Inspection on 03/10/07 for Gordon Lodge Rest Home

This is the latest available inspection report for this service, carried out on 3rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Gordon Lodge Rest Home 43 Westgate Bay Avenue Westgate-on-sea Kent CT8 8AH Lead Inspector Mrs Susan Hall Key Unannounced Inspection 3rd October 2007 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gordon Lodge Rest Home Address 43 Westgate Bay Avenue Westgate-on-sea Kent CT8 8AH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01843 831491 Fleming Care Homes Ltd Mrs Diane Bridget Fleming Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 33. Date of last inspection Not applicable – new service Brief Description of the Service: Gordon Lodge Rest Home is situated in a pleasant residential area of Westgate on Sea, within walking distance of the beach, and close to facilities in the town. It has operated as a care home for over 20 years, and was purchased by new providers in May 2007. One of the providers is also the registered manager for the home, and carries out the day to day running of the home. She has previously had experience in running care homes. The premises are a Victorian detached building, which has been extended at one side and the back several years ago, to provide additional bedrooms and other rooms. Most bedrooms are for single use, and many have en-suite facilities. The home has several rooms for communal use, and a very well maintained garden at the rear. Fees currently range from £309.00 - £600.00 per week, depending on the amount of assistance needed, and the size of the room available. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Inspection which includes assessing all information gained about a home since the last inspection, and assessing key standards. As this home was purchased by new providers in May 2007, it has been registered as a new service, so previous inspection reports are no longer applicable. The inspector has therefore analysed information about the service since the time of purchase. All key standards were inspected, and most other standards. The inspector was welcomed by the head of care, who was on duty throughout the day, and assisted with providing information. The manager arrived later in the morning, and also assisted the inspector during the day. The inspection visit lasted for 6.5 hours, during which time the inspector chatted with a number of residents and staff; read documentation such as care plans and medication charts; viewed all areas of the home; and observed care staff carrying out their duties. The inspector sent out a number of survey forms, and was pleased to receive 11 replies, from residents, relatives and staff members. The home was spotlessly clean throughout. Residents spoke highly of the staff, and the levels of care given. Comments included “ I find staff helpful; and the food is good”; “ staff are always available when needed”; and “the staff treat everybody as a very important individual person”. What the service does well: It was clear from talking to residents and reading survey forms that staff are genuinely caring, and treat residents with respect and dignity. Food is well managed in the home, with most foods being home cooked, and with a good variety on the menus. The premises are kept very clean. Bedrooms are “spring cleaned” every 6 weeks; and residents pointed out the well laundered and ironed duvet covers and other soft furnishings. Residents expressed confidence that any concerns raised are quickly dealt with, and appropriate action is taken. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (standard 6 is not applicable to this service). People who use the service experience good quality outcomes in this area. The service provides clear and detailed information for prospective residents to make an informed choice. Pre-admission assessments are carried out with sufficient attention to detail. EVIDENCE: The statement of purpose and service users’ guide have been re-written, and include details of the new providers and registered manager. The statement of purpose is well presented, and includes details of the aims and objectives of the home, and all aspects of the home as outlined in schedule 1 of the regulations. The service users’ guide is produced in large print, so that it is easy to read. This includes a summary of the statement of purpose, and clearly states details such as this is a non-smoking home; the care home is for long stay or Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 9 respite care for older adults (over 65yrs); the number of staff on each shift; and what is included/not included in the fees. Residents stated on survey forms that they were given ample information about the home prior to admission. Some are able to visit and view the home for themselves, whilst others rely on relatives to make the initial visit and decision for them. Pre-admission assessments are carried out by the manager or head of care, and the inspector read two of these. They included sufficient information for the assessor to determine that the home could meet the person’s needs. This includes personal details and medical history; and details for all aspects of daily living such as: communication, personal hygiene needs, nutrition, continence, mobility, medication and skin care. The assessor obtains joint assessments from social services/hospital where available, and may gain additional information from previous carers or relatives. The preferred room is checked for its suitability, ensuring that any necessary equipment is available. The service users’ guide contains a sample contract, and this clearly states that the first four weeks are a trial period, and there will be a care review at the end of this time. The contract includes data in respect of termination agreements and insurance of personal belongings, and is signed by the manager and the resident or their representative. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 People who use the service experience good quality outcomes in this area. Health care is generally well managed, and residents are confident that their health needs will be met. There are some improvements to be made with medication management. EVIDENCE: Care plans are presented in individual A4 folders, and are stored in a small room which is kept locked when not in use. This preserves confidentiality. Initial care plans are drawn up from pre-admission assessments, and basic care plans are usually drawn up within seven days. The inspector viewed three care plans, and found that the content is clearly laid out in different sections, and so it is easy to find the required information. Care plans are drawn up according to the assessed needs, and are hand written by the allocated key worker. The format for care plans had been altered since the new providers/manager took over. Each care plan is recorded on a separate page, which allows for plenty of space for care staff to reevaluate each plan, and enter any changes in care. Assessments and care plans are checked monthly. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 11 There was no evidence to show that the care plan is discussed with the resident (or representative where indicated), and the inspector requires that there is clear provision to discuss care plans, and to show formal agreement (standard 7.6). There are separate sections showing the details for doctors’ or District Nurse visits; blood tests; weight; accident records; and daily records. These were well written and signed and dated. Daily records include relevant details such as a resident feeling unwell and staying in bed; how well the person had eaten that day; and social interaction or behavioural difficulties. Some residents have tense interaction at times, such as shouting at other residents or staff. These incidents are recorded separately, with documentation stored where it is easy for staff to access quickly. Any ongoing aggressive behaviour is discussed with the GP, and a referral made to a Psychiatrist if necessary. Staff are not trained in dementia care, and residents in this category are not admitted to the home. However, some residents have developed some symptoms over the years, and staff are quick to recognise if residents are acting unusually or out of character. Most residents belong to the same GP surgery, and doctors visit as needed on request. The inspector pointed out some minor areas where care plans could be improved, and the manager and head of care discussed the importance of auditing care plans on a regular basis. Staff were seen to interact well with residents and the inspector had lots of positive comments on survey forms and on the day of the visit. For example: “The all round care of residents is excellent. I am content that my relative is well cared for;” and “ all of the staff are very good, and this includes the night staff who are excellent”. Privacy and dignity is always observed. There has been no specific training in regards to management of death and dying. The head of care said that this is a difficult subject to broach, and the staff try to ensure that they handle it at the right time and in a sensitive manner. Some residents/relatives discuss that a resident may not wish to be admitted to hospital etc, if very ill and dying. The inspector pointed out that these situations must be clearly discussed with the relevant GP, and clearly recorded. Medication is stored in a small storage cupboard, and in a medication trolley – which is kept locked to the wall when not in use. Most is dispensed via a cassette system. The trolley and storage cupboard were generally in good order with no overstocking or out of date items. Medication ordering is carried out by the senior carers. The inspector noted a number of items labelled for staff use, ( e.g. paracetamol) and brought this to the attention of the manager and head of care. These items were going to be removed immediately, and Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 12 staff informed that it is not acceptable practice to retain any medication for staff. There were also some “homely remedy” items – e.g. pholcodine cough linctus, – but no homely remedy policy and procedure in place. The manager and head of care said they would discuss this situation with the GP, and decide if they wish the home to stock any “homely remedies” in the future; and draw up the appropriate documentation if this was agreed. Medication administration records (MAR charts) were neatly maintained, but some signatures were missing, and the head of care was already aware of this and was taking action to address the situation. Medication administration was on the agenda for items of discussion for a staff meeting the next week. Some medication items had been handwritten on MAR charts, but had not been signed at all. The inspector stressed the importance of two care staff to sign any hand written entries. The manager and head of care had identified the need for further medication training, and were in the process of accessing this. The inspector recommended that the management staff also assess staff competency on a regular basis. The inspector was confident that the manager and head of care were addressing these issues. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use the service experience adequate quality outcomes in this area. Activities are provided in the home, but the range and frequency of these could be improved. Food is well managed, and is suitably varied and nutritious. EVIDENCE: Activities are arranged on a day by day spontaneous basis, apart from fortnightly exercise classes on a Monday, and arranged entertainment once per month. This is usually musical entertainment, and residents said they enjoyed these sing alongs. Other activities available includes games such as scrabble, card games and bingo; ball games, quizzes and reminiscence; and going out for walks, having a manicure, or reading/watching TV. A local theatre company comes into the home approximately every 3 months to perform a play. Outings are sometimes arranged to go to places such as pantomimes, garden centres, or a drive in the countryside, and the manager said she was looking at the possibility of increasing outings – maybe with 2-3 residents at a time, so it is easier to organise and fit in with the life of the home. Residents’ surveys indicated that many do not feel sufficient activities are available, and would prefer more stimulation. One relative pointed out that Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 14 more activities of a shorter duration could be of help, as many residents have a short attention span. There is a requirement to review the management of activities, with the expectation of these being increased, and possibly with a more formalised approach, so that residents have a programme, and can decide what they wish to join in with. The manager and inspector discussed the possibility of having a designated carer for activities in the afternoons. A local vicar gives a communion service in the home every month, and residents are enabled to go to their church of choice if they wish to do so. Visitors are welcomed into the home, and relatives stated that they are always kept informed of any changes for their residents by the staff. The home has a well maintained garden, and residents said that they enjoy sitting outside in good weather. Barbecues are sometimes arranged. The home has a cook on duty each day to prepare lunches and teas, with care staff completing teatime preparation and serving. Care staff also work together to serve breakfasts. A designated carer is assigned to the kitchen each teatime, and does not give any personal care until after teas are served and the washing up and kitchen cleaning has been completed. The home works to a 4 weekly menu plan, and seasonal changes are included when the menu is changed. A record is kept of what residents eat, and if residents are unwell, food charts are maintained to show the type and amount of food eaten. Most food is home made, including cakes and pastries. Residents all said that the food is “good” or “very good”. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. The complaints procedure is satisfactory, but could be made more easily available. The manager is arranging more training for understanding the recognition and prevention of adult abuse. EVIDENCE: The complaints procedure is included in the service users’ guide, and is on display in the entrance hall. The copy in the entrance hall included details for local adult Social Services, which is helpful, as it is a reminder that residents can talk to their care manager (if applicable). The copy in the service users’ guide did not include these details. The displayed copy was not easy to find amongst many other notices displayed downstairs, and was rather a “tatty” copy, which the manager said she would change. A folder has been implemented to record any formal complaints. There had been no formal complaints since the purchase of the service, and no complaints directly to CSCI or “Safeguarding Adults” procedures since the new ownership. Residents said that they are confident that any concerns they raise will be listened to and responded to positively. Everyday minor concerns are recorded in residents’ own care plans. However, this does not make provision for recording any small concerns voiced from other sources (e.g. relatives, visitors). The manager stated that the home would commence a notebook for day to day concerns, so that these can be documented, and the action taken as a result can be clearly seen. It will also Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 16 help the manager to see if there are any patterns or frequency of minor concerns. The home has policies and procedures in place for the recognition and prevention of abuse, including a whistle blowing policy. There was evidence of training for most staff in this subject, but some staff need updated training in this. The manager had already recognised this, and was in the process of implementing more training. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 People who use the service experience adequate quality outcomes in this area. The premises are generally well maintained, and kept clean and tidy. The kitchen and one of the bathrooms require attention. EVIDENCE: The premises are a large Victorian, detached house, which has been extended some years ago to provide additional bedrooms and other facilities. The inspector viewed all areas, except for rooms where residents were resting or being assisted with personal care. The building is decorated in a style which is suitable for a Victorian building, and there is a programme in place for keeping the décor updated. Rooms are redecorated as needed, or when they become vacant. Residents and relatives may choose colour schemes when redecoration takes place. The home was spotlessly clean throughout, and a credit to the cleaning staff. There are usually 3 cleaning staff on duty each day, and they have a system for Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 18 thoroughly spring cleaning several rooms per week, so that all rooms are deep cleaned approximately every 6 weeks. Bedrooms had suitable quality furniture in place, and good quality soft furnishings. Duvet covers and curtains are well ironed and present an attractive appearance in the rooms. Most of the bedrooms are for single use, and many have small en-suite toilet areas. Two rooms have large en-suites with their own bath. There are 3 bathrooms for shared use, but one of these can only be used occasionally, as it is a small room, with only access to the bath from one side, and no room for any hoisting facilities. This is therefore unsuitable for use by many of the residents. The manager stated that they are considering re-designing this bathroom into a shower room (a “wet room”) which would make better use of the space, and also provide residents with a choice of bath or shower. The home has many corridors and stairs, and residents are carefully assessed to see that rooms are sited where they have access to them in regards to their mobility. There is a stairlift providing access to the first floor at the front of the building, and a passenger lift to the first floor at the back of the building. Stairways lead to other rooms on the second floor. The corridors are equipped with handrails, and the home has 3 mobile hoists available. Other equipment includes bed rails, raised toilet seats, and a few shared wheelchairs for residents who cannot walk far when going out of the building. The home has a large lounge which is very suitable for shared activities, and a smaller lounge. There is also a large dining room, and dining tables were very nicely presented for lunch time. A ramp leads from the large lounge into the gardens. This is an old wooden ramp which would benefit from replacing, or fitting a concrete ramp. It leads on to a patio area which can be accessed by all residents. Steps lead down to well kept lawns and flower beds, with other areas for seating. All radiators are fitted with guards and individual thermostatic controls. Windows on the first and second floors are fitted with window restrictors. Thermostats are fitted to hot water taps for the baths, and the care staff record each bath temperature prior to residents getting in the bath. Wash hand basins in residents bedrooms/en-suites and shared toilet facilities are not fitted with thermostats. No records are retained for hot water temperatures at these outlets. There is a requirement that these are checked and recorded on a regular basis (e.g. monthly), so as to protect residents from possible scalding. The laundry room is set up with 4 domestic washing machines and 2 tumble dryers. Washing is also dried on an outside washing line. An alginate bag system is in place for dealing with soiled items, and this is a good system for promoting infection control. All items of clothing are ironed, and the laundry assistants check that clothes are clearly labelled. Residents looked very well groomed, and this was partly due to the good quality of the ironing and the attention to detail. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 19 The kitchen is quite small for the numbers of residents. It is divided into 2 sections – a food preparation area, and a washing up area. There is a large dry food storage area, and an area for freezers and fridges, adjacent to the laundry room. There is no dishwasher in place as yet, and washing up is therefore carried out by hand. However, the new providers have already purchased a dishwasher, and this should make a difference to enabling staff to spend more time with residents. The kitchen units are old and tired, with damaged edges in some places. The tiling on the floor has broken tiles, and the tiling on the walls is old, and does not clean well. There is a requirement for the providers to produce an action plan for how they intend to refurbish the kitchen, with timescales for when they intend to do this. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use the service experience good quality outcomes in this area. There are sufficient numbers of staff to provide effective care for the needs of the residents. The home provides good recruitment procedures and induction training; and needs for ongoing mandatory training are being addressed. EVIDENCE: The home has a stable staff team, with many staff having worked at the home for several years. Staff generally felt that the transition to new management has been smoothly managed. Staffing levels in the day time are set as 4 care staff, and the head of care and manager on weekdays; 3 cleaning staff; 1 cook, and 1 laundry assistant. In the evenings there are 4 care staff, one of which is allocated to administer medication, and 1 for preparing teas. They assist with care duties when they have completed these tasks. At night times there are 2 care staff, and they keep a record of hourly checks carried out for residents. Some staff are trained in both caring and domestic duties. This means that they are able to cover for either of these jobs in times of sickness or holidays. Over 50 of care staff have completed NVQ training, and others are in the process of this. The inspector viewed 2 staff recruitment files, and found that there are robust recruitment procedures in place, with all required checks. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 21 Staff inductions have been carried out to a good standard, and staff stated on survey forms that the induction programme has been very good. The induction was consistent with Skills for Care standards, but not in the same format. The manager is now commencing the Skills for Care induction programme. Mandatory staff training was evidenced well in some areas (e.g. fire awareness) but less well in others. The manager had already noted this and was working with the head of care to arrange training for subjects including updates in moving and handling, prevention of abuse, infection control, and medication understanding and administration. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33 and 35-38 People who use the service experience good quality outcomes in this area. The manager is settling into her new role, and has recognised the input which needs to be made to facilitate the continued smooth running of the home. The inspector is confident in her ability to improve the general organisation, and to increase the opportunity for feedback from staff and relatives. EVIDENCE: The manager has been in post since May 2007, and is suitably experienced and competent to run the home. She has completed the Registered Managers’ Award (RMA), and is about to commence NVQ 4 in care, (which is the practical outworking of the academic RMA). She is ably assisted by a head of care, who has worked in the home for over 20 years. The head of care has completed the RMA and NVQ 4 this year. They are working well together, with established roles for different areas of responsibility. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 23 There are senior care staff on duty each day, who carry out medication administration, and overseeing the shifts generally. The home has a key worker system in place, whereby care staff are responsible for ensuring named care plans are up to date, and can build an extra rapport with allocated residents and their relatives. The manager said that she is commencing regular staff meetings, so that all staff have the opportunity to voice ideas and concerns. These were starting the next week. Relatives commented on survey forms that staff interact well with each other, and with residents, and approach their role with a genuinely caring attitude, and a sense of humour where applicable. Relatives and residents meetings (both formal and informal) are being commenced, so as to obtain frequent feedback about any proposed changes in the home, and discuss menus, activities etc. The manager had already carried out a survey for residents, with questionnaires to see how they felt the home is running. The inspector suggested that they might appreciate some feedback from these. Residents’ finances are not managed in the home – only small amounts of pocket monies are stored on request. A record is made of all debits and credits, and receipts are retained. These records can be viewed by the resident or authorised representative at any time. The manager has commenced a programme of formal supervision for staff. This had been valuable for those staff so far. Other staff commented on survey forms that they would value more support from the manager. She is going to carry out all initial supervision sessions herself, so as to have opportunity to get to know the staff on an individual basis. Records are stored confidentially, and are generally well maintained. Fire records are satisfactory. The fire alarm system is tested each week, and fire drills and fire training are carried out at regular intervals. The inspector saw evidence of other servicing records being up to date, for example: gas and electricity, passenger lift and mobile hoist servicing. Accidents are recorded in care plans, and in accordance with legal requirements. Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 2 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12 (2) Requirement Timescale for action 03/12/07 2. OP9 13 (2) Care plans must be discussed with the resident or their representaive,and the home must be able to show evidence for this. Medication management must be 03/11/07 improved in the following areas: No medication to be retained in the home for staff use. • Ensure there are no signatures missing from MAR charts. • Any handwritten entries on MAR charts must be signed by 2 care staff. • The manager must decide if the home is going to offer homely remedies; and if so, this must be discussed and agreed in writing with GPs, and a policy and procedure drawn up. To increase the amount and variety of activities available for residents. • 3. OP12 12 (1,3) 03/01/08 Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 26 4. OP19 23 (2) (b) 5. OP21 23 (2) (j) 6 OP25 13 (4) (c) For the providers to produce an action plan, showing how they intend to upgrade and refurbish the kitchen; with proposed timescales. To review the small bathroom on the ground floor near to the kitchen; and produce an action plan (with timescales) to refurbish this so that it can be used by a greater number of residents. To ensure that all hot water outlets accessible to residents, are safe for them to use. 03/02/08 03/02/08 03/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP30 OP32 OP36 OP38 Good Practice Recommendations To assess staff competency in medication administration on a regular basis. To ensure that all staff are kept up to date with relevant mandatory training. To commence regular staff meetings as proposed. To ensure that all staff receive formal one to one supervision at regular intervals (e.g. 6 times per year). To record hot water temperatues on a frequent basis ( e.g. monthly). Gordon Lodge Rest Home DS0000070106.V347167.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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