Care Home: Lockermarsh

What the care home does well There are no significant gaps on the medication administration records. This indicates that people receive their medicines correctly as prescribed. Management checks of medication processes and staff practice help to indentify any improvements needed. What the care home could do better: Further staff training and new detailed medication procedures would ensure staff knew exactly what is expected of them when handling and administering medicines. Some aspects of medication ordering and record keeping should be improved so that all medicines entering the home can be fully accounted for. Storage arrangements should be reviewed and monitored to ensure medication is kept safely according to manufacturers` recommendations. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Lockermarsh 36 Ellison Street Thorne Doncaster South Yorkshire DN8 5LH The quality rating for this care home is: The rating was made on: new service which has yet to be given a quality rating 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: Steve Baker Date: 2 7 1 0 2 0 0 8 Information about the care home Name of care home: Address: Lockermarsh 36 Ellison Street Thorne Doncaster South Yorkshire DN8 5LH 01405740777 01405814563 jkstothard69@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Miss Susan Jane Leigh,Mr Stephen John Oldale care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 24 Conditions of registration: 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 categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 24 Date of last inspection Brief description of the care home Lockermarsh has been registered as a care home since 1991 and is located in pleasant surroundings about 1/4 mile from Thorne town centre. It is within reach of local shops, a post office, church and other local amenities. Lockermarsh is a detached listed building. It provides its accommodation on two floors. There is a passenger lift to facilitate access between floors. The communal areas are located on the ground floor Care Homes for Older People Page 2 of 9 and include two lounges and a dining room. The kitchen and laundry facilities and office are also found on the ground floor. There are pleasant gardens that are easily accessible with a range of garden seating. Information gained on the 5th August 2008 indicated the current fees vary from #390.14 to #400.00 per week with additional charges made for hairdressing and chiropody. These fees applied at the time of inspection, more up to date information may be obtained from the manager of the home. A copy of the home?s statement of purpose, service user guide and complaints procedure was available in the entrance hall. Care Homes for Older People Page 3 of 9 What we found: This inspection visit was carried out at the request of the lead inspector following the changes made by the new manager and the new ownership. The visit lasted 3 hours and involved examining the homes medication policy, the current medication administration record (MAR) charts and the storage & handling arrangements for all medicines, including controlled drugs. We were told no self-adminstration of medicines took place and no observation of medicines administration by staff took place during this visit. We gave verbal feedback during the visit to the manager and deputy manager. The commercial medication policy in use in the home does not provide clear information on medication mamanegent for staff working in the home. Local medication procedures applicable to Lockermarsh would enable all staff in the home to understand exactly what is expected of them when handling and administering medication. Neither CSCI guidance nor the Royal Pharmaceutical Society of Great Britain guidelines on handling medicines in social care are available for staff to consult. We were shown evidence of recent checks of medication systems and records. This good practice enable the management team to identify any weaknesses in medication systems and helps to identify any improvements which may be needed. Staff are regularly supervised and any changes to practice are agreed and action is taken. Staff should also be given the opportunity to receive independent refresher training in the safe handling of medicines. Having well trained competent staff helps to reduce the risk of mistakes being made. Most medicines are stored securely in locked drug cupboards or in a trolley in a locked store room. The temperature of the storage areas is unknown as no monitoring takes place. Some medicines are stored in a fridge but again no temperature records for this fridge are kept. All medicines must be stored securely at temperatures recommended by the manufacturer so that staff know they are safe to use when needed. The arrangements for ordering, receiving and disposal of medication are not fully in line with good practice guidance. Comprehensive records of medicines ordered and received should be maintained to help account for all medicines entering the home. The person in charge of ordering medication should see the regular monthly prescriptions before a supply is made. The prescription is the authority for the staff to administer medication to the person. This also provides an opportunity to check if any new medicines or dose changes are included. Any problems with prescriptions can be addressed at this point rather than after the supply has been made. The checking of prescriptions is an important part of the management of medication in the home. There are no significant gaps on the MAR charts. This means there is a good record kept of people receiving their medication as prescribed. However, we found some inconsistency in handwritten entries of medicines on the MAR charts. To make sure there is an accurate record the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. This makes sure that there is an accurate record of new medicines and changes made. The quantity of medication from one monthly cycle to another is not Care Homes for Older People Page 4 of 9 always recorded on the new MAR chart. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. A signed list of staff authorised to administer medicines should be produced and kept up to date. This will help to correctly identify who was involved if a problem or administration error was to occur. 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 £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 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, Care Homes 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 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 A system should be in place to record all medication received in to the home and medication carried over from the previous month. This helps to confirm that medication is being given as prescribed and when checking stock levels. Regular, monthly prescriptions should be seen before sending to the pharmacy. This makes sure a check can be made that all the medicines required have been listed and prevents people from being without. The temperature of all medication storage areas, including the fridge, should be regularly monitored. This makes sure that medicines are being stored at the temperature recommended by the manufacturers. Handwritten entries on MAR charts should must be accurately recorded and detailed. This makes sure that the correct information is recorded so a person receives their medication as prescribed. The management team should produce a set of local medication procedures for all staff to use when handling and administering medication. These new procedures should reflect current professional best practice guidance in social care settings. 2 9 3 9 4 9 5 9 Care Homes for Older People Page 7 of 9 6 9 Refresher medication training that reflects best practice guidance should be provided to all staff involved in the administration of medication. Having well trained competent staff helps to reduce the risk of medication errors. Care Homes for Older People Page 8 of 9 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. 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