Latest Inspection
This is the latest available inspection report for this service, carried out on 14th June 2010. CQC found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Millbrook Lodge.
What the care home does well Suitable secure storage is available for medicines. Medicines are given by trained staff. A system of auditing medicines is available in the home, which can be used to improve standards. What the care home could do better: Improvements are needed to ensure that complete and accurate records are kept of of the administration and disposal of medicines. If medicines to be prescribed regularly are not given a reason must be recorded. This is to ensure that medicines are given as prescribed. Action is needed to ensure that arrangements for the ordering and supply of medicines are robust and reliable so that prescribed medicines are available for administration. Advice from the national patient safety authority (NPSA) about the safe use of one particular medicine should be available in the home. To make sure that people`s health is protected. Clear guidance should be available for medicines prescribed to be given "when required" to ensure that they are given consistently and appropriately. Action is needed to ensure that medicines supplied in standard packs can be more easily audited, to check that they have been given correctly. Random inspection report
Care homes for older people
Name: Address: Millbrook Lodge Moorfield Road Brockworth Gloucester Gloucestershire GL3 4EX two star good 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 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 6 2 0 1 0 Information about the care home
Name of care home: Address: Millbrook Lodge Moorfield Road Brockworth Gloucester Gloucestershire GL3 4EX 01452863783 01452862643 manager.millbrook@osjctglos.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Louise Samantha Turley Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Orders of St John Care Trust care home 80 Number of places (if applicable): Under 65 Over 65 80 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 80. The registered person may provide the following category of service only: Care home with Nursing - Code N 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 Millbrook Lodge is a care home for eighty older people that provides personal and nursing care, and respite care if required. It is situated in Brockworth on the outskirts of Gloucester, is located close to local amenities, and is managed as part of The Orders
Care Homes for Older People Page 2 of 10 Brief description of the care home of St John Care Trust. The accommodation has been purpose built with a new extension opened recently. The accomodation is divided into four units Birdlip, Robinswood, Coopers View and Leckhampton. Residents private accommodation is provided in single rooms on both floors, and there are spacious and easily accessible toilet facilities conveniently situated. There are two small lounges and a dining room on each of the units. Information about the home is available in the Service User Guide, called the Residents Handbook, which is issued to prospective residents. A copy of the most recent CSCI (now CQC, Care Quality Commission) report and the statement of purpose are available in the home for anyone to read. The charges for Millbrook Lodge range from GBP678 to GBP928 per week and the home also can admit residents at the contract rates from the Local Authority. Hairdressing, chiropodist, optician, and toiletries are charged at individual extra costs. Care Homes for Older People Page 3 of 10 What we found:
The pharmacist inspector carried out this inspection to look at some concerns raised about the handling of medicines in the home. During the inspection we, the Care Quality Commission (CQC), spoke with the registered manager and the head of nursing care. We also spoke to senior staff on each of the four units in the home. We looked at how medicines are stored and the records kept of the receipt, administration and disposal of medicines. We found that some improvements are needed in the handling of medicines in the home to ensure that medicines are always available and given as prescribed. People living in the home are all registered with one local doctors practice and a doctor visits the home to see people two days a week. Prescriptions are checked by staff at the home before being sent to the pharmacy. Medicines are supplied to the home using a monthly blister pack system. A small number of people are able to look after their own medicines. The home has a policy and risk assessment in place to ensure that people are safe to do this. Most medicines are looked after and given by staff from the home. Birdlip, Robinswood and Coopers View provide nursing care and medicines are given by nursing staff. Senior care staff are trained to give medicines on Leckhampton, although staff told us that night time medicines on this unit are given by nurses. Care staff involved with giving medicines receive training and the head of nursing care checks that they are competent to carry out this task safely. The head of nursing care showed us some audits she had carried out on some units to check whether medicines are being given as prescribed with appropriate records kept. She had noted a number of improvements that were needed. She told us that she planned to do an audit on each unit once a month. We looked at the blister packs on each unit and at several medicines supplied in standard packs to check that they had been given as recorded. We saw some discrepancies but it was difficult to check some of the medicines in standard packs because it was not clear when they had been started. Action should be taken to ensure that medicines supplied in standard packs can be more easily checked to see that they have been given correctly. The pharmacy provides printed medicines administration record (mar) sheets for staff to complete when medicines are given. We looked at the mar sheets on each of the four units. We saw that where handwritten additions had been made they had been signed, dated and checked by a second member of staff to reduce the risk of mistakes. Where medicines had been prescribed with a variable dose the amount given had been recorded. However we also noted that some improvements were needed, as had been noted in the homes own audits. On three units we saw some gaps in the administration records. This means that it was not clear whether the medicine had been given or not. In some cases the blister for the medicine was empty suggesting that it had been given but not recorded. If a medicine is
Care Homes for Older People Page 4 of 10 prescribed regularly but not given, a reason must be recorded. Many creams and ointments are applied by carers in peoples rooms and recorded in the care file. We looked at one persons record and saw that this had not been completed fully, so it was not clear that these had always been used. We saw four instances where a medicine had been marked as being out of stock for two or more days. Action is needed to ensure that procedures for ordering medicines are robust so that prescribed medicines are always available. We saw that for several people a medicine used to reduce acid in the stomach had been prescribed to be given when required but there was no guidance available for staff about how to judge if it was required. Staff told us that they intended to check with the doctor whether these medicines should be given regularly. We saw that for some medicines prescribed to be given when required there was no information with the administration record to explain what the medicine was to be used for. This means that it may not be given consistently or appropriately. We saw that one person had been prescribed two eye preparations but there was no indication about whether these were for one eye or both. This means that these could be given incorrectly. One person is prescribed a medicine which requires more careful monitoring. We were concerned that information from the National Patient Safety Agency about the safe use of this medicine was not available in the home and advised that this information should be obtained. Records are kept of the receipt of medicines into the home. We also saw records of the disposal of medicines. One unit had a bottle of waste tablets, which people had not wanted to take. A form was available to record these medicines but this had not been completed. Action should be taken to make sure that records are kept of the disposal of these medicines so that there is a clear audit trail of all medicines used in the home. Each unit in the home has secure storage for medicines including a medicine fridge and suitable storage for controlled drugs which need additional security. Records for these medicines kept on each unit showed they had been looked after appropriately. Daily records of both fridge and room temperatures showed that these were suitable for safe storage of medicines. What the care home does well: What they could do better:
Improvements are needed to ensure that complete and accurate records are kept of of the administration and disposal of medicines. If medicines to be prescribed regularly are not given a reason must be recorded. This is to ensure that medicines are given as
Care Homes for Older People Page 5 of 10 prescribed. Action is needed to ensure that arrangements for the ordering and supply of medicines are robust and reliable so that prescribed medicines are available for administration. Advice from the national patient safety authority (NPSA) about the safe use of one particular medicine should be available in the home. To make sure that peoples health is protected. Clear guidance should be available for medicines prescribed to be given when required to ensure that they are given consistently and appropriately. Action is needed to ensure that medicines supplied in standard packs can be more easily audited, to check that they have been given correctly. 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 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 7 of 10 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 Make sure that advice from 14/07/2010 the National Patient Safety Agency about the safe use of one particular medicine is available in the home. To help to protect the health of people taking this medicine 2 9 13 Action is needed to ensure 14/07/2010 that arrangements for the ordering and supply of medicines are robust and reliable. To ensure that medicines are available for administration. Action must be taken to ensure that complete and accurate records are kept of the administration and disposal of medicines. If medicines to be prescribed regularly are not given a reason must be recorded To ensure that medicines are given as prescribed 14/07/2010 3 9 13 Care Homes for Older People Page 8 of 10 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 Action should be taken to make it easier to audit medicines supplied in standard packs. So that staff can check that they have been given correctly. Action should be taken to ensure that clear guidance is available for all medicines prescribed to be given when required so that staff can give these consistently and appropriately. 2 9 Care Homes for Older People Page 9 of 10 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 10 of 10 - 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!
