CARE HOMES FOR OLDER PEOPLE
Waterside Lodge 60 Rochdale Road Todmorden Lancashire OL14 7LP Lead Inspector
Liz Cuddington Unannounced Inspection 17th November 2005 14:50 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 Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 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. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Waterside Lodge Address 60 Rochdale Road Todmorden Lancashire OL14 7LP 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) 01706 818580 01706 818581 Todmorden Residential Homes Limited Ms Carol Tait Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (1) of places Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd March 2005 Brief Description of the Service: Waterside Lodge is a warm and welcoming residential home offering care and accommodation for up to 41 older people. It is situated near to Todmorden town centre, within walking distance of all local amenities and near to bus routes. The bedrooms are all single rooms and the majority have en suite facilities. There are three lounges, two dining rooms and a quiet room. Outside is an attractive garden area with plenty of seating for service users and their guests. The garden has been developed as a sensory garden with easy access for all. The management and staff at Waterside Lodge are committed to enabling the people who live there to lead active and fulfilled lives. Among the many activities on offer are exercise classes, reflexology and the use of two computers provided solely for the use of service users. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Once again this was an excellent inspection. For the third inspection in succession no statutory requirements or good practice recommendations have been made. The manager and staff are to be commended for their commitment to the comprehensive programme of continuous improvement at Waterside Lodge. During the inspection I spent time talking with some of the ladies and gentlemen who live at Waterside Lodge, a district nurse, several members of staff and the manager of the home. I looked at individual plans of care and other documentation. I would like to thank everyone at Waterside Lodge for their welcome and hospitality during the inspection, and for taking the time to talk to me and expressing their views. What the service does well:
Four of the National Minimum Standards, numbers 7,12,15 & 31, have exceeded the expected standard. The individual plans of care clearly detail how each person’s care and health needs are to be met. They are reviewed monthly and service users and their relatives are involved in this process. Service users privacy and dignity is seen to be respected at all times. The staffing levels are high and this means that there are staff available to accompany service users who prefer to go to their health care appointments in Todmorden, rather than be visited at the home. Staff are also available to escort service users to attend social events and activities in the town. There is a wide range of activities available in the home, for those who want to participate. The meals are of a good quality with plenty of choice available. The building is well decorated and maintained. Hygiene and infection control measures are in place and health and safety matters are given a high priority. The staff group are well qualified and are encouraged to spend time and effort in improving their qualifications and training. Approximately 70 of care staff have an NVQ qualification in care and all the senior staff have either achieved an NVQ level 4 care management qualification or are studying towards one. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 6 Waterside Lodge is very well managed. The manager takes professional advice to make sure that the home is run as well as possible. Service users, relatives, staff and other stakeholders are included in the consultation and management processes of the home. 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. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 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 Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply. The pre-admission process is thorough and forms the basis for the new service user’s plan of care. EVIDENCE: Before a new service user is admitted to Waterside Lodge all the necessary pre-admission assessments are undertaken to ensure the individual’s needs can be met. People are invited to spend time at the home. A plan of care is developed from the assessments as well as from discussions with the service user and their relatives, if they wish. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 Standard 7 has exceeded the National Minimum Standard. The individual plans of care are of a very high standard. They contain all the necessary information to enable staff to meet the individual health and care needs of each service user. They are reviewed monthly. Service users are able to access local services. Service users privacy and dignity is respected at all times. EVIDENCE: I examined a number of individual plans of care. The plans are excellent. They are very comprehensive and show clearly how each person’s care and support needs are to be met. The plans are reviewed monthly, to ensure they are up to date, and service users and their relatives are involved in the review process if they wish. The manager said that they are getting good responses from relatives. The plans of care clearly show how individual’s healthcare needs are to be met. Where necessary the home involves specialists, such as the tissue viability nurse, in planning and delivering suitable care to maintain service users
Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 10 optimum health. The home has sufficient staff to be able to accompany service users to local healthcare appointments with, for example, their GP, dentist or chiropodist. A range of activities is offered, with people coming into the home to run events such as the exercise classes. The District Nurse confirmed my observations that the service users at Waterside Lodge are treated with dignity and that their privacy is always respected. All medical examinations take place in the service user’s own room. There is a quiet lounge which can be used for private meetings, if this is preferred. Some people have their own telephone in their bedroom. Otherwise the office phone can be taken to the service user, or they can use it in the office if they prefer. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 Standards 12 and 15 have exceeded the National Minimum Standard. There are plenty of activities within the home as well as opportunities for people to follow their social interests outside. The meals are varied and of good quality, with sufficient choices available. EVIDENCE: The plans of care record service user’s interests and preferences. Staff accompany service users to attend social events of their choice and are available to take people out and about within the local community, according to their wishes. Waterside Lodge also offers a wide range of activities within the home. These include reflexology, music and movement and reminiscence sessions which are generally run by specialists who visit the home. Visitors are welcomed to the home during the day and evening, in line with each service user’s preferences. Local community groups are involved in the life of the home, if the service users are agreeable. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 12 Everyone who commented said how good the meals are. On the day of the inspection the lunch was a choice of chicken casserole or tuna steaks. There was also a good choice of food at teatime. Mealtimes are unhurried and service users choose the time when they prefer to eat. Part of the service users’ quality assurance questionnaire asks their views on the meals provided. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards was assessed at this inspection. EVIDENCE: Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 In all respects the home and grounds are well maintained. The house is clean and hygienic with good infection control measures in place. EVIDENCE: At the rear of the house there is a specially designed sensory garden, which is accessible to all. One service user commented on how pleasant it is to sit out there during the better weather. Over the last few years the home has worked hard to comply with the recommendations of the Fire Safety Officer. At the time of the inspection there was just one piece of work, to fit a fire door between the kitchen and the dining room, which needed to be completed. The home is hygienically maintained and all appropriate infection control measures are in place. This includes the use, by staff, of anti-bacterial hand cleanser in addition to the usual hand washing and other hygiene routines.
Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30 Waterside Lodge has a well-qualified and well-trained staff team. Continuous professional development is given a high priority. EVIDENCE: More than 70 of the care staff have achieved an NVQ qualification in care. Four more members of staff are taking NVQ level 2 in care at present. In addition three of the senior care staff are studying the NVQ level 4 in care management. The deputy and assistant managers have all achieved the level 4 Registered Managers’ Award. Following their appointment new staff undertake induction and foundation training. Staff training is considered very important and all the care and anciliary staff have the opportunity to gain qualifications, learn new skills and update their existing knowledge and skills. Soon after the inspection four of the senior staff were to spend two days at a care event in Harrogate. They were then reporting their findings back to the rest of the staff team. National Minimum Standard 27, referring to staffing levels and skill mix, was exceeded at the last inspection in March 2005. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 38 Standard 35 does not apply. Standard 31 has exceeded the National Minimum Standard. The management of Waterside Lodge is excellent, showing clear leadership and lines of accountability. The service users, staff and other stakeholders are consulted about how the home should be run. Health and safety matters are considered very important. EVIDENCE: The home’s manager is the driving force behind the excellent staff development programme and the commitment to continuous improvement in the quality of care and accommodation offered at Waterside Lodge. Service users, staff and other stakeholders are consulted, through formal and informal methods, to obtain their views on how the home should develop and further raise standards. The manager takes professional advice on training, business,
Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 17 management and other issues to make sure the home is run as well as possible. The management process is inclusive and the lines of accountability are clear. Regular meetings are held with staff to obtain their views and to keep everyone up to date with developments within the home. All mandatory staff training is carried out and safety checks are completed as they become due. Health and safety issues at Waterside Lodge are given a high priority. Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 18 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 X X N/A X X 3 Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Waterside Lodge DS0000001003.V254655.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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