Latest Inspection
This is the latest available inspection report for this service, carried out on 15th July 2010. CQC found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Richmond Mews Nursing Home.
What the care home does well The systems in place to manage medicines were comprehensive and would support staff giving residents their medicines safely. What the care home could do better: It would be better if staff followed the systems to manage medicines safely. A senior manager, not involved in the day-to-day management of medicines, should audit the administration and recording of medicines to ensure they are given safely. Random inspection report
Care homes for adults (18-65 years)
Name: Address: Richmond Mews Nursing Home Richmond Terrace Shelton Stoke-on-Trent Staffordshire ST1 4ND one star adequate 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: Elaine Bray Date: 1 5 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Richmond Mews Nursing Home Richmond Terrace Shelton Stoke-on-Trent Staffordshire ST1 4ND 01782222310 01782209800 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Angela B Warrilow Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shelton Care Limited care home 48 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 48 The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 48 Date of last inspection Brief description of the care home Richmond Mews consists of seven flats that surround a central courtyard as well as an additional semi-independent unit, situated across the road from the home and an eight-bedded bungalow, located across the main car park. Each flat is self-contained in
Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home that they each can accommodate between one or up to eight service users, have their own kitchen, bathrooms, lounges and dining room. All of the flats have single bedrooms with 15 of those having en-suite facilities. The home has a central laundry. Each flat, apart from the semi-independent unit, provides both nursing and personal care for young people who have a learning disability. The semi-independent unit provides personal care and support. The service provides care and accommodation for service users who have a learning disability, and may have varying degrees of behavioural problems, a physical disability or mental health issues. Each flat on the main site has its own enclosed garden area. There is a car park to the side of the property. Richmond Mews is situated within a residential area of Stoke on Trent that is close to Hanley town centre and all local amenities. Service users are able to access day facilities at Regent College, part of the Richmond Care Homes Ltd and the newly established Networks group. Weekly fees range from GBP333.00 to GBP2,962, and are subject to annual review. Care Homes for Adults (18-65 years) Page 3 of 9 What we found:
We carried out this specialist pharmacist inspection to see if medicines were being managed safely and that requirements to improve, made at the last specialist pharmacist inspection on 8th June 2010, had been actioned. We looked closely at a sample of sixteen residents medicines, medicine records and places where medicines are stored. We also spoke to nurses that help residents have their medicines. We looked where residents medicines were stored. Each flat had its own medicine cupboard. A months supply of each residents medicines were supplied, some in bulky calendar packs and some in conventional containers. Medicines that would not fit were stored in locked filing cabinets in a central office. This room was hot and stuffy and the temperature was not monitored.. We were informed that the wall between this and the next room was to be knocked down to give more space and air, and an air conditioning machine installed if it is still so hot. There was a fridge for storing medicines. Its control knob was missing and its temperature was minus five degrees celsius, much too cold for medicines. Only one bottle of eye drops in it needed cold storage and it was moved to another fridge. There were systems to handle and record medicines safely. The pharmacy provide documents to record giving medicines. The home had additional records that duplicated the administration record and had a running balance of the amounts of medicines remaining as a confirmation that the dose had been given correctly. The summary of the residents most recent out patient visit to hospital was included to confirm doses of medicines. These systems were not being followed consistently. According to the records, some medicines were not given as the doctor directed. eg. a resident suffering from asthma was prescribed a steroid inhaler continuously to prevent attacks, with a reliever inhaler to relax the airway during an attack. Directions on the steroid were to take continuously unless requested by the doctor but it had only been given once in the current month but the reliever was used every day. Sometimes the pharmacy add a dot to the box that shows the time a medicine should be given. These were not always correct. eg. a resident was prescribed eye drops four times a day. Only three time boxes were dotted. Staff only gave the three dotted doses rather than reading the printed directions on the sheet. Another resident was prescribed co-codamol 30/500 tablets for pain. One supply was labelled co-codamol, the next codeine phosphate with paracetamol. The nurse was recording the administration of the second as codeine phosphate only. Medicines were given to residents by registered nurses whose training includes managing medicines. The audit trail of medicine records of receipt, administration or refusal and records of disposal of medicines was not always recorded accurately. The additional records of medicines given when required for symptom relief were not consistently entered. Sometimes doses were recorded given at different times than on the administration record, some not recorded at all. Sometimes there was a discrepancy between the amount of medicine left and the expected medicine remaining shown in the records. This means that it is not possible to be sure when and at what dose the medicines were given. Some medicines were signed as given but were not available in the pack. I observed one nurse adding signatures to the records retrospectively.
Care Homes for Adults (18-65 years) Page 4 of 9 On the day of the visit one nurse was working a day off to record the receipt of the months supply of medicines of all the units. The nurse said that she was going to record how many medicines were to carry over from the current to the new administration record to improve the audit trail. There was also a document to record communications between the home and the pharmacy. There was in addition a new audit of accuracy of the administration records. The nurses felt that this was something that they would be doing rather than a senior manager. 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 Adults (18-65 years) 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 20 13 Ensure that the medicines and their records are reconciled at suitable intervals to confirm their accuracy. To show that medicines have been given correctly 01/08/2010 2 23 12 The provider must ensure that referrals are made under the Mental Capacity Act, to ensure that peoples wishes listened to and acted upon. 16/01/2010 Care Homes for Adults (18-65 years) 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 20 13 Ensure records of medicine 23/08/2010 administration are made immediately after the task is complete To be sure that medicines records are not forgotten 2 20 13 Ensure complete and 23/08/2010 accurate records are made of administration of medicines To show that residents have had their medicines safely. 3 20 13 Ensure medicines are stored as specified on the label To be sure residents medicines are fit to use. 23/08/2010 4 20 13 Ensure that a senior 23/08/2010 manager supervises the administration of medicines by auditing the medicines and their records at frequent intervals. To be sure staff follow the procedures for safe medicine administration Care Homes for Adults (18-65 years) Page 7 of 9 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 5 20 13 Ensure that all medicines are 23/08/2010 given according to the doctors instructions. To be sure residents have medicines safely. 6 33 18 Ensure that all staff that administer medicines have the necessary training and experience To ensure residents are protected from the risk of errors 23/08/2010 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 Adults (18-65 years) 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 Adults (18-65 years) 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 Adults (18-65 years) 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!
