Care Home: Westleigh Lodge

What the care home does well The service now handles all aspects of medication well. They make sure that records about medication are completed accurately which show that people are given their medication as prescribed. Effective systems are now in place to ensure that people`s health is not placed at risk from poor medicines handling. What the care home could do better: The manager and staff must keep a careful check on medicines handling, especially liquid medication, to make sure that everyone is given all their medicines as prescribed. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Westleigh Lodge Nel Pan Lane Leigh Lancashire WN7 5JT zero star poor service 17/11/2008 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: Avril Frankl Date: 2 3 0 2 2 0 0 9 Information about the care home Name of care home: Address: Westleigh Lodge Nel Pan Lane Leigh Lancashire WN7 5JT 01942262521 01942674783 westleighlodge@schealthcare.co.uk www.schealthcare.co.uk 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) : Southern Cross Healthcare Services Ltd care home 48 Number of places (if applicable): Under 65 Over 65 48 dementia Conditions of registration: 3 The home is registered for a maximum of 48 service users, to include: Up to 48 service users in the category of DE(E) (Dementia over 65 years of age); Up to 3 service user in the category of DE (Dementia under 65 years of age) may be accommodated within the overall number of registered places The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Westleigh Lodge is a purpose built three-storey nursing home that offers care for up to forty-eight people of either sex who are suffering with a dementia related illness. The Home is owned by Southern Cross Health Care and is situated on the outskirts of Leigh town centre. The Home is within easy reach of local shops and other amenities and is well served by public transport. There is a car park to the front of the Home and gardens at the rear. Accommodation is provided on the ground and first floor; both Care Homes for Older People Page 2 of 9 1 7 1 1 2 0 0 8 Brief description of the care home floors have a communal lounge and dining rooms. All residents have a single room with en suite facilities. Bathrooms and toilets are situated on both floors. There is a passenger lift to all floors; the third floor houses the homes kitchen, laundry and staff room. Residents do not access this area. The current rate of fees at Westleigh Lodge is 325.55 pounds per week. Additional charges are made for hairdressing and chiropody and tuck shop. Care Homes for Older People Page 3 of 9 What we found: The reason for this random inspection was to make sure that the requirements made in the Statutory Requirement Notice,dated 2 January 2009 had been complied with. A Statutory Requirement Notice is a legal notice, which is served on the provider when there has been a breach of regulations.The notice describes which regulations have been broken and what the provider must do to put right the breach; it also gives the date by which this must be done. We then follow up the notice by visiting the service to make sure that actions have been taken to meet the requirements and regulations. The requirements in this notice were made to make sure that service users health was not at risk from poor medication practices. A pharmacist inspector carried out the inspection. The visit lasted approximately four hours during which time we looked at medication together with records about medicines for six people. The manager made herself available to us throughout the whole of the inspection and we gave her detailed feedback during and at the end of the inspection. Four requirements were made in the Statutory Requirement Notice,which had to be complied with by 31 January 2009. We found significant progress had been made to meet all these requirements. The first requirement was to ensure that supplies of medicines are obtained in a timely fashion to make sure that service users do not go without their prescribed medication. We found effective systems had been put in place to make sure that staff knew how to order medicines properly and named members of staff were in charge of the ordering process. The staff now worked together with the supplying pharmacy to make sure that medicines did not run out. We saw a number of good examples of the systems working well and everyone had all their medicines available in the home in sufficient quantities to ensure continuity of treatment. The second requirement was to put in place effective arrangements at the home to ensure that all medication administration records are completed to accurately record medication administered to service users. We saw that a number of effective systems had been put in place to make sure the records accurately reflected the medication given to people. The manager made regular checks on the accuracy of the records and also did spot checks to ensure they were completed properly. Where the manager found that errors in recording had been made, she took appropriate action which included staff counseling. When we looked at the records we could see clearly exactly what medicines had been administered to people and that all medication could be accounted for by accurate record keeping. The third requirement was to put in place effective arrangements at the home to ensure that any omissions,variations or errors in the administration of prescribed medication are clearly, legibly and promptly recorded. This system must give an Care Homes for Older People Page 4 of 9 explanation for such errors. We found that staff were now recording when medicines were not given exactly as prescribed and the record included a full explanation as to exactly why the medicines had not been administered.The records also showed clearly when the prescriber changed the dose of medication or discontinued it, together with an explanation as to why the prescriber had taken this action. We also saw that the staff acted promptly on the new instructions, ensuring peoples health was not placed at risk. A system had been put in place to safeguard the health of service users who regularly refuse to take their medication. Letters were written to the prescriber seeking advice and their responses were kept with the persons medicines records. The fourth requirement was to put in place effective arrangements at the home to ensure that all medication is administered to service users in exact accordance with the prescribers directions. The managers audits, checks, on medicines together with better communication between staff ensured that people were being given their medicines properly. The standard of record keeping had improved which provided evidence that people were being given their medicines properly and that medicines could be accounted for. Records about how people should take their medicines had greatly improved. When creams were prescribed the records showed exactly where to apply the cream. When fluids, which needed to be thickened, were prescribed very clear information was displayed as to exactly how to thicken each persons fluids, and full records were kept by staff who were thickening the fluids. Care plans were put in the medication file when people were taking short courses of medicines to make sure they could be given their new medicines as prescribed, we also saw similar plans in place for medicines which were prescribed on a when required basis.The manager told us that all the staff had been on medication training courses, to make sure that they had a better understanding of how to manage medicines safely. When we looked at peoples medicines together with their records we saw that almost all medicines had been given as prescribed. However we found that one service user had only been given some of their medicines properly,liquid medicines had not been given well, even though the records showed that they had all been given as prescribed. The manager assured us that a full investigation would be carried out as to why some of their medicines had apparently not been administered properly. We found that all the requirements in the notice had been met and residents health was no longer at risk of harm from poor medication handling practices. What the care home does well: What they could do better: The manager and staff must keep a careful check on medicines handling, especially liquid medication, to make sure that everyone is given all their medicines as prescribed. Care Homes for Older People Page 5 of 9 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 6 of 9 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 Prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. To ensure that staff have relevant information and the care plan is a working tool. 15/12/2008 2 31 24 (1) You must ensure a system 08/08/2008 for maintaining the quality of the services provided and in the manner in which the services are to be provided. Care Homes for Older People Page 7 of 9 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 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 03000 616161 (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). 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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