Care Home: St Helens House

What the care home does well . What the care home could do better: To follow safe practices when giving medicines. Inspecting for better lives Random inspection report Care homes for older people Name: Address: St Helens House 3 The Ridge Ore Hastings East Sussex TN34 2AA 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 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: Suni Chotai Date: 1 7 0 3 2 0 0 9 Information about the care home Name of care home: Address: St Helens House 3 The Ridge Ore Hastings East Sussex TN34 2AA 01424439239 01424439239 sthelens@house124 wanadoo co uk 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) : Mrs Gloria Williams care home 31 Number of places (if applicable): Under 65 Over 65 31 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 31 The registered person may provide the following category/ies of service only: Care home only - (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 (OP) Date of last inspection Brief description of the care home St Helens House is a family owned and run care home on The Ridge in Hastings Twenty-four hour care is provided for up to 31 older people, most of who have lower levels of dependency care needs The Home is set out on three floors and a passenger lift provides access to all floors It provides 27 single rooms and 2 double rooms At the front of the building there is a Care Homes for Older People Page 2 of 13 Brief description of the care home small area providing off road parking facilities Current fees range from #345 to #400 per week Care Homes for Older People Page 3 of 13 What we found: Suni Chotai, Pharmacist inspector inspected the home to access medicine management in the home Medicines are stored safely One person managed their own medicines under a risk assessment however there was no procedure in the care plan giving details of this process Medicines are received in a blister pack system We were told potting up has stopped but there was evidence to suggest that this was not the case People on insulin were given their insulin by staff trained by the district nurse There was no certificate relating to this training The administration of insulin was recorded elsewhere and not on the MAR chart Medicines given late at night were also recorded elsewhere and not on the MAR chart There were no Controled Drugs [CD] in the home and there was no provision to store Controlled drugs according to the law A CD register was available The medicines policies of the home lacked detail The care plan did not have any guidance on the use of medicnes to be used only when needed 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 4 of 13 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 3 14 The registered person shall 27/02/2009 not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so - (a) needs of the service user have been assessed by a suitably qualified or suitably trained person; (b) the registered person has obtained a copy of the assessment; (c) there has been appropriate consultation regarding the assessment with the service user or a representative of the service user Where a prospective resident is funded by a local authority the registered person must obtain a care manager assessment and plan of care The homes pre-admission assessment must include items as detailed in 3 3 of the National Minimum Standards This is to ensure that the home is able to meet the needs of the prospective resident 2 7 13 The registered person shall 27/02/2009 ensure that unnecessary risks to the health and safety of service users are identified and so far as possible Page 5 of 13 Care Homes for Older People 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 eliminated Risk assessments should be drawn up for each individual resident, and should relate to the level of care and health needs for each individual resident risk assessments should not be generic 3 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home Medication should not be secondarily dispensed into pots Monthly Administration Records, should be signed off seperately for each resident All incoming medication must be recorded onto the Monthly Administration Record, with the date, the quantity and the initials of the person receiving the medication into the home None of the Monthly Administration Records should have Tippex used on them There should be a policy and procedure for the administration of PRN (as required) medication Where medications have specialised instructions for example take half an hour prior to food, this should be clearly highlighted on the Monthly Administration Record Eye drops/ointments and liquid medication should be dated Care Homes for Older People Page 6 of 13 27/02/2009 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 on the bottle or tube on the day of opening The list of medication trained staff must be reviewed regularly to ensure that it is up to date and contains the signatures and inititals of staff who are currently medication trained and work 4 18 13 The registered person shall 27/02/2009 make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse Staff must receive training in Safeguarding Vulnerable Adults from abuse Under no circumstances should CCTV (closed circuit television) cameras be placed in residents private space 5 22 23 The registered person shall 27/02/2009 having regard to the number and needs of the service users ensure that - suitable adaptations are made, and such support equipment and facilities, including passenger lifts, as may be required are provided, for service users who are old, infirm or physically disabled Each resident must have a call bell system that is easily accessible from their bed, this means that all bedrooms must have a call bell cord Care Homes for Older People Page 7 of 13 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 that residents can have easy access to from their bed In communal toilets and bathrooms call bell cords should be of sufficient length, that will enable a resident to reach the call bell cord should they fall on the floor 6 25 13(4) The registered person shall 31/08/2007 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety in that all radiators must be guarded or have guarunteed low temperature surfaces This must be completed by the given timescale, if not sooner 7 26 13 The registered person shall 27/02/2009 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home All communal toilets and bathrooms and the laundry room must be supplied with liquid soap and paper handtowels and not bar soap and cloth hand towels This is to ensure there is not a risk of cross infection 8 26 12(1), The registered person shall 31/08/2007 13(3)16(2)(j) make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in Page 8 of 13 Care Homes for Older People 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 that appropriate soap dispensing and hand drying facilities must be provided in all communal toilets This must be completed by the given timescale, if not sooner 9 29 19 The registered person shall 27/02/2009 not allow a person to work in the care home unless the employer has obtained in respect of that person the information and documents specified in paragraph 1 to 9 of Schedule 2 Schedule 2 paragraph six states - A full employment history, together with a satisfactory written explanation of any gaps in employment The application form should enable prospective employees to give a full employment history and request written evidence for any gaps in employement 10 30 18 The registered person shall, 30/03/2009 having regard to the size of the care home, the statement of purpose and the numnber and needs of the service users - ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform including structured induction training Page 9 of 13 Care Homes for Older People 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 All staff working the home must complete mandatory training in moving and handling, food hygiene, infection control, first aid and safeguarding vulnerable adults 11 33 13 The registered personb shall 27/02/2009 ensure that - unnecessary risks to the health and safety of service users are identified and so far as possible eliminated Risk assessments should be carried out for each person who uses oxygen in the home A legionella check must be carried out on the water system in the home Window restrictors should be fitted to all opening windows Care Homes for Older People Page 10 of 13 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 to have detailed policies on all aspects of medicine mangement So that staff have clear guidance on medicine use and a consistent approach is maintained 30/06/2009 2 9 13 To provide a secure cupboard 30/06/2009 to store controlled drugs that complies with the Misuse of Drugs Act 1973 To comply with thw law 3 9 13 The home must ensure that 30/04/2009 the administration of medication follows current good practice and guidance as produced by the Nursing and Midwifery Council, The Royal Pharmaceutical Society of Great Britain guidance The Handling of Medicines in Social Care and the Department of Health Building a Safer NHS In the interests of safe medication handling all Care Homes for Older People Page 11 of 13 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 medication must be administered directly from the original labelled container and not placed into any secondary container for later administration 4 9 13 Staff must receive training in 27/06/2009 the handling of medication and there must be evidence that this has taken place So that safe practice are followed around medicine use 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 To have clear, individual guidelines on the criteria of when to give a medicine prescribed on a when required basis Care Homes for Older People Page 12 of 13 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 13 of 13 - 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