‘Culture’ of drug sharing at Riverside

Scotland’s care home regulator has issued three damning reports into Selkirk’s Riverside Healthcare Centre.

The Riverside nursing home on Bridge Street provides 24-hour care for up to 45 older people.

The Care Inspectorate’s (CI) first two reports, seen by The Southern, investigated complaints made last year by a relative of a female resident, concerning her end-of-life care, and the use of a scheduled drug, Oramorph: a morphine sulphate painkiller. The CI’s third report then followed a surprise inspection in December.

In the first two reports, the CI upheld nine out of 14 elements of the relative’s complaints, observing “inconsistencies” in residents’ medication records, called MAR charts.

It found: “a record of administration of medication signed approx. two hours after a person had died,” and “entries signed by named nurses when they were not on duty.”

“This would suggest retrospective signing of medication administration,” it concluded. The CI sent an error response form to Riverside to identify any factual errors, and gave it 24 hours to clean up its “inaccurate and poor-quality recording”.

The CI saw “a culture in the home, that it is acceptable to use other people’s medication. We found four incidents of this, involving different nurses.”

The complainant’s relative, it found, was “given two injections of Midazolam from a supply prescribed for another resident”.

NHS Borders staff who prescribed the drugs were unaware of this practice at Riverside.

The CI warned: “Any item prescribed and dispensed for a named person on an NHS prescription is the property of that person and must not be used for someone else.” The home’s manager assured it would cease immediately, as the CI required.

The CI upheld that Riverside “failed to discuss how [the complainant’s relative’s] pain would be assessed and managed”, ruling: “a nurse did not carry out a pain assessment prior to the administration of Oramorph,” and “failed to assess [her] when [her] family raised concerns about [her] difficulty in breathing following the administration of Oramorph.”

Overall the CI found, “a lack of consultation with [the] family before the move to palliative care,” adding: “there was no planned approach to palliative or end of life care and good practice guidance was not followed.”

The CI followed its October and November reports with a surprise inspection in December, grading Riverside ‘weak’ in ‘quality of care and support’ and in ‘quality of management and leadership’, and found it had failed meet eight out of nine improvements required.

Riverside gave no comment.