Care Home: Phoenix House

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What the care home does well To help ensure staff understanding of the homes medication policies competency assessments are carried out. What the care home could do better: Medicines record keeping needs to improve to better support and evidence the safe handling of medication. Consideration should be given to completing written medicines audits to help ensure that the homes policies are consistently followed and that should any shortfalls arise, they can be promptly addressed. The procedure for ordering medicines outside the `normal` monthly medicines order should be reviewed to reduce the risk that medication may `run out`. Random inspection report Care homes for older people Name: Address: Phoenix House 54 Andrews Lane Formby Liverpool Merseyside L37 2EW 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: Stephanie West Date: 1 4 0 9 2 0 1 0 Information about the care home Name of care home: Address: Phoenix House 54 Andrews Lane Formby Liverpool Merseyside L37 2EW 01704831866 01704831866 phoenix_house@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sandra Farrell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Total Care Homes Ltd care home 30 Number of places (if applicable): Under 65 Over 65 0 20 dementia old age, not falling within any other category Conditions of registration: 10 0 The registered person may provide the following categories 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 (maximum 20) Dementia Code DE (maximum 10) The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home Phoenix House is a care home for thirty older people situated in a quiet residential street in Formby, close to a bus route and train station. The home is a converted and Care Homes for Older People Page 2 of 9 Brief description of the care home recently extended Victorian villa with a car park at the front of the building and a garden at the back. There are two communal lounges one having a dining area, there is also a separate dining room. Bedrooms are situated on ground and upper floors and there is a passenger lift for use by residents who are accommodated on upper floors. The home has assisted baths and shower rooms and does not have a hoist. Phoenix House is staffed throughout the day and night, providing personal care, home cooked meals and a laundry service. All residents are registered with a GP of their choice and are supported to receive the services of district nurses and paramedical services if needed.The weekly charge for this service is GBP398 - GBP420 with extra charges for chiropody and hairdressing. Care Homes for Older People Page 3 of 9 What we found: We carried out this visit to look at the homes medication arrangements following receipt of a concern about medicines handling. The visit lasted approximately three hours and involved discussing the handling of medication with the manager, and examination of medicines records and storage arrangements. At the end of the visit feedback was given to the manager. Overall, we found that generally suitable arrangements were in place for handling peoples medicines but we found some weaknesses in the medicines record keeping that need to be addressed to better support and evidence the safe handling of medication. We looked at medicines administration. We saw that people wishing to self-administer medication are supported to do so. But, written risk assessments and care plans were not always completed to show any support people may need to manage their medicines safely. This needs to be addressed to help ensure people always receive any support they may need. All other medicines are administered by staff who have completed certificated medicines training. The manager additionally carries out checks to confirm staff understanding of the homes medicines policy, helping to ensure consistency in the handling of medicines at the home. We looked at how information within peoples care plans supported the safe administration of medication. We found some individual written guidance for staff about the use of when required medicines but were concerned that on occasion this was missing. Written guidance is important to help ensure consistency in the use of when required medicines, when needed. Similarly, we found that there was sometimes a lack of written information about the use of prescribed creams, when and where they may be needed. We saw that advice from healthcare professionals was recorded but that it was not always easy to find because the homes separate dated record of contact with healthcare professionals was no longer maintained. This meant it was not always possible to evidence (track) changes to peoples medicines. This needs to be addressed to reduce the risk that any advice, especially about monitoring or follow-up may be missed. We looked at medicines record keeping. Records showing the administration of medication were generally up-to-date but there were some areas for improvement to ensure the completeness and clarity of these records: We saw that on occasion the reason was not recorded where doses of medicines were not given and occasional inaccurate records that incorrectly showed additional doses of medication had been administered. We found examples where records were not completed to show that creams had been applied. This meant that it was not possible to tell if they were being used correctly and must be addressed. We saw that records for the receipt and disposal of medication were generally clear and accurate. We looked at medicines stocks and storage. We saw that medicines were securely stored reducing the risk of miss-handling or miss-use. Unwanted medicines were sent to the pharmacy for safe disposal. But, we found that eye drops were not always dated on first opening, this is important to help ensure that they are replaced on time. We saw that generally adequate quantities of medication were maintained to allow continuity of treatment, but were concerned to find that where medication needed to be re-ordered outside the homes main monthly medicines order there was a risk that doses would be Care Homes for Older People Page 4 of 9 missed because there was none left. The homes procedures for ordering medicines outside the main monthly order need to be reviewed to reduce the risk of medication running out. The manager does not currently carry out written medication audits. This is recommended to help ensure that should any weaknesses arise, they can be promptly identified and addressed. 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 13(4) To keep people safe in the 14/08/2009 home, unnecessary risks to their health and safety (such as from door openings, bedrails and fire hazards) should be identified and as far as possible eliminated. 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 Where people self-administer 18/10/2010 medication written risk assessments and care plans must be completed to help ensure people receive any support they may need to safely manage their own medicines. 2 9 13 The medicines administration 18/10/2010 records must be completely and clearly completed to support and evidence safe medicines administration. 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 Consideration should be given to completing written medicines audits to help ensure that the homes policies are consistently followed and that should any shortfalls arise, they can be promptly addressed. The procedure for ordering medicines outside the normal monthly medicines order should be reviewed to reduce the 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 risk that medication may run out. 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. 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