Latest Inspection
This is the latest available inspection report for this service, carried out on 19th April 2010. CQC found this care home to be providing an Good 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 Rebecca Court.
What the care home does well The service follows comprehensive systems for medicine management including frequent audits of medicines, checking staff competence and provision of training. What the care home could do better: The service has provided the Commission with a number of notifications related to medicine errors arising at the home, however, is taking action to prevent further errors. Records for the administration of medicines prescribed for external use could be improved. Random inspection report
Care homes for older people
Name: Address: Rebecca Court Rebecca Court 9 Staithe Road Heacham King`s Lynn Norfolk PE31 7EF two star good service 10/08/2009 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: Mark Andrews Date: 1 9 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Rebecca Court Rebecca Court 9 Staithe Road Heacham King`s Lynn Norfolk PE31 7EF 01485570421 01485572910 rebeccacourt@norfolk.gov.uk www.norfolk.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Glynda Jermy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Norfolk County CouncilCommunity Care care home 36 Number of places (if applicable): Under 65 Over 65 8 36 dementia old age, not falling within any other category Conditions of registration: 0 0 That Norfolk County Council undertakes a review of the windows with a view to replacement of those which are causing discomfort to the Service Users. The review to be carried out by the end of March 2004. Wheelchair users may be admitted only to rooms of at least 12 sq m, rooms numbered 10, 11, 24, 32, 33, 35, 36, 49, 50, 61, 62, 65, 66 & 67 as at 31 March 2003. Date of last inspection 1 0 0 8 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Rebecca Court is a care home providing personal care and accommodation for thirtysix (36) older people. The Home does not provide nursing care. The Home is owned by Norfolk County Council-Community Care. Rebecca Court is a large detached building set in its own grounds located in the village of Heacham, which is between Kings Lynn and Hunstanton. This is a non-smoking home for residents. Accommodation is in thirty-six single rooms on the ground and first floors. A small passenger lift is available. People have a financial assessment to determine how much it will cost them to live in the home. Information about the full current fee level is available in the guide to the home . Additional costs include chiropody, hairdressing, newspapers, magazines, toiletries, clothing and the payphone at varying costs. Care Homes for Older People Page 3 of 9 What we found:
The inspection of arrangements for the management of medicines was undertaken by the Commissions pharmacist inspector Mark Andrews by arrangment with the manager Glynda Jermy at short notice.The inspection follows a number of notifications received by the Commission related to medicine errors arising at the home. During the visit we looked briefly at arrangements for the storage of medicines. Backup stocks of medicines are held in locked cabinets in a ground floor office room. The manager informed us that the door to the room is also always locked and that a combination lock has recently been fitted, however, there were no arrangements in place to change the combination number regularly. The manager informed us that cabinets have been fitted in peoples rooms to store and secure their medicines. Since February 2010 oral medicines currently in use for all residents have been stored in the cabinets. We were informed that some errors have since arisen when members of staff have not checked each medicine round time if there are medicines scheduled to be administered. The manager said that members of staff are now asked to check each persons medicines in their rooms at each scheduled medicine rounds to ensure all medicines are administered as prescribed because some errors have arisen by members of staff not examining medicine administration charts properly in peoples rooms. We discussed how the arrangements for holding current medicine charts could be improved to enable members of staff to more easily check them at each scheduled medicine round. We examined recent medicine administration record charts and noted that external medicines are handwritten on separate MAR charts. The manager informed us this is because the pharmacy do not print them (or oral) medicines if they are not supplied at that 28-day cycle. We also noted that the medicine charts are not those usually provided by this pharmacy supplier and have a different coding system for the non-administration of medicines. The manager informed us that some errors had arisen when a peripatetic member of staff was working at the home from elsewhere within the organisation. The manager also confirmed some difficulties with staff using wrong codes to record the nonadministration of medicines. We also discussed if medicines not supplied in monitored dosage system (MDS) containers could be made more prominent on medicine charts to assist ensuring these medicines are not missed by members of staff. The manager also informed us that some MDS containers were not in the same order on their racks as medicine chart entries and that action is regularly taken to resolve this. We found that the home has extensive checking systems and records in place with many medicines checked daily and reports provided to the manager. Daily counts and records are in place for medicines not supplied in MDS containers. Medicines in MDS containers are checked at least weekly. Whilst we noted some omissions in records for the administration of oral medicines in the recent 28-day period, there were still many omissions in records for the administration of external medicines. The manager confirmed that this is an area needing further improvement and also some external medicines labelled directions differ with medicine chart entries. However she informed us that omissions in records for the administration of oral medicines had improved in the most recent two-week period. We also discussed the completion of a separate medicine round form for each person at each scheduled medicine round. Care Homes for Older People Page 4 of 9 The manager informed us that there are approximately 20 staff authorised to handle and administer medicines at the home. All staff authorised have been trained and their competence assessed. Assessment of staff competence includes observation four times by a competent person including full discussion on the stages of medicine administration procedure. The manager informed us that she has held staff meetings and also developed learning questions to test staff knowledge and is actively reviewing all competences. We discussed the workload impact of regular supervision processes for approximately 20 members of staff. The manager described internal performance management stages for staff involved in errors. The manager informed us that the home has a weekly GP visit and in addition Primary Care Trust pharmacists have undertaken medicine reviews and been involved in assisting medicine management issues. Outstanding statutory requirements made at previous inspections that are unrelated to medicine management at the service were not examined during this inspection. 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 7 13 Assessments, including about 11/09/2009 moving and handling people, must be kept up to date when things change. This is so people are not at risk of staff using equipment that is not of sufficient calibre to move them safely. This is so people are not placed at unnecessary or avoidable risk. 2 26 13 There must be arrangements 09/10/2009 to ensure the shifts of ancillary workers are covered. This is so care staff are not taken away from supporting service users in order to carry out cleaning tasks. This is so people are not exposed to increased risk of infections spreading. 3 27 18 The management team must 30/10/2009 re-assess peoples dependency and support needs at peak times of day and review staffing levels accordingly. This is so people can have support from staff when need it and in a reasonable Care Homes for Older People Page 6 of 9 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 time. This is so the manager can show there are always sufficient staff on duty to meet changing needs. 4 38 13 The hazards and risks presented by freely accessible antibacterial handwashes must be assessed. This is to see if any action is needed to promote peoples safety and reduce risks. This is to make sure they do not present a risk to confused people who may ingest or use them inappropriately. 5 38 13 The hazards and risks 16/10/2009 presented by open and accessible stairways must be assessed and recorded. This is to see if any action is needed to promote peoples safety and reduce risks. This is so the home makes sure people who may be confused, disorientated or over-estimate their abilities, are not placed at avoidable risk. 16/10/2009 Care Homes for Older People Page 7 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 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 It is recommended that arrangements are made with the supplying pharmacy to review the supply of medicine administration record charts to ensure parity with the service organisation and also to ensure monitored dosage system containers are always synchronised on their racks with chart medicine entries. It is recommended that further action is taken to improve records for prescribed external medicines It is recommended that arrangements are made to regularly change the medicine storage room door combination code It is recommended that arrangements are made for making current medicine administration record charts more easily accessible to members of staff when checking them each medicine round 2 3 9 9 4 9 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. 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 9 of 9 - 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!
