Care Home: Thornton Hall & Lodge

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What the care home does well Regular medicines audits (checks) are completed to help ensure that should any shortfalls arise in the handling of medication they can be promptly addressed. What the care home could do better: Medicines record keeping needs to further improve to better support the safe administration of all medication, including external preparations. Care needs to be takento ensure that any special label instructions e.g. `before food` are followed when administering medication. Random inspection report Care homes for older people Name: Address: Thornton Hall & Lodge Tanhouse Road Liverpool Merseyside L23 1UB two star good service 18/05/2009 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: Stephanie West Date: 0 3 0 3 2 0 1 0 Information about the care home Name of care home: Address: Thornton Hall & Lodge Tanhouse Road Liverpool Merseyside L23 1UB 08456044972 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Paul Ashmore Type of registration: Number of places registered: Conditions of registration: Category(ies) : Thornton Hall & Lodge care home 96 Number of places (if applicable): Under 65 Over 65 48 48 dementia old age, not falling within any other category Conditions of registration: 48 0 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 care home are within the following categories:Old age not falling within any other category - Code OP (maximum number of places: 96) Dementia - Code DE (maximum number of places:96). The maximum number of service users who can be accommodated a the care home is 96. Date of last inspection Brief description of the care home Thornton Hall and Lodge is registered to provide care for up to 96 older people. The home can provide care to older people who have dementia as part of their registration. Care Homes for Older People Page 2 of 8 1 6 1 1 2 0 0 9 Brief description of the care home The home is owned and managed by Orchard Care. The home is new and was purpose built. As such the home environment meets requirements in relation to size, facilities and aids and adaptations. The home and grounds are fully accessible to people who are physically disabled or who use a wheelchair. The home is a two storey building and access to the first floor can be gained via stairs or a passenger lift. The rear garden is large and is landscaped for ease of use by the people living at the home. The home is currently divided into four seperate areas each accomodating twenty four people. Each area offers three lounges, a large dinning room and satellite kitchen area. There is also a communal hairdressing salon. The fees for residing at the home range from £389 to £585 per week. Care Homes for Older People Page 3 of 8 What we found: This visit was carried out to look at the homes medication arrangements to look at the action taken to meet the requirements of our previous visit. The visit involved discussing the handling of medication with the managers and senior staff, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the managers. This visit focused on medicines handling, other areas and requirements were not examined at this time. We found that continued action had been taken to improve the handling of medicines at the home, but there were some areas that remained to be addressed in order to better support and evidence the safe handling of medication. We looked at medicines administration. All medicines are administered by staff who have completed certificated training. Care was taken to refer to, and complete the medicines records at the time of administration to each person. But, as seen at our previous visit the arrangements in place to help ensure any special label instructions e.g. before food are followed need to be improved. Staff spoken with explained that they knew which people needed to have medicines before breakfast and made tried to ensure they had their medicines first. However, this reliance on memory increases the risk that these special instructions will be missed. On the visit day we saw that one person had not been given a tablet labeled before food before their breakfast. We compared a sample of medicines stock and records and found with the exception of an occasional discrepancy it was possible to account for (track) medicines handling in the home. We saw that medicines stock control had improved helping to ensure that an adequate supply of medicines was kept in stock, without overstocking. However, shortfalls remained in the handling of prescribed external preparations e.g. creams. We saw that records were not always made to show the application of prescribed creams and that some people had supplies of cream that were not included on, or had been crossed off their current medication record. We found a lack of information about the use of creams within peoples care plans. This meant we could not always tell whether creams were being applied as needed. Similarly, we found occasional gaps in the records for the use of prescribed nutritional supplements. We saw someones medicines records showed that doses had been missed because they were away from the home at the time the medicines were administered, where possible consideration should be given to peoples medicines needs when away from the home. The manager carries out regular medicines audits (checks) helping to ensure the homes medication procedures are followed and that should any shortfalls arise, they can be promptly addressed. What the care home does well: What they could do better: Medicines record keeping needs to further improve to better support the safe administration of all medication, including external preparations. Care needs to be taken Care Homes for Older People Page 4 of 8 to ensure that any special label instructions e.g. before food are followed when administering medication. 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 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 There must be a complete, clear and accurate list of currently prescribed medication (including external preparations) for each person and of the time and date of administration. This is to help ensure medication is safely administered as prescribed. 28/12/2009 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 Further consideration should be given to the arrangements for ensuring any special label instructions such as, before food are followed to reduce the risk that they will be accidentally missed. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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