Latest Inspection
This is the latest available inspection report for this service, carried out on 29th July 2010. CQC found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Newbury Manor Nursing Home.
What the care home does well The recording of the receipt of medicines had improved since the last inspection. What the care home could do better: The home needs to ensure that the administration records can demonstrate that the people who are using the service are having their medicines administered as prescribed. The home needs to ensure that the care plans have detailed information about the administration of medicines. The service must ensure that all medicines are stored at the correct temperature. The service must ensure that the staff administering medication to the people who use the service are safe and competent to do so. The home must ensure that the medication administration practices do not place people at risk Random inspection report
Care homes for older people
Name: Address: Newbury Manor Nursing Home Newbury Lane Oldbury West Midlands B69 1HE one star adequate 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: Ian Henderson Date: 2 9 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Newbury Manor Nursing Home Newbury Lane Oldbury West Midlands B69 1HE 01215321632 01215330727 Telephone number: Fax number: Email address: Provider web address: www.newburymanorhome.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Carol Ann Pearce Type of registration: Number of places registered: Conditions of registration: Category(ies) : Superior Care (Midlands) Limited care home 47 Number of places (if applicable): Under 65 Over 65 0 47 0 learning disability old age, not falling within any other category physical disability Conditions of registration: 1 0 1 The maximum number of service users who can be accommodated is: 47 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 (OP) 47 Learning disability (LD) 1 Physical disability (PD) 1 Date of last inspection 1 2 0 5 2 0 1 0 Care Homes for Older People Page 2 of 12 Brief description of the care home Newbury Manor is a purpose built home registered in 1997 to provide personal and nursing care to a maximum of forty seven older people. Superior Care took ownership in February 2002. The property is close to Oldbury town centre and the Midlands motorway network. The home has a large car park; a garden with a paved patio area and seating surrounds three sides of the building. There are two floors and two lifts. Single and double bedrooms each have a toilet and washbasin. Curtained dividers are provided for the privacy of people sharing rooms. All bedrooms are fully furnished and decorated, with profiling or divan beds according to need. There are sufficient bathrooms with assisted baths or showers and additional toilets. There are two lounges and a dining room on the ground floor, and private meeting rooms. On the first floor there is a lounge and kitchenette for people and visitors to help themselves to refreshments. Additional charges are made for hairdressing, some activities, toiletries and newspapers, if wanted. Information provided by the owner about fees indicated they ranged from GBP358 to GBP588 per week. The nursing element is retained by the home for people who are not self funders. For up to date information on fees people are advised to discuss the details when making enquires. Care Homes for Older People Page 3 of 12 What we found:
The reason for the visit was to assess whether the home had met the requirements set out in the Statutory Requirements Notice issued on the 7th July 2010. The home was required to comply with the notice by the 19th July 2010. The home was required to 1. Make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 2. Ensure that all medication administration records have clear directions about what to give and when. 3. Ensure that all care plans for the people using the service contain detailed information of the GPs directions for medicines to be administered PRN as needed or when required. 4. Put in place a written procedure for the administration of medicines which is monitored to make sure that care workers follow safe practice. In order to assess whether the home had complied with the Statutory Requirements Notice a number of medication and care records were examined. We found that the management of medicines was still poor and the Statutory Requirements Notice had not been complied with. We again examined a sample of the medication records along with the medicines present in the home in order to determine whether the home had systems in place to demonstrate that medicines were being administered as prescribed. The first person we looked was a person that we had looked at during the lasting inspection. We again found that the audit of this persons medicines identified a number of problems. We found with some tablets that were used to treat diabetes that the home had started the next months supply but had not recorded the receipt of this supply. We also found that on transferring the information from one administration chart to another the home had missed a date so there was a record of administration on the 27th and 29th July 2010 but no record of administration on the 28th July 2010. We found with another two medicines that the administration chart had not been signed on the morning of the inspection. We also found that the administration chart for one of the medicines had also not been signed on the morning of the 27th July 2010. The audit of these medicines indicated that the reason for the gaps in the administration record was that the medicines had not been administered. We found after the lunchtime medication round that the gaps present for both medicines on the morning of the inspection had now been filled in with the initials of one of the nurses on duty. The nurse on duty was spoken to about this and admitted that he had forgotten to give the tablets that morning so gave them during the lunchtime round. We also came across a problem that we had encountered at the last inspection and again it would appear that the medication administration record chart was being signed but the medication was not being administered. We found this with a dry powder inhaler that had been prescribed for this person. This particular inhaler had an indicator that showed the user how many doses were left before it ran out. The inhaler would have had 120 doses upon opening and the administration records showed that since opening a quantity of 96
Care Homes for Older People Page 4 of 12 doses had been administered. We would have expected therefore that the indicator on the inhaler would be showing that there were between 20 to 30 doses available for the users. We found that the indicator was showing that there was between 100 and 110 doses still available indicating that the inhaler had not been administered as prescribed. We found that nine analgesic tablets could not be accounted for. We also found that two dose of a when required medicine could not be accounted for. The manager said that the staff had probably removed them from the blister pack and then realised that the person concerned did not require them so had disposed of the tablets but had not made a record in the disposal record book. We also found no information in the care plan explaining to the staff when the when require medicine should be administered. The second person we looked at had been admitted to the home five days prior to the inspection for respite care. We found that the administration records were handwritten and there was an indication on each entry that a second member of staff had checked the information on each medicine against the handwritten entries for accuracy. We found that the quantity of each medicine had been recorded on the administration record. We however found that on the 27th July 2010 at 10pm the member of staff on duty did not complete the administration record for three medicines therefore the home was not able to evidence that the medicines had been administered. We found with the third person we looked at that the home had failed to record the receipt of one of the medicines. We found that some analgesic tablets had been prescribed with a variable dose of one or two tablets to be taken four times a day. We were unable to determine whether the administration record was accurate because the staff had failed to record what quantity had been administered on a number of occasions. We again found signatures missing from the administration record and therefore the home could not evidence that the medicines had been administered. We found with some tablets that were used to treat depression that the records showed that a dose was administered on the 13th July 2010 and the next dose was administered on the 17th July 2010. We were unable to determine through audit whether this medicine had been administered during this period because the audit trail was poor. We found that the carry forward system which accounted for medication being carried over from the previous month had not been fully completed and therefore we had to start the audit trail on the 16th June 2010. Over that period we found that 74 tablets had been present in the home and 40 of these tablets had been administered. We therefore expected to find 34 tablets remaining but we only found six tablets. We found a similar problem with some sleeping tablets in that 60 tablets had been present in the home and 15.5 tablets had been administered. We were able to account for 13 tablets which were either present in the home or had been recorded as being destroyed. This therefore meant that 31.5 tablets could not be accounted for. We also found further evidence of where the administration record had been signed but the medicines had not been administered. We found with a weekly injection that was used to treat anemia that four injections had been received and four injections had been administered so we expected not to find any injections present in the home. We however found one injection still present in the home therefore indicating that only three injections had been administered. The records for the last person we looked at were able to demonstrate that this person was receiving their medicines as prescribed except for some anticoagulant tablets. The records showed that 12 tablets had been received and 12 tablets had been carried over from the previous month making a total of 24 tablets available in the home. This particular tablet was only required to be administered on the Sunday of each week and
Care Homes for Older People Page 5 of 12 therefore the records showed that two tablets had been administered one on the 11th July and one on the 25th July. The administration record had not been completed for the 18th July 2010 so in order to try to determine whether the dose had been administered the quantity of tablets remaining was counted. If the dose on the 18th July had been administered we would have expected to find 21 tablets and if it had not we would have expected to find 22 tablets. We found only 10 tablets in the home and therefore we were unable to determine whether the correct dose had been administered on the 18th July 2010. We found no information in the care plan about how to deal with the risk associated with anticoagulant medicines. We found that the nursing staff had undergone further training since the last inspection but the home still did not have any evidence of an ongoing assessment programme to ensure that the staff that were administering medicines safely and in accordance with the homes policies and procedures. We found that the fridge temperatures were being measured and recorded on a daily basis. However the records showed that the fridge was not being maintained within the expected temperature range of between 2 and 8 degrees Celsius. From the 19th July to the 28th July 2010 the minimum temperature had been recorded at 1.2 degrees Celsius. Because of this the home was advised to discard any medicine that had been subjected to these low temperatures. As a consequence of a continued breach of the Care Homes Regulations 2001 with respect to the management of medicines the sampled medication records were seized under the provision of the Police and Criminal Evidence Act 1984. This evidence will be used to determine what course of action CQC will take to ensure standards with the management of medicines is improved. 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 6 of 12 Care Homes for Older People Page 7 of 12 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 9 13 Medication must be 22/04/2010 adminstered to the person it has been prescribed to as per clinicians orders. Any reason for omission must be recorded and the dlinician informed. 2 9 18 To ensure that staff are suitably qualified experienced and competent to safely administer medication before they administer medication to people who use the service. To ensure that people receive their medication as prescribed 12/07/2010 3 9 13 To make arrangements to ensure that medication is stored securely and at the correct temperature recommended by the manufacturer. To ensure that medicines remain safe and do not become contaminated. 12/07/2010 4 9 13 Staff must ensure that people living in the home receive their medication as prescribed and records demonstrate this. 22/04/2010 Care Homes for Older People Page 8 of 12 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 To ensure that people receive their medication as prescribed. 5 9 13 Appropriate information 12/07/2010 relating to medication must be kept for example in risk assessments and care plans to ensure that staff know how to use and monitor all medication including as directed and when required so that all medication is administered safely correctly and as intended by the prescriber to meet individual health needs. To ensure that people receive their medication as prescribed 6 9 13(2) Staff must ensure that people living in the home receive their medication as prescribed and records demonstrate this. To ensure that people receive their medication as prescribed. The home must carry out a risk assessment for people commencing work on an Independent Safeguarding Authority adult first check and take appropriate action to reduce any risks. To safeguard people living at the home. To ensure the safety and well being of people living in the
Care Homes for Older People Page 9 of 12 30/09/2009 7 29 19 12/07/2010 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 home 8 29 19 The home must carry out a 12/07/2010 risk assessment for people commencing work at the home that may have a positive Criminal Records Bureau check [CRB] and put the appropriate safeguards in place to reduce any risk, to safeguard people living at the home. To ensure the safety and well being of people living in the home Care Homes for Older People Page 10 of 12 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 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 Older People Page 11 of 12 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 12 of 12 - 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!
