Care Home: Willows Nursing Home Limited

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What the care home does well We found no significant examples of good practice when handling medicines. What the care home could do better: Records of medicines received into the home, given to people and disposed of must be clear, accurate and complete so that all medicines can be fully accounted for. Medicines must be administered to people as prescribed because giving medicines at the wrong dose or not at all can seriously affect their health and wellbeing. Regular recorded audits of the medicines should be carried out to help make sure medicines are handled safely by suitably skilled staff. Random inspection report Care homes for older people Name: Address: Willows Nursing Home Limited 10 Weld Road Southport Merseyside PR8 2AZ one star adequate service 22/04/2010 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: Simon Hill Date: 0 6 0 9 2 0 1 0 Information about the care home Name of care home: Address: Willows Nursing Home Limited 10 Weld Road Southport Merseyside PR8 2AZ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Willows Nursing Home Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category/ies of service only: Care home with nursing- Code N to people 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 The maximum number of people who can be accommodated is: 30 Date of last inspection Brief description of the care home The Willows is an older detached property that has been converted into a care home providing nursing care for thirty older persons. It is situated close to the sea front at Birkdale and is also within walking distance of Birkdale village. The home provides accommodation over three floors with lift access to all three. One bedroom situated on Care Homes for Older People Page 2 of 9 2 2 0 4 2 0 1 0 Brief description of the care home a mezzanine level floor has stair access and is used for residents with no mobility problems. There are twenty four single bedrooms and three double bedrooms. The communal day space consists of one large sitting room and a conservatory extension attached. There is disabled access to the rear of the building and the garden can be accessed. There is a call bell system in the home. This service is operated by Mr & Mrs Jackson and the manager is Ms Benita Calderbank. The fee rate for accommodation is from £515.00 to £616.00 a week. Care Homes for Older People Page 3 of 9 What we found: We carried out this visit to look at how medicines were being handled because we found some shortfalls on our last inspection. The visit was carried out by a specialist pharmacist inspector who looked at medicines stocks, medicines records and spoke with two members of staff. Overall we found some improvements had been made but still found shortfalls that meant medicines were not always handled safely. We carried out detailed checks on a sample of medicines records and found the records of medicines received into the home were not always complete. We found several records where quantities of medicines had not been recorded so we could not account for them and most records were not dated properly so we could not be sure when the medicines were received into the home. Medicines were not clearly carried forward at the start of a new monthly medicines cycle and we saw excessive stock being destroyed because the reordering system was not efficient. External medicines such as creams were not always well recorded so we gave some advice about how these could be improved. Poor record keeping can lead to serious mistakes that could harm the health and wellbeing of people who live in the home. We checked the records of medicines given to people and found some mistakes. When medicines were omitted for example if they were refused then a clear reason was not always recorded and the paperwork to support this was not always completed correctly. Medicines to be given as when required had very little or no information about how and when they were to be used so we gave the manager some advice about how to improve this. One person received the wrong dose of a strong medicine on three consecutive days because nursing staff had not acted on information sent to them following a blood test. We found further examples of medicines not adding up showing occasional doses had been missed particularly for medicines contained in traditional boxes and bottles. Having medicines at the wrong dose or not at all can seriously affect a persons health and wellbeing. We looked at how people were supported to look after their own medicines and found some improvements since our last visit because new paperwork had been developed that helped monitor how much medicine people were using. However, we still found it difficult to account for all these medicines so we gave some further advice about how this could be improved. Supporting people to safely look after their own medicines helps them retain some of their independence. We looked at how controlled drugs were handled and found the cupboard used to store them was secure. Records were made in a suitable register and these were properly witnessed. Having secure storage and properly witnessed records help prevent the misuse and mishandling of controlled drugs. We looked at how the manager made sure staff were competent and made sure medicines were being handled safely. The manager said audits were carried out every month but none had been recorded in the last four months. The manager agreed that these unrecorded audits had not been effective at finding mistakes so we gave some advice about how to improve this. Formal assessments of staff competence had been carried out since our last visit and we saw some evidence of poor practice being dealt Care Homes for Older People Page 4 of 9 with through staff disciplinary procedures. Having regular effective audits and thorough assessments of staff competency help make sure medicines are handled safely by suitably skilled staff. 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 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 9 13 Records of medicines 05/08/2010 received into the home, given to people and disposed of must be clear, accurate and complete. This is important to help make sure medicines can be fully accounted for. 2 9 13 Medicines must be administered to people as prescribed. This is important because giving medicines at the wrong dose or not at all can seriously affect their health and wellbeing. 05/08/2010 3 19 16 The carpet must be replaced 01/07/2010 in the conservatory, as there is adhesive tape over worn areas. This will help to provide suitable floor covering in this room. The use of adhesive tape may pose a trip hazard to people in this room. 4 19 23 The windows affected by condensation as the glass has blown must be replaced. 01/07/2010 Care Homes for Older People Page 6 of 9 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 This will help to ensure the room is suitable for the residents to sit in. 5 19 13 The two damp patches to the 01/06/2010 first floor and ground floor must be treated. Damp may be hazardous to the residents health and must be eliminated. 6 24 16 Bedrooms identified with the 01/07/2010 manager must be provided with new bedroom furniture, to include bedside tables. This will help to provide suitable furniture for the residents to use. 7 25 13 Checks of the hot water to the baths/showers must be undertaken and recorded This will help to ensure the hot water is delivered at a safe temperature for residents use. 8 26 16 The laundry room requires plastering and replacement of a chipped tile. This will help to improve the standard of infection control in this room 9 37 17 Staff files must be available for inspection. This will ensure recruitment practices are safe to protect people in the home. Care Homes for Older People Page 7 of 9 01/06/2010 01/07/2010 11/08/2009 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 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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