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Ellesmere Port Hospital Good

This service was previously managed by a different provider - see old profile

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Inspection report

Date of Inspection: 20 November 2012
Date of Publication: 18 December 2012
Inspection Report published 18 December 2012 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 20 November 2012, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

Patients were protected against the risks associated with medicines whilst in hospital, but were not protected against risk when they went home because policies for supporting safe self-administration in preparation for discharge had not been implemented.

Reasons for our judgement

We looked at how medicines were handled and saw appropriate arrangements were in place for their prescribing and recording. A stock of discretionary medicines was available to enable the prompt treatment of minor ailments. We found that medicines were safely stored and controlled drugs were properly recorded and checked. Emergency medicines were available and daily checks were completed to ensure these were in date and available when needed.

We spoke with seven patients about their medicines. Most patients told us they had enough information about their medicines. One person told us they, “they always ask if you want painkillers”. A second person confirmed that nurses, “have explained my medicine changes” and “I have the information I need to take my medicines at home”. Another person said “The staff are good at managing my pain, they look after me very well indeed.”

The seven prescription charts we looked at were clearly presented. Prescription charts were normally looked at by a ward pharmacist but the Sapphire Ward (winter ward) had a reduced pharmacy service compared with the other three wards. This meant that prescription charts sometimes had to be faxed to the pharmacy for a check before any new medicines were dispensed.

On the whole medicines were administered in accordance with the prescriber's directions. We saw that the times medicines were given was recorded to ensure that enough time was left between doses of the same medicine. Arrangements were in place to ensure that people prescribed medicines for Parkinson’s disease (where timing is very important) received their medicines at the right times. However, we did note that a bowel chart for one person showed that they had constipation, but records did not demonstrate that the prescribed ‘when required’ laxatives were offered more frequently. This resulted in another stronger laxative being prescribed after a week.

We looked at the arrangements in place for managing people’s medicines on discharge from hospital. Nurses explained that people’s medicines needs were considered as part of their discharge plan and checks were made to ensure that, when needed, care packages were in place prior to discharge. Discharge medicines were normally delivered to the hospital mid-afternoon. Where medicines were needed at other times, special transport was arranged. Audits were not carried out to measure how effective current arrangements were in ensuring there were no delays in obtaining discharge medicines.

One person we spoke with explained that they managed their own medicines at home but were uncertain about the medicines they were having in hospital, because they had changed. The hospital did not have a medicines self-administration policy. This meant that patients could not be supported to self-administer medicines as part of their rehabilitation plan.