Care Home: Marple Dale Hall Nursing Home

What the care home does well Some medicine records were clear and correct and there were some examples of good practice. eg. there was a note to withold a resident`s medicine for cholesterol whilst taking an antibiotic that interacts with it. This ensures that the resident is not made ill by taking medicines that interact. The drug storage situation is being addressed. This will help staff store medicines in an organised way so that medicines are available when needed. It will also help staff to check medicines when reordering to avoid overstocking and to ensure all medicines are within their shelf life and in good condition. What the care home could do better: The storage facilities should be improved without delay to ensure staff can organise the medicines well. Handling and recording medicines should be improved so that residents are given the correct dose of the correct medicine at the correct time. A system of audit and supervision should be implemented without delay to ensure residents have their medicines safely. Random inspection report Care homes for older people Name: Address: Marple Dale Hall Nursing Home Dale Road Marple Stockport Cheshire SK6 6NL two star good service 08/10/2009 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: Elaine Bray Date: 0 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: Marple Dale Hall Nursing Home Dale Road Marple Stockport Cheshire SK6 6NL 01614490771 Telephone number: Fax number: Email address: Provider web address: www.barchester.com/oulton Name of registered provider(s): Name of registered manager (if applicable) Mr Joshua Henley-Adams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 86 Number of places (if applicable): Under 65 Over 65 0 86 0 learning disability old age, not falling within any other category physical disability Conditions of registration: 86 0 86 The maximum number of service users who can be accommodated is: 86. 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. Learning disability - Code LD. Physical disability - Code PD. Date of last inspection Care Homes for Older People 0 8 1 0 2 0 0 9 Page 2 of 9 Brief description of the care home Marple Dale Hall Nursing Home is a care home that provides 24 hour nursing care and accommodation to 86 people. The home is split into three separate units, the Main Hall, the Balmoral Unit and Clarence House. Marple Dale Hall nursing home is owned by Barchester Healthcare Homes Limited and they also own another home on the same site called The New Windsor nursing home. The two homes have the same manager and the policies, procedures and organisational records and paperwork within the two homes are the same. Clarence House offers a specialised service to three residents with a history of brain injury. The Main Hall and Balmoral units offer nursing care and personal care for people. Marple Dale Hall is situated on Dale Road, a quiet leafy residential road approximately half a mile from Rose Hill railway station in Marple. Local bus services and shops are also available fairly close by.A long driveway leads to a car park and the different entrances to each of the suites can be accessed from here. The home has accessible garden areas and patios, which are bordered by woodlands and open countryside. Assisted bathing facilities are available throughout the home.There are a selection of lounges and dining rooms. The current weekly fees start from £327 upwards depending on the package of care required. Further details regarding fees are available from the manager. Additional charges may also be made for hairdressing, chiropody and other personal requirements. Care Homes for Older People Page 3 of 9 What we found: We carried out a specialist pharmacist inspection to see how safely medicines were handled on the three units, Main Hall, Balmoral and Clarence. We looked at how medicines were stored and found that each unit had secure facilities for storage and for taking them to the residents. This means that residents medicines are safe and only authorised staff can get to them. Whilst Clarence and Balmoral had sufficient storage, the Main Hall had only limited space for the quantities of medicines held. This can cause problems when staff cannot find the medicines they need. Also, checking the medicines for reorder or expiry dates would be very difficult. We were informed that a larger room was in the process of being refitted with new medicine cupboards to overcome these problems. The medicines facilities on Balmoral were also being made bigger. Clarence had enough storage. We also noticed that the cupboard on Balmoral that is used to store controlled drugs (those medicines, like very strong painkillers, that are liable to abuse) is not to the specification required by law. During the inspection we were shown a fax copy, ordering a suitable one. Seperate fridges were kept for medicines and both were running at a suitable temperature. Records of their temperatures were made on most days but they did not note the maximum and minimum temperatures. These can be obtained by using a special thermometer to be sure that the fridge temperatures stay within a safe range. This means staff can be sure that medicines needing cool storage are fit to use. We then looked at how medicines were handled and recorded. The medicines, where possible, were packed into calendar packs by the pharmacy so that staff can see at a glance which have been used. Other medicines are in standard containers. We observed both nursing and care staff taking medicines to residents. Some residents were having their morning medicines very late, close to lunchtime. When medicines are not given at the prescribed time residents may have unwanted effects as the blood level of the drug is not stable. Also, these medicines were recorded given at the earlier time which is very misleading. All medicines given to residents are recorded on a printed form provided by the pharmacy. It is important that these are accurate to show that the medicines have been given safely. All medicines must be recorded when received into or leaving the home. This makes it easy to show that the correct number of doses have been given. These records are not always made to a satisfactory standard. Where records were omitted or not clear it was not possible to prove that the resident had been given the correct dose of their medicines. It is quite common for medicines, such as pain-killers, to be prescribed with a dose that can vary according to the residents needs. As many have a maximum safe daily dose it is important for staff to record the actual dose given each time. This was not always done properly. It is also important for the dose of some medicines to be constantly under review, according to the results of blood tests. This was not always recorded clearly and correctly. Some residents records included additional notes, eg. stock counts of pain-killers used when needed, anticoagulant records. Some were well done, some poorly done. There were other documents in with the records, which, whilst useful, would be better kept in the residents file to streamline the number of pages to search. eg carbon copies of the records used for reordering, communications with the doctor or pharmacist. Care Homes for Older People Page 4 of 9 The standard of medicines management was very variable. It appears that, currently, the systems in place are not always followed. Medicines are managed by registered nurses whose training includes medicines. Staff carrying out personal care have had training to handle medicines correctly. After the inspection we were informed that a Care Manager had just been appointed to ensure that all staff follow the safe practice required. 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 38 23 Staff must receive sufficient 30/11/2009 training in fire safety and use of fire fighting equipment including participating in fire drills. This will ensure that staff understand the procedures that need to be followed to maintain the safety of themselves and people living in the home in the event of a fire. 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, 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 Ensure that medicines are 16/08/2010 given and recorded correctly. To protect the health and well-being of the residents 2 9 13 Ensure that the handling and 16/08/2010 recording of medicines is closely supervised by a senior member of staff. To ensure residents health is protected by ensuring that all staff follow the correct procedures 3 9 13 Ensure all medicines are 16/08/2010 stored in an organised way in appropriate facilities. To ensure that residents medicines are always available and in good condition Care Homes for Older People Page 7 of 9 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 The maximum and minimum temperatures of the medicine fridges should be recorded every day to show that residents medicines have been stored within the correct temperature range. 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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