Care Home: Manor Barn

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What the care home does well Good records for medication are kept and show that people receive correct treatment to keep them well. Regular checks of medication are done that show that it is handled safely. People are able to look after and take their own medication where they choose to and where it is safe to do so and are monitored properly. This helps them to remain independent. What the care home could do better: The service must obtain appropriate storage for the safe keeping of medicines liable to misuse, called Controlled Drugs, and a bound register for recording them. However, as no such medicines have been stored for a long time no requirement will be issued as a result of this visit. Care plans could contain more detail on long term medication condition especially those that may require emergency treatment to show that staff know action to take. Residents files could contain more detail of contacts with health care professionals so that changes to medication are more easily tracked. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Manor Barn Wattsfield Lane Kendal Cumbria LA9 5HF The quality rating for this care home is: The rating was made on: two star good service 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: Angela Branch Date: 2 8 1 0 2 0 0 8 Information about the care home Name of care home: Address: Manor Barn Wattsfield Lane Kendal Cumbria LA9 5HF 01539739108 Telephone number: Fax number: Email address: Provider web address: shelley.stokes@oakleatrust.co.uk Name of registered provider(s): Type of registration: Number of places registered: The Oaklea Trust care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability 2 0 Over 65 3 4 Conditions of registration: The home is registered for a maximum of 5 service users to include: up to 2 service users in the category of LD (Learning disabilities) up to 3 service users in the category of LD(E) (Learning disabilities over 65 years of age) up to 4 service users in the category of PD(E) (Physical disabilites over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection Brief description of the care home Manor Barn is a converted barn, in a residential area of Kendal, Cumbria within walking distance of the amenities of the town centre. It is registered to provide residential care for five people with a learning disability, some of whom may have elderly needs or a physical disability. The accommodation is on three floors. There is ramped access to the property from a car park at the front of the building. There is a small garden to the front and a larger private garden to the rear of the building, which leads to a riverside Care Homes for Adults (18-65 years) Page 2 of 8 walk. On the lower ground floor there is a self-contained flat, this has a lounge with a small kitchen/dining area, a single bedroom with fully accessible en-suite toilet and shower facilities. Also situated on the ground floor but separated from the registered accommodation, are several rooms used as offices by the Trust. The middle floor has three single bedrooms, two of which have en-suite facilities and showers. There is a large lounge/dining room leading to a kitchen and utility room. The upper floor has a self-contained flat with a single bedroom, with en-suite facilities and a lounge with kitchenette. Also on this floor is a staff sleep-in room, which is also used as an office. The fees for the home are currently £660, with additional charges made for personal expenses such as toiletries. Inspection reports are made available to residents and their representatives on request. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: The home was selected for a random check of the way that medication was handled. The pharmacist inspector assessed this through inspection of relevant documents, storage and meeting with staff. The inspection took three hours. Feedback was given at the end of the inspection to senior staff. Overall we found that medication is well managed so that peoples health and wellbeing are protected. We found that records for receipt, administration and disposal of medication were very well kept with only rare signature omissions on the administration records. This means that the treatment received by the people who lived there was clear. The records for administration of when required medicines that were not needed regularly, such as painkillers, were signed at each medication round. If they were not needed then the code F was used to show this. However, where this is recorded four times a day on the administration record it leaves little space to record when medicines are administered at other times of the day. It was suggested that, for when required medicines only, the administration records be signed when they are administered, and not every time they are offered, to reduce confusion and allow space for clear records to be made when they are given. Most medication was received from the pharmacy who packed them down into monthly blister packs. Some medicines were received in original packaging. In these cases the service kept balance sheets for the medications so that they could continually monitor them. This meant that all medicines could be accounted for and low stock levels prompted the ordering of medication so that they did not run out. We counted most medicines and compared them with records. With the exception of one missing tablet, all balances were correct showing that medicines were administered as intended. Care plans in relation to medication were checked for all people living at the service. All people gave consent, where appropriate, to their medication being stored on their behalf and administered by staff and this was recorded. There was also information recorded for each prescribed medication including their uses and side effects to watch for. When medicines were prescribed on a when required basis, such as painkillers, protocols were in place for staff to follow to make sure they were given appropriately. Seizure charts were kept for people with epilepsy to monitor the frequency of and type of fits. However, care plans would benefit from more detail on how to manage people with long term medical conditions especially those that could require emergency treatment to show that staff are prepared and know action to take. People were able to look after and take their own medicines when they wished and this helped them to remain independent. Risk assessments were in place and included monitoring arrangements to make sure people were kept safe. Records showed regular checks of medication by staff. We saw records of contact with health care professionals such as doctors. Sometimes these were in residents own files and sometimes in the contacts book though on occasions these were not always transferred into residents own files. This can make tracking of medication changes difficult. On occasions the information was incomplete. For example, a resident had been prescribed new medication but this had not been Care Homes for Adults (18-65 years) Page 4 of 8 started immediately. Staff said that the doctor had given instructions not to start it until the beginning of the next month. The record in the contacts book said not to start medication until this time but did not record that the doctor gave this instruction. It is recommended that residents files contain all details of contacts with health care professionals so that changes to medication can be tracked easily. The storage of medication was good. The service did not have any medicines liable to misuse, called Controlled Drugs, and did not have a Controlled Drugs cabinet or a bound register to record them. New regulations now require all care homes to have storage for Controlled Drugs. Since this service has not had any such medicines for years and there are no other major concerns around medication there will be no requirement made as a result of this visit. However, the service must obtain a Controlled Drugs cabinet that complies with the regulations and a bound register and this will be checked at the next inspection. A requirement will be issued at the next visit if suitable storage has not been obtained. All staff who administer medication had received training in the task. We spoke to a member of staff who had recently joined the service. She said that she was not allowed to administer medication until she had been trained in safe medication handling. During the inspection trained staff left the service for a short time leaving no staff on duty who were trained in the administration of medication. We asked staff how medication would be administered safely if it were needed during this time. We were told that backup arrangements were in place and that trained staff from the home next door, that belonged to the same organisation, would come over to give medication if necessary. 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 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 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. 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