Care Home: White Ash Brook Nursing Home

What the care home does well Patient support is offered where people need help when taking their medicines and Home Remedies as kept to enable people to have treatment for e.g. minor pain without needing a prescription from the doctor. What the care home could do better: Some medication records could be more clearly and completely made to better support the safe handling of medicines and reduce the risk of mistakes. Inspecting for better lives Random inspection report Care homes for older people Name: Address: White Ash Brook Nursing Home White Ash Brook Nursing Home Thwaites Road Oswaldtwistle Accrington Lancashire BB5 4QR one star adequate service 01/12/2008 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: Stephanie West Date: 1 6 0 3 2 0 0 9 Information about the care home Name of care home: Address: White Ash Brook Nursing Home White Ash Brook Nursing Home Thwaites Road Oswaldtwistle Accrington Lancashire BB5 4QR 01254394163 01254872152 whiteashbrook@mimosahealthcare.com www.mimosahealthcare.com 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) : Mimosa Healthcare Limited care home 53 Number of places (if applicable): Under 65 Over 65 0 0 27 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 1 1 0 8 Within the overal total of 53 a maximum of 1 named service user who falls into the category of MD. When the named service user reaches the age of 65 years or no longer resides at the home an application to vary the registration and revert back to the original must be made. Within the overall total of 53 a maximum of 27 service users requiring nursing care who fall into the category of OP Within the overall total of 53 a maximum of 8 service users requiring nursing care who fall into the category of PD Care Homes for Older People Page 2 of 8 Within the overall total of 53 there can be a maximum of 1 named service user who falls into the category of DE. When the named service user reaches the age of 65 years or no longer resides at the home an application to vary the registration and revert back to the original must be made. Within the total of 53 places there can be a maximum of 20 service users requiring personal care who fall into the category of OP Within the total of 53 places there can be a maximum of 25 service users requiring nursing care who fall into the category of DE(E) Date of last inspection Brief description of the care home White Ash Brook is a purpose built home registered to provide 24 hour nursing and personal care for up to 53 people. The home has two separate units. Foxhill, which offers personal and nursing care for both older and younger adults and Stanhill, which offers care to older people suffering from dementia. Accommodation is provided in single en-suite rooms located on the ground floor. Communal lounges and dining rooms are also on the ground floor. The gardens are easily accessible to all residents. There is a car park for visitors and staff. The home is situated in the small town of Oswaldtwistle close to local amenities. The current fees charged at White Ash Brook are £342.50 - £675 per week. Additional charges are payable for hairdressing and newspapers. A copy of the statement of purpose and service user guide is available on request. 0 1 1 2 2 0 0 8 Care Homes for Older People Page 3 of 8 What we found: This visit was carried out to look at the arrangements for handling medicines at the home and to look at how concerns raised at the previous inspection were being addressed. The visit focused on medication handling, other areas and requirements were not examined on this occasion. The visit lasted approximately fours hours and involved discussing the handling of medication with the nurse-in-charge, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the nurse-in-charge. We found the medicines arrangements were generally satisfactory but that weaknesses in the handling of prescribed external preparations (e.g. creams) remain to be addressed. Medicines policies were available for reference providing written guidance to nurses in the handling of medicines at the home. The home has arrangements in place so that non-prescribed medicines for the treatment of minor ailments can be given. This benefits people at the service as they can receive treatment for conditions such as minor pain without delay and without the need to see the doctor. Part of the morning medicines round was observed. Care was taken to complete the records immediately after administration to help ensure they are accurately maintained, reducing the risk of mistakes. Where medicines were prescribed when required there was generally written guidance for staff about when they may be needed and how this need may be made known, although this still needed to be completed for a person who had only recently come to live at the home. Patient support was offered where people needed help when taking their medicines. Care was taken to ensure that where doses were repeated through the day, enough time was left between doses. People who wished to, and were able to were supported to selfadminister their own medicines. Records showing the administration of medication were generally up-to-date but there were some areas that could be improved to ensure the completeness and clarity of these records: When medicines were prescribed for example, one or two the actual dose given was not always recorded and as previously seen (although one person spoken with said their creams were being used as needed) records were not always made to show the application of prescribed creams, so it was not always possible to tell if they had been used properly. It is important to show exactly what was administered and records for the application of prescribed creams must be accurately maintained, as for any prescribed medication. Care needs to be taken to ensure that where doses of regularly prescribed medicines are not given, the reason is always recorded. Records for the receipt and disposal of medication were generally clear and accurate. Records for communication with doctors were mostly good and changes to medication could be tracked, reducing the risk of errors. We saw that new prescriptions and dose changes were normally started promptly. Stock control was generally satisfactory, but we again saw examples where people had missed (1 day), or were at risk of missing doses of medicine, because new stocks did not come with the regular monthly order. Nursing staff explained that they had again recently changed supplying pharmacy, and that they had not been able to see and check all the previous months prescriptions. Care Homes for Older People Page 4 of 8 Nurses explained that arrangements had now been made for all monthly prescriptions to come to the home as soon as possible, giving more time for any queries or changes to be checked, reducing the risk of medicines running out. We found that medicines, including controlled drugs, were stored securely. This helps to ensure that they are not misused or mishandled. Regular audits of medication handling are carried out. These need to continue to help ensure continued improvement in the handling of medication, and that where weaknesses are identified they are promptly addressed. 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 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 Appropriate arrangements must be made for handling and recording of prescribed external preparations (e.g. creams) to help ensure they are safely used as prescribed. 05/01/2009 2 22 13 All nurse call bells must be in 13/02/2009 full working order and accessible to people using the service. This ensures people using the service can ask for help when needed and members of staff can summon help in an emergency without leaving the room. 3 26 16 The odour problem in the shower room must be addressed. rationale This will promote the wellbeing of people who use the service and provide a homely environment. 16/01/2009 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 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. 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. 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