Care Home: Sandrock Nursing Home

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What the care home does well We found no significant examples of good practice for handling medicines. What the care home could do better: Medicines must be given to people `as prescribed` because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a person`s health and wellbeing. A clear system of medicines stock control and auditing must be in place so that all medicines can be fully accounted for. Medicines must only be given to the person they are prescribed for because sharing medicines is against the law and is not safe. Care plans and supporting paperwork should have detailed information about how `when required` medicines should be given to people to help make sure they are used properly. Random inspection report Care homes for older people Name: Address: Sandrock Nursing Home 1-3 Sandrock Road New Brighton Wallasey Wirral CH45 5EG 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: Simon Hill Date: 2 4 0 4 2 0 0 9 Information about the care home Name of care home: Address: Sandrock Nursing Home 1-3 Sandrock Road New Brighton Wallasey Wirral CH45 5EG 01516303254 01516303254 Noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Prasur Investments Limited care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Conditions of registration: 0 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: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 28 Date of last inspection Brief description of the care home Sandrock Nursing Home provides general nursing care for up to 28 people, and is situated in a quiet area of New Brighton, a popular seaside town. The home offers single and twin bedded rooms on all three floors, and has assisted bathing and toileting facilities with call alarm in all areas. The home has a large lounge, divided into two main areas, a dining room and a conservatory, which opens out onto a patio area in the back garden. Sandrock benefits from being close to all amenities and is a Care Homes for Older People Page 2 of 9 Brief description of the care home few minutes walk from local bus stops. The registered provider is Prasur Investments Ltd and the registered manager is Karen Lea. Care Homes for Older People Page 3 of 9 What we found: We carried out this visit to make sure medicines were being handled safely. The inspection was carried out by a pharmacist inspector and it lasted five hours. We checked medicines records, medicines stock and peoples care plans. Overall we found some shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. When we checked current stocks we found a liquid laxative prescribed to people was being shared as general stock. The manager said they did this to help save space in the medicines trolley, this is not good practice as it is against the law and not safe. The manager said she would take action immediately to help prevent this happening again. When we checked the medicines records against medicines stock we found no clear system of stock control that meant we could not account for many medicines, notably those contained in traditional packets and liquid medicines. Remaining stock from the previous month was not properly carried forward so current stock could not be easily checked to show that medicines were being given to people correctly. We were able to carry out some detailed checks of the medicines and found some did not add up correctly, which showed that they had not been given to people at the right dose and in some cases missed completely. Over the last month several peoples records showed their antibiotics had been missed and one persons liquid medicine had been missed even though the records were signed to show it had been given. We saw several recording mistakes that showed staff were not always checking the records carefully whilst giving medicines to people. Poor record keeping of medicines can lead to mistakes that could seriously affect the health and wellbeing of people who live in the home. We looked at the times medicines were given and found the records did not always state the correct time to take medicines in relation to food intake. This means that some medicines might not always be given at the right time in relation to mealtimes, particularly those that need to be given before food and this was confirmed by the manager. Medicines must be given to people at the right time and dose to help make sure their health and wellbeing is maintained. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We found missing information about how a medicine used for anxiety was to be used so there was a risk it might not be given at the right and best time for this person. We also found little information about how epileptic seizures were to be managed for one person and how someone elses problems with constipation were to be managed. We gave some advice to the manager about how to develop some paperwork to do this because having clear written plans helps make sure people get their medicines when they need them. We checked how controlled drugs (medicines that can be misused) were handled. A suitable cupboard was used for storage to help make sure they were safely kept. A special register was used for record keeping and the entries we checked were usually witnessed, accurate and complete. Witnessed records and secure storage of controlled drugs help prevent mishandling and misuse. Care Homes for Older People Page 4 of 9 The manager said that no formal audits of the medicines were carried out so any mistakes with medicines were not routinely found. We gave some advice on how to improve this, the general stock control of medicines and assessing staff competence to help make sure medicines are given to people correctly and to help make sure staff have the necessary skills. 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 9 13 A clear system of medicines stock control and auditing must be in place. This will help make sure all medicines can be fully accounted for. 28/05/2009 2 9 13 Medicines must only be given 28/05/2009 to the person they are prescribed for. Sharing medicines is against the law and is not safe. 3 9 13 Medicines must be given to people as prescribed. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 28/05/2009 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 1 9 Care plans and supporting paperwork should have detailed information about how when required medicines should be given to people. This will help make sure they are used properly. 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. Copyright © (2009) Care Quality Commission (CQC). 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