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Sue Ryder - Leckhampton Court Good

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Inspection report

Date of Inspection: 13 December 2011
Date of Publication: 23 December 2011
Inspection Report published 23 December 2011 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

Our judgement

Overall, we found Sue Ryder Leckhampton Court Hospice was compliant with this essential standard.

People who are cared for at Leckhampton Court are protected against the risks associated with the unsafe use and management of medicines. The service makes appropriate arrangements to obtain, record, and manage medicines.

User experience

We talked with people about being given their medication and if they had them on time. We also asked if people were given information about the medicines they were prescribed. We were told that people were given their medicines on time, although one person said they were "sometimes a bit late in the evening." People said that some of the medicine that they were being given had changed in order to see if other medicines worked better. We were told that the doctor explained to people what was changing and why they were trying something new or a different strength.

People who come to the day hospice and administered their own medicine were able to ask staff to remind them to take their medication on time. People also told us that staff were available to answer any questions about medicines. We were told that doctors would review what people were taking if people felt the medicines were no longer as effective as they could be.

Other evidence

The hospice did not have a pharmacy service on site. Medicines were ordered daily from a local NHS pharmacy through a service level agreement and in accordance with the planned needs of patients. Medicines that were required quickly could be delivered on the same day if requested in time. Particular attention was paid to ordering of medicines prior to a weekend as deliveries were only made on Mondays to Fridays. Otherwise, medicines were checked weekly by a pharmacy technician from the Trust. The pharmacy technician kept records of what medicines were being prescribed by the hospice and reported to the manager if there were any trends or concerns developing in prescribing.

The hospice had controlled drugs stored on the premises that were kept in locked cupboards in the clinic rooms. The controlled drugs were either stock items or patient's own drugs. These drugs were stored separately and managed in different registers. We checked a sample of the stock and found it to be accurate. We observed the preparation of a syringe driver which would be used for pain control. The preparation was carried out with two members of the nursing team and with cross-checking and accurate recording. Controlled drugs were ordered, delivered, and recorded in accordance with strict guidelines around transportation and recording.

We checked a number of patient medicine charts to see that the prescription and administration was complete and accurate. We found that in all but one case, medicines had been administered in line with their prescription. One person's medicine chart did not record that person having had their medication on the previous evening. The patient told us that they were almost sure that they had taken their medication. The hospice had already picked up this gap in the chart before we commented upon it and were waiting to check with the member of staff. The lack of recording had also been raised as an incident to be investigated.