Random inspection report
Care homes for older people
Name: Address: Bemerton Lodge Christie Miller Road Salisbury Wiltshire SP2 7EN one star adequate service 12/05/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Alison Duffy Date: 1 9 0 5 2 0 1 0 Information about the care home
Name of care home: Address: Bemerton Lodge Christie Miller Road Salisbury Wiltshire SP2 7EN 01722324085 01722324561 manager.bemertonlodge@osjctwilts.co.uk www.osjct.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ruth ODea Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Orders Of St John Care Trust care home 56 Number of places (if applicable): Under 65 Over 65 20 36 dementia old age, not falling within any other category Conditions of registration: 0 0 The home may, from time to time admit one person aged 60 - 65 years Date of last inspection Brief description of the care home Bemerton Lodge was built in the 1970s. It is a residential care home, for up to 56 older people, 20 of whom may have a dementia. The home is registered to the Orders of St John Care Trust. The registered manager is Mrs Ruth ODea. Bemerton Lodge is situated within a residential area, on the outskirts of Salisbury city centre. Peoples bedrooms and communal areas are located on the ground and first floor. There are a variety of sitting and dining rooms. There is a passenger lift, which gives easier access
Care Homes for Older People Page 2 of 10 1 2 0 5 2 0 0 9 Brief description of the care home to the first floor. There is an intermediate care unit. Additional day centre facilities are located in an adjoining building. There is car parking on site and well maintained gardens to the rear of the building. Fees for living at the home range from 500 to 600 pounds a week. People are able to pay an additional 25-65 pounds a week for a premium room. Care Homes for Older People Page 3 of 10 What we found:
This random inspection took place on the 20th May 2010 between 9.45am and 12.45pm. Mrs ODea, the registered manager was available throughout. A locality manager within the organisation, arrived at the home for the latter part of the inspection. Before visiting the service, we sent the registered manager an Annual Quality Assurance Assessment (known as the AQAA). This was the services own assessment of how they were performing. It told us about what had happened during the last year and about their plans for the future. We sent the service surveys, for people to complete if they wanted to. We also sent surveys to be distributed to members of staff and health/social care professionals. This enabled us to get peoples views about their experiences of the service. We received five surveys people using the service, five from staff members and two from health/social care professionals. Within our site visit, we toured the accommodation with Mrs ODea. We looked at the assessment documentation and care plans of two people new to the service. We looked at accident reports and the recruitment documentation of two newly appointed staff members. The last inspection of this service took place on the 12th May 2009. Mrs ODea was the acting manager at the time. Her application to register is now approved. We looked at the assessment documentation and the care plans of two people newly admitted to the home. We saw that the assessments were fully completed. They were dated and showed who had been involved in the assessment process. The assessment identified peoples health and personal care needs. There was a tick style format yet additional information had been added, in order to give greater clarity. One person told us that they had recently moved to the home. They said they were happy and the staff were very good and friendly. At our last inspection, we made a requirement to ensure that all care plans were clearly organised and sufficiently detailed to reflect peoples individual needs. We also required that the plans were reviewed on a regular basis or as peoples needs changed. Significant effort had been made by the manager to address these issues. We saw that the plans were more organised and contained detailed, well written information. Aspects such as the persons preference of receiving intimate personal care from a male or female carer were identified. There was very good information about the support the person required and their preferred daily routines. The plans were up to date and had been regularly reviewed. We advised that the standard of care planning Mrs ODea had set should be reached by all staff. This would ensure consistency and enable staff to have detailed information about all the people they supported. We looked at the medicine administration record. We saw that staff had not consistently signed the record after administering peoples medicines. A member of staff had countersigned any hand written medicine administration instructions in order to minimise
Care Homes for Older People Page 4 of 10 the risk of error. There were records to show the medicines received into the home. We saw that when people were new to the home, staff asked their GP for written confirmation about the medicines they took. One person had their medicines covertly in food. A staff member told us that the GP had authorised this and details were documented within their care plan. Since our last key inspection, there had been two errors with peoples medicines. These were investigated within the home and additional control measures applied, to minimise further risk. A staff member told us that all staff received ongoing training in the safe handling of medicines. Regular competency checks were also undertaken. At our last inspection, we required that all controlled drugs and oxygen cylinders be stored in compliance with current legislation. We saw that this had been addressed. Ms ODea had gained further advice about the storage of oxygen cylinders from the Fire and Rescue service. Mrs ODea told us that this advice had been adhered to. At our last inspection, we made a number of requirements about minimising peoples risk of developing a pressure sore. We saw that these requirements had been addressed. People had a tissue viability risk assessment in place which linked to the persons nutritional needs. There was also a detailed, well written care plan in relation to promoting healthy skin. We saw that there was clear information about the potential areas of skin, which would be prone to pressure damage. This information was also shown in a pictorial format. We looked at the accident records and saw that the majority of incidents had involved falls. Ms ODea had reviewed the accident forms in order to identify any trends or possible causes. The records were factual and well written. Information such as the position in which the person was found, was recorded in relation to an accident that had not been witnessed. Within a tour of the accommodation, significant redecoration and refurbishment had taken place. This included the lounges, dining rooms, some toilets and some peoples bedrooms. New pictures and curtains had been purchased. Signs to help people find their way around the home had been displayed. Some people had memory boxes outside of their bedrooms. This helped them identify their room more easily. We saw that the laundry room had been fully refurbished. This included new self feed washing machines, tumble driers and laundry bins. The laundry bins enabled staff to sort the laundry at source in order to minimise the risk of infection. At our last inspection, we made a requirement to replace stained commode buckets and to ensure all commodes were easily wiped. Mrs ODea told us that all commodes had been replaced. She showed us the style of the commodes purchased. The requirement we made about staff cleaning less visible areas such as the undersides of bath hoists, had been addressed. We saw that there were fresh flowers and bowls of fruit in the lounge. A copy of the social activity programme and pictorial formats of the menus were available in the lounge and on the dining room tables. We looked at the recruitment and training records of the two most recently appointed staff members. The files were ordered and well maintained. There was a recruitment checklist at the start of each file. We saw that there was an application form, two written references and a health care questionnaire. In response to one reference, we saw that Mrs ODea had gained additional information about the prospective staff member. There
Care Homes for Older People Page 5 of 10 were details about the prospective staff members interview. The file contained documentary evidence of the persons identity. There was also evidence that the persons suitability to work with vulnerable people had been checked. The two staff members had undertaken a range of mandatory training. This included first aid, health and safety, manual handling, infection control and fire safety. Staff had also completed training in palliative care and the management of aggression. The training files were ordered with certificates demonstrating the training staff had completed. Within surveys, people told us that they always received the care and support they needed. They said staff were generally available when they needed them. People said that staff listened and acted on what they said. They said the home was always fresh and clean. In relation to what the home did well, one person said the staff are lovely and I enjoy living here. Another person said the home is spotless. Staff always come as soon as they can when I press the bell. I think all the staff are wonderful and helpful. In relation to what the home could do better, one person said we feel the place is understaffed. Another person said sometimes the staff could communicate better. On occasions when asking staff questions they answer I dont know. Some staff will go and find out information. Others will not. Staff told us within their surveys that checks such as references and a Criminal Records Bureau disclosure were carried out before they started employment. They said they received training related to their role and were given up to date information about the needs of people they supported. They said there were usually enough staff to meet the individual needs of people. In relation to what the service did well, one staff member said promote independence. Good activities. Another member of staff said providing good care, dignity and respect to all residents. Within their survey, a health/social care professional told us overall there is a high level of care provided. Staff are generally helpful. Care is structured and planned according to individual needs. Another health/social care professional said Bemerton Lodge provides a safe and secure environment and they accommodate individual needs as much as possible. Managers have always been helpful and quick to respond to assessments and requests. In relation to what the service could do better, they said response to calls via alarms could be quicker. What the care home does well:
There is a clear admission procedure in place, which enables people to be assured that their needs will be met within the home. Care planning has been developed significantly. The documents are now ordered, well written and person centred. Risk assessments have been reviewed and there is clear information about reducing the risk of a person developing a pressure sore. People benefit from an environment which has been enhanced through redecoration and some refurbishment. The laundry has been fully refurbished and commode chairs replaced. There is an attention to detail with flowers on the dining room tables and bowls of fresh fruit in the lounge. Signs have been posted around the home in order to enable people to find their way around more easily. Some people have memory boxes outside of their bedroom to help them locate their room.
Care Homes for Older People Page 6 of 10 Activity plans are posted around the home to inform people of what is going on. Menus are available on the dining room tables. People benefit from more thorough cleaning with evidence that staff are now cleaning less visible areas, such as the undersides of bath hoists. Staff have good access to varied training sessions in relation to their role. The procedure for recruiting staff is organised and thorough which means that people are protected from anyone who us unsuitable to work with them. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Staff must ensure that they 30/06/2010 sign the medicine administration record, as per procedures, after administering peoples medicines. So that people receive their medicines safely and as prescribed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 7 Staff should ensure that consistency in the detail within care plans is maintained throughout all documents. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
