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Inspection on 10/10/05 for Abbeyfield Stangrove Lodge

Also see our care home review for Abbeyfield Stangrove Lodge for more information

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Manager is qualified, competent and runs the home well. Well-trained staff support the residents and all new staff go through a detailed induction before they can begin working alone. The Manager has formed good links with the Dementia nurse and has arranged more training for staff. The residents benefit from large communal rooms and well maintained gardens.

What has improved since the last inspection?

The Statement of Purpose has been updated. This now tells the reader the complaints procedure for the home. The Manager has started to ask residents about the types of activities they would like to do. The staff are now keeping better records of this. Recently, the staff and some residents chose to do a sponsored walk to raise some money for new activity equipment. Areas of the home are being redecorated and new carpets ordered. The frames around all the toilets have been replaced with new ones. Most of the radiators have now been covered to reduce the risk of scalds to residents. Some residents like to manage their own medication and the risks involved have been assessed to keep everyone safe.

What the care home could do better:

The Manager must make sure that there is always enough staff on at the weekends and should arrange for more care staff to do their NVQ award. The Manager must also tighten the recruitment procedure. Staff must always remember to knock on residents` doors before entering their rooms. It is recommended that the menu be displayed in each dining room in a format the residents can understand. Prescribed medications for residents must be ordered in time to ensure they do not run out. It is recommended that the bathrooms are refurbished this year as planned and the remaining radiators are covered. Any bolts on bedroom doors must be replaced with locks that the residents can safely use. Activities for residents should be developed further.

CARE HOMES FOR OLDER PEOPLE Abbeyfield Stangrove Lodge Manor House Gardens Edenbridge Kent TN8 5EG Lead Inspector Jo Griffiths Announced 10 October 2005 09:30 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 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. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Abbeyfield Stangrove Lodge Address Manor House Gardens Edenbridge Kent TN8 5EG 01732 864975 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Abbeyfield Medway Valley Society Mrs Rita Beryl Blatcher CRH Care Home 49 Category(ies) of DE(E) Dementia - over 65 (22) registration, with number OP Old age (27) of places Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/06/05 Brief Description of the Service: Stangrove Lodge is located in a quiet residential area within easy walking distance of local shops. All accommodation is on the ground floor. There are plenty of communal areas for residents to access and the majority of bedrooms are single. The gardens include an enclosed sensory garden, which is attractively laid out and well maintained with a paved area and seating; the garden is easily accessible from the home. 24 hour care and support is provided to older people, some of whom have Dementia. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced. The Manager and staff on duty were spoken with. Some residents were spoken with and feedback cards were received. What the service does well: 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. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 7 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 standard(s) 1, 5, 6 Residents are provided with the information they need about the home and are encouraged to visit prior to moving in. EVIDENCE: The Manager has updated the Statement of Purpose to include the complaints procedure. Prospective residents are invited to visit the home for overnight stays or for meals to allow them to “test drive” the home. The Manager said this is dependant on the wishes of the person. One resident had recently moved from another part of the home and described how she was consulted and the process was based around her wishes. The home does not provide intermediate care. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 8 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 standard(s) 8, 9, 10, 11 Residents’ health needs are well met, but they are at some risk from poor ordering procedures for medication. Residents feel they are treated with respect and know that they will be supported sensitively at the end of their life. EVIDENCE: Visits are made by the GP each week and other health professionals also visit when needed. Residents said that their health needs were well met. Signing for medication has improved. It was recommended at the last inspection that a blind be fitted to the window of the medicine room to help keep it cool. This still needs to be done. One lady had not received her prescribed medication for 5 days as it had not been delivered by the pharmacy. This puts this lady at risk and the Manager was asked to resolve this immediately. A risk assessment has been completed for the resident who takes his own medication. Most residents said that staff treat them with respect and maintain their privacy. The Manager must ensure staff always knock on residents doors before entering as feedback from residents indicated this did not always happen. The Manager described how the home was supporting a resident who is terminally ill. Additional support from external professionals is being provided. The resident will be supported to stay at the home for as long as her needs can be met. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 9 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 standard(s) 12, 14, 15 Residents are provided with activities daily, but would benefit from a wider range. They are supported to make choices in their lives. Residents enjoy their meals. EVIDENCE: The Manager has started an exercise to consult with residents about their preferred activities and the recording of these activities has now improved. An activity co-ordinator works in the home twice a week, but there is still scope to develop the type of activities that are available. Recently the staff and some residents did a sponsored walk to raise money for more activity resources. The PAT dog scheme continues to be a popular weekly activity. Residents said they are encouraged to make choices about most things in their lives. An advocacy scheme is available to support those who have difficulty with this. Residents said that most of the time they liked the meals. They choose what meal to have daily. It is recommended that a menu be displayed on the notice board in each lounge; this should be in a format that all residents can understand. Residents said that they can choose to eat in their rooms if they wished to and some said they liked to eat supper in their rooms. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 10 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 standard(s) 17, 18 Residents are supported to maintain their legal rights. They are protected from potential forms of abuse. EVIDENCE: The Manager said that residents are supported to maintain their right to vote. They can do this either by post or at the polling station. Leaflets telling residents and relatives about a new advocacy service have been placed in the entrance hall. Most staff have received training in the protection of vulnerable adults. The new staff who have not yet undertaken this training work alongside other trained carers; further training has been planned. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 11 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 standard(s) 19, 20, 22, 23, 24, 25 Residents live in a safe and comfortable home. They have the equipment they need and have access to plenty of communal space. Their bedrooms meet their needs. EVIDENCE: The home’s handyman has begun to redecorate the hallways and new carpeting has been delivered. New toilet frames have been fitted and the Manager said that the bathrooms are to be refurbished this year. More radiators have been covered. Residents are all accommodated in single rooms except for 2 ladies who have expressed their wish to share. Evidence was seen throughout the day of their close friendship. Some residents have keys to their rooms. Some bedrooms have bolts on the outside of the doors for residents to use. These must be removed and replaced with key locks to prevent residents being accidentally locked in their bedroom. Residents have access to plenty of communal space. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Trained staff support the residents and they are in safe hands. There are sufficient staff on duty to meet residents needs at most times. EVIDENCE: Staffing levels are sufficient for the needs of the residents during the week, but the Manager acknowledged there are some problems with staff cover for weekends. Incentives for staff to work at weekends are being explored. 9 members of staff have achieved their NVQ award and the Manager plans to register more to undertake this qualification. A specialist dementia nurse is planning to provide some training for staff in November, this will be for the new unit. Most staff are well trained and the Manager has identified areas where further training is needed. The home has a good induction programme for new staff. The recruitment procedures are generally robust. Staff files showed that all the required checks had been made for the majority of new staff. However, there was one new member of staff for which a 2nd reference had not been obtained. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 37, 38 Residents live in a well managed home that is run by a competent and experienced Manager. They are consulted on their views, and their safety and welfare is protected. EVIDENCE: The Manager is a qualified nurse and has completed the NVQ4 in management. This standard is exceeded, as the Manager has other management and care qualifications in addition. The home is well managed and financially viable. An annual survey for residents and relatives to give their views on the home is carried out and the Manager plans to start residents’ meetings again. The Manager audits different areas of the service each month. Residents’ safety and welfare are protected by good staff training and robust polices. Equipment in the home is serviced and maintained. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 1 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 x 2 3 2 2 x STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 4 x 3 3 x x 3 3 Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 15 No Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13(2) Requirement The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines into the care home. In that, Prescribed medicines must be re-ordered as needed. 2. OP24 13(4)(a) The registered person shall ensure that all parts of the home to which service users have access are, so far as reasonably practicable, free from hazards to their safety. In that, the bolts from bedroom doors must be removed. 3. OP27 18(1)(a) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service 31/10/05 16/10/05 Timescale for action 11/10/05 Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 16 users. In that, sufficient staff must be working at the home at weekends. 4. OP29 19(1)(b) The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in schedule 2. In that, 2 written references must be obtained before a member of staff starts work. 11/10/05 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. Refer to Standard OP9 Good Practice Recommendations It is recommended that a blind be fitted to the medication room window. This recommendation is carried forward from the previous inspection. 2. OP22 It is recommended that seated scales be available to monitor the weight of residents who cannot use standing scales. This recommendation is carried forward from the previous inspection. 3. 4. 5. OP10 OP15 OP12 It is strongly recommended that the Manager discuss with staff the importance of knocking on residents doors. It is recommended that the menu be displayed in each dining room in a way the residents can understand. It is recommended that, following the consultation taking H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 17 Abbeyfield Stangrove Lodge place with residents, the range of activities available be expanded. 6. 7. 8. OP19 OP25 OP28 It is recommended that the bathrooms be refurbished as planned. It is recommended that the remaining radiators and pipes be covered. It is recommended that at least 50 of care staff have an NVQ level 2 or above. Abbeyfield Stangrove Lodge H56-H06 S24017 Abbeyfield Stangrove Lodge V244492 101005 Stage4.doc Version 1.40 Page 18 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: 0845 015 0120 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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