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The Priory Hospital North London Good

All reports

Inspection report

Date of Inspection: 21 October 2010
Date of Publication: 21 December 2010
Inspection Report published 21 December 2010 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

Our judgement

We found out of date controlled drugs in the medication cabinet. In the treatment room we found medication that was no longer being used kept in a cardboard container rather than being stored in a locked box until removed by the pharmacist. Medication audits carried out by the pharmacist had been only partially completed. Poor monitoring and unsafe storage and disposal of medication increase the risk of patients being given out of date medication and/or the wrong medication.

User experience

No specific comments were received.

Other evidence

When we went to the hospital we visited the treatment rooms on both the adult ward and adolescent ward. The arrangements for storing medications for use on the wards were viewed. In the adolescent ward all medications were either stored safely in a locked cupboard or fridge. All those inspected were found to be in date.

In the medication cabinet on the adult ward we checked three medications in general use and these were in date. The Controlled Drugs Book was viewed and this had been completed appropriately. Evidence was seen of the amount received by the establishment, the stock balance and two signatures. On inspecting the controlled drugs cupboard we found two 50 ml bottles of methadone which had expired at the end of September 2010 and was therefore out of date.

The auditing records for out of date stock were inspected and was found to be complete for each month in 2009, but in 2010 only a small number of entries had been made in July and one each in October and November (noting the medication due to go out of date). In addition we found a cardboard box on the counter in the treatment room which contained a large amount of discarded medication. The medication had been prescribed to patients who had been discharged and was therefore no longer required. We were told that the medication was awaiting removal by the pharmacist. When we pointed out that the auditing of out of date medication did not appear to have been carried out consistently in 2010, the nurse stated that it was the external pharmacist's role to do this. She did not have any knowledge of the process and was not aware of any oversight by ward staff of the pharmacist’s audit.

We checked three medication charts on the adult ward and these had been completed. The signatures of the doctor prescribing the medication and the nurses giving the medication were clearly documented. The medication chart of one patient detained in hospital under Section 3 of the Mental Health Act 1983 was reviewed. The prescription chart did not have the completed consent/capacity to consent form attached. We later located the consent form in the patient’s file and this showed that consent had been obtained from the patient.