Care Home: Upton Grange

What the care home does well Storage facilities for medicines are secure. This means only authorised staff have access to the medicines and this keeps them safe. What the care home could do better: A controlled drug cupboard should be obtained so that medicines, specified in law as being liable to misuse, can be stored properly. More attention must be given to making medicine records complete and correct. These provide evidence that residents are protected by having their medicines correctly. There should be a system to ensure that medicines are given and recorded correctly by competent staff. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Upton Grange 214 Prestbury Road Macclesfield Cheshire SK10 4AA two star good service 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: Elaine Bray Date: 0 9 1 2 2 0 0 8 Information about the care home Name of care home: Address: Upton Grange 214 Prestbury Road Macclesfield Cheshire SK10 4AA 01625829735 01625820266 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) : Cheshire Residential Homes Trust care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: 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 home are within the following categories: Old age, not falling within any other category. The maximum number of service users who can be accommodated is: 25. Date of last inspection Brief description of the care home Upton Grange is one of three care homes owned by the Cheshire Residential Homes Trust, which is a charitable non-profit making organisation. A committee of volunteers runs the home, which provides personal care and accommodation for up to 25 older people. There is one bedroom available for a person to stay for a short stay. The home is close to Macclesfield town centre. There are a number of shops, and other facilities nearby. There are adequate car parking facilities available at the home. Upton Grange is an older style large country house, with bedrooms on the ground and first floor. Care Homes for Older People Page 2 of 8 Brief description of the care home Access between floors is via a passenger lift or the stairs. There are 25 single bedrooms of varying sizes, all of which have en-suite facilities. Communal space consists of 2 lounges and a dining room. There is a large well-maintained private garden with walkways and seating areas and an enclosed courtyard seating area. The current fees are 422 pounds per week or 1828 pounds per calendar month. Further details regarding fees are available from the manager. Additional charges are made for newspapers, hairdressing, private chiropody, dentist, toiletries and opticians. Visitors to the home and residents are able to read the latest CSCI inspection report, which is available in the office. Care Homes for Older People Page 3 of 8 What we found: This inspection was carried out to see if the requirements about medicines, made at the last inspection on 30th July 2008, had been met. We found that whilst there was some improvement in the records, the three requirements had not been fully met. We looked at the facilities for storing medicines and found them to be secure. But, the law about medicines that are liable to misuse has changed. Now, care homes that provide only personal care (not nursing) must store these in a controlled drug cupboard (one that meets the specification of the Misuse of Drugs Regulations). We looked at how medicines were given and recorded. The standard of recording medicines had improved. Most medicines had clear, complete directions of how they should be given. Many medicines had been given and recorded correctly. It was easy to compare the medicines in the monitored dose pack with the records, to show that the medicines had been given correctly. It was difficult with the medicines supplied in conventional containers as there was no cross reference between the records and the amounts left. There was no record of the evening dose of three medicines prescribed twice daily. It appearred that they had been given incorrectly. The manager said that these evening doses had been given but not recorded. Sometimes, more doses of antibiotics were recorded given than had been supplied. This suggests that records have been made but the medicine not given. Hand written additions to the printed records were not signed and dated to show who to ask if there were problems. Records of receiving medicines into the home were not complete (showing quantity received, date of receipt and the initial of staff) and some had been missed, particularly for those medicines received mid-cycle. When medicines, like painkillers, were prescribed as a variable dose, the actual dose given was not recorded. This should be shown to help ensure that an overdose is not given. It is important that medicines are given and recorded correctly to protect residents health from harm. There was no evidence of a system to check that medicines and medicine records were correct. Staff supervision is important to be sure that residents are protected by having their medicines correctly. What the care home does well: What they could do better: A controlled drug cupboard should be obtained so that medicines, specified in law as being liable to misuse, can be stored properly. More attention must be given to making medicine records complete and correct. These provide evidence that residents are protected by having their medicines correctly. There should be a system to ensure that medicines are given and recorded correctly by competent staff. Care Homes for Older People Page 4 of 8 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 requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 9 13 The standard of giving and 31/08/2008 recording medicines must be supervised. To be sure that medicines are given and recorded correctly to protect residents health. 2 9 13 Clear and accurate records of 31/08/2008 medicines received into, administered and disposed of by the home must be maintained. So that residents medicines can be fully accounted for to show that they have been given correctly and have not been mishandled. 3 9 13 A controlled drug cupboard must be ordered. To provide the additional security, required by law, to the medicines liable to misuse so that they are not mishandled. 31/08/2008 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, Care Homes 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 7 of 8 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. 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