Care Home: Sunningdale

What the care home does well Medication administration follows best practice guidance. Medication records indicate most prescribed medicines are given correctly. What the care home could do better: The medication policy and procedure documents should be updated to reflect current professional guidance. General medication storage arrangements, including those for medicines needing cool storage, should be upgraded to ensure medicines are kept under conditions and at temperatures recommended by the manufacturer. Personal medication plans should reflect any authorised changes and people`s own preferences about their medication. Random inspection report Care homes for older people Name: Address: Sunningdale 5 North Park Road Manningham Bradford West Yorkshire BD9 4NB two star good service 23/04/2009 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 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: Steve Baker Date: 0 7 1 0 2 0 0 9 Information about the care home Name of care home: Address: Sunningdale 5 North Park Road Manningham Bradford West Yorkshire BD9 4NB 01274545859 01274543265 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) : Crabtree Care Homes care home 40 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 40 The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category 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 category: Dementia - Code DE Date of last inspection Brief description of the care home Sunningdale is a 40 bedded home for people with dementia, some of whom may be under 65. The home is situated in the Manningham area of Bradford overlooking the park. A main bus route is close by. The home is operated by Crabtree Care Homes, which is a family run business. The building, a large Victorian house has been extended to provide additional single en Care Homes for Older People Page 2 of 9 2 3 0 4 2 0 0 9 Brief description of the care home suite bedrooms. Accommodation is on two floors with passenger lift access. Some of the very large rooms in the older part of the house are shared between two people. The walled garden surrounding the property has a parking area and has been pleasantly landscaped to provide secure outdoor walking and sitting areas. This allows people the freedom of walking around and out of the house without restriction. Access to the property is through electric gates controlled with the help of CCTV cameras by staff from inside the house. Details of current fees can be obtained from the home. The following services are not included in the fees, Hairdressing, Chiropody private , personal clothing and toiletries and outings. A charge may be made to cover additional staff time needed for hospital escort duties. Care Homes for Older People Page 3 of 9 What we found: The reason for this inspection visit was to follow up progress made against controlled drugs storage and record keeping concerns identified at the last full inspection in April 2009. A pharmacist inspector spent 3.5 hours in the home looking at medication storage and handling arrangements (including those for controlled drugs), the current months medication administration record charts (MARs), selected care files and the medication policy and procedure documents. We also observed the deputy manager giving medicines to people during the lunchtime period. Verbal feedback was given during the visit to the manager and deputy manager. The outcome is as follows. The administration of medicines at lunchtime was observed to be in accordance with good practice. Drinks were offered to help with the taking of medicines and staff were very attentive, spending time with each person and carefully encouraging them take their medication. A total of 39 MARs were looked at and 14 were examined in detail for accuracy and completeness. There were no significant gaps on the MARs indicating that people can expect to receive their prescribed medication correctly. Six MARs, however, contained a total of eight hand written entries or amendments which lacked the necessary information or checks for staff to be sure they could follow the changes safely. Most of the hand written entries had been not checked for accuracy. For example, the maximum permitted daily dose of a painkiller was not always copied from the pharmacy label. Two MARs contained three entries for medicines originally prescribed to be given regularly which were being offered to people as and when needed but no amendments had been made on the MARs to show that the prescriber had agreed to this change. Such changes in peoples medication needs should be added to a personal medication care plan which would guide all staff when helping people with their medication. Another MAR lacked any administration details for a controlled drug. Records of controlled drugs administration should be made on the MAR at the time each dose is given as well as in the controlled drugs register. The homes medication storage arrangements whilst basically secure should be improved in line with best practice guidance. The temperatures of the medication storage areas are not checked so staff can not be sure that medication is always kept at the temperature recommended by the manufacturer. The medication fridge thermometer indicated that medicines, including insulin, were being kept at excessive temperatures. The fridge itself did not appear to be of suitable quality for medication storage. All medication must be stored securely at the recommended temperature so that staff know it is safe to use when needed. There were no discrepancies between controlled drugs held in the home and the relevant entries in the controlled drug register. All entries were accurately recorded and appropriately witnessed. The opening date was missing from two containers of eye drops. Containers of medication with a short in-use shelf life such as eye preparations, skincare products and oral liquids, should be marked with the date they are first opened. If staff do not know when such products were first opened then they do not know that they are still safe to use. The medication policy and procedures were last revised in April 2006 so do not take account of current professional guidance issued by the Care Quality Commission or the Royal Pharmaceutical Society of Great Britain. They should now be updated to reflect current best practice guidance. This will help to ensure all staff know exactly what is expected of them when handling and administering medication. Care Homes for Older People Page 4 of 9 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 £ No R 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 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 All medication must be 13/11/2009 stored securely at the correct temperature recommended by the manufacturer Staff will then know medicines are safe to use when needed. 2 9 13 Arrangements must be put in 13/11/2009 place to ensure that medication administration records are made and maintained in an accurate and timely manner. This will help to show that all prescribed medication has been given correctly. 3 9 13 Arrangements must be put in 13/11/2009 place to ensure that all medication is correctly admininistered according to the prescribers directions. This will help to make sure peoples health and well being are maintained through the use of prescribed medicines. 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 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 Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information is recorded so that each person receives their medication as prescribed. Individual medication care plans should be developed and agreed which reflect the personal preferences and needs of people living in the home. These care plans should be regularly reviewed in line with changes in peoples medication, health and wellbeing. The medication policy and procedures should be updated in line with current professional guidance so that staff understand exactly what is expected of them. 2 9 3 9 Care Homes for Older People Page 8 of 9 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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