Random inspection report
Care homes for older people
Name:
Haylands
Address:
93 Crofts Bank Road
Urmston
Manchester
M41 0US
The quality rating for this care home is:
two star good service
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:
Avril Frankl
Date:
2
6
0
8
2
0
0
9
Information about the care home
Name of care home:
Haylands
Address:
93 Crofts Bank Road
Urmston
Manchester
M41 0US
Telephone number:
01617483185
Fax number:
Email address:
Provider web address:
Name of registered provider(s):
Urmston Housing Society
Type of registration:
care home
Number of places registered:
24
Conditions of registration:
Category(ies) :
old age, not falling within any other
category
Number of places (if applicable):
Under 65
Over 65
0
24
Conditions of registration:
The registered person may provide the following category of service only: Care home
only - Code PC. To service users of the following gender: Male. 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 service users
who can be accommodated is: 24.
Date of last inspection
Brief description of the care home
Haylands home for retired gentlemen is registered to accommodate a maximum of
twenty-four service users who require personal care by reason of old age. The home is
situated within walking distance of Urmston town centre with public transport routes
close by. The building is a large detached Victorian house with well-maintained
enclosed gardens. There is off road parking at the front of the property. There are
fourteen single rooms and five twin bedded rooms. Two of the single rooms have ensuite facilities and there are toilets and bathrooms on each floor. A stairlift provides
Care Homes for Older People
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Brief description of the care home
access to all floors and there are additional toilet facilities on the ground floor with
disabled access. The fees for accommodation are 250 pounds per week and the fees
include all meals, laundry, domiciliary chiropody and entertainment. Additional costs
include hairdressing, dry cleaning and telephone calls.
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What we found:
We visited the home because at the previous two inspections we had found some
concerns in the way medicines were handled. This visit was to make sure that
improvements had been made so that service users' health was not at risk from poor
medication practices.
The visit was carried out by a specialist pharmacist inspector. The visit lasted about three
and a half hours during which time we looked at medication together with records about
medicines for several service users. We spoke to the registered manager about medicines
handling as she was administering medicines during our visit and we gave her full
detailed feedback at the end of the inspection
We found that little improvement had been made since our last inspection in June 2009.
Sample signatures of the staff had been updated so that it was possible to tell who had
administered the medicines. Also a system of recording the date on which medication was
started and what it was used for had been put in place. This was good information which
explained to all staff why the service users were prescribed their medication.
At the last inspection we found that the medication administration records contained a
number of signature omissions or gaps, so it was not possible to tell if service users had
been given their medicines as prescribed. During this inspection we found some
improvement in that the number of gaps had been reduced.
At the last inspection it was noted that handwritten records did not contain two
signatures to confirm the administration details were correct, during this visit we also
found that some of the second signatures were missing. If handwritten information is not
double checked, errors which may have been made in copying out the information on the
dispensing labels may go unnoticed and service users will not be given their medicines
properly.
At this inspection we found that some of the medication administration records were
inaccurate and when compared with the stock of medicines for service users we found
that some medication had been signed for but had not been given. Some records could
not show that all medicines could be accounted for. At the last inspection we found that
medicines were not always recorded when they arrived in the home, making it difficult to
keep track of medication. During this inspection we found that no record had been made
of any medicines which had been received into the home for a new service user. There
was also no record of any medication which had been given to this gentleman since his
arrival in the home the previous day. It is very important that accurate records about
medicines are kept so that it is possible to tell exactly what medication has been given to
service users in order to avoid doses of medicines being missed or given too often. It is
also important that the records show that all medicines can be accounted for to show that
they have not been mishandled.
We looked at the way medicines were supplied to the home in. Most medicines were
supplied in a "monitored dose system"; however the system in use was not the best
design for use in a care home. The easiest system to use is one where each tablet is
Care Homes for Older People
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packaged in its own blister so that it is possible to identify the individual tablets. In the
current system more than one tablet was supplied in each blister without any means of
identifying each tablet or capsule. When medication doses were changed or stopped, the
blisters had to be opened by staff and tablets removed or added and resealed using
sticky tape. The package in which the pharmacist supplies medication must not be
tampered with by care staff as they do not have the skill or qualifications to re package,
dispense, medication. We found that staff had placed 7 unwanted tablets of the same
medication in one "blister"; this is seen to be dangerous practice as the medication could
have been administered in error. It is important that the way medicines are supplied to
the home is looked into urgently so that service users' health is not placed at risk
We also found a number of tablets placed in a small tablet dosette box which was
unlabelled and the manager could not explain why they were in the dosette or to whom
they belonged. All medication must be accounted for to ensure it is not misadministered.
The arrangements for storage for some drugs were poor. We found tablets which needed
to be stored in a fridge had been stored at room temperature. There was no lockable
medication fridge for such medication to be stored in. Although there were no controlled
drugs, powerful drugs, which need special secure storage, in the home during our
inspection there were no facilities to store them should they be prescribed. All care
homes must have a special controlled drugs cabinet which meets current legislation.
Some service users were not given their medicines properly because staff failed to follow
the directions printed on the labels. Some medication had special directions to administer
before food, during this inspection we saw such medicines had been administered with
food. This was also a concern at previous inspections. If directions on how to give
medicines are not followed carefully the service users' health may be at risk, as the
medication may not work well.
At the previous inspection it was identified that arrangements needed to be put in place
to make sure that staff who have responsibility for administering prescribed medicines
are competent, able, to do so safely. However the manager told us that staff had not had
their competency assessed. If staff are not competent in handling all aspects of
medication the health and well being of service users could be at risk. The manager told
us all staff who handled medication did medication training after the inspection in June
2008. The manager also told us that she had not undertaken formal audits, checks, to
ensure that service users were being given their medicines properly or that all medication
could be accounted for. As a result of failing to do formal audits the quality of medication
handling could not be assessed and service users' health may be at risk
What the care home does well:
Each service user had a sheet in their medication file explaining when their medication
had been first prescribed and the condition for which it had been prescribed. This is useful
information for staff looking after these gentlemen to help them protect their health and
well being.
What they could do better:
The standard of record keeping must be improved so that records can show exactly what
medicines have been administered to service users. The records must also be able to
Care Homes for Older People
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show that all medication can be accounted for. Medicines must be stored properly; if
medicines are not stored at the correct temperatures they may not work properly. Staff
must not tamper with the packing in which medication is supplied in by the pharmacy by
adding or removing medication. This activity is called secondary dispensing and is
considered a high risk activity: to avoid this it is important that a different packing
system is urgently looked at. All medicines should be given as prescribed and this
includes carefully following the additional instructions printed on the dispensing labels.
Staff who administer medication must be assessed as competent in doing so. The
manager must put in place an efficient auditing system to ensure that service users'
health is not placed at risk form harm.
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.
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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
1
9
13 (2)
The registered manager
31/07/2008
must make sure that
medication administration
procedures are carried out in
a safe and appropriate
manner thereby ensuring
that service users receive the
right medication.
2
19
23
The registered person must
make sure that the building
complies with fire safety
regulations at all times and
cease wedging doors open.
Timescale for
action
23/07/2009
In order to minimse the risk
of smoke inhalation and the
spread of fire in the event of
a fire emergency.
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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
1
9
13
There must be effective
systems in place to ensure
staff that handle medicines
are competent to do so
safely.
To help make sure that
people who live in the home
are kept safe
14/09/2009
2
9
13
There must be effective
systems in place to audit
medication.
14/09/2009
To help make sure that
medicines are handled safely
and to make sure that people
who live in the home are
kept safe.
3
9
13
All medicines must be stored 01/09/2009
safely and securely.
Medicines must be stored
safely and at the correct
temperatures so they can not
be mishandled and so that
they work properly. Provision
for the storage of medicines
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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
under the in accordance with
the Misuse of Drugs (Safe
Custody regulations) must be
made.
4
9
13
Secondary dispensing must
cease.
01/09/2009
This is a high risk activity
and service users' health and
well being may be put at
risk.
5
9
13
Clear and accurate records of 01/09/2009
medicines received into,
administered and disposed of
by the home must be
maintained.
So that medicines can be
fully accounted for to prevent
mishandling and to show that
they are being given
correctly so service users'
health is not at risk form
harm
6
9
13
Medicines must be given to
service users as prescribed.
01/09/2009
Because receiving medicines
at the wrong dose, wrong
time or not at all can
seriously affect their health
and wellbeing.
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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
Care Homes for Older People
Good Practice Recommendations
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Reader Information
Document Purpose:
Inspection Report
Author:
Care Quality Commission
Audience:
General Public
Further copies from:
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: [email protected]
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) Care Quality Commission (CQC). 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. The material
should be acknowledged as CQC copyright, with the title and date of publication of the
document specified.
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