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Inspection report

Date of Inspection: 25 November 2013
Date of Publication: 20 December 2013
Inspection Report published 20 December 2013 PDF

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

Meeting 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 25 November 2013, talked with people who use the service and talked with carers and / or family members. We reviewed information given to us by the provider.

Our judgement

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Reasons for our judgement

At our last inspection in September 2013 we had concerns that Fistral House did not have a policy for the ordering, recording and disposal of controlled drugs. We saw the home stored people's medication, which required cold storage, in the food fridge in the kitchen. The cook was recording the internal temperature of this fridge daily, and the records demonstrated the fridge was not consistently remaining between two degrees centigrade and eight degrees centigrade, as required for the safe storage of the medication kept within it. We discussed this with the registered manager who agreed to ordered a dedicated medicines fridge.

Some of the people who used the service were not able to comment in detail about the service they received due to their healthcare needs. We relied on our observations and discussions with the registered manager and deputy manager to reach our judgement on this outcome.

We saw a dedicated fridge had been purchased and was storing medicines which required cold storage. We saw the fridge was having the minimum and maximum temperatures recorded every 24 hours. There was some gaps in the records we saw which began on the 8th November 2013. For example, 11th November had one recording missing and the 25th November 2013 was blank. We noticed the temperatures of this fridge were occasionally being recorded at lower than two degrees C. We discussed this with the deputy manager who told us the home had been visited by the medicines management team for an audit on the 19th November 2013 and the fridge temperatures had been discussed. We were told it was due to the thermometer not being 'cleared' after every 24 hour reading. This was being monitored by the deputy manager and the potential risk to the medicines stored within this fridge, should the temperature drop below two degrees C was discussed. It was agreed by the deputy manager that advice would be sought from the pharmacist regarding this matter.

We reviewed the controlled drugs policy and procedures. We saw there was a procedure for the ordering, recording and disposal of controlled drugs dated 25th July 2013. We were told Fistral house did not hold any controlled drugs at the time of this inspection. We checked the record book which stated all controlled medicine stocks showed as zero.

During our tour of Fistral House we noted people's topical medications, such as creams and lotions, were named and dated upon opening.This practice ensured staff were aware of expiry dates as creams were dated upon opening, and ensured people's named creams were not shared.

We reviewed the training records for staff who administered medication. We were told two staff were currently working towards an accredited certificate in medicines management, having completed two of the four units required. The registered manager, who we were told administered medicines when the deputy, and one other member of staff were not on duty, had not undertaken a medicines management update. Staff who are involved in administering any medication, should receive suitable training regarding the administration of medication. Medication training should be updated at regular intervals according to national guidance (for example 'Skills for Care', Nursing and Midwifery Council). The registered manager agreed this would be undertaken.