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Care home in breach of regulations over medicine delays to stay in special measures

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A care home in Manchester is to remain in special measures, after the Care Quality Commission’s latest inspection uncovered a series of problems, including nurses recording that they had offered prescribed medication that was in fact out of stock.

Inspectors visited the Nada Residential and Nursing Home in the Cheetham Hill area of north Manchester on 26 and 27 June and rated it as being “inadequate” when they assessed leadership, responsiveness, safety and effectiveness.

“We…. noted that people did not receive person centred care and their needs were not discussed with them”

Debbie Westhead

In addition, when they assessed how caring the services was, they said the home “requires improvement”.

The privately-owned care home offers nursing care and accommodation for up to 28 people who may have a combination of mental health needs and personal care needs. At the time of June’s inspection, there were just 20 residents in the home.

The CQC found some improvements since the previous inspection in March, such as with staff training and the security of the building. They also saw good interactions between those living there and the staff.

However, there were continued breaches of regulations in a number of areas, as well as additional concerns.

In one case an end of life care plan had not been written for a resident, and appropriate support was not provided until recommendations were made by a social worker.

In another, inspectors found staff had failed to make referrals to specialist services for a resident who urinated in their room after drinking alcohol but had refused support.

“We were told that the Fybogel had been re-ordered…This meant the person would not have received their medicine for over one week”

CQC report

They noted staff did not have the time or knowledge to provide one-to-onesupport around people’s anxieties and drug or alcohol use.

Meanwhile, the CQC found staff had breached regulations due to a delayed medication incident. A resident received their prescribed laxative medication, Fybogel, on 20 June but nurses later wrongly recorded it had been offered to them again when it was in fact out of stock.

“We were told by the nurse on duty that the Fybogel had been re-ordered on the 26 June 2017. It therefore would not be available at the home until the 28 or 29 June 2017 as the GP had to sign the prescription and the pharmacy had to deliver the medicine to the home. This meant the person would not have received their prescribed Fybogel medicine for over one week,” said the CQC in its report on the home.

As with previous inspections, the CQC also found concerns with fire safety checks, medicines management, the environment, the lack of service-specific staff training, staff supervisions, lack of activities, and lack of quality assurance systems.

Debbie Westhead, deputy chief inspector of adult social care in the North of England, said: “We also noted that people did not receive person centred care and their needs were not discussed with them.

“I was also very concerned to see that fire safety checks and records in the service did not demonstrate the service was safe, and this represents very poor practice,” she said.

“We are currently considering our options in relation to enforcement action and if not enough improvement is made, we will take action in line with our enforcement policy to begin the process of preventing the provider from operating this service,” she added.

Nursing Times has contacted Nada Residential and Nursing Home about the concerns raised by the CQC, but is yet to receive a response.

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