Working at St Faith's Nursing Home

Managers did not spot record gaps quickly enough, so some people missed doses of their medicines.

The process for monitoring the administration of people's medicines had not been effective enough to identify that two people, had not been receiving some of their medicines as prescribed. A delay in senior managers being aware of this meant action was not taken in a timely way.

Agency workers cover sickness and gaps in shifts, so you might not always work with the same team.

Managers used agency staff if needed, to cover last minute staff sickness or gaps in staffing.

Oversight on checking medication records was not strong enough to catch problems early.

A process for identifying gaps in staff signatures, on people's medicine administration records (MARs), was in place. However, this was not leading to effective action being taken, in a timely manner.