Care Home: Peel Gardens Nursing Home

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What the care home does well No significant examples of good practice when handling medicines were found. What the care home could do better: There should be an effective system in place to check medicines and staff competence to make sure medicines are handled safely. Medicines should only be given to people that they are prescribed for and should not be used as general stock because it is against the law and could lead to mistakes. For people that look after their own medicines a risk assessment and a care plan must be carried out to make sure their medicines are managed safely. Records of medicines received into the home and given to people must be accurate so that all medicines can be fully accounted for and to make sure they are safely handled. When necessary, information on how medicines should be used should form part of an individuals care plan to make sure they are given to people correctly. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Peel Gardens Nursing Home Off Vivary Way Colne Lancashire BB8 9PR 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: Simon Hill Date: 1 0 1 1 2 0 0 8 Information about the care home Name of care home: Address: Peel Gardens Nursing Home Off Vivary Way Colne Lancashire BB8 9PR 01282871243 01282871344 peelgardens@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: European Care (UK) Limited care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 45 0 Over 65 0 45 Conditions of registration: The service is registered to provide personal care to a maximum of 45 service users, 29 of whom may be in the category of DE (Dementia). Date of last inspection Brief description of the care home Peel Gardens has recently made changes to the registration and is now registered to provide personal care for a maximum of forty-five people; twenty-nine of who may be suffering from a dementia. The home is situated in a quiet residential area and there is adequate parking. Attractive lawned areas surround the home and there is a patio area that is accessible from the main lounge. There is also a sensory garden area with seating, raised flowerbeds and wheelchair access. All rooms were single occupancy and offered en suite toilets and hand basins. There is a passenger lift to access the first floor. There are a variety of communal areas in the home including two adjoining lounges and a separate dining room on the ground floor and a dining room and two Care Homes for Older People Page 2 of 9 lounges areas on the first floor. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. On the day of the inspection the fees ranged from £319.00 to £647.00. Items not included in the fee include newspapers, toiletries, hairdressing and private chiropody. Care Homes for Older People Page 3 of 9 What we found: The home was randomly selected for a visit by a pharmacist inspector to look at the arrangements for handling medicines. The visit lasted approximately five hours and involved speaking with the manager, two nursing staff, two care staff and a resident. We also looked at the arrangements for the storage and recording of medicines and gave detailed feedback to the manager at the end of the visit. Overall we found some shortfalls in medicines handling that need to be addressed to make sure medicines are handled safely. We looked at the records of medicines brought into the home and found these were not always complete, which made it difficult to check to see if they had been given to people correctly. There was no clear system of stock control and when we checked medicines stocks we found excessive amounts of some medicines that showed stock reordering was not well organised. We also found that some medicines prescribed to individuals were being used as general stock, this is against the law and could lead to serious mistakes. When we checked the records we found some were inaccurately completed because the exact dose of medicine given was not clearly recorded, we saw this for medicines with a variable dose and notably for a medicine used to prevent blood clots. We also found that the records were not always clear when medicines were not given to people, for example, if they were asleep or refused them. Accurate records of medicines given to people help make sure they can be fully accounted for and help prevent mishandling. We looked at how medicines were stored and found the rooms and trolley to be clean and tidy. A fridge was used for storing medicines that required cold storage and this was kept at the right temperature. However, we found excessive amounts of eye drops kept in the fridge for two different people that showed they may have been missed on numerous occasions. When we spoke with one of these people they were unsure whether they had been getting them and when we checked their current bottle it was twelve days out of date and still full. We also found an extra two bottles in the main stock cupboard that should have been stored in the fridge, which means they would have been spoiled and were not safe to use. We looked at a sample of care plans and records and found some good information about how peoples agitation and anxiety were to be managed. However, when medicines were prescribed as when required there was little or no information about how and under what circumstances they should be given. We saw some paperwork kept with the medicines records for when required medicines but this was not usually kept up to date and lacked the required detail. We discussed specific examples with the manager who agreed that some care plans were not detailed enough and she said that these would be reviewed and updated as soon as possible. This is important to help make sure people get their medicines when they need them. We checked how controlled drugs (medicines that can be misused) were stored and recorded. The cupboard was secure and a suitable special register was used for record keeping. The entries seen were accurate and always witnessed by two staff. Having Care Homes for Older People Page 4 of 9 witnessed records and secure storage helps prevent mishandling and misuse. We looked at how a person was supported when they looked after some of their own medicines and found the paperwork to support this was not detailed enough. No formal risk assessment had been carried out and a care plan had not been written, which could mean they would not get the right amount of support to handle their medicines safely. The manager said regular monthly checks were carried out by the deputy manager. However, these had not identified the shortfalls we had found and did not check in detail whether medicines were being given to people correctly because the current system of stock control was not good enough for this to happen. The manager also said no formal competency checks on staff were carried out. Having detailed audits and regular checks of staff competency help make sure medicines are given to people correctly and help make sure staff have the necessary skills to handle medicines safely. 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 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 1 33 13 Up to date policies and procedures must be accessible to all staff to support them with safe practice guidance. 02/06/2008 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, 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 9 13 For people that look after their own medicines a risk assessment and a care plan must be carried out. This will help make sure people receive the right amount of support to manage their medicines safely. 12/12/2008 2 9 13 Records of medicines received into the home and given to people must be accurate. This will make sure medicines can be fully accounted for. 12/12/2008 3 9 24 There should be an effective system in place to check medicines and staff competence. This will make sure sure medicines are handled safely and make sure staff have the necessary skills. 12/12/2008 4 9 13 Medicines should only be 12/12/2008 given to people that they are prescribed for and should not be used as general stock. Page 7 of 9 Care Homes for Older People This is against the law and could lead to serious mistakes 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 When necessary, information on how medicines should be used should form part of an individuals care plan to make sure they are given to people correctly. Care Homes for Older People Page 8 of 9 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 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: 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 © (2008) Commission for Social Care Inspection (CSCI). 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