Inspection on 25/11/09 for Elm Lodge

This is the latest available inspection report for this service, carried out on 25th November 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elm Lodge 27/03/07

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Elm Lodge 107-109 Enys Road Eastbourne East Sussex BN21 2ED     The quality rating for this care home is:   two star good 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: Kathy Flynn     Date: 2 5 1 1 2 0 0 9 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 25 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 25 Information about the care home Name of care home: Address: Elm Lodge 107-109 Enys Road Eastbourne East Sussex BN21 2ED 01323419257 01323722257 dee.yates@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr Vidya Vishwas Sapatnekar care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 22. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Elm Lodge is registered to provide accommodation and care for up to twenty two older people with a dementia type illness. Dr Vidya Vishwas Sapatnekar owns the business and the Registered Manager, Dolores Yates has day-to-day control. The home is a large property made up of two buildings connected by a corridor on the ground floor. There are sixteen single bedrooms, of which ten have ensuites and three double rooms, which are situated on the first floor. All rooms have a wash hand basin. Access is provided by a stair lifts to the first floor in both parts of the building, Care Homes for Older People Page 4 of 25 22 0 Over 65 0 22 Brief description of the care home although steps are still involved. In addition there are two lounges, a small seating area in the original building and a small conservatory in the new part, with doors leading to the garden, and two separate dining rooms, two walk-in shower rooms, one assisted and one unassisted bathroom. At the rear there is an attractive enclosed garden mainly laid to lawn with established borders and seating, that is accessible by wheelchairs from both buildings. There is a large parking area at the front of the building, which can be accessed from the road; additional parking is also available on the road itself. The home is situated approximately 15-minutes walk from Eastbourne town centre and its amenities including the train station. A bus stop is located just outside the home. The staff compliment consists of a registered manager, an assistant manager, a deputy manager, senior health care assistants and health care assistants. Staff work a rota that includes a minimum of three staff on day duty and two at night. Current weekly charges range from £440 to £750. Additional charges are made for some hairdressing. Previous inspection reports are available from the provider or can be viewed and downloaded from www.csci.org.uk. Care Homes for Older People Page 5 of 25 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Asct 2000 and the Care Homes Regulations Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Elm Lodge will be referred to as residents. This was a key inspection that included an unannounced visit to the home by two inspectors. A range of documentation was reviewed including care plans, medication charts, recruitment files, and the menus. The manager, assistant manager, care staff and cook were happy to discuss the support they provide. They were all very positive and felt they could meet the Care Homes for Older People Page 6 of 25 residents needs. The Annual Quality Assurance Assessment (AQAA) was completed by the manager within the required timescale, and identified areas where improvements have beeen made, and where others are planned when the proposed changes to the building have been completed. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? 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 25 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 25 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. Assessments are carried out to ensure the home can meet the individual needs of people who wish to move in, this is completed with the involvement of the prospective residents and their representatives. Evidence: The statement of purpose and service users guide include information about the services offered at Elm Lodge. These are available to people enquiring about moving into the home and their representatives. The statement of purpose should be updated to reflect the current staffing in the home. The information could be more detailed and written in a more user friendly format, to reflect how the home operates to provide a good level of care. Relatives spoken with during the inspection said they had visited a number of homes, and found Elm Lodge to be the best one they have seen. The atmosphere is relaxed Care Homes for Older People Page 10 of 25 Evidence: and homely, the staff are very good and they provide the residents with the support and help they want and need. Their relatives were assessed before they moved into the home, and they are involved in all decisions about the care provided. The manager and assistant manager confirmed that they are responsible for completing assessments before people are offered a place at the home. Four of these were viewed and found to contain a considerable amount of information regarding their individual needs. It was noted that additional information had been added to assessment following admission, and on one the date of the assessment was after the person had move in to the home. The expectation is that the information recorded is dated and signed appropriately. Care Homes for Older People Page 11 of 25 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. The care planning system enables staff to provide the care and support residents at the home need. Medication training is provided for staff to protect residents. Evidence: Four care plans were examined and the information included details of the individual needs of people living in the home, pre-admission assessments, care plans, risk assessments including falls and nutrition, and daily records, with some evidence that the care plans are reviewed, with the involvement of the residents and their representatives. Moving and handling assessments had been completed in the care plans viewed, however the staff member who completed these has not attended the required risk assessment training and therefore may not be qualified to do the assessments. The manager advised that appropriate training will be arranged, and in the meantime an external provider will be used. The layout of the care plans was confusing as pre-admission assessments, kept at the Care Homes for Older People Page 12 of 25 Evidence: front of the folders, did not reflect the current needs of some residents. To get a clear picture of residents needs it was necessary to work through all the information recorded, and it was noted that some assessments had not been reviewed, and the daily records of care did not reflect the support offered to residents or how their needs were met. When well written the daily records help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review, and to record that they are following the assessment of needs. The manager advised that additional support and training will be provided for staff to ensure that the care plans and daily records reflect the care provided at the home. Residents are registered with GPs, and they have access to allied health professionals if required, including District Nurses, chiropodist and opticians, with visits recorded in the care plans. The home has policies and procedures for the ordering, storage, and administration of medicines. The medicine administration records (MAR) charts were viewed and found to be completed correctly and staff said they have attended training. Procedures are in place for homely medicines, although these should be signed by the residents GP, and the policy regarding administering medication when needed, on a PRN basis, should be reviewed and updated to included clear guidance for staff. Medicines that need to be kept in a fridge are kept in a locked box, and a pharmacy check was carried out in March 2009. Staff were noted to treat residents with respect, and residents and visitors who took part in the inspection said that the staff are very good and look after us very well. Care Homes for Older People Page 13 of 25 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. The home offers a range of group and individual activities throughout the week, for residents to participate in if they wish. The food at the home is good, residents are assisted at meals times if required, choices are available and specific dietary requirements are met. Evidence: A range of activities are arranged for people living at the home to participate in if they wish. During the inspection an external entertainer sat with all the residents in the lounge, playing the guitar and singing popular songs. Many of the residents were singing along or tapping their feet and they were clearly enjoying themselves. Visitors said they are always made to feel welcome, they are offered drinks and a quiet place to sit with their relatives if they wish, and they were very positive about the care their relatives receive. Links with the local community are encouraged, with churches visiting as required, and arrangements have been made for a carol service before Christmas. Communication between residents, visitors and staff was noted to be relaxed, friendly and one first name terms. They were able to choose where they wanted to spend their Care Homes for Older People Page 14 of 25 Evidence: time during the inspection, some like to sit in the small area overlooking the garden and others prefer the lounges. Breakfast was still being served at 09.30, the start of the inspection, and some residents had chosen to have a lie in. The food at the home was good, lunch looked appetising and residents in the small dining room said it was very nice and it is always good. The atmosphere was relaxed with residents and staff chatting and laughing, second helpings were offered and drinks were provided, including tea if requested. Some residents require assistance or prompting at meal times, and it was noted that the manager and assistant manager were assisting residents in the lounge. Considering that the residents sit in three different rooms to have there lunch, with staff offering support in each of these, the concern is that the staff will be unable to offer appropriate support for all the residents at weekends when the manager and assistant manager may not be working. Refer to standard 27. Care Homes for Older People Page 15 of 25 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. Appropriate complaints policies and procedures are in place. Training in protecting vulnerable adults is provided for staff to protect residents. Evidence: The homes Statement of Purpose and Service Users Guide provide information about making complaints, or raising concerns about the services offered at Elm Lodge. Visitors involved in the inspection said that they did not have any concerns and if they did they felt able to talk to the manager or staff about them. The home has not received any complaints since the last inspection, and the one complaint received by the Commission was investigated by the provider and is now closed. Training in protecting vulnerable adults has been provided for staff. Those involved in the inspection have attended this, they were able to demonstrate a good understanding of abuse and what action they would take if they have any concerns. Care Homes for Older People Page 16 of 25 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. Elm Lodge offers a comfortable and homely environment for the residents, and training in the control of infection has been provided for staff to protect residents. Evidence: Elm Lodge offers people living there a comfortable and homely environment, they are encouraged to regard it as their home, and some have personlised their rooms with ornaments, pictures and soft toys. Following the purchase of the building next door the home has been extended, and the two parts are now linked on the ground floor by a small corridor. There are plans to add four rooms to the new building, and the refurbishment of the original building will include combining the lounge and dining room to provided a larger room for residents. It was noted that the bathroom on the ground floor of the new building needs handwashing facilities, including paper towels and liquid soap dispenser; the provision of shower chairs should be reviewed, to ensure that there are sufficient numbers available for use by residents; the fire doors throughout the home should be checked to ensure they close appropriately, and the hot water provision should be assessed as the hot water temperature checks were 36-37 degrees centigrade rather than the required 43. Care Homes for Older People Page 17 of 25 Evidence: The manager had identified that the flooring in the kitchen is damaged and should be replaced, and the flooring in the corridor to the new building has some ridges and is unsafe so should be replaced. She confirmed during the inspection that the provider has authorised her to deal with this as soon as possible. Environmental Health visit the home yearly and made a number of requirements in June 2009 with regard to the kitchen. The manager confirmed that a follow up visit had been made and all the requirements had been addressed. There are stair lifts in each side of the home to enable residents to access their rooms, and residents are supported to use them safely. Infection control training is provided for staff, those spoken with have attended the training and were aware of the importance of using gloves and aprons appropriately. Care Homes for Older People Page 18 of 25 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 homes training programme enables staff to be aware of their roles and responsibilities, and robust recruitment procedures protect the people living at the home. Evidence: The staffing levels at the time of the inspection included the manager, assistant manager, three care staff, two housekeeping staff and the cook. However at weekends there are only three care staff, one housekeeping staff and the cook working at the home, there are concerns that this may not be sufficient to meet the needs of all the residents. Staffing levels should be reviewed and increased in line with the assessed needs of the residents. The staff rota should reflect the hours actually worked by all staff employed at the home, including the registered manager. The homes recruitment procedures are robust, four files were viewed and found to containt relevant information including application forms, two references, and Protection of Vulnerable Adults (POVA) and Criminal Record Bureau (CRB) checks. The manager confirmed that employment gaps are discussed and to support this records should be kept of the information obtained. Care Homes for Older People Page 19 of 25 Evidence: Staff involved in the inspection said that they had completed induction training when they started at the home, and were able to work towards National Vocational Qualifications (NVQs), and some were in the process of doing this. There is an ongoing training programme for staff which includes those required by legislation medication, fire training and moving and handling, and a training session on dementia had been arranged for the week of the inspection. The training records are kept in the individual staff files, a matrix would enable the manager and staff to review their training needs at a glance rather than looking through all the files. Care Homes for Older People Page 20 of 25 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 management style at Elm Lodge is open and encourages the people who live there, their relatives and staff to be involved in decisions about the support and care provided. Evidence: The manager has been managing the home for a number of years, she has completed the Registered Managers Award and NVQ level 4 in care and management. Feedback from people living in the home, their relatives and staff was very positive and all felt that they could talk to her about any concerns they might have, she is very approachable and deals with anything you want as soon as we tell her. Quality assurance and monitoring systems are in place, regular newsletters inform the people living at the home and their representatives about current and future developments of the services; monthly staff meetings and managers meetings enable them to discuss any issues, and the provider visits monthly to complete a separate Care Homes for Older People Page 21 of 25 Evidence: assessment of the services offered. The manager advised that the home is not responsible for the residents finances. The health and safety of residents, visitors and staff is protected through the risk assessments for the home. The fire risk assessment should be developed to show exactly what is checked including fire doors. There is a health and safety check list, up to date insurance certificates, and checks by external contractors for the electrical system, stair lift and mobility aids. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 27 18 Staffing levels to be 28/12/2009 reviewed and increased when required to meet the assessed needs of residents. To ensure residents receive the care and support they need and want. 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 Care Homes for Older People Page 24 of 25 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. 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