Care Home: St Helens Hall and Lodge

What the care home does well We saw records supporting self-administration that had been done well to support a resident`s confidence and independence. What the care home could do better: Medicine storage needs to be more secure so that unauthorised and vulnerable people do not have access to the medicines. Medicines must be given according to the doctor`s directions and be completely and clearly recorded to show residents are safe from harm. A system of monitoring the quantities of medicines provided in conventional packs compared with records would show whether the medicine had been given correctly, that there was no mishandling and so protect the resident from harm. It is important to carry out frequent audits of medicine administration and recording to support staff who have difficulties to have training and supervision. Inspecting for better lives Random inspection report Care homes for older people Name: Address: St Helens Hall and Lodge Elephant Lane Thatto Heath St Helens Merseyside WA9 5EL two star good service 20/01/2009 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 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: Elaine Bray Date: 1 6 0 4 2 0 0 9 Information about the care home Name of care home: Address: St Helens Hall and Lodge Elephant Lane Thatto Heath St Helens Merseyside WA9 5EL 08456006432 Telephone number: Fax number: Email address: Provider web address: www.orchardcarehomes.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Orchard Care Homes.Com Limited care home 94 Number of places (if applicable): Under 65 Over 65 0 94 dementia old age, not falling within any other category Conditions of registration: 94 0 The registered provider may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 94. Date of last inspection Brief description of the care home St Helens Hall and Lodge is a purpose built care home that was registered in July 2008. It can accomodate up to 94 people who have care needs around general elderly and dementia. The care is managed on two seperate units. The home is in a residential setting. 2 0 0 1 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home The home is owned by Orchard Care Homes Ltd and the Registered Manager is Ms Chris Wood. The current fees for the service are 520 pounds to 550 pounds per week. Care Homes for Older People Page 3 of 8 What we found: The lead inspector requested this visit by a pharmacist inspector to see whether residents medication was managed correctly. The visit took about an hour and a half and included inspecting a sample of residents medicines and medicine records and discussing the findings with the deputy manager. We found that staff did not always follow the homes procedures for giving and recording medicines. This could put residents health at risk from harm. We looked at how medicines were stored. The facilities provided were satisfactory. There were several large green bags of medicines on the floor that had been delivered by the pharmacy. These had not yet been recorded received. The delivery also included a box of morphine sulphate tablets that had not been put away in the controlled drug cupboard. The room was also used to store items of equipment not related to medicines. During the visit staff moved in and out of the room for items they needed. The district nurse came in. The residents that needed an insulin injection queued in the room. This gives vulnerable and unauthorised people access to medicines and puts residents at risk of harm. This also does not comply with the Misuse of Drugs Safe Storage Regulations that ensure medicines that are liable to misuse have additional security. We were concerned when we looked how medicines were given and recorded. Staff did not always follow the homes procedures for safe medicine management. Where possible the pharmacy packs medicines into a twenty-eight day pack so that it is easy to compare the pack with the records to see the doses given. We found some medicines had not been recorded given. Others were recorded given when the dose was still in the pack. There was no system to check the amounts of medicines supplied in conventional containers to be sure that they had been given correctly. This puts residents health at risk of harm. Some medicines had not been given as prescribed. Where the doctor said a medicine dose could be varied according to the residents needs (like painkillers) the amount given was not recorded. It is important to record the amount of medicine given so that staff can be sure when it is safe to give another dose. Systems are in place to allow those residents who wish and are able to keep control and take their own medicines. The two examples of this we saw were well done. This promotes independence for the resident. We were told that medicine training had been organised for 1st May 2009 but had been cancelled. We are very concerned about the issues found at this visit. To protect residents health from harm, the competence of staff giving medicines needs to be assessed. Further training and supervision will be required. We were very concerned to be told by the deputy manager that medicine audits had been discontinued because of staff sickness. It is important to monitor whether staff are giving medicines correctly. Medicines were found to be of concern at the key Care Homes for Older People Page 4 of 8 inspection in January 2009. 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 8 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 17 Full and clear records must be kept of all medicines received, administered and leaving the home including those disposed of. This ensures no mishandling of medicines and that all medicines can be easily audited. 02/03/2009 2 12 16 There must be a planned 01/04/2009 activities program developed so that people living in the home can be more engaged and stimulated. This is particularly so on the dementia care unit. This ensures a better quality of daily life. Care Homes for Older People Page 6 of 8 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 Ensure residents are given medicines exactly as the doctor prescribed To ensure residents health and wellbeing is protected from harm. 07/05/2009 2 9 13 Ensure residents medicines are securely stored. To ensure no unauthorised people have access. 07/05/2009 3 27 18 Ensure all staff that handle medicines are competent. To protect residents from medicine errors. 07/05/2009 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 Older People Page 7 of 8 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. 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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!