Inspection on 16/07/09 for Camberley Lodge

This is the latest available inspection report for this service, carried out on 16th July 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Camberley Lodge 01/05/07

Camberley Lodge 09/05/06

Camberley Lodge 03/02/06

Camberley Lodge 12/10/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Camberley Lodge 99 Fronks Road Dovercourt Harwich Essex CO12 4EQ     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Finney     Date: 1 6 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Camberley Lodge 99 Fronks Road Dovercourt Harwich Essex CO12 4EQ 01255552976 01255552976 Crlbrough@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Bibi Shimintaz Mohedeen care home 13 Number of places (if applicable): Under 65 Over 65 3 13 dementia old age, not falling within any other category Additional conditions: 0 0 Persons of either sex, over the age of 65 years, who require care by reason of old age only (not to exceed 13 persons) The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The total number of service users accommodated in the home must not exceed 13 persons Three service users, over the age of 65 years, who require care by reason of dementia, whose names were made known to the Commission Date of last inspection Brief description of the care home Camberley Lodge is an established care home situated in a residential area of Dovercourt, close to the sea front and within easy reach of the shops. Care Homes for Older People Page 4 of 31 Brief description of the care home The home provides care and accommodation for up to 13 people over the age of 65. Accommodation consists of seven single bedrooms and three double rooms. The majority of the rooms are on the first floor. Access to the first floor is by means of stairs. Communal areas include a large lounge and dining room. There is a small garden and a patio at the rear of the home and parking facilities to the front of the property. The home charges between £410.00 and £430.00 a week for the service they provide. Other services such as hairdressing and chiropody are available at an additional charge. This information was given to us in July 2009. Information about the home can be obtained by contacting the manager. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was carried out on 25th July 2008. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as care plans, rotas, menus and personnel files. The provider completed an Annual Quality Assurance Assessment, which is required by law to be completed by the service, with information about the home and sent it to us at the Commission when requested. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 16th July 2009 and included a tour of the premises, discussions with people living in the home and members of staff. Completed surveys Care Homes for Older People Page 6 of 31 were received from people living in the home, members of staff and relatives. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. On the day of the inspection we were given every assistance from the manager and staff team. What the care home does well: What has improved since the last inspection? What they could do better: The manager should continue to update care plans so that they contain greater detail. This would ensure that staff have sufficient guidance to deliver care in a consistent manner, in ways that the individual wishes. The service could continue with the programme of maintenance and re-decoration to ensure the environment is homely, well maintained and safe for people living there. The laundry room could be better organised and storage facilities could be improved so that there is less clutter, which would reduce risks of cross infection. The registered provider could involve the registered manager to a greater extent in Care Homes for Older People Page 8 of 31 compiling information for the homes Annual Quality Assurance Assessment and other information required by us at the Commission. 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Through the comprehensive admission process people choosing to live at Camberley Lodge can be confident their needs will be met. Evidence: The provider told us in the AQAA, When we have a vacancy, the prospective client or their relative comes in for a visit first and has a chat with the other residents and staff. Sometimes they may decide to stay for lunch and spend some hours in order to get a feel of the atmosphere in Camberley Lodge before making a decision. They also stated, All residents are assessed first, sometimes in the hospital, and only admitted if we can meet their needs. They have a one month trial before they make the decision to stay long term or not. During the past year all residents who have been on a month trial have liked it in Camberley Lodge and decided to stay long term. As at the last inspection records examined confirm that there continues to be an Care Homes for Older People Page 11 of 31 Evidence: assessment process in place. They are now using the Single Assessment Process documentation that looks at the persons needs from a range of areas. The service users view, the carers views and the views of others are recorded. Areas covered include Medical History, Disease Prevention and Health Intervention, Pharmacy Risk Indicator, Physical Function, Mobility and Transfers, Risk Indicators for Activities of Daily Living and a Mental Health Risk Indicator. Through discussions the manager was able to explain how they assess the needs of any prospective resident to ensure they are able to meet those needs before the person is admitted to the home. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can expect their personal and healthcare needs to be identified and to be provided with the support to ensure these needs are met as they would wish. Evidence: The provider told us in the AQAA, Our care plans and other records have been updated in order to make them clear for staff to follow. A sample of three care plans was examined on the day of the inspection. The care plans identify the need, the aim for the person and the actions to be taken to meet the identified needs. In some of the areas covered by the care plans the information was quite scant. One care plan had the needs for the person identified as Diabetic. The aim was to ensure this [persons] diabetes is kept under control. The actions stated X is a diabetic and cannot administer [their] own insulin. Xs diabetes is kept well under control. In addition to the care plan, other information in relation to diabetes and glucose monitoring was available in the medication file. The manager and staff spoken with Care Homes for Older People Page 13 of 31 Evidence: were able to demonstrate a good awareness of this persons needs around diabetes. However, greater detail is needed in the care plan to reflect their knowledge about the condition and the care being provided. Each persons care plan records all the identified needs in a single document. This appears to contribute to the tendency for the information to be brief and does not give much flexibility to alter or make additions to the information recorded, particularly in the section on actions to be taken to meet the need. We discussed this with the manager on the day of the inspection, who is going to consider ways to improve the care plans so that they reflect the good level of care that people are experiencing in the home. The provider told us in the AQAA, As stated in their care plans different residents have their own individual way of washing and dressing and their wishes are always taken into account. Staff spoken with were able to demonstrate a sound knowledge of peoples preferences about the way they want to be supported with their personal care needs. Someone living in the home who completed a survey told us, All my personal care needs are attended to. A residents choice form in one of the care plans documented the persons likes and dislikes around food and activities that the person currently enjoys or liked to do in the past. The persons preferences around rising and retiring were documented, including the number of pillows the person prefers, whether they want the light off or on and whether they prefer the bedroom door to be left open or closed at night. Their likes and wishes around hygiene, dressing and their preferred type of clothing were recorded and there was information about their personal history. People living in Camberley Lodge and their relatives have made positive comments about the care provided in the home. Someone living in the home who completed a survey told us, I always have a carer help me up and down stairs, which I find very difficult due to my arthritis. A relative who completed a survey told us, Am pleased with all aspects of [my relatives] care. First class. Another relative stated, From the time my [relative] moved to Camberley Lodge [their] care has been first class. The provider told us in the AQAA, If a resident needs medical care their GP is called and if needed they are also referred to the district nurse. They are also seen regularly by the chiropodist, dentist and optician. The provider also stated, Due to our health promotion efforts, our residents are in reasonably good health and No residents have developed pressure sores for a long time and staff have had refresher courses to update them. Care Homes for Older People Page 14 of 31 Evidence: Care plans examined contain records of how people are supported with their health care needs. There are details of visits from health care professionals including Community Psychiatric Nursing Services, District Nurse and Doctor. Records are kept around peoples health including weight charts and continence needs. There are fluid intake and output charts where these need to be monitored. The provider told us in the AQAA, All senior carers have been trained how to administer medications to residents and keep a written record. They also stated, The pharmacist comes every three months to check the medication. Every month the medications are checked by the registered manager and the person who delivers them and also double checked by two senior staff and A nurse comes every six months to review medication and liaise with GPs. Since the last inspection there have been significant improvements in the system used to support people with their medication. The home uses a Monitored Dose System (MDS) and the manager explained that they have changed to a new pharmacy provider, who is giving a greatly improved service. The provider told us in the AQAA, A new medication cabinet has been obtained for both controlled drugs and normal medication and a new lockable fridge to store insulin. We examined the new storage facilities for medication including a large trolley secured to the wall, a controlled drugs cabinet and a lockable drugs refrigerator. The drugs trolley was clean and well organised and controlled drugs were securely locked in the controlled drugs cabinet. Medication that is unsuitable for dispensing into MDS blister packs and which is dispensed in the original containers was clearly marked with the date of opening. Medicines Administration Record (MAR) sheets examined were completed appropriately with no gaps in signatures. The controlled drugs ledger was examined and found to be in order. The MDS packs have a photograph of the individual on the front and there is a card to remind staff of other medication, such as liquid medicines, that need to be administered as well as the tablets in the blister pack. These measures help reduce the risk of errors either by omitting to administer a particular medication or administering to the wrong person. The manager and staff spoken with were confident that the system was much better. The provider told us in the AQAA, Residents privacy and dignity are always respected and staff always knock before they enter residents rooms. Care Homes for Older People Page 15 of 31 Evidence: It was evident from our observations that people are treated with courtesy and respect. Staff were seen to knock on doors before entering peoples rooms and interactions between staff and people living in the home were friendly and respectful. The manager explained that some staff have already completed a course about Dignity and Respect and there is a programme in place for all staff to complete this. A member of staff who completed a survey told us, The service users are always treated with respect and dignity. Visitors who come to see their relatives are treated with the utmost courtesy. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall people living in the home can expect to enjoy a lifestyle that meets their wishes, needs and interests. Evidence: The provider told us in the AQAA, We have organised several activities such as Halloween parties, coffee mornings, table top sale, Christmas parties, Tinas Clothing, Elvis Presley, fish and chips day out, outings to Colchester Park, garden centre at Frinton. Friends and relatives are also always invited when we have parties, coffee mornings or on outings. Records examined confirm that the entertainments and activities that take place in the home have improved since the last inspection. There is evidence of the activities the provider told us about in the AQAA, as well as other daily pastimes such as watching television. The home recently had a 50s and 60s Rock n Roll singalong and Elvis Presley tribute act that the manager said was very popular and will be returning. Another popular event is the cream tea afternoons that people enjoy. The provider told us in the AQAA, Our visitors book shows that relatives visit Care Homes for Older People Page 17 of 31 Evidence: regularly. Most residents have a TV in their rooms, giving them more privacy. When relatives come to visit, they can go to their own rooms, go to the quiet room or sit in the lounge according to their wishes. They are always made welcome and are offered refreshments. Someone living in the home who completed a survey told us that what the home does well is, makes everyone feel part of a family. The home has a Residents Council which aims to identify concerns, give residents an arena to voice their wishes and choices, to maintain and improve communication and to gain feedback relating to the service. All the people living in the home are members of the Residents Council and they can extend membership to relatives and advocates at the residents request. Meetings are held approximately monthly and minutes are taken to record what is discussed. One record showed that requests for changes to menus were discussed. It stated, pork has now been taken off the menu as not many people seem to like it. It has been suggested that chicken casserole be put back on the menu to replace the pork. The provider told us in the AQAA, From our residents monthly meetings the menu is changed according to residents tastes and An alternative choice is available on the menu to suit individual tastes. A diabetic diet is provided and staff have been on courses on diabetes. It is evident from the menus that Camberley Lodge provides a variety of food and choices on a daily basis. Through discussions the cook was able to demonstrate a commitment to providing home cooked food that people enjoy. Lunch on the day of the inspection was toad-in-the-hole, roast potatoes, carrots, cabbage and cauliflower. There is a range of both fresh and frozen vegetable used. Desserts such as jelly and blancmange are popular and the cook prepares home made cakes. People spoken with said, the food is good and lovely. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: The provider told us in the AQAA, Our Service Users Guide and Statement of Purpose have details of how to make a complaint and the CQC details are available if anyone wants to take the matter further. They further stated, During the past year we have not had any formal complaints made. If a resident has been dissatisfied with anything, our registered manager has been able to resolve the matter to satisfy the resident. As reported at the previous inspection, Camberley Lodge continues to have an appropriate complaints procedure in place. There have been no formal complaints received by us and records examined indicate there have been no complaints recorded by the home in the past year. Through discussions the manager demonstrated how they deal with peoples minor concerns as and when they arise. These are also recorded in the minutes of the Residents Council meetings. People spoken with on the day of the inspection told us they had no complaints. The provider told us in the AQAA, Our staff have an enhanced CRB check done before providing care to residents and Our staff have had POVA training and are aware how Care Homes for Older People Page 19 of 31 Evidence: to whistle blow if they suspect abuse within the home. Staff have received training around safeguarding (previously referred to as Protection of Vulnerable Adults or POVA). There have been no referrals made to the local authority under their safeguarding processes in the past year. Personnel records examined confirm that staff undergo Criminal Record Bureau (CRB) enhanced disclosures and PovaFirst checks to ascertain that they are not prohibited from working with vulnerable people. Staff spoken with were aware of their responsibilities around recognising and reporting abuse or poor practice. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: The provider told us in the AQAA that since the last inspection, The kitchen has had a face lift and is still in the process of being completed. All of the residents furniture was re-varnished and painted. The laundry room was repainted. It was evident following a tour of the premises that actions have been taken to improve many of the issues identified at the last inspection. There was evidence of redecoration throughout the home including communal areas and some individual bedrooms. The kitchen was in the process of being redecorated and already had a new refrigerator and an extractor hood fitted over the cooker. The painting of the kitchen was in process and the manager told us the that it was due to be finished in the following few days. We observed that there had been improvements to some of the furnishings in individual rooms and although furniture had not been replaced it had been revarnished and repainted. Care Homes for Older People Page 21 of 31 Evidence: Some areas throughout the home were somewhat cluttered, in particular storage facilities in the laundry room could be better. As there was insufficient cupboard or shelf space, a lot of items were stacked on the draining board which restricted access to the sink. The manager explained that they were planning on having shelves put in, which would alleviate the problem. Overall all areas of the home are accessible for the people who live there. However, people living in the home are becoming more elderly and they increasingly need additional assistance with mobility, particularly when negotiating steps or the stairs to the upper floor. Some thought needs to be given as to how the service is meeting those needs and whether additional measures need to be taken. A relative who completed a survey told us, Maybe an update as regards to handrail for ramp leading into garden would be an advantage to residents who wish to sit in the garden. Another relative suggested that the home could, Maybe provide a stair lift as my [relative] has great difficulty getting up and down the stairs, even with the help of carers. A member of staff who completed a survey also stated, Would be better if there was a lift or stair-chair would benefit the clients greatly. The provider told us in the AQAA, We are often complimented on the cleanliness of Camberley Lodge by relatives and this is demonstrated in our quality assurance report. We have a domestic who cleans in the morning so that staff get more time to care for residents and, We keep a good standard of hygiene free of unpleasant odours often associated with care homes. On our tour of the premises we noted that the home was clean throughout and there were no unpleasant odours. The provider told us in the AQAA, Staff have had a refresher course on infection control and are aware of the policies and procedures. The environmental health officer was satisfied after we made some changes which he recommended on his last visit. During the course of the inspection we observed staff following good practices around hand washing. Personnel records examined confirmed that staff have had appropriate training around Health and Safety issues, including Infection Control and Food Hygiene. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident they are cared for by a competent staff team who can meet their needs. Evidence: The provider told us in the AQAA, We have a mix of skilled staff who are on duty on each shift and an extra carer during peak times. On the day of the inspection we observed that peoples needs were being met promptly by the staff on duty and they were not waiting unduly when they needed support. Rotas examined confirmed that there were sufficient staff on duty to meet the needs of people living in the home. The provider told us in the AQAA, More than 50 of our staff have NVQ level 2 and several staff have started NVQ level 3 and they encourage those staff without NVQ to do it. On the day of the inspection we discussed NVQ with the manager who demonstrated a commitment to supporting staff to achieve the award. The AQAA dataset confirmed that the numbers of staff with a National Vocational Qualification (NVQ) at level 2 or above have improved since the last inspection. A sample of personnel records Care Homes for Older People Page 23 of 31 Evidence: examined contained evidence of NVQ certificates. The provider told us in the AQAA, All staff recruited have a CRB check done, 2 pieces of ID, 2 references taken and have their photo on their file. As at the last inspection there is a robust process in place for the recruitment of staff. A sample of three personnel files was examined and these were found to be in order. There was a checklist of the contents on the front and all the documentation required by regulation was in place, including application forms with no unexplained gaps in employment history, two written references, relevant proofs of identity, PovaFirst checks and Criminal Record Bureau (CRB) advanced disclosures. The provider told us in the AQAA, We have a record of all the courses that staff have attended and their certificates are photocopied and kept in their files. Staff have received refresher courses on the following subjects this year, Infection Control, Manual Handling, Food Hygiene, First Aid, POVA, Respect and Dignity, Vision Call, Health and Safety and Medication Administration. We reported that training had improved at the time of the last inspection and it is evident the process continues to improve. Training records examined confirm that staff have received training around Manual Handling, Infection Control, Health and Safety, Food Hygiene, Care of Medicines, Fire Safety, First Aid, Safeguarding and Dementia Awareness. Staff have also had additional training around peoples specific healthcare needs including Diabetes Awareness and Parkinsons Disease. Relatives who completed surveys were complimentary about the staff at Camberley Lodge. One person told us, I visit at least twice a week and every visit I have found staff caring. Even though my [relatives] dementia has deteriorated and gets days when [they] can be difficult, I have not found fault with the care. Well done staff at Camberley Lodge. Another stated, We are very happy with all the staff and the way [our relative] is looked after. A member of staff who completed a survey told us, Camberley Lodge has a very friendly atmosphere and all staff get on very well together. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately managed in the best interests of people living there. Evidence: The provider told us in the AQAA, The registered manager has done the Registered Managers Award and NVQ level 4 and All procedures and policies have been updated. All records have been updated and appropriate changes made. The management of Camberley Lodge is jointly carried out by the Registered Provider, who takes responsibility for much of the record keeping, and the Registered Manager, who takes a care management role dealing with the day to day running of the home and the care of people living there. On the day of the inspection we had a discussion with the manager around ensuring information is returned to us at the Commission when requested. In particular we discussed the Annual Quality Assurance Assessment or AQAA, which is required by law Care Homes for Older People Page 25 of 31 Evidence: to be completed by the service. This had not been returned when requested, nor when a reminder was sent. However, following the discussion with the manager, the AQAA was returned promptly just after the inspection. The AQAA was completed by the provider and contained appropriate information, some of which has been recorded throughout this report. However, some of the sections of the AQAA document could have been completed in greater detail. We explained to the manager the importance of completing this document with information that reflects the day to day running of the home and what people experience from living there. In view of this, it is important that the manager has relevant input into compiling this information. Similarly, the improvement plan that was submitted by the proprietor following the last inspection of the service gave very general statements but did not reflect what had been done in practical terms to make improvements as per the requirements and recommendations that were made in the previous inspection report. Through discussion, the manager was able to demonstrate what improvements had been put in place. Again, it is important that the manager has input into providing us with this information so that it reflects what is happening on a day to day basis in the home. We discussed Regulation 37 notifications with the manager, as we had not received any in the past year. However, the manager explained that they have not had any deaths, hospital admissions or serious incidents in the past year. In general, although people living in the home are becoming increasingly elderly, they maintain reasonably good health. We further discussed that it would be good practice to complete a notification under Regulation 37 in the event of falls even when there is no apparent injury, as consequences are not always immediately obvious and fractures may only become evident some time later. The provider told us in the AQAA, The way the care home is managed is by consulting residents and relatives on many issues by having monthly resident and staff meetings. Through discussions with the manager and the evidence examined it is evident that the home continues to ensure the views of residents and relatives are sought. This is done through residents meetings and surveys and, as recorded elsewhere in this report, those opinions and suggestions are acted upon. This indicates that the service is run in the best interests of the people who live there. A sample of Health and Safety documentation was examined and found to be in order. This included maintenance certificates relating to the hoist, gas boiler, electrical wiring, nurse call system, portable appliance testing (PAT), fire panel, fire extinguishers, emergency lighting and water. Personnel records examined confirmed that staff have Care Homes for Older People Page 26 of 31 Evidence: received Health and Safety training and Infection Control training. We observed that staff followed good practices around personal care, cooking and washing hands to ensure good infection control. Care Homes for Older People Page 27 of 31 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 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, Care Homes 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 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 The care plans could be improved if they contained greater detail. This would ensure that peoples care needs and wishes were fully recorded so that staff can be confident they have sufficient guidance around the care to be provided. The provider should consider how the environment could be improved to ensure elderly residents with increasingly restricted mobility can be supported to access all areas of the home. The service should continue with the programme of redecoration and refurbishment that is in progress to ensure people enjoy living in a home that is well maintained. The provider should ensure improvements to the laundry facilities continue so that there is sufficient storage space to remove the clutter of objects in the room that restrict access to the washing facilities. The registered provider should ensure the registered manager has input into producing information that is requested by us at the Commission such as The Annual Quality Assurance Assessment or any improvement plan that my be requested. Page 29 of 31 2 19 3 19 4 26 5 31 Care Homes for Older People Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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