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Archived: Ashton House Nursing Home

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Inspection report

Date of Inspection: 13 March 2013
Date of Publication: 3 April 2013
Inspection Report published 3 April 2013 PDF

People should be given the medicines they need when they need them, and in a safe way (outcome 9)

Not met this standard

We checked that people who use this service

  • Will have their medicines at the times they need them, and in a safe way.
  • Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 March 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

The provider had appropriate arrangements in place for safe prescribing, administration and disposal of medication. However, some of the storage arrangements were unsatisfactory.

Reasons for our judgement

Medicines were prescribed and given to people appropriately; but some of the medication storage was unsatisfactory.

We inspected the storage and administration of medicines in both units. Hazelwood unit had a clinical room where three medicine trolleys were stored when not in use. We saw that these were locked to the wall for safety. Stock medications were stored in locked cupboards, and we saw that the cupboards were clean and tidy. We did not see any out of stock medication, and there was evidence of appropriate stock rotation. We found that bottles of medicine and eye drops were dated on opening, which showed good practice, as this ensured that staff would not use these items when they became out of date.

The main house had two cupboard areas for medicines storage, and a trolley which was kept locked to the wall in the nurses’ office area.

One of the cupboards in the main house did not provide suitable storage, as it had a low ceiling which did not provide sufficient head room, and medicines were stored on open shelves (See guidelines "The Handling of Medicines in Social Care" by the Royal Pharmaceutical Society). There was no record of the daily temperature being recorded for both of the storage cupboards in this unit. This meant that it was not possible to know if medicines were being stored at safe temperatures. Temperatures for the safe keeping of medicines (excluding items for refrigeration) should not exceed 25 degrees Centigrade. Temperatures could exceed this in hot weather, but without records it was not possible to determine if storage was suitable.

One of the cupboards was used for storing oxygen. The manager told us that the fire officer was aware of this. The safety of the oxygen could be compromised by temperatures above 25 degrees Centigrade, but the temperature of the cupboard had not been recorded.

Each unit contained a drugs fridge for storing specific medicines. The temperatures of the drugs fridges were recorded each day to ensure these medicines were kept at correct temperatures. One of the drugs fridges was not locked.

We saw that controlled drugs were correctly stored, and the registers were accurately maintained. One of the nurses stated that the numbers of controlled drugs were audited at frequent intervals, but these audits had not been recorded.

We examined the Medication Administration Records (MAR charts) for both units. We saw that clear and accurate records were maintained. The MAR charts were accompanied by a photograph of each person so as to check their identity. We saw that there were sufficient nursing staff on duty to enable them to take appropriate time in giving medication to people with dementia, some of whom needed coaxing to take their medication.

We saw that there was an agreement in place for one person to have their medication given covertly in their food. This had been appropriately discussed and agreed with the doctor, next of kin and relevant health and social care professionals, as being within the person's best interests.