Care Home: Stoneleigh Care Home

What the care home does well There are no significant gaps on the medication administration records. This indicates that people receive their medicines correctly as prescribed. Management checks of medication processes and staff practice help to identify any improvements needed. What the care home could do better: Further staff training and new detailed medication procedures would ensure staff knew exactly what is expected of them when handling and administering medicines. Some aspects of medication ordering and record keeping should be improved so that all medicines entering the home can be fully accounted for. Storage arrangements should be reviewed and monitored to ensure medication is kept safely according to manufacturers` recommendations. Supplies of emergency medicines should be available to treat anyone who develops a serious allergic reaction to a dose of flu vaccine. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Stoneleigh Care Home Station Road Gunness Scunthorpe North Lincolnshire DN15 8SU 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 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: Steve Baker Date: 1 6 0 1 2 0 0 9 Information about the care home Name of care home: Address: Stoneleigh Care Home Station Road Gunness Scunthorpe North Lincolnshire DN15 8SU 01724784019 01724782585 lesleybatten@prime-life.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) : Prime Life Ltd care home 42 Number of places (if applicable): Under 65 Over 65 42 0 0 dementia mental disorder, excluding learning disability or dementia physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 10 10 Stoneleigh is registered as a nursing home. The service category is DE (E) Dementia over 65, MD Mental Disorder, and PD Physical Disability. The home is registered for 42 people. The home is provided in an old adapted building that was originally a private home and is owned and managed by Prime Life Ltd. The future plans for the home is to transfer it to a purpose built, single storey home in the Scunthorpe area. Work is expected to commence on this project in the next six weeks. Nursing care is provided in the home, and the home provides RMHN staff. The accommodation is provided over two floors, and there is a passenger lift to the first floor, as well as stairways. Care Homes for Older People Page 2 of 9 Brief description of the care home Stoneleigh is in the village of Gunness, close to Scunthorpe, there is a bus service to the town centre, but this is not regular. The home is close to the junction of the M181, and links to the M180, the M62, and the M18. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home is on display in the reception area of Stoneleigh. Care Homes for Older People Page 3 of 9 What we found: This unannounced visit lasted 4 hours and involved examining the homes medication policy, the current medication administration record (MAR) charts and the storage & handling arrangements for all medicines, including controlled drugs. We were told no self-adminstration of medicines currently took place and no observation of medicines administration by staff took place during this visit. We gave verbal feedback during the visit to the manager and deputy manager. The medication policy in use in the home does not provide sufficient information for staff on all aspects of medication management. Locally written medication procedures applicable to Stoneleigh would enable all staff in the home to understand exactly what is expected of them when handling and administering medication. Neither CSCI nor the Royal Pharmaceutical Society of Great Britain guidance documents on handling medicines in social care are available for staff to consult. Staff are regularly supervised and agreed changes to practice are actioned. Care staff are soon to be given the opportunity to receive independent refresher training in the safe handling of medicines. Having well trained competent staff helps to reduce the risk of mistakes being made. We were shown evidence of regular checks made by staff of medication systems and records. This good practice enables staff to know that sufficient medicines are always available in the home when needed. It also enable the manager to identify any weaknesses in medication systems and any improvements which may be needed. We found very few gaps on the MAR charts. This means there is a good record kept of people receiving their medication as prescribed. However, we found some inconsistency in handwritten entries of new medicines and dose changes on the MAR charts. Handwritten entries of medicines on the MAR charts should be sufficiently clear and detailed so that other staff can follow the changes correctly. MAR charts should be amended where necessary to include additional instructions to make sure medicines are given correctly. The records of the use of prescribed creams and ointments by 5 people should be improved to show exactly who applied these products each time they were used. Trained care staff assisting nurses with medication tasks should be identified on the MAR charts and take responsibility for their own actions. Although people living in the home had received their flu vaccines correctly as prescribed, the home has no supply of adrenaline injection available. Arrangements must be put in place to have supplies of emergency medicines available in the home when nurses administer flu vaccines. This will ensure anyone suffering a serious allergic reaction can be treated in line with current professional guidance. Most medicines are stored securely in locked drug cupboards or trolleys in the locked clinical room. The temperature of the storage areas, including the fridge, is recorded regularly so that staff know medicines are being stored at temperatures recommended by the manufacturer. A lock should be fitted to the medicines fridge to protect those medicines from loss or diversion. No discrepancies were found in the controlled drugs records, but a new controlled drugs cupboard which meets current safe custody requirements should be installed. All medicines must be stored securely at temperatures recommended by the manufacturer so that staff know they are safe to use when needed. We found several containers of creams and liquid medicines being used without the date of first opening being known. A system should be in place to Care Homes for Older People Page 4 of 9 check the expiry dates of medicines and to record the opening date of those medicines with limited use once opened. This helps to make sure medication is safe to administer when needed. The arrangements for ordering, receiving and disposal of medication are adequate but could be improved further. The quantity of medication from one monthly cycle to another is not always recorded on the new MAR chart. This means it is difficult to produce a complete record of medication within the home and to check if medication is being administered correctly. The person in charge of ordering medication should see the regular monthly prescriptions before a supply is made. The prescription, not the MAR chart, is the authority for the staff to administer medication to the person. This also provides an opportunity to check if any new medicines or dose changes are included. Any problems with prescriptions can be addressed at this point rather than after the supply has been made. The checking of prescriptions is an important part of the management of medication in the home. 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 requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 19 23(2)b The provider must ensure 30/04/2008 that the beading to the external windows is repaired, missing beading is replaced and repainted to maintain safety within the home. 2 19 13(4)a The provider must ensure that the worn carpet on the landing outside of room 43 should be repaired or replaced to prevent a trip hazard from developing. 30/04/2008 3 22 23(2)c The provider must ensure that the arm to the bath chair in the downstairs toilet is replaced or repaired. 30/04/2008 4 38 23 (2)c The provider must ensure 30/04/2008 that all portable appliances within the home are routinely checked on n annual basis. 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, Care Homes 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 Nurses should consider delegating all associated tasks to carers who apply creams and ointments. This includes making their own records on MAR charts so that each individual can take responsibility for and be held accountable for their own actions. Regular, monthly prescriptions should be seen and checked before sending to the pharmacy. This check makes sure all the medicines required have been listed, identifies any changes and prevents people from being without essential medicines. A system should be in place to check expiry dates of medicines and to record the opening date of those medicines with limited use once opened. This makes sure medication is safe to administer when needed. A system should be in place to record all medication received in to the home and medication carried over from the previous month. This helps to confirm that medication is being given as prescribed and when checking stock levels. Handwritten entries on MAR charts should must be accurately recorded and detailed. This makes sure that the correct information is recorded so a person receives their medication as prescribed. Page 7 of 9 2 9 3 9 4 9 5 9 Care Homes for Older People 6 9 Arrangements must be put in place to have supplies of emergency medicines (such as adrenaline injection) available in the home when nurses administer flu vaccines. This will ensure anyone suffering a serious allergic reaction can be treated rapidly in line with current professional guidance. The management team should produce a set of local medication procedures for all staff to use when handling and administering medication. These new procedures should reflect current professional best practice guidance in social care settings. 7 9 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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