Nursing Home Inspection Report

Transcription

1 Nursing Home Kilbrew Recuperation & Nursing Care Ltd. Number of Residents 55 Registered for 60 Nursing Home Address Proprietor Proprietor s Address (if different from above) Kilbrew Demense Ashbourne Co. Meath. Francis Whelan, Ivan Keeling Ian Counihan Inspection Report Person-in-Charge of Nursing Home Date and Time of Inspection(s) Helena Moore 21/11/2007 at pm Date report issued Summary of previous report findings Compliance status The previous inspection report dated from Inspections of , & showed; The following Articles have been satisfactorily addressed: Article 18.1 (b)& (c), Article 11.2 (d), Article 10.5(d) The following Article has been partially addressed; Article 12(a) The following Article has not been addressed; Article 12(a) Current Inspection Summary Findings Findings of latest unannounced inspection which took place on 21/11/2007 The inspectors findings based on the current nursing home inspectorate regulations are as follows: Findings 1

2 Summary Findings of Current Nursing Home Inspection Under Care & Staffing the nursing home was compliant with 18 out of 21 regulations. On the basis of this inspection and under current nursing home regulations, there are issues that need to be addressed as outlined below in relation to the Care and Staffing. Under Management the nursing home was compliant with 24 out of 27 regulations. On the basis of this inspection and under current nursing home regulations, there are issues that need to be addressed as outlined below in relation to Management. Under Physical Environment the nursing home was compliant with 9 out of 11 regulations. On the basis of this inspection and under current nursing home regulations, there are issues that need to be addressed as outlined below in relation to the Physical Environment. Compliance/Non Compliance 2

3 Based on the most recent nursing home inspection the nursing home is non-compliant under one or more regulations. For more details see below. Article 18.1.(e) where the person has left the nursing home, the date on which he or she left and a forwarding address, On the day of Inspection it was noted that the forwarding address was not entered into the register in 30 instances. Ensure all details as required by the Care & Welfare regulations are entered into the register in respect of all residents. Within 48 hours of receipt of this report. (This section should be deleted if no noncompliances have been recorded) Article 18.1(d) the date on which the person was last admitted to the nursing home, On the day of Inspection it was noted that the last admission date in relation to resident ** was not entered in the register. Ensure all details as required by the Care & Welfare regulations are entered into the register in respect of all residents. Within 48 hours of receipt of this report. Article 7.3 Such contract shall deal with the care and welfare of that person in the nursing home and shall include details of the services to be provided for that person and the fees to be charged. On the day of inspection it was noted that Fees were not included in the contract of care in relation to ** & **. Ensure all details as required by the Care & Welfare regulations are entered into the contract of care in respect of all residents. Within 48 hours of receipt of this report. Article 12(a) ) take precautions against the risk of accidents to any dependent person in the nursing home and in the grounds of the nursing home The handrail and side of the staircase which is located in the main entrance of the nursing home is not fixed and moves position when being used. The outside of the staircase is made up of a series of wire strands and there is no handrail on the left hand side. There 3

4 are no protective measures in place to reduce the risk of injury for any persons using the stairs This was noted n the last inspection and is a recurrent non-compliance. Hand rail and staircase to be secured. Risk Assess the staircase and implement measures to ensure there is no risk of persons becoming trapped ot injured on the staircase. The Designated officers were advised by the general manager on the day of Inspection that an assessment has been carried out and plans are in place to secure the staircase. The Designated officers agreed to extend the timeframe to rectify this issue. Within two months of receipt of this report. Article 17 The registered proprietor and the person in charge of the nursing home shall have a brochure available with information about the nursing home, including the name and address of the home, the name of the registered proprietor, the admissions policy, accommodation provided and special facilities and services, The current brochure does not include the name of the proprietors nor an admission policy. This is a recurrent non- compliance. Provide a brochure which includes the names of the registered proprietors and an admission policy. The Designated Officers were advised on the day of inspection by the person in charge that a new brochure is currently at the printers and therefore agreed to extend the timeframe to allow time to have the new brochure printed. Within two months of receipt of this report. Article 14(b) The registered proprietor and the person in charge of the nursing home shall make adequate arrangements for the prevention of infection, infestation, toxic conditions, or spread of infection and infestation at the nursing home. 1. On the day of inspection communal hand towels were noted in the ensuite of the twin bedrooms. 2. Pads were also found on the floors of some of the ensuite bathrooms and behind the toilets Discontinue this practice as per evidence based infection control guidelines. 4

5 1. Implement the use of papers towels and liquid soap dispensers in communal toilets currently in place. 2. Remove pads and store appropriately. 1. Within one month of receipt of this report. 2. Immediately on receipt of this report In every nursing home the following particulars shall be kept in a safe place in respect of each dependent person: ( c ) a record of the medical and nursing condition of the person at the time of admission; The designated officers noted on the day of inspection that one resident ** did not have a record of their medical condition at the time of admission. The Reg. Proprietor and Person in charge to ensure that a record of the medical condition of all resident s at the time of admission are to be kept in a safe place in the nursing home. Within 1 Week of receipt of this report 30. The registered proprietor and the person in charge of the nursing home shall ensure that:( a ) where medical treatment is recommended and agreed to by a dependent person or the person acting on his or her behalf that it is carried out; The designated officers noted on the day of inspection that a resident ** who was admitted on the 14/12/2005 with a discharge summary from Mater Hospital dated 16/12/2005was recommended to have a follow up appointment at Dr. * s ophthalmology clinic within 1 year, however there is no record to indicate that this has been carried out, nor is there a record to indicate that the resident refused. Secondly on 14/5/2007 Dr. ** during her inspection of the nursing home queried this and recommended the appointment be followed up but again there is no record to indicate that this has been done. It was also noted that the last date on which this patient was reviewed /seen by a medical practitioner was 20/12/2005. The Registered Proprietor and the person in charge to bring this to the GP s attention and request a medical review of this patient which is to be recorded, signed and dated. Within a week of receipt of this report 5

6 19.1 In every nursing home the following particulars shall be kept in a safe place in respect of each dependent person: ( e ) a medical record with details of investigations made, diagnosis and treatment given, and a record of all drugs and medicines prescribed, signed and dated by a medical practitioner; The designated officers noted that resident ** admitted on 22/7/06 with a prescription of warfarin and N/aspirin has no record of INR investigations made at any time. Neither is there any record of the warfarin being stopped. It was also noted that the resident s last medical review was 17/11/06. The designated officers also noted that 6 residents **, **, **,**, ** and ** s record of investigations made and medical notes were not available on the day of inspection To update patient s medical records and request GP to review patient. To put in place medical record with details of investigations made,diagnosis and treatment given and be kept in a safe place in the nursing home Within a week of receipt of this report All regulations, their reference s and the details of those regulations can be viewed in Nursing Homes (Care and Welfare) s, Comments and Recommendations 6

7 Comments and recommendations made by the inspection team as a result of the inspection Nursing Home Inspection Report It was noted that the Nursing home have a policy manual. It is recommended that a policy on the Norovirus and MRSA be included in the policy manual as per evidence based guidelines. Although there are sterilising gel dispensers on the corridors outside the high dependency rooms, it is also recommended that the person in charge consider the installation of sterilising gel dispensers or liquid soap & paper towel dispensers inside the four designated high dependency bedrooms. A of residents do not have a record of a medical review for the past 12 months All resident s medical records should be updated and it is best practice to request the GP to review every resident medically at least every three months. These reviews to be signed and dated. In a of cases the physiotherapist makes progress/assessment notes on the same doctor s medical notes This is confusing as to know which is the medical practitioner s treatment and recommendations and which is the physiotherapist s progress or assessment report. This report has been completed/issued by Noel Mulvihill, LHO. Author 7