Care Home: Shandon House

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What the care home does well The acting manager is currently taking action to bring about improvement in medicines handling at the home. What the care home could do better: Care needs to be taken to ensure all records of medicines handling are clearly and accurately completed to better support and evidence the safe administration of medicines. Random inspection report Care homes for older people Name: Address: Shandon House 20 Crescent Road Birkdale Southport Merseyside PR8 4SR zero star poor service 29/06/2010 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: Stephanie West Date: 1 3 0 9 2 0 1 0 Information about the care home Name of care home: Address: Shandon House 20 Crescent Road Birkdale Southport Merseyside PR8 4SR 01704564801 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Sara Jane Fowler Type of registration: Number of places registered: Conditions of registration: Category(ies) : SBS Care Homes Limited care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 20 The registered person may provide the following categories of service only. Care home only - code PC, 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 Date of last inspection Brief description of the care home Shandon House is a care home that is currently registered to provide personal care and support for up to 20 older people. Care Homes for Older People Page 2 of 10 3 0 0 9 2 0 0 9 Brief description of the care home The home is a large detached property situated close to the town centre of Birkdale village and is within easy reach of Southport town centre and all its amenities. Local services such as shops, a post office, bank and public transport are in close proximity to the home. All the 20 bedrooms are for single occupancy and thirteen have en-suite toilets. The home has a pleasant garden and communal areas including a lounge, dining room and conservatory to the side of the building. The building has three floors which are accessible by a passenger lift and the main and side entrance are equipped with ramps to provide disabled access. A small area is provided for off-road parking. The care home fees range from £389.90 to £450.00 per week. Care Homes for Older People Page 3 of 10 What we found: The purpose of this visit was to look at the homes arrangements for handling medication to look at the action taken to improve medicines handling, to address the concerns identified at our previous visit. This visit focused on medicines handling, other areas were not examined on this occasion. We looked at care documentation within the home and the medication systems that were in place. We spoke with acting manager about the homes medication arrangements. Overall, we found that action was being taken to improve medicines handling at the home but some shortfalls remain to be addressed to help ensure peoples health and well-being is best protected. We looked at medicines administration. Since our previous visit all staff handling medication had completed certificated medicines handling training. This had been followed-up by the acting manager who had completed written observations of staff administering medication. We found that there was generally supporting information in place to guide staff in the use of when required medicines and about external preparations (e.g. creams) to help ensure consistency in their use, when needed. But, although advice had been sought about the homes medicines policy it had not yet been reviewed. As previously recommended, the policy needs to be reviewed to provide clear guidance for staff about medicines handling at the home. Following implementation, competency checks should be completed to check staff understanding of the homes procedures. We found that medicines record keeping had improved but were concerned that although we could generally account for (track) the handling of solid dosage forms (tablets and capsules) this was not always possible for liquid medicines. On occasion we saw records that impossibly showed more doses of liquid medicine had been administered than actually received into the home. Further audits need to be carried out to address this concern to help ensure liquid medicines are administered correctly, evidenced by clear and accurate record keeping. We also saw some additional areas where medicines record keeping and stock control could be further improved. We saw that the actual dose given was not always recorded where a variable dose e.g one or two was prescribed. And that the times pre-printed on the medicines administration record were too close together between the tea-time and evening doses of medicines, should medicines be required four times a day. We saw that new supplies of eye drops were currently in use, but it is recommended that eye drops are dated on first use to help ensure that they are replaced on time. We saw that generally clear records of G.P. advice and medicines changes were made and that new medicines were started promptly. But, we recommended that advice was sought more promptly from the G.P. where doses of prescribed medicines were regularly missed. The acting manager had introduced a written medicines audit but consideration needs to be given to expanding this to help ensure that any shortfalls can be promptly addressed. What the care home does well: The acting manager is currently taking action to bring about improvement in medicines handling at the home. Care Homes for Older People Page 4 of 10 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 10 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 1 3 Assessments of need should be completed for residents living at Shandon House. This will enable the service to identify needs and demonstrate it is able to meet the needs of people living at Shandon House. 29/10/2009 2 7 15 Care plans for people must 19/08/2010 be maintained up to date and include all care needs including acute and immidiate needs. This helps ensure that care can be carried out consistently and all staff can be kept up to date. 3 9 17 medication records kept in the home must be maintained up to date and accurate. This helps ensure that people are given correct medication. 19/08/2010 4 19 13 All environmental saftey checks are regularly reviewed and any action needed must be prompt and timely. This helps ensure that the 19/08/2010 Care Homes for Older People Page 6 of 10 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 home is maintained and provides a safe environment. 5 25 13 All hot water outlets must be 28/06/2010 maintained at a safe temperature This will reduce the risk of people being scalded. 6 29 19 All staff must receive the 19/08/2010 appropriate pre employment checks and these must be evidenced in the staff files. This includes two written references from appropiate sources and evidence of both CRB and ISA checks. All staff files must be audited against the requirements listed in schedule 2 of the care home regulations. This helps ensure that staff employed are fit to work with vulnerable people and they are protected. 7 37 37 All incidents relating to 19/08/2010 regulation 37 notifications must be reported through to the Care Quality Commission [CQC] This ensures that the regulator is fully informed of incidents in the home. 8 38 13 Any hazards or risks 19/08/2010 identified in the environment must be acted on to ensure safe standards are maintained. Care Homes for Older People Page 7 of 10 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 This ensures residents are protected and are living in a safe environment. Care Homes for Older People Page 8 of 10 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 The homes medication policy needs to be reviewed and implemented. And staff competency checks should be carried out to check staff understanding of the homes procedures. Care Homes for Older People Page 9 of 10 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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