Care Home: Regency Court Nursing and Residential Centre

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What the care home does well There were some care plans that had been reviewed and reflected the needs of the individual. The home is aware of the action needed to safeguard individuals who live there. What the care home could do better: Care plans must be reviewed and rewritten to ensure that staff have the most up to date information in order to support individuals. Medication records must be kept for all medication this includes when a variable dose is given, why an `as required` medication is given, why a medication is not administered, and a safe and appropriate method of disposing of pain relief patches which is in line with current guidance. Random inspection report Care homes for older people Name: Address: Regency Court Nursing and Residential Centre 18/20 South Terrace Littlehampton West Susex BN17 5NZ 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: Val Sevier Date: 1 7 0 6 2 0 1 0 Information about the care home Name of care home: Address: Regency Court Nursing and Residential Centre 18/20 South Terrace Littlehampton West Susex BN17 5NZ 01903715214 01903732982 gill.rankin@bupa.com www.bupacarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gillian Rankin Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes Ltd care home 50 Number of places (if applicable): Under 65 Over 65 50 0 old age, not falling within any other category physical disability Conditions of registration: 0 50 The maximum number of service users to be accommodated is 50 The registered person may provide the following category Of service: Care home with nursing(N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Physical disability (PD) Date of last inspection Brief description of the care home Regency Court is a care home, which is registered to accommodate up to fifty residents in the category (OP) old age, not falling within any other category. This Care Homes for Older People Page 2 of 9 Brief description of the care home includes five residents who are over 50 years of age and who within the category (PD) physical disability. It provides personal and nursing care. Regency Court is a detached five storey, which provides accommodation in bedrooms located on each floor. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. Other smaller lounges are also available on other floors. The property is located in the town of Littlehampton close to the seafront. The fee levels ranged from £450 to £710 per week at the time of the last inspection. Additional charges are made for the following services: chiropody, hairdressing, dentist, optician, telephone, newspapers. The registered provider is ANS Homes Ltd, who have appointed Mrs Moira Baxter to be the Responsible Individual and to supervise the overall management of the care home. There is a manager in post and she recently had an interview with the commission to be registered. Care Homes for Older People Page 3 of 9 What we found: The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The visit was carried out on the 17th June 2010 between the hours of 10:50 and 3:20 pm. Prior to the visit to the home we reviewed, previous inspection reports and information received from the home since it was last visited in June 2007. We met with the registered manager, and three members of staff. We looked at four care plans and medication records. In the care plans we saw that there was information on family and social support. There was information on how staff should support the individual. There was information on care when an individual was being looked after in bed to help with pressure relief. We saw that two care plans had not been reviewed monthly and information in the plan of care did not reflect current support needs. For example we saw for one individual who had been seen by a health professional earlier this year regarding their difficulty to swallow, a recommendation that a pureed diet be given and that fluids be thickened to a stated grade of thickness. The care plan did not reflect this although when the plan had been reviewed it said that a pureed diet was needed and fluids be thickened it did not give staff information on how they would do this. We saw assessments for risk, moving and handling, nutrition, and tools used to monitor individuals pressure areas and support needs such as Barthel and Waterlow. These documents had not all been reviewed monthly. There was information on what was important to the individual with the addition of likes and dislikes these included environment and activities as well as food. There was information on how staff were to support the individual with their physical difficulties and what action they should take medically. However we saw that for one individual where it was requested that they be weighed monthly due to issues there were no records for the months February to May this year. We did not see plans of care where an individual required pain relief either regularly or when there was additional as required pain relief available. We looked at the medication storage and administration records. We saw the medication records for the month up to and including the day of the visit. There are three medication trolleys; one on each floor of the home all were attached to the wall and kept locked in a clinic room or store room. We saw that the home has Temazepam, Buprenorphine and Fentanyl patches stored as a controlled medication and these were kept locked in locked cabinet in the downstairs clinic room. We saw a list of staff names who are deemed competent to administer medication. We saw copies of BUPA policies and procedures for medication. This included a policy on out of stock medication and an as required medication protocol. The home has recently changed their medication supplier and they were advised to have a method to monitor the administration of topical creams. This has not been done. We Care Homes for Older People Page 4 of 9 also saw that there were five gaps where there was no record of whether a medicine had been offered. When an as required medication has been given there was not always a record of reason, effect and outcome for the individual in the medication records. There was not always a record of how many tablets were given when there was a variable dose to choose from. We saw that for one individual a medication was out of stock for three days. We discussed this with the manager who said that the chemist had not been able to source it although they had been given a months notice. She will monitor this as another chemist had to supply it. We asked a nurse how she disposes of a pain relief patch when she changed it , she told us that it was put into the sharps container. We spoke with the manager about a method of disposal which be in line with guidance from the Royal Pharmaceutical Guidelines. In one of the medication stores we saw a container with several items for different individuals in it; for example insulin, and inhalers. The manufacturers have stated on the box for the insulin that it needs to be refrigerated the manager said that the chemist had sent guidelines differing to this. We also looked at other recommended storage instructions which included do not store above 25 degrees C. We saw that the room temperature records ranged between 24 and 26 degrees C. We also asked why these medications were not locked away. The manager said she would look into this. We spoke with the manager regarding the safeguarding allegation that is being investigated at the moment by social services. The manager was able to state what was being done by the home and social services to ensure the safety of people who live in the home. Staff have received training in safeguarding. The manager started at the home in January 2010. She has applied to be registered with the commission and had her interview earlier this month. We were able to discuss the new ways of working post October and current events at the home. 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 £ No R 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 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 7 15 15 Schedule 3 17/08/2010 The registered person must ensure that the action in the care plans is carried out. To ensure that the needs of individuals are met and monitored. 2 7 15 15 Schedule 3 The registered person must ensure that care plans are regularly reviewed and reflect the needs of the individual. To ensure that staff have relevant information to meet support needs. 17/08/2010 3 9 13 13 (2) The registered person must ensure a record is kept of when a prescribed cream or lotion is administered. To ensure safe practice and that the individual receives the correct medication 17/07/2010 4 9 13 13 (2) 17/07/2010 Page 7 of 9 Care Homes for Older People 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 The registered person must ensure that medication administration records are kept for when, why and outcome of an as required medication and the amount when there is a variable dose. To ensure safe practice. 5 9 13 13 (2) 17/07/2010 The registered person must ensure that pain relief medication is disposed of safely in line with guidance from the Royal Pharmaceutical Guidelines. That there is a policy in place and staff are aware of what they have to do. To ensure safe practice. 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 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. 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