Random inspection report

Transcription

1 Random inspection report Care homes for older people Name: Address: Hunningley Grange 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ The quality rating for this care home is: zero star poor service The rating was made on: 24/11/2009 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: Date: Steve Baker

2 Information about the care home Name of care home: Address: Hunningley Grange 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ Telephone number: Fax number: address: Provider web address: none NONE Name of registered provider(s): Mr Azad Choudhry Name of registered manager (if applicable) Mrs Julie Scholey Type of registration: care home Number of places registered: 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 old age, not falling within any other category 0 36 Conditions of registration: Date of last inspection Brief description of the care home Hunningley Grange is a detached residence with a purpose built extension, registered to provide personal care for 36 residents. All accommodation and services are on the ground floor. The home is located in the centre of Stairfoot, approximately two miles from Barnsley Town centre and situated on a main bus route. The home is within walking distance of a full range of shops e.g. chemist, newsagent, hairdressers, dentist, supermarkets, post office, health centre, cafes and fast food outlets. There is car parking at the front and side of the home. Care Homes for Older People Page 2 of 9

3 Brief description of the care home The home provides information to people and their relatives prior to admission into the home. Service User Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in entrance for visitors to read. Fees were , further details can be obtained from the manager. Care Homes for Older People Page 3 of 9

4 What we found: The reason for this inspection was to find out what actions the home had taken to improve medication practices following the last full inspection of the home in November A pharmacist inspector spent 4.75 hours in the home looking at the medication ordering, storage, handling and disposal arrangements, examining medication administration record charts (MARs) and speaking to staff. The outcome is as follows. We found many improvements in medication ordering, receipt, checking and record keeping. Although most medication management processes in the home now follow best practice, staff were not aware of all recent professional guidance documents. Some additional improvements in medication record keeping are recommended to ensure a complete record is maintained of all medicines used in the home. The outstanding medication requirements issued at previous inspections are now met. The management team is clearly commited to ensuring all medication practices throughout the home continue to be safe. Some authorised staff are receiving appropriate update training in medication safety and further training is planned. The staff on duty were willing to find out about the latest best practice guidance as the home's medication policy does not always reflect such guidance. We observed staff on duty working closely with visiting healthcare professionals to improve people's health and wellbeing. We examined the 15 current MARs for accuracy and completeness and found no significant gaps. Together with the checks made by the management team, this indicates that people living in the home can expect to receive their prescribed medicines correctly. We found good records for the use of painkillers prescribed to be taken as and when needed and staff had also clarified some MAR entries with detailed explanations of how to give medicines prescribed 'as directed' by the doctor. This good practice helps to ensure all staff understand what is expected of them when interpreting such vague instructions. However, a few hand written changes and entries on the MARs were not signed or dated and they lacked a witness signature. Hand written entries and changes to MARs must be clear, detailed, complete and safe arrangements must be made to ensure staff know the reasons for the changes. A second person should always check these entries for accuracy so that all staff follow the changes on the MARs correctly. Not all the new MARs indicated the quantities of medicines brought forward from the previous month. Without this information, it is difficult to check that medicines are being given correctly or to be sure that sufficient medicines are available until the next delivery is due. In future, it would also be helpful if staff were to assess and record the personal medicine taking preferences of people living in the home. This good practice will help to reduce the risk of doses of medicine being refused or omitted. Medication ordering, receipt, storage and disposal arrangements in the home are good, but the GP prescriptions are not yet checked by staff each month before the medicines are delivered. Putting this check in place will help to make sure the home is aware of any prescription changes and staff will know that sufficient quantities of everyone's medicines have been prescribed each month. Care Homes for Older People Page 4 of 9

5 Finally, it was of some concern to learn on the day that suitably qualified staff are not always available 'round the clock' to give medicines to people whenever they might be needed. The management team agreed to put effective arrangements in place within 24 hours to cover all shifts with a senior carer who has received medication training and is competent to give medicines. The success of these arrangements will be assessed at a future inspection. What the care home does well: The new management team has made improvements to ensure medication practices in the home are made safe. All staff are carrying out medication safety update training. Good working relationships and communications exist with NHS healthcare professionals. Most medication records are clear and detailed. What they could do better: Suitably trained staff should be on site at all times to administer medication whenever needed. GP prescriptions should be checked for accuracy and completeness each month. All hand written entries and changes to MARs should be signed, dated and checked for accuracy. New MARs should include a record of the quantities of medicines brought forward from the previous month. People's own preferences for taking medicines should be recorded and respected. The medication policy and procedures should reflect currect professional guidance. 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

6 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 Suitable arrangements must be made to ensure good hygiene practices take place. This includes appropriate kitchen facilities, 04/01/2010 To control the risk of infection and maintain a clean, hygienic environment. (timescale 05/10/09 not met) Care Homes for Older People Page 6 of 9

7 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 Arrangements must be put in place to ensure that sufficient numbers of suitably trained and competent staff are working in the home at all times. 09/04/2010 This will help to make sure that everyone's personal and healthcare needs, including receiving medicines as and when needed, are always met. 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 9 New MARs should include a record of the quantities of medicines brought forward from the previous month. 2 9 GP prescriptions should be checked for accuracy and completeness each month. 3 9 The medication policy and procedures should reflect current professional guidance. 4 9 People's own preferences for taking medicines should be recorded and respected. Care Homes for Older People Page 7 of 9

8 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 5 9 All hand written entries and changes to MARs should be signed, dated and checked for accuracy. Care Homes for Older People Page 8 of 9

9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act Copies of the National Minimum Standards Care Homes for Older People can be found at or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: Online ordering from the Stationery Office is also available: Helpline: Telephone: Web: 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. Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and Care Quality Commission Care Homes for Older People Page 9 of 9