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Inspection report

Date of Inspection: 3, 14 January 2013
Date of Publication: 7 February 2013
Inspection Report published 7 February 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 3 January 2013 and 14 January 2013, observed how people were being cared for and talked with people who use the service. We talked with staff.

Our judgement

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Reasons for our judgement

We found that there was a written policy related to the management of medicines but this was not followed in practice. As a result we judged that medicines were not stored securely or disposed of effectively.

The policy stated that medicines stored on the premises should be held in a locked cupboard. We found that the medicines were actually in a cupboard which had no lock, in an unlocked room adjacent to the upstairs waiting room. This meant that items could be accessed by anyone who did not have cause to do so, including staff and people using the service, posing a risk to their safety and welfare.

The policy also stated that the medicines stored should be reviewed at least once every three months by the doctor to ensure that they were within their use by date. We spoke to the doctor and staff who were unable to confirm or provide a record of when this review had last been performed. We checked the cupboard and found three items that were more than six months out of date. We showed these to a member of staff so that action could be taken.

The written policy stated that certain medicines should be stored in a freezer at a temperature of minus 5 degrees. We checked the freezer and saw that this was covered in stock boxes which could interfere with the normal running of the freezer. We also saw that the temperature monitor gauge had fallen down behind the appliance. We spoke to staff who told us that they knew the freezer should be monitored but could not recall when this had last been done or where the log book was kept. We saw that at the time of our second visit the provider had cleared the freezer top, replaced the temperature monitor and set up a log book to record the checks performed.