Care Home: Pendale Retirement Home

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What the care home does well We found no significant strengths in the homes arrangements for handling medication. What the care home could do better: There need to be suitably trained and competent staff on duty at all times to enable medicines to be safely administered, when needed. The home`s medicines policy needs to be reviewed and staff competency assessed to ensure that people handling medication have the knowledge and skills to do so safely. Medicines record keeping needs to improve to support and evidence the safe handling of medication. Controlled Drugs must be handled and stored in accordance with current law. Random inspection report Care homes for older people Name: Address: Pendale Retirement Home 6/8 Greystoke Place Blackpool Lancashire FY4 1NR two star good service 04/05/2010 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: Stephanie West Date: 2 5 0 8 2 0 1 0 Information about the care home Name of care home: Address: Pendale Retirement Home 6/8 Greystoke Place Blackpool Lancashire FY4 1NR 01253342191 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Pendale Care Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only: Care home only: Code PC, 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. Date of last inspection Brief description of the care home Pendale Care Home provides 24-hour care and accommodation to 23 older people of both sexes. The home is situated in a residential area in the south of Blackpool and is close to the sea front. There is a small parking area for visitors at the front of the building. The home has 23 single bedrooms all with an en-suite facility. The ground Care Homes for Older People Page 2 of 8 0 4 0 5 2 0 1 0 Brief description of the care home floor comprises of two lounges and a dining room with the front lounge overlooking the Solarium Gardens and the promenade. The home has a passenger lift, which people can use independently. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is available from the owner to help people make an informed choice whether to move into the home. The range of fees at the home are three hundred pounds to three hundred and sixty four pounds and seventy pence covering all aspects of care, food and accommodation. The Home owner provided this information on the 4th May 2010. Hairdressing is provided free of charge unless people wish to make their own arrangements. Care Homes for Older People Page 3 of 8 What we found: The purpose of this visit was to look at the homes arrangements for handling medication to look at how concerns identified at our previous visit had been addressed. This visit focused on medicines handling, other areas were not examined on this occasion. We looked at care documentation within the home and the medication systems that were in place. We spoke with manager and staff who administered medication. At the end of the visit feedback was given to the manager. Overall, we found shortfalls in the handling and recording of medicines handling remained to be addressed putting peoples health and wellbeing at unnecessary risk. We looked at medicines administration. We were concerned to find that it was not clear who was responsible for handling and administering medicines at the home during each shift. The manager explained that the most experienced staff member should administer the medicines but then added that there was no reporting structure in the home, except to the manager. We saw that doses of medicine were sometimes missed, especially around lunchtime. Examination of the current medicines records showed that one person should have been having four daily doses of antibiotic but several doses had been missed. A lack of information about who is responsible for medicines administration increases the risk of this type of error. The medicines administration records showed that morning medicines were administered at 8:00 am. But, on our arrival at 9:45am no-one had been given their morning medicines. Staff on duty explained that this was because medicines were not given until after other duties; helping people get up, have breakfast and cleaning were completed. Because the actual time that medicines are administered is not recorded, there is a risk that where doses of the same medicine are repeated throughout the day they may be given too closely together. As seen at our previous visit the manager was unable to confirm that all staff handling medicines had completed certificated medicines training. But, arrangements had been made for staff handling medicines to attend an external medicines training course. In addition to completing this external training, the homes medicines policy needs to be reviewed and staff understanding and adherence to this policy assessed to help ensure consistency in medicines handling at the home. We compared a sample of medicines records and stocks. Since our previous visit the manager had arranged medicines reviews for all people resident at the home, confirming their current medication. There was also improvement in the arrangements for handling Warfarin, although a written protocol was still to be developed, written dose instructions were kept at the home and the dose given was clearly recorded. And, the manager had started to carry out checks (audits) of medicines stocks and records. One audit identified failure to administer a nighttime medicine to one person on four occasions. The manager explained that this had been discussed with the staff concerned and (see above) further medicines training was planned. But we found that doses of this medication had been missed on two further occasions. We were concerned to find other examples where medication was not given as prescribed, and that where doses were missed the reason was not recorded. For example, records showed that a nutritional supplement (sip feed) labelled once daily was given on only one occasion in the previous two weeks, although a stock check suggested that nine had been given. A second record showed a delay of four days in starting treatment for an eye infection and then no record of any further use Care Homes for Older People Page 4 of 8 beyond the first application. Another record showed that a short course of antibiotics had not been given correctly as prescribed. These errors put peoples health and well-being at risk. The medicines monitored dosage system was now used as intended and old stock has been sent to the pharmacy for safe disposal. But, written records had not been made for the most recent quantities of medicines sent for safe disposal. This needs to be addressed so that all medicines handling can be accounted for. The manager explained that additional supporting information about the use of medicines had not yet been included within peoples care plans. Written guidance for staff would help ensure consistency in the use of when required medicines and provide further information about the use of external preparations (e.g. creams) such as, where and when they may be needed. Since our previous visit the home had begun to handle controlled drugs (a class of medication with special storage and handling requirements). We were concerned to find that no record was made of the date or quantity of controlled drug received into the home. Additionally, the controlled drug was not stored in a controlled drugs cupboard (described in law) and the handling and administration of this medication was not witnessed. It is important that current law describing the safe storage and handling of controlled drugs is adhered to, to reduce the risk of mishandling or misuse. 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 8 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 Medicines must be administered as prescribed, supported by complete and clear record keeping to help protect peoples health and well-being. 16/08/2010 2 9 13 Suitably trained and competent staff must be on duty at all times to enable medicines to be safely administered, when needed. 16/08/2010 3 31 9 The person in day to day control of the home must apply to be registered with the Commission. This will ensure the home is being run for the benefit of the people who live there. 25/02/2010 Care Homes for Older People 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, 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 Arrangements must be made 30/09/2010 for the safe storage, handling and recording of controlled drugs to meet with current law. 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 7 of 8 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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