Care Home: Reuben Manor

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What the care home does well Good systems and working practices mean that people living in the home can expect to receive their medicines correctly and safely. What the care home could do better: Staff who apply creams should make their own daily records. The manager should decide how best to record the use of medicines prescribed `when required` so that all staff do this consistently. Random inspection report Care homes for older people Name: Address: Reuben Manor 654 Yarm Road Eaglescliffe Stockton on Tees TS16 0DP one star adequate service 17/11/2009 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: Steve Baker Date: 1 2 0 7 2 0 1 0 Information about the care home Name of care home: Address: Reuben Manor 654 Yarm Road Eaglescliffe Stockton on Tees TS16 0DP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Julie Peyton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Silk Healthcare care home 83 Number of places (if applicable): Under 65 Over 65 0 30 0 dementia old age, not falling within any other category sensory impairment Conditions of registration: 58 0 0 The maximum number of service users who may be accommodated is 83 The registered person may provide the following category of care service only: Care home with nursing- Code N. To service users of the following gender: Either whose primary care needs on admission are within the following categories: Old age not falling within any other category : Code OP 83. Dementia Code DE 83 Date of last inspection 1 7 1 1 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Reuben Manor is a purpose built; three storey 83 bedded care home providing both nursing and personal care. The home has seperate units, called suites for the four different categories of care. All bedrooms are single rooms. There is a good amount of communal space on all three of the floors as well as very pleasant gardens. The home is situated at Eaglescliffe, in close proximitiy to public transport and other public amenities. Care Homes for Older People Page 3 of 9 What we found: We carried out this inspection to find out what actions had been taken to make sure medication practices were of a high standard. We did this in response to concerns raised following information we received since the last inspection of the home. A pharmacist inspector spent five hours in the home looking at the medicines ordering, storage, handling and disposal arrangements. We also looked at medication administration records (MARs), some care files and spoke to the manager and senior staff on duty. The outcome is as follows. We found the systems for ordering, receiving, storing and disposing of medicines to be good. The standard of record keeping has also improved since the last inspection. Good working practices with local healthcare professionals help to ensure peoples health needs are being met. The previously issued medication requirements were met at the time of this inspection. No significant administration gaps were seen on the MARs suggesting that people living in the home can expect to receive their medicines correctly. We were told, however, that senior staff and nurses sometimes signed the MARs for other staff who had applied prescribed skin care products. The manager agreed to make sure that records of the use of skin creams were made in a timely and accurate manner by the staff responsible. Clear and detailed information is available to guide staff how and when to give those medicines prescribed when required. Despite this we found some inconsistent practice between staff in how the use of these medicines were recorded on the MARs. The manager agreed to make sure all staff followed current professional guidance in this respect. We found good records of the use of those medicines needing regular blood tests. The MARs showed that NHS directions for dose changes were followed quickly and accurately so that peoples health needs were met. Improvements made to the medicines ordering and checking systems mean that sufficient medicines are now always available when needed. Since the last inspection, the medicines storage rooms have been equipped with air conditioning units. This makes sure medicines are kept at temperatures recommended by the manufacturer so staff know they are safe to use. In the light of recent concerns raised about medicine safety, the management team has supported staff with additional information and training about the safe use of medicines. This means staff should know exactly what is expected of them and regular checks of their work are carried out to make sure any new problems are resolved quickly. All medicines management systems have been checked recently by local NHS pharmacy staff and some further improvements have been suggested. The management team told us they are totally commited to putting the necessary arrangements in place to ensure medicines in the home are given correctly and safely at all times. What the care home does well: Care Homes for Older People Page 4 of 9 Good systems and working practices mean that people living in the home can expect to receive their medicines correctly and safely. 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 18 18 All staff must receive Protection of Vulnerable Adults training. This will ensure that the safety, wellbeing and welfare needs of people living at the home are protected. 31/12/2009 2 30 18 Staff must receive appropriate induction training on commencement of employment. This will ensure they have the appropriate training for the work they are to and ensure the health, safety and wellbeing of people living at the home. 08/01/2010 3 37 37 Notifications that affect peoples welfare, wellbeing and safety must be forwarded to CQC. This will ensure that appropriate action has been taken and people are protected. 31/12/2009 4 38 13 The records detailing the testing of water temperatures must be more specific and contain detail of the specific areas tested. This particularly relates to 31/12/2009 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 baths and showers where there is full body submersion. This will help to ensure the health and safety of people using these facilities. 5 38 13 All staff must receive induction and ongoing mandatory training. This will ensure they have the knowledge needed to keep the people they are caring for, staff and themselves safe and protected. 31/12/2009 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 2 9 9 Staff who apply creams should make their own daily records. The manager should decide how best to record the use of medicines prescribed when required so that all staff do this consistently. 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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