Care Home: Lynden

What the care home does well Home Remedies are kept enabling people to have treatment for e.g. minor pain without needing a prescription from the doctor. What the care home could do better: Some medication records could be more clearly and completely made to better support the safe handling of medicines and reduce the risk of mistakes. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Lynden 18 Thornton Road Morecambe Lancashire LA4 5PE three star excellent 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: Stephanie West Date: 0 5 0 1 2 0 0 9 Information about the care home Name of care home: Address: Lynden 18 Thornton Road Morecambe Lancashire LA4 5PE 01524420762 01524401947 lyndencare@aol.com 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) : Mrs Kathryn Lesley Regan,Mr Robert John Murray care home 11 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 11 The registered person may provide the following category/ies 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief description of the care home The Lynden is registered to provide care for up to 11 adults with a learning disability. The home is a large terraced property in Morecambe, situated close to the promenade. There is a small patio area at the rear, with plants and seating, where people can enjoy the better weather. There are two lounges/dining rooms for the use of the people who live at The Lynden, one of which is a smoking area. There are 9 single bedrooms and 1 flat which has a double bedroom. There is easy parking for cars on the road outside the home, and local shops and the seafront are a short walk away. Care Homes for Adults (18-65 years) Page 2 of 8 Brief description of the care home Information about the service the home provides is available in an easy to read Service User Guide, which tries to cover everything a resident needs to know about daily life in the home. CSCI reports are available in the entrance hall of the home, and from the manager. Fees range from £366 to £502 per week, depending on the care required. Further details are available from the manager. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: The home was randomly selected for a visit to look at the arrangements for handling medication. The visit lasted approximately two and a half hours and involved discussing the handling of medication with the manager and care staff, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the manager. Overall suitable arrangements were in place for the handling of medication at the home. Care staff administer most medicines but where people wish to and are able, selfadministration of medication is supported. Written assessments are completed where people self-administer medicines but there could be more information about how people are supported to safely managed their medicines, to help ensure people always receive any help that may be needed. All staff administering medication have completed certificated training the safe handling of medicines. Some staff have also completed specialist training in the administration of medicines using a PEG (feeding) tube. Since the initial PEG training some new people have joined the staff team. The manager should contact the Primary Care Trust for advice about training and the delegation of this task to them, where needed to ensure continuity of care. The home has arrangements in place so that non-prescribed medicines for the treatment of minor ailments can be given. This was based on guidance from the Primary Care Trust, but the guidance was rather old and checks should be made to make sure the home has the newest version. Records for the receipt and disposal of medication were generally clear and accurate. Records showing the administration of medication were generally up-to-date but there were some areas that could be improved to ensure the completeness and clarity of these records. For example we saw that one record wrongly showed someone took a dose of two tablets each night, when staff said that in fact only one was taken and the other refused. Where a varying (differing) dose of tablets was prescribed the actual dose administered was not recorded. To help support the safe administration of medication it is important to show exactly what was administered. Where quantities of medication were brought forward from a previous months delivery this quantity was not recorded. Recoding the carry forward quantity will make it easier for the manager to track the safe handling of medicines at the home. Most administration records were pre-printed by the pharmacist but where handwritten entries were made these were not always signed and countersigned. We saw one example where doses of a medicine handwritten onto the medicines record had been given less frequently than prescribed. Signing, checking and countersigning records should help to reduce the risk of errors. We found that medicines were stored securely. This helps to ensure that they are not misused or mishandled. We checked the arrangements for storing and recording controlled drugs (medicines that can be misused) and found that the manager had bought a new controlled drugs cupboard, that will meet with current law once fitted. Medication handling is checked as part of the homes annual audit. These checks help to ensure medicines are safely handled in accordance with the homes policies. It is recommended that when any changes are made consideration be given to increasing the frequency of these checks. Care Homes for Adults (18-65 years) Page 4 of 8 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 Adults (18-65 years) Page 5 of 8 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 Adults (18-65 years) 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, 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 1 20 13 Complete, clear and accurate 06/02/2009 records of all medication administered must be maintained to help ensure medication is safely administered as prescribed. 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 20 Handwritten entries should be signed and countersigned to reduce the risk of errors. Quantities of any medicines carried forward from the previous month should be recorded to enable the safe handling of medicines to be tracked. Advice should be sought from the Primary Care Trust about the delegation of specialist medication tasks to ensure training and assessment is kept up-to-date. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 8 of 8 - 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!