Care Home: Sunrise Operations Edgbaston Ltd (Assisted Living)

What the care home does well The inspection was only looking at whether the home had complied with the Statutory Requirements Notice issued on the 8th June 2010 and the results of the inspection found the home had not. Due to the inspection being very focused on medicines we therefore found it difficult to determine what the service does well. What the care home could do better: We again found shortfalls in the way in which medication was being administered and recorded. These problems had been identified prior to this inspection and we had made the home aware of the action which should have been taken. This places people at risk. The manager and staff need to make sure that the homes policies and procedures are followed at all times so that people are kept safe. Random inspection report Care homes for older people Name: Address: Sunrise Operations Edgbaston Ltd (Assisted Living) 5 Church Road Edgbaston Birmingham B15 3SH zero star poor service 28/04/2010 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: Ian Henderson Date: 0 8 0 7 2 0 1 0 Information about the care home Name of care home: Address: Sunrise Operations Edgbaston Ltd (Assisted Living) 5 Church Road Edgbaston Birmingham B15 3SH 01214551100 01214556689 Telephone number: Fax number: Email address: Provider web address: www.sunrise-care.co.uk Name of registered provider(s): Name of registered manager (if applicable) Ms Joanne Anita Gordon Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sunrise Operations Edgbaston Limited care home 68 Number of places (if applicable): Under 65 Over 65 68 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 68. The registered person may provide the following category 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 (OP) 68 Date of last inspection Brief description of the care home Sunrise Senior Living Edgbaston offers a purpose built care home for older people who require varied levels of support with day to day living (Assisted Living), nursing care Care Homes for Older People Page 2 of 10 2 8 0 4 2 0 1 0 Brief description of the care home and residential care. People can choose to live in the home for a short or long term stay. Sunrise Assisted Living is registered to provide assisted living care with nursing for up to 68 older people. Assisted living care is provided on the ground and first floors of the premises. The home offers spacious accommodation within bedroom suites of varying sizes and layouts. Each suite provides a bedroom, living area and en suite facilities, which has a level floor access shower or a bath. Two separate spa baths are available. The home offers a welll maintained environment which is furnished to high standards. Two passenger lifts and a staircase provide access to all floors in the home. There are large lounge areas, a restaurant style dining room, bistro and a well maintained kitchen. The fees for this home are available on application and vary with the services required. Care Homes for Older People Page 3 of 10 What we found: The reason for the visit was to assess whether the home had met the requirements set out in the Statutory Requirements Notice issued on the 8th June 2010. The home was required to comply with the notice by the 28th June 2010. The home was required to 1. To ensure that there is a system in place for the safe recording handling safekeeping safe administration and disposal of medicines received into the care home. 2. Ensure that there is a continuous supply of medicines available for administration to the service user at all times to promote and make proper provision for the health and welfare of service users. 3. Put in place a written procedure for the ordering of medicines which is monitored to make sure that nursing staff order medicines in time to ensure continuous supply. In order to assess whether the home had complied with the Statutory Requirements Notice a number of medication and care records were examined. We found that the management of medicines was still poor and the Statutory Requirements Notice had not been complied with. The audit of one of the people sampled showed that the medication record could not evidence that the home were administering their medicines as prescribed. We found with some inhalation nebules that 135 of them had been received by the home. The administration records showed that 115 nebules had been administered so we expected to find 20 nebules remaining but we found 45. The home was unable to establish a reason for this anomaly but did acknowledge that the reasons could be due to the staff not recording the receipt of a supply or the nursing staff were signing the administration record to confirm administration but were not administering this medicine. We also found that the service had not been administering another inhaler in accordance with the prescription. This particular inhaler had an indicator that showed the user how many doses were left before it ran out. The inhaler would have had 60 doses in it upon opening. Now because this inhaler had been brought in from this persons home we did not know when the inhaler had been opened or how many doses had been used prior to the person arriving at the home. However when comparing the amount of doses administered on the MAR chart [47 doses] with the amount of doses left in the inhaler [25 doses] these two figures amounted to more than the number of dose that would have been originally in the inhaler when it was opened. We also found that a weekly administered medicine which is normally administered on the same day of the week had been administered two days late. We found that this person had also not received three dose of another nebuliser solution because the home appeared to be out of stock. We found with another person using the service that the same weekly administered medicine had been administered a day later than it should have been. We found that three tablets could not be accounted for with another of this persons medicine. We also found that a variable dose had been prescribed for some laxative tablets but the records did not show what quantity had been administered on all of the occasions where Care Homes for Older People Page 4 of 10 administration had taken place. There were also some gaps in the record of signatures and therefore we were unable to establish whether the medicines concerned had been administered. We found similar issues with a third person we looked at. Of the seven medicines this person had been prescribed we found that the records could evidence that this person had received two of the medicines correctly. We found that for three of the medicines some of the capsules/tablets could not be accounted for. The audit of the last two medicines appeared to show that the administration charts were being signed but the medicines on some occasions had not been administered. We also found that the home was not ensuring that medicines that required cold storage conditions were being stored within the correct temperature range. As a result of the findings the information was forwarded to the link inspector so that a management review could be undertaken to decide what enforcement action CQC would adopt to ensure that the management of medicines within this home improved to a safe level. 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 10 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 A system must be installed 14/05/2010 to check all the medicines received into the home. This includes service users medicines who self administer their own medicine and also all new service users to the home regardless whether they will be a permanent or temporary respite resident. All discrepancies must be addressed with the healthcare professional. This is to ensure that all medicines are administered as prescribed at all times 2 9 12 All prescribed medicines must be available for administration at all times. This is to ensure that the service users are administered medicines as prescribed. 14/05/2010 3 9 13 All dose changes recorded on 14/05/2010 the MAR chart must be confirmed by a second member of staff. This is to ensure that the staff have clear accurate directions to follow. Care Homes for Older People Page 6 of 10 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 4 9 13 The medicine chart must 03/10/2009 record the quantity of medicines received and the date. It must be referred to before the preparation of the service users medicines and be signed directly after the transaction and accurately record what has occurred. This is to ensure that the right medicine is administered to the right service user at the right time and at the right dose as prescribed and records must reflect practice 5 9 13 A quality assurance system must be installed to assess staff competence in their handling of medicines. Appropriate action must be taken when these indicate that medicines are not administered as prescribed and records do not reflect practice. This is to ensure that individual staff practice is assessed on a regular basis and appropriate action is taken if audits indicate that staff do not administer the medicines as prescribed and records do not reflect practice. 14/05/2010 6 9 13 All medication polices must 14/05/2010 be adhered to and management must take appropriate action if staff fail to follow them. Page 7 of 10 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 This is to ensure that all staff are handling medicines safely. 7 9 13 All service users must be risk 03/10/2009 assessed as able to self administer their own medication and a MAR chart written to record these prescribed medicines. Regular compliance checks must be undertaken and documented and further support offered if necessary. This is to ensure that they can handle their medication safely Care Homes for Older People Page 8 of 10 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 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 9 of 10 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - 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. 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