Care Home: The Perry Tree Centre

What the care home does well The medicine management has improved to a safe level and good systems had been installed to ensure that the home maintains this standard. What the care home could do better: The home must ensure that all medicines are stored in compliance with their product licences and current regulations at all times. Inspecting for better lives Random inspection report Care homes for older people Name: Address: The Perry Tree Centre Dovedale Road Kingstanding Birmingham B23 5BX one star adequate service 18/12/2008 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: Debby Railton Date: 2 8 0 4 2 0 0 9 Information about the care home Name of care home: Address: The Perry Tree Centre Dovedale Road Kingstanding Birmingham B23 5BX 01216755571 01216755573 Telephone number: Fax number: Email address: Provider web address: Katymeakin@Birmingham.gov.ukwww.birmingh am.gov.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Social Care and Health care home 32 Number of places (if applicable): Under 65 Over 65 0 0 0 32 0 0 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Conditions of registration: 32 32 32 0 32 32 The maximum number of service users to be accommodated is 32. 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 (OP) 32 Dementia (DE) 32 Mental Disorder (MD) 32 Sensory Impairment (SI) 32 Learning Disability (LD) 32 Physical Disability (PD) 32 Care Homes for Older People Page 2 of 10 Date of last inspection Brief description of the care home 1 8 1 2 2 0 0 8 The Perry Tree Centre is a new two-storey building of Brick and tile construction. The centre has been designed and built to a high standard with input from the Sterling University regarding dementia design. The residential unit is accessed through a security door to which passes can be set to varying access levels, to exit a push button system is in operation. The accommodation consists of thirty-two single occupancy bedrooms all with en-suite facilities, on the ground floor, which include a walk in shower and an adjustable sink for wheelchair users. The accommodation is divided into units of eight with their own lounge/dinning areas, staff work stations for the location of files and medication. All bedrooms have communication systems, which, include pull cords and voice communication, which can only be cancelled at the point of call. The system can be extended to included other assistive technologies. All bedrooms exceed current NMS about personal space. All rooms have access for wheelchair users. Bedrooms have TV and telephone points; the site has Wi-Fi for computer access. The centre has two gardens, which have been equipped to a high standard with sensory facilities. There is kitchen that caters for the whole building and a laundry sited outside of the unit. There is some parking in a designated car park at the front of the building. Fees charged at the home are assessed by placing social workers. Care Homes for Older People Page 3 of 10 What we found: The pharmacist inspection lasted just over two hours. The team leader was present during the inspection and was very pro-active throughout. Six people who live in the home medicines were looked at together with their medicine administration record (MAR) charts, care plans and other supporting documentation. Due to the poor standard of medicine management seen at the last pharmacist inspection on 11th February 2009 a warning letter was issued. The medicine management had improved to a safe level since then and seven of the eight requirements issued at the last inspection had been met. No new requirements were left at the end of this inspection. The home has installed a system to check all the prescriptions before they are dispensed and also to check the medicines received into the home. A simplified system is now in use to record what medication has been received which make audits to demonstrate that they have been administered correctly, easier to undertake. All the staff adhere to this system so all the information recorded is easy to check. All peoples MAR charts have a facing page enabling staff to identify the resident and also see who their doctor is and if they have any allergies to some medication. Audits indicated that the majority of medicines had been administered as prescribed and records reflected practice. A few errors were seen mainly where staff had failed to record exactly what they had done. Some medicines had been administered but staff had not signed the MAR chart following the transaction. The team leader was to identify who was on each shift where the errors were found and take appropriate action to prevent this occurring in the future. A quality assurance system had been set up to check all medicines dispensed in traditional bottles or boxes on a regular basis to ensure that they are administered as prescribed. This had reduced the number of errors seen compared to the last inspection. All external preparations for example creams, ointments and shampoos were recorded on the MAR chart but there was also a separate cream chart kept in the persons room for the care staff to complete when they had applied the preparation. The daily records recorded all doctors visits with outcomes so it was easy to see why a new medication had been prescribed. The care plans detailed the clinical condition of the people who lived in the home, but this information was not that easy to find. The team leader had a thorough understanding of the clinical needs of the people she looked after and understood what the majority of the medicines administered were for. The medication room was still too hot and the temperature inside of the medication trolleys was as high as 28C. Medicines stored in the surplus cabinets and the Controlled Drug cabinet were also stored at too hot a temperature (28C). During the inspection the manager obtained a portable air conditioning system to ensure that the temperature in the medication room would at last be lower to safely store the medication by the end of the day. A permanent air conditioning system was due to be Care Homes for Older People Page 4 of 10 installed at a later date. All controlled drug balances were correct and the balances and transactions recorded on the MAR chart reflected those recorded in the CD register. They unfortunately were not stored correctly as the CD cabinet used did not comply with current legislation. Again the manager was keen to address this immediately after the inspection. 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 7 15 There must be a written plan 31/03/2009 that describes how the needs of the people living in the home are to met. This will ensure that the staff know the needs of the people living in the home and they can be met in a person centred way. 2 7 15 Care plans (ISS) must be updated as changes in need oocur. Ths will ensure that the staff will know what the current needs of the people living in the home are. 01/02/2009 3 8 13 There must be a risk assessment and management plan in place for all identified risks. This will ensure that the staff know how any risks can be safely managed and the people living in the home is safeguarded. 28/02/2009 4 8 13 A tissue viability assessment 01/02/2009 and management plan must in place for people at risk of developing pressure ulcers. This will ensure that a plan is 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 in place that will minise the risks of individuals developing pressure ulcers. 5 9 13 The MAR chart must record 13/03/2009 the current drug regime as prescribed by the clinician. 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 correct medicine is administered to the correct service user at the correct dose and time and records reflect practice 6 12 12 Any decisions made to 28/02/2009 override an individuals decision must be recorded with details of why the decision has been made, by whom and whether it is in line with the mental capacity act. This will enable the people living in the home toremain in control of decisions affecting their lives unless it has been determined that it is in their best interest. 7 22 23 The emergency call system 31/01/2009 must meet the requirements of the home. This will ensure that the people living in the home get help when they need it. Care Homes for Older People Page 7 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 8 32 26 The providers representative 31/01/2009 must visit on a monthly basis and provide a report of the visit. This will ensure that any problems arising can be addressed and the provider can be assured that the home is being run in the manner required. 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 1 13 All medication should be stored in compliance with current regulations and at the correct temperature as stated in the medications individual product licences. Care Homes for Older People Page 9 of 10 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). 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