Care Home: Victoria House Care Centre

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What the care home does well People can expect to be given their prescribed medicines correctly. Medicines record keeping on both residential units is of a very high standard. Storage and handling arrangements for medicines, including for controlled drugs, are good. What the care home could do better: The use of those medicines prescribed `when required` should be supported by a robust care plan. Medicines management record keeping on the nursing unit needs further improvement. The company`s medicines policy should be updated to reflect current professional advice. Random inspection report Care homes for older people Name: Address: Victoria House Care Centre Middlesbrough Park Road North TS1 3LD one star adequate 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 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: Steve Baker Date: 2 3 0 8 2 0 1 0 Information about the care home Name of care home: Address: Victoria House Care Centre Middlesbrough Park Road North TS1 3LD 01642242975 Telephone number: Fax number: Email address: Provider web address: vh@keyhealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Deborah McKinley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Key Healthcare (Operations) Limited care home 68 Number of places (if applicable): Under 65 Over 65 0 10 0 dementia old age, not falling within any other category physical disability Conditions of registration: 58 0 12 The maximum number of service users who can 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 - Code OP, maximum number of places 10, Dementia - Code DE, maximum number of places 58, Physical Disability - Code PD, maximum number of places 12 Date of last inspection 0 9 0 6 2 0 1 0 Care Homes for Older People Page 2 of 8 Brief description of the care home Victoria House Care Centre is a large converted Victorian property with a modern extension that has been in place for a number of years. The home is close to the centre of Middlesbrough and is opposite Albert Park. It is close to public transport and shops are nearby. Victoria House Care Centre offers spacious accommodation both communal and bedrooms. Some of the bedrooms have ensuite facilities, whilst others have wash-hand basins. There are a number of units within Victoria House Care Centre, a unit for younger adults with physical disabilities on the ground floor, a unit for older people with dementia, set across two floors and two units for older people with dementia who have nursing needs set across two floors. Care Homes for Older People Page 3 of 8 What we found: The reason for this inspection was to check the quality of the medicines management systems following concerns identified at earlier inspections. A pharmacist inspector spent four hours in the home looking at selected care files, the medication administration record charts (MARs) and the medicines ordering, receipt, storage and disposal arrangements in the home. People living in the home can expect to be given their prescribed medicines correctly. We found that the medicines systems are of a very high standard in the two residential care units but some improvements in practice and record keeping are needed in the nursing unit. We examined 45 recent MARs for accuracy and completeness and found no administration gaps. We found no evidence that people had run out of their medicines during the last month. There are good communication systems in place with local healthcare professionals meaning that any changes in treament are acted upon quickly. Medicines are stored securely at temperatures recommended by the manufacturer. This means that staff know medicines should be safe to use when needed. We found several examples of good practice on each of the residential units. For example, MAR charts are marked with detailed additional directions for the use of skin care products prescribed as directed by the GP. This means all care staff understand what needs to be done so that people are likely to receive the intended benefits of such treatment. Improved medicines checking systems are in place to identify gaps in the records and any likely shortages in good time. One team leader told us that care staff now constantly check their work to make sure everyone always gets the right medicine and that no-one ever runs out of anything. Some hand written changes and new entries to MARs on the nursing unit had not been signed, fully completed or checked for completeness and accuracy by a second person. The wrong treatment may be given if these details are not copied correctly from the pharmacy label. Some MARs on the nursing unit lacked up to date information about the amount of medicine received in the home or brought forward from the previous month. Without this information, it is not always possible to check that medicines are being used correctly. We looked at the care plans for some people who were prescribed medicines as required. Not all these care plans were sufficently clear or detailed to ensure nursing staff would use these medicines safely and consistently. Such care plans should be reviewed regularly and advice sought from the appropriate healthcare professional. We were told that care staff applied most of the skin creams prescribed on the nursing unit each morning but that the records were made afterwards by the nurse on duty. On checking, we found incomplete records for the use of some skin care products. Most of the MAR charts listing skin creams did not describe how they were to be used so it is not clear whether these products were being used as intended. Finally, we were shown the companys medicines policy and saw that it was dated November 2005. This document should now be updated to reflect current professional guidance on the safe and effective use of medicines in care homes. What the care home does well: Care Homes for Older People Page 4 of 8 People can expect to be given their prescribed medicines correctly. Medicines record keeping on both residential units is of a very high standard. Storage and handling arrangements for medicines, including for controlled drugs, are good. 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 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 38 23 Risk assessments on the safe 15/07/2010 use of bed rails must be in place in all cases where bed rails are in situ. To ensure the safety and welfare of people living at the home. 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 2 3 4 5 9 9 9 9 9 All hand written entries to the MARs should be checked for accuracy and completeness by a second person. Quantities of medicines in use brought forward from the previous month should be recorded on the new MARs. The companys medicines policy should be updated to reflect current professional advice. Effective arrangements for the use of prescribed skin care products should be put in place. The use of medicines prescribed when required should be supported by an up to date robust care plan. 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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