Care Home: Springfield Park Nursing Home

What the care home does well We found no significant examples of good practice when 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. Records of medicines received into the home, given to people and disposed of must be clear, accurate and complete so that all medicines can be fully accounted for. Staff competency in giving and recording medicines should be regularly assessed to help make sure staff have the necessary skills. 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. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Springfield Park Nursing Home Springfield Park Bolton Road Rochdale Lancashire OL11 4RE three star excellent 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: 0 6 0 4 2 0 0 9 Information about the care home Name of care home: Address: Springfield Park Nursing Home Springfield Park Bolton Road Rochdale Lancashire OL11 4RE 01706646333 01706523898 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) : Bendan Care Ltd care home 70 Number of places (if applicable): Under 65 Over 65 70 0 old age, not falling within any other category physical disability Conditions of registration: 0 56 The bedrooms on the first floor are not to be used for category PD or for those requiring nursing care. The registered person may provide the following categories 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, (maximum number of places: 70) Physical Disability - Code PD (maximum number of places:56) The maximum number of service users who can be accommodated is: 70 Date of last inspection Brief description of the care home Springfield Park is a large detached building that has been extensively extended and refurbished to a high standard. It is situated in parkland with easy access to public Care Homes for Older People Page 2 of 9 Brief description of the care home transport and the motorway network. The home is equipped to cater for male and female residents in 70 single en-suite bedrooms. It is registered to care for people who require personal care and for people who have nursing needs. The majority of the accommodation is on the ground floor. The home is suitably adapted for disabled access. Suitably qualified and experienced nurses, supported by trained care assistants, provide nursing care. Physiotherapy is provided, as is access to chiropody, dentists and opticians. There are activities organisers who ensure that the social needs of the residents are met. The weekly fees at the time of the last inspection ranged from £331.42 to £526.01 plus any registered nursing care contribution entitlement from the primary care trust. There were also residents in receipt of additional continuing health care funding for the provision of one to one staffing for an agreed number of hours per day or week. Information about the home can be obtained from the manager along with copies of the latest inspection report. The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody £8.50 Hairdressing From £5.25 to £18.50 Newspapers As charged Outings/Activities Cost dependent on outing 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 because at a recent inspection we found some shortfalls in the way medicines were being given and recorded. The visit was carried out by a pharmacist inspector and it lasted seven hours. We checked medicines records, medicines stock and spoke with eight members of staff and one resident. Overall we found medicines were poorly handled, which places the health and wellbeing of people who live in the home at unnecessary risk. We observed part of the morning and lunchtime medicines rounds and found best practice was not always being followed. We saw some records signed in advance of people taking their medicines and some records not signed immediately after wards, both could result in serious mistakes. We saw some medicines popped out into a carers hand before giving them to a person, this is unhygienic and does not follow best practice. We discussed these issues with the manager who said that staff were not routinely observed when giving medicines so their competency was not formally assessed. We gave some advice about how to best to record and do this to help make sure staff have the necessary skills to handle medicines safely. We found at least six different medicines prescribed to people were being shared as general stock. Staff said they needed to do this because there was not enough space in the trolleys to hold stock for each person, this is poor practice as it is against the law and not safe. Action was taken immediately by the manager to obtain a new trolley and stock was reorganised during the inspection to help prevent this happening again. We checked a sample of peoples current medicines records and found some supplies had not been properly recorded when received into the home. The home had recently started using a new pharmacy and with it a new system of medicines supply and record keeping. The manager said the changeover to the new pharmacy had not been smooth and this had clearly contributed to the current problems, particularly with the medicines records and medicines stock not being well organised. 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 examples of medicines not adding up properly, 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 people had missed their medicine used for treating stomach ulcers on numerous occasions, two people had missed their medicine for epilepsy and the current stock of a liquid medicine used to treat anxiety showed it had probably been given at the wrong dose on several occasions. 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 staff on duty. Medicines must be given to people at Care Homes for Older People Page 4 of 9 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 no information about how epileptic seizures were to be managed for one person and how someone else with swallowing difficulties was to be supported. We gave some advice to the manager about how to develop some paperwork to do this because having clear written care 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. We saw an example of a recent audit that had been carried out but this had not found the mistakes that we had found. We gave some advice on how to improve this and the general stock control of medicines to help make sure they 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 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 9 13 Ensure that all residents 27/04/2009 medication is in stock so they are enables to have their medication when it is prescribed which will support their health and wellbeing To ensure the health and safety and wellbeing of residents in the care of Springfield Park 2 19 23 Ensure that the home is well 27/04/2009 maintained and that the furnishings and decoration and furniture is in a good state of repair and appearance. Provide to the commission an action plan of work to be undertaken in the home to improve the decoration and furnishings and the timescale that this work and future work will be completed to keep the appearance of the home in good order To promote the respect of residents living at Springfield Park and to promote the appearance of the home. 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 Medicines must only be given 08/05/2009 to the person they are prescribed for. Sharing medicines is against the law and is not safe. 2 9 13 Records of medicines 08/05/2009 received into the home, given to people and disposed of must be clear, accurate and complete. This will make sure all medicines can be fully accounted for. 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. 08/05/2009 4 9 18 Staff competency in giving 08/05/2009 and recording medicines should be regularly assessed. This will help make sure Care Homes for Older People 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 medicines are handled safely. 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 CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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