Latest Inspection
This is the latest available inspection report for this service, carried out on 14th 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 but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Latimer Lodge.
What the care home does well The purpose of this inspection was to follow up concerns raised about medicines handling and only this area of care was looked at. What the care home could do better: Systems for ordering must ensure that medicines are ordered at an appropriate time and action taken if they are not received so that people do not miss doses of their medicines because they are not available. Discrepancies in dosage instructions must always be checked with the prescriber and/ or pharmacist to make sure that the correct dose is always given. Clear accurate records must be kept of medicines given by staff. If regular medicines are not given a reason must be recorded. Action should be taken to ensure that information is available about a medicine that requires special monitoring. This can be obtained from the National Patient Safety Agency (NPSA). Results from blood tests and confirmation of the dose to be given should be received in writing. This is to reduce the risk of mistakes being made. Two cupboards used to store medicinal items are in an unsuitable location because of heat and steam and alternative storage is needed. Action should be taken to ensure that storage for controlled drugs meets the Misuse of Drugs (safe custody) Regulations 1973. This is so that suitable storage would be available, if anyone living in the home is prescribed a controlled drug. Random inspection report
Care homes for older people
Name: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ two star good service 25/08/2009 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: 1 4 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ 01935474520 01935432380 cmbw@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Heather Elizabeth Neal Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Christopher Michael Bruce Wharton care home 14 Number of places (if applicable): Under 65 Over 65 14 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who may be accommodated is 14. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Latimer Lodge Residential Home is part of a continuing care complex that includes Tyndale Nursing Home, which provides nursing care and Coverdale Court, which is a sheltered housing complex.
Care Homes for Older People Page 2 of 11 1 4 0 5 2 0 1 0 Brief description of the care home All businesses are run entirely independently but come together to share resources, interests and activities. Latimer Lodge Residential Home is a fourteen-bed care home providing personal care for older people. It is situated close to the centre of Yeovil. It stands in its own gardens, in close proximity to Tyndale Nursing Home and Coverdale Court. There is good access for frail people and wheelchair users, including pleasant garden areas. Car parking is available. Communal rooms and some bedrooms are located on the ground floor with further bedrooms on the first floor, some of which are very spacious. A passenger lift is available. Care Homes for Older People Page 3 of 11 What we found:
The pharmacist inspector carried out this inspection, following a concern about the handling of medicines in the home. We (the Care Quality Commission) spoke to the senior carer on duty and to another carer who gives out medicines in the home. We also spoke to the owner of the home. We looked at the arrangements for storing medicines and the records of their receipt, administration and disposal. We spoke to two people living in the home and looked at two peoples care notes to see whether there was information to help staff give medicines safely. People living in the home are registered with doctors from a number of local surgeries. Medicines are supplied by a local pharmacy using a monthly blister pack system. Staff request their regular monthly medicines via the pharmacy using a copy of the medicines administration record (mar) sheet. Staff keep a copy of the order so that they can check that the correct medicines are supplied. We saw that two medicines for one person were outside the regular order. Each had been unavailable for some time in July. We saw records that showed the medicines had been ordered but had not been received in time. Systems for ordering must ensure that medicines are ordered at an appropriate time and action taken if they are not received so that people do not miss doses of their medicines because they are not available. One person is able to look after their own inhaler but all other medicines are looked after and given by staff. We saw staff give medicines at lunchtime using safe practice. We saw that the pharmacy had recently provided medicine training for staff, to help them look after medicine safely. Staff told us this had been useful. We spoke to two people living in the home who said that they were happy with how staff looked after their medicines. One person likes to take one of their medicines later in the day but staff sign that they have been taken in the morning. A care plan should be in place for this and records should demonstrate that staff do not see the medicine being taken. The pharmacy provides printed medicines administration record (mar) sheets each month for staff to complete. The manager had sent us details of a system she had introduced to audit the medicines used to check that they have been given correctly. However staff were not sure where this was to be found. We could not audit some medicines supplied in standard packs because it was not clear when the pack had been started. Handwritten additions to the mar sheets had been initialled by the person making the entry and checked by a second person. We saw that one handwritten entry stated that the dose of medicine was one twice daily and this was confirmed by the hospital discharge letter. However a supply received from the pharmacy more recently was labelled one daily . The medicine was still given twice daily and it appeared that no-one had confirmed the dose with the pharmacy or doctor. Any discrepancies with dosage instructions when a new supply of medicine is received must be checked with the prescriber and or pharmacist to ensure that the correct dose is always given. We saw occasional gaps in the mar sheets. One cream prescribed to be used twice daily was signed as being used once daily and another prescribed to be used three times daily
Care Homes for Older People Page 4 of 11 was signed as being used twice daily. Staff said both people had asked to have the creams in this way. We asked one person about a medicine listed on their mar sheet that was unavailable and they told us that they had never taken it and did not need it. Staff should discuss with the pharmacy why this appears on the mar sheet. One medicine error had been reported to us which involved medicines being given incorrectly from a weekly dosette box of medicines, brought in by someone staying in the home for a short time. The manager sent us a chart designed for recording medicines received in these weekly boxes. We discussed with staff how these would not be suitable because they do not list the contents of the box and do not show which medicines have been given. We saw that one person takes a medicine which need additional monitoring. Action is needed to ensure that the results of blood tests and the dose to be taken are always confirmed in writing. Information about the safe use of this medicines is available from the National Patient Safety Agency (NPSA) and action should be taken to ensure that this information is available in the home. The dose of medicine to be given should be clear on the mar sheet so that the record shows how much has been given and staff can be confident they are giving the correct dose. Secure storage is available for medicines. However we advised the registered provider that the controlled drugs cupboard used to store medicines which need additional security did not appear to meet the requirements of the Misuse of Drugs Act (safe custody) regulations 1973. Action is needed to check this with the manufacturer. If the cupboard does not meet regulations a new cupboard should be obtained. Some medicines and other medical items are kept in locked cupboards in the kitchen. As discussed, kitchens are not recommended for storing medicinal items because of the heat and steam which may be present. Alternative, more suitable storage should be found for these items. What the care home does well: What they could do better:
Systems for ordering must ensure that medicines are ordered at an appropriate time and action taken if they are not received so that people do not miss doses of their medicines because they are not available. Discrepancies in dosage instructions must always be checked with the prescriber and/ or pharmacist to make sure that the correct dose is always given. Clear accurate records must be kept of medicines given by staff. If regular medicines are not given a reason must be recorded. Action should be taken to ensure that information is available about a medicine that requires special monitoring. This can be obtained from the National Patient Safety Agency (NPSA). Results from blood tests and confirmation of the dose to be given should be received in writing. This is to reduce the risk of mistakes being made.
Care Homes for Older People Page 5 of 11 Two cupboards used to store medicinal items are in an unsuitable location because of heat and steam and alternative storage is needed. Action should be taken to ensure that storage for controlled drugs meets the Misuse of Drugs (safe custody) Regulations 1973. This is so that suitable storage would be available, if anyone living in the home is prescribed a controlled drug. 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 6 of 11 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 18 (1) The registered person must ensure that all staff who administer medication are competent in this area and their competency is regularly assessed. To minimise the risks of mistakes in the administration of medication. 09/04/2010 2 9 13 (2) The registered person must ensure that there are safe and robust systems in place for the recording and administration of medications, including medicines for temporary residents. To ensure that people receive medications as prescribed. 09/04/2010 3 9 13 (2)Medication must be 26/09/2009 administered in line with the instructions on the Medication Administration Records. To ensure that people receive the prescribed dosage and that its effectiveness can be monitored. Care Homes for Older People Page 7 of 11 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 4 9 13 (2) The registered person must ensure that a suitable system is in place for the audit of medicines and that regular audits are carried out. To ensure that all medication is accounted for and given as prescribed. 09/04/2010 5 29 19 (1) schedule 2. No staff should begin work in the home until two written references have been received. 31/08/2009 To minimise the risk s of abuse to people who live at the home. (Not inspected on this occasion) 6 31 18 (1) The registered person must keep the management arrangements under review. To ensure that at all times there are clear lines of responsibility and accountability. (Not inspected on this occasion) 31/12/2009 Care Homes for Older People Page 8 of 11 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 Suitable storage must be available for all medicinal items used in the home So that these items are kept safely and securely 30/08/2010 2 9 13 Staff must ensure that 09/08/2010 information is available about one medicine which requires special monitoring. Dosage instructions must be confirmed in writing. To ensure this medicine is given safely. 3 9 13 Systems for ordering medicines must be robust and ensure that medicines are received in a timely manner. Clear accurate records must be kept of medicines given by staff. If regular medicines are not given a reason must be recorded. So that prescribed medicines are always available and given correctly. 02/08/2010 Care Homes for Older People Page 9 of 11 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 10 of 11 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 11 of 11 - 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!
