Care Home: The Good Companions

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What the care home does well The service kept good records for medication so that the treatment received by residents was clear. There were also good records of communications with health care professionals so that treatment changes could be easily tracked. What the care home could do better: The service could improve care plans for the management of medication and healthcare issues so that they are more person-centered. This will ensure that staff have clear management and monitoring guidelines so that residents receive safe, effective, appropriate and consistent treatment. The service could ensure that cautionary labels on dispensed medicines are taken account of and managed appropriately. Where medication is stored and recorded as controlled drugs, these records should be accurate. Random inspection report Care homes for older people Name: Address: The Good Companions Criffel Street Silloth Cumbria CA7 4BT two star good service 24/05/2010 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: Angela Branch Date: 0 3 0 8 2 0 1 0 Information about the care home Name of care home: Address: The Good Companions Criffel Street Silloth Cumbria CA7 4BT 01697331553 01697331553 info@goodcompanionscumbria.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Derrane Type of registration: Number of places registered: Conditions of registration: Category(ies) : Good Companions Cumbria Ltd care home 39 Number of places (if applicable): Under 65 Over 65 0 38 0 dementia old age, not falling within any other category physical disability Conditions of registration: 38 0 1 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 categories: Old age, not falling within any other category - Code OP (Maximum places - 38), Dementia - Code DE (Maximum places - 38), Physical disability - Code PD (maximum places - 1). The maximum number of service users who can be accommodated is: 39. Date of last inspection 2 4 0 5 2 0 1 0 Care Homes for Older People Page 2 of 8 Brief description of the care home The Good Companions is owned by Good Companions Cumbria Ltd with Mr Mark Newby being the responsible individual. The home is run on a day to day basis by Mrs Jacci Derrane. The home is situated in Silloth, a seaside town overlooking the Solway Firth. The Good Companions is an older property that has been adapted and extended for its present use as a care home. Accommodation for service users is on three floors that are served by a passenger lift and stair lifts. All of the bedrooms are for single occupancy, with all but two having en-suite toilet and washbasin facilities. There are three lounges and a large dining room and a smoking area for those residents wishing to smoke. The toilets and bathrooms are equipped to assist people with disability. There are well kept gardens around the building and car parking facilities are provided. The home does not provide intermediate care. Full detials of the facilities, services and weekly charges at The Good Companions may be obtained by contacting the manager. Care Homes for Older People Page 3 of 8 What we found: The pharmacist inspector examined the handling of medicines by looking at relevant documents, storage and meeting with the manager Jacci Derrane and the head of care. The reason for the visit was to follow up a requirement made at the last pharmacist inspection on 27 May 2010. The inspection took three hours. Feedback was given at the end of the inspection to the manager and the head of care. Overall we found that medicines were handled well. The records relating to them had improved. The requirement made at the last inspection was met. No further requirements are made as a result of this visit but there are good practice recommendations. We looked at records for receipt, administration and disposal of medication. These were well kept with only occasional errors such as gaps. Overall there was an accurate record of the treatment received by residents. We did a stock check of a sample of medicines and compared them with records. These samples added up showing that residents received their medication in accordance with prescribed instructions, and all the medicines that were counted could be accounted for. We saw good records of communications with health care professionals such as GPs and changes to treatment were well documented. This enabled us to track most medication changes. The manager and head of care had introduced a system to highlight residents who were prescribed medicines that had special requirements for administration in relation to food, such as needing to be given on an empty stomach. This meant that these medicines were given at the appropriate time to ensure safety and effectiveness. We saw two recent courses of an antibiotic that should not be given with certain other medicines due to reduced effectiveness. However, in both cases we saw that they were given at the same time as another interacting medicine. One of these courses of antibiotics was ongoing at the time of the visit and the cautionary label on the dispensed medicine advised against this. We discussed this with the head of care who was going to seek further guidance. We checked a sample of care plans for managing medication and health related issues. These were variable in the level of detail they contained. We checked a care plan for the administration of a when required sedative for managing agitation. However, this was inadequate as it did not provide a plan for the management and monitoring of agitation that is person-centred. On occasions records did not fully account for why the medication was administered. Care plans should be reviewed so as to provide a clear management plan that is person-centred so that treatment is delivered in a safe, appropriate and consistent manner. We checked medicines liable to misuse, called controlled drugs. A register must be kept of all dealings with morphine type controlled drugs. The homes records for these were accurate and a stock check was in order. The home also kept a record in the register of diazepam and lorazepam that is not required by law but which could be seen as good practice. A stock check of these medicines was also done but the quantities did not tally with the register due to inaccurate records being kept. Although these records are not required by law it is recommended that if the medications are stored and recorded as controlled drugs that these records are accurate. Care Homes for Older People Page 4 of 8 The manager did regular checks, or audits, of medication and this will help identify areas for improvement to protect residents from medication errors. Staff who administer medication had received training in the task and had been assessed as competent to make sure that they employ safe practices. 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 £ 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 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 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 The service could ensure that cautionary labels on dispensed medicines are taken account of and managed appropriately. Where medication is stored and recorded as controlled drugs, these records should be accurate. The service should improve care plans for the management of medication and healthcare issues so that they are more person-centered. This will ensure that staff have clear management and monitoring guidelines so that residents receive safe, effective, appropriate and consistent treatment. 2 3 9 9 Care Homes for Older People Page 7 of 8 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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