Inspection on 05/05/10 for Compton Lodge

This is the latest available inspection report for this service, carried out on 5th May 2010.

CQC found this care home to be providing an Excellent 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

Compton Lodge 14/12/06

Compton Lodge 10/01/06

Compton Lodge 23/07/05

Compton Lodge 17/02/05

Compton Lodge 21/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Key inspection report Care homes for older people Name: Address: Compton Lodge 7 Harley Road London NW3 3BX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Pearlet Storrod     Date: 0 7 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Compton Lodge 7 Harley Road London NW3 3BX 02077221280 02075868113 eileen.salem@ccht.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Central & Cecil Housing Trust Name of registered manager (if applicable) Ms Mary Walsh Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Compton Lodge is a three storey Edwardian House that has been extended and adapted to provide accommodation for 34 older people. The home is owned and managed by the Central and Cecil Housing Trust. The house is situated in a quiet residential area close to Primrose Hill. The home is convenient to shops, amenities and public transport with the nearest tube station being Swiss Cottage. The house is set back from the road and surrounded by mature gardens. There are 30 single rooms and two shared rooms, all of which have an ensuite facility comprising of a toilet and a hand washbasin. There is a television aerial socket and a telephone point installed and each room is linked to a call bell system. Each room is furnished with a single bed, armchair, wardrobe, chest of drawers and a lockable bedside cabinet. All the radiators are low surface temperatures to meet health and safety requirements. There is a step down to bedrooms 31 & 32. On the ground floor there are four sitting rooms and one dining room. Access to all floors is via stairs or a shaft lift. There are assisted Care Homes for Older People Page 4 of 26 0 Over 65 34 Brief description of the care home bathrooms and toilets on each floor. The range of fees for privately funded service users is from £775 to £875 according to the size of the room. For service users who are supported by public funding, the level of fees is in line with local authority pricing. Care Homes for Older People Page 5 of 26 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: three star excellent 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 quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. During the inspection we spoke with the manager and her deputy and volunteers, people using the service and a relative. We looked at records and examined three of the files held for people using the service and staff. The self-assessment document, previous key inspection and annual service review reports were used in the inspection process. This unannounced inspection visit was undertaken on 23 April and some outstanding issues were followed up on 7 May 2010, a total of seven hours was taken to complete the inspection. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? The home has improved in various ways. For example, Two requirements and one recommendation from the previous inspection report have now been met. These were, to keep staff training records up to date to provide and record staff supervision and to discuss the alternative meals available to the main meal with people using the service. The home now had recruited to all their vacant posts. The deputy manager was successfully appointed as the manager in day to day charge of the home and she has been approved by the Commission as the registered manager. The home has installed electronic systems to assist them in developing the care plans and service delivery. They had installed a computer with a large keyboard for people using the service and they provide the necessary training to individuals to use the equipment. Surveys were sent to people using the service and to relatives to capture their views Care Homes for Older People Page 7 of 26 about improving the service. 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 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 8 of 26 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 9 of 26 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. People using the service are assessed and supported when moving into the home so that staff can meet their needs and aspirations. Standard 6 was not applicable to this home. Evidence: There was clear evidence that the home continued to offer a planned admission process, which supported the people moving in to feel at ease. The process of admission for an individual moving in on the inspection day was examined. The operation went smoothly as planned. This person had been invited to visit the home and have lunch to help them decide if they wanted to move in. In addition a deputy manager had completed a very detailed assessment that included getting a good understanding of their interests and wishes as well as their care needs. A previous comprehensive assessment had recently been undertaken by the local authority and information gathered were used to develop a care plan. Care Homes for Older People Page 10 of 26 Evidence: Other assessments of needs were available on the files of people using the service together with contracts. Information gathered enabled staff to plan and develop individual programmes of care for individual people using the service. Care Homes for Older People Page 11 of 26 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. An ongoing care planning process ensures that the personal and healthcare needs of people living in the home are met. Evidence: We looked at the care plans, risk assessments and daily records for three people who use the service. These are held on a computer system. The care plans were up to date and they reflected the needs and wishes of each person. Care records were comprehensive with important health and personal care needs identified and recorded. The care/support plan summaries were typed up systematically and in a way that enabled staff to easily access, assess and review individuals care plans. It was evident that health care professionals such as the GP and/or district nurses had involvement. A doctor from the local GP practice visits the home for 4-5 hours each week to review the care, medication and arrange investigations and referrals as necessary. This was reflected in the self-assessment document and confirmed in discussions with the manager. Care Homes for Older People Page 12 of 26 Evidence: From viewing the records, discussions held with people using the service, a relative and staff, it was apparent that the home offered a person centred approach to care planning . One person told me at lunch for example, I am going to the dentist, which is in Golders Green, I chose to keep my own dentist as he is very good. The care plans were very comprehensive and work had begun to change the style of the care plans, making them more person centred, and to put the choices and decisions of the people at the forefront of care delivery. From observation we were satisfied that staff demonstrated an awareness and understanding of the needs of individual people living at the home. Reviews occurred monthly or more frequently if necessary, and there was evidence that equality and diversity issues were taken into account. Individuals religious, ethnic, disability, cultural and social needs have been recorded. A Chinese person lived in the home and we met a Chinese individual who provided Chinese food for the client on two occasions each week. It was evident that people using the service with dementia were enabled to maintain their independence with support and assistance from care staff. Care planning for these people considered their personal care, communication needs and behavioural needs. Staff working with people living with dementia had received appropriate training, this was evident in care practice observed during the inspection. For example, an individual threw hot tea at a staff member who was in the process of administering medication to the clients. The situation was handled very well by the staff member concerned. Pressure sores and nutritional risks were included in care plans and scored accordingly. Individuals mobilities were also taken into consideration as well as their weight. Moving and handling risk assessments were in place for people who needed assistance. Any cause for concern is addressed immediately with the appropriate health professionals. Risk assessments were in place for people susceptible to falls. Although health professionals such as the chiropodist, dentist and optician visit the home, wherever possible people were encouraged to go for appointments in the community. From discussion with two people using the service it was obvious they preferred this. Entries in care records showed clear evidence of collaborative care with interventions from other health and social professionals including input from the palliative care team. Observation at the site visit, discussions held with staff and a volunteer and examination of the care records showed that staff respected the privacy and dignity of the people living at the home. The home has a very efficient medication policy, procedure and practice guidance, and a medication administration round was observed Care Homes for Older People Page 13 of 26 Evidence: during the inspection. This was done in accordance with the homes policy and the medication administration records for two individuals case tracked were found to be satisfactory. Senior staff had completed a distance learning course on medication and a certificate was evidenced on one of the files observed. The audit identified that staff were accurately recording the receipt, administration and disposal of medication. The self assessment document made reference to the end of life care and six staff were waiting to complete the End of Life care/Liverpool Care Plan training with the palliate care team. The management team is further developing these care plans. People who used the service and were dying were given the choice to remain at the home if that was their wish. They are treated with sensitivity and respect and their wishes were complied with. Where necessary relatives were very involved and arrangements were made for their support. The home had begun to concentrate on the Gold Standard Framework (GSF) which focuses on end of life care. Some staff had already completed an end of life care course with the local palliative care team. The Manager said they worked closely with the team and have an excellent named nurse as their link. Carers were reported to be more confident to discuss sensitive issues pertaining to end of life care with individual people using the service. The following comments were taken from recent card sent to the home: I cannot explain how happy I am to be at this home. It is wonderful. Care Homes for Older People Page 14 of 26 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. People who use services are able to follow their preferred lifestyle and can engage in opportunities for stimulation and occupation. The ethos of the home is to recognize the therapeutic value of visits from friends and family members. Evidence: The care plans examined made reference to and included individuals interests, wishes and preferences. They reflected other pertinent issues such as times of rising and retiring , bathing, weight, continence needs, individuals beliefs and religious needs if any. The home had a welcoming atmosphere and a volunteer who has been associated with the home for a long time was still very much involved with the home. We were introduced to a relative who was visiting a parent who was not responding to their mobile phone. The visit was to alert the parent to watch David Cameron being interviewed on the television in relation to the general election. The relative spoke well of the home and the replacement of the willow tree which was key feature in the garden. They also made reference to the next resident and relatives meeting, which is co-ordinated by a relative. Care Homes for Older People Page 15 of 26 Evidence: The care plans make reference to activities that are liked by individuals and detailed social histories and social interests and activities were noted. For one individual their social interests were dancing and singing. This individual was part of the case tracking protocol. They escorted me to look at their room which was decorated in a personalized manner with photographs of themself and their loved ones. The individual maintained regular contact with family members and they confirmed that life in the home was very good. We asked two different people whether they knew the activities planned for later. One person said it was exercises and added, I would much prefer to stand up when doing the exercises rather than sitting down. Another individual agreed with this and said they too would prefer to stand up and do the exercises. A polite comment was made in response stating, your mobility is not so good now and you should not try to do the exercises whilst standing. I think you are right, the other person said in response. The home was jovial with a three way conversation, which was humorous at times and respectful. Feedback about the food was positive. People using the service are consulted on the menu for their lunch and supper for the following day. Individual choices are recorded on a food ordering sheet for the chef. Alternatives to the daily menu were available and people with whom I spoke confirmed this to be the case. Care Homes for Older People Page 16 of 26 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 home can be confident that there are effective systems in place to manage complaints and to protect people using the service. Evidence: Complaints, incidents and accidents were recorded. The records were cross-referenced with those relating to care for the people case tracked. The accident reports were compared with the Regulation 37 notifications sent by the service since the last inspection. The home had a robust complaints policy and procedure. The procedure was available to people living in the home and their relatives. Feedback from two people that I spoke with confirmed that they knew who to approach if they were unhappy. One person said, I would speak to the manager. The other person said, I would go and report to the office. The home received two formal complaints within the last two years, one of which remained outstanding from the previous inspection relating to a lack of hot water. Staff had attempted to address this matter and on the inspection day, another person arrived to carryout the work. Unfortunately they confirmed that a particular part was needed, which they ordered. The Inspector followed this up since it was a long outstanding issues. The home confirmed that the problem was now resolved. There was a comprehensive policy and procedure on adult protection, aligned to the host authoritys guidance. Staff receives on-going training on adult protection as evident from the training records. The home had acted promptly regarding allegations Care Homes for Older People Page 17 of 26 Evidence: made and we were notified accordingly. Since the previous inspection in August 2007, one investigation was undertaken and one referral was made to the local authority, the outcome of which was inconclusive. No names had been referred for consideration of inclusion on the register held by the Independent Safeguarding Authority. Care Homes for Older People Page 18 of 26 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 residing in this home live in a comfortable, safe and clean surroundings Evidence: The home was maintained internally and externally. A key feature of the garden was a willow tree, which staff and a volunteer said had blown down. People using the service their relatives, volunteers and staff were exploring ideas to replace the tree. People living in the home were encouraged to personalize their bedrooms. We looked into the room of an individual with their expressed permission and agreed with the information reflected in the self assessment, that the bedrooms were personalized according to individuals taste and desires. The home should ensure that the bedside drawer of an individual if repaired. The draw was sliding in an opened position after being pushed in by the client and could potentially cause harm to the individual concerned. Since the inspection, the manager reported that the carpet on the first floor corridor had been replaced. Gas and other relevant health and safety checks were looked at and found to be in order. The home was clean and in an orderly state of repair and tidiness. Care Homes for Older People Page 19 of 26 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. The service places great emphasis on recruiting appropriate staff who in turn are provided with the training to meet the needs of the people living in the home. Evidence: The care home has a good track record for the retention of staff. Warm and friendly relationships were displayed by staff working with the people in their care. The period of observation showed some good practice. It was however observed that the handover between shifts took place within hearing of some residents. This needs to be done in private. There was sufficient staff on duty to meet the assessed needs of the people using the service. The self-assessment reflected that a number of permanent staff were on maternity leave and that some others had moved on for various reasons. This had left a shortfall in the number of permanent staff employed at the home. A recruitment drive and the use of some creative approaches such as the use of job share, ensured that all the vacant posts had been recruited to. Once the outstanding Criminal Records Bureau checks are satisfied, the service would then have a full complement of staff. On examination of staff individual files, it was evident that the operational policy and procedure for recruitment was properly conducted. All relevant checks were carried out and two satisfactory references were on each file observed. Induction training were undertaken by all staff employed and there was evidence also of mandatory Care Homes for Older People Page 20 of 26 Evidence: training and refresher courses. All staff had been trained in relation to dementia care and they were participating in the Gold Standard Framework for end of life care. Evidence of staff attendance at courses and copies of certificates attained, were noted. The homes investment in the recruitment of an administration officer for 14 hours per week has enabled an improvement in updating and recording systems and processes within the home. Areas that were previously reported as needing attention had now been addressed. The current situation has allowed senior staff to concentrate on managing the care needs of people using the service and to provide more support to staff. For example, the supervision of individual staff had increased as confirmed by two staff members with whom I spoke and evidenced in three of the personal files observed. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home is managed in the best interests of the people who reside there. Evidence: The manager of the home was the deputy manager for a number of years. She was appointed as manager of the home when the previous registered manager retired. The manager has now been registered. The home was found to be well managed. From talking to the manager and reading the homes self assessment we could see a good level of awareness of the strengths of the service and the areas where improvements were necessary. Clear lines of accountability and communication were evident within the service. The judgments in the preceding sections of this report have contributed to the judgment in this outcome area. The care home has a welcoming environment and promotes an open and transparent style of management. The company invests in the continual development of the staff team. People using the service were protected by the policies and procedures updated within the last year. Care Homes for Older People Page 22 of 26 Evidence: Actions were taken in regard to suggestions made at the meetings held for people using the service and their relatives to improve service delivery. The personal finances looked after by the home for people using the service were appropriately managed and monitored. Individuals personal monies are checked by staff, monitored by the Responsible Individual and audited by an independent auditor. A sample of health and safety records were looked at. These confirmed that the home is being managed responsibly with essential checks being made. There were robust procedures in place to monitor compliance. Equipments was regularly serviced and where required, repaired or replaced. Surveys were issued to people using the service and to relatives the, the outcome of which was not yet available to the home. According to the manager an action plan would be put in place following receipt of the outcome. Care Homes for Older People Page 23 of 26 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 24 of 26 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 2 23 29 The registered manager should that all bedroom furniture is in good working order. The registered manager should ensure that the handover between shifts occur in private to ensure the confidentiality of information for people using the service. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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