration. This increases the risk of making mistakes in the record keeping and reduces their clarity as alterations need to be made, should the medicine then be refused. Similarly, the reason was not always clearly recorded when medicines were not given. Records of GP or other healthcare professional advice were generally clearly recorded but on occasion it was difficult to track clearly when changes where made to peoples medicines, and on whose advice. Additionally, nursing staff did not promptly seek written confirmation of verbal instructions to change peoples medicines. This increases the risk of mistakes because the medicines are given differently from the instructions on the medicines label. We found that all medicines including controlled drugs could be securely locked away but were concerned that on occasion the medicines room was left open when unattended whilst nurses were administering medication. It is important that this room is always locked when unattended to reduce the risk of medicines miss-handling or miss-use. Written audits of medicines handling were completed by nursing staff at the home, but Care Homes for Older People Page 4 of 9 recent copies of these could not be found. It is important that written audits of medication handling continue to help ensure medicines are safely handled and that should any weaknesses arise, they will be identified and quickly addressed. 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 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 19 23 All parts of the home must be reasonably furnished and decorated. Staff must not commence duty until all the necessary checks have taken place. (previous timescale of 07/08/06 not met) 30/09/2008 2 29 19 31/05/2008 3 31 39 The registered provider must 12/07/2010 inform the CQC in writing about the temporary management changes at the home and provide details of the interim management arrangements, ensuring that satisfactory management support is in place. In order that the CQC has up to date information about the management of the home. 4 31 12 The registered provider and registered manager must maintain good personal and professional relationships with each other, service users and staff. This will help all concerned to function as a team and promote a pleasant 12/07/2010 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 atmosphere at the home. 5 31 39 The registered provider must 01/08/2010 apply to the CQC to register the home as being owned by a limited company. In order for the home to be appropriately registered with the CQC. 6 31 43 The Registered Person must comply with all conditions of registration. To fail to do so would be an offence under the Care Standards Act 2000. 7 38 13 Cleaning products must be safely stored. 31/05/2008 12/06/2009 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 Prescribed medicines must 27/08/2010 normally be administered from peoples own labelled supplies and clear records of the dose, time and date of administration made to reduce the risk of errors and to enable the safe handling of medicines to be accounted for. 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 Regular audits of medicines handling should continue to help ensure that the homes policies are adhered to, and that medicines handling can be accounted for. To reduce the risk of errors, nursing staff should seek written confirmation of verbal advice to change peoples medicines. 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. 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