CARE HOMES FOR OLDER PEOPLE
Adelaide Lodge 27 Kings Road Honiton Devon EX14 1HW Lead Inspector
Michelle Oliver Announced 1 August 2005
st 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. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Adelaide Lodge Address 27 Kings Road Honiton EX14 1HW 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) 01404 42921 01297 24912 Adelaide Lodge Care Home LLP Mrs Melissa Salter CRH PC Care Home providing Personal Care 37 Category(ies) of OP Old Age [37] registration, with number PD[E] Physical Disability over 65 [37] of places DE[E] Dementia over 65 [37] Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 10th March 2005 Brief Description of the Service: Adelaide Lodge is a large older property with a modern extension situated on the edge of the town of Honiton close to local amenities. The home can accommodate and provide personal care for up to 37 service users who may have needs associated with old age, with dementia type illnesses and/or with physical disabilities. Adelaide Lodge receives support from the local Health Care team.The home has 34 bedrooms. 31 provide single accommodation, 13 of which have ensuite facilities. There are 3 double bedrooms, 2 of which have ensuite facilities. The home has a stair lift and a passenger lift. The home is set back from a main road with ample parking to the front and a good-sized garden with patio to the rear. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Monday 1st August 2005 from 9.30am to 2.pm. The manager and director of care were present throughout the inspection. The inspector spoke to the majority of residents on this visit and enjoyed a traditional African lunch in the homes comfortable dining room [which had been decorated to maintain the African theme]. All members of staff on duty also took part in the inspection. The atmosphere in the home was warm, welcoming and friendly and residents were relaxed, content and spoke highly of the care they received in the home. The inspectors looked around the home, a number of records were inspected, which included pre inspection questionnaire, comment cards, thank you letters from relatives and staff file. The manager and staff were very helpful on the day of the inspection and a lot of positive discussions took place throughout the inspection. What the service does well:
The providers, manager and staff are committed to continually improve care at the home. Residents live in a very comfortable home which is well decorated and maintained. Residents are encouraged to take control of their own lives. The staff are kind and due to the high commitment to training at the home are able to meet residents needs well. The home is well managed. The registered manager and director of care have recently completed the Registered Managers Award and are undertaking NVQ4 in care. In addition to the manager the home has shift team leaders and it is their responsibility to manage the shift. They also have specific responsibilities such as developing and managing the activities and management of medication at the home. The management ethos at the home is to empower staff, provide resources to develop continued learning and to provide a stimulating atmosphere for residents and staff. The staff team work well together, are experienced, enthusiastic and work very hard to meet the needs of the people who live at Adelaide Lodge. Meals at the home are well presented, offer residents a choice and all residents spoke positively of the meals provided at the home. At the time of this visit a themed lunch had been organised.
Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 6 All staff had undertaken a lot of hard work, especially staff recruited from overseas who had prepared, cooked and served a typical African meal and were dressed in National dress. The atmosphere in the home is very relaxed. Residents and staff interact very well and everyone living at the home appeared comfortable and at ease. Residents said “a lot of laughing goes on here” and “ all staff are kind and helpful, nothing is too much trouble”. Residents are able to personalise their rooms if they wish. The home offers residents the opportunity to make decisions about their lives and daily routines. Residents confirmed they are “helped when needed, and supported with things we can’t do for ourselves.” Records of “ thank you” letters are kept. Comments included “ mum was happy at Adelaide Lodge and it was a great comfort to us to know that she was well cared for”, “ the carers certainly do a wonderful job and deserve every praise” and “ for all the love and attention shown to our mother we are extremely grateful” 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. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 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 standard(s) 3 & 6 Residents benefit from good admission and assessment practice which ensures the home is able to meet their needs. EVIDENCE: Care needs are well met through a full assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information. The assessment includes all the elements listed in the standard. The home does not admit residents for intermediate care. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10. Resident’s health and social care needs are well met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at Adelaide Lodge. Medication is managed well. EVIDENCE: All residents have individual plans of care based initially on a pre admission assessment. The plans of care are regularly updated to reflect up to date care needs. The plans clearly explain residents’ needs and how they are to be met with good individual detail. Daily reports and staff handovers ensure staff are aware of any changes in each service users needs. Residents confirmed that they are treated with respect and their right to privacy is maintained. Residents said, “Nothing is too much trouble”. Care staff knocked on residents’ doors and waited to be invited before entering. The interaction between the staff and residents was friendly and respectful. Medication is well managed by the staff trained to administer medication at the home. Good policies and procedures are in place to protect residents. Administration records were well documented. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 10 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 & 15. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. EVIDENCE: Staff and management have worked hard to gain information about individual residents social and leisure needs and this is included in care plans. The home has a good selection of books, jigsaws, crafts and games. Activities including visits to Otter nursery, parties, harpist recitals, trips out to clubs and pubs and exercises are regularly provided. Residents told the Inspector that they enjoyed walking around and sitting in the well laid out garden. A variable, nutritious diet is provided at the home. This was confirmed by residents and from the meal on the day of the visit. A menu is displayed in the dining room. At the time of the visit a themed lunch had been arranged by the manager and staff recruited from overseas. The food was typical of their culture, the dining room had been decorated and staff were dressed in National costume. All residents and staff enjoyed the meal and atmosphere created by the staff. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 11 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) 16 & 18 The home has a satisfactory complaints process with evidence that complaints are listened to and acted upon. Satisfactory arrangements are in place for protecting residents and responding to concerns. EVIDENCE: Residents are aware of how to make a complaint at Adelaide Lodge. They were confident that any issues raised by them would be listened to, taken seriously and acted upon. A resident confirmed that they” know who the boss is” and would feel comfortable making a complaint if necessary. No complaints had been received since the last inspection. The manager confirmed that a record would be kept of all complaints, responses and investigations into complaints received at the home. Members of staff confirmed they are aware of the homes policy on the prevention of abuse and the Whistle Blowing policy and would not hesitate to report any incidents of poor care practice at the home. Staff undertook training in the prevention of adult abuse in July 2005. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 12 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 & 26 The standard of the environment within the home is very good providing the residents with an attractive and homely place to live. Residents’ rooms suit their needs and have been personalised. Attention has been made to the safety of residents and staff. EVIDENCE: The property is very well maintained, with homely and comfortable communal spaces. The home offers two large lounges and a dining room. Residents confirmed that they felt that they were safe and that the home is well maintained. The home was attractively decorated and well maintained internally and externally. The standard of furniture, furnishings, fittings and equipment is of a high quality. Residents’ rooms were personalised with sentimental items, photographs and small pieces of furniture and all expressed their satisfaction with the accommodation provided. The home was very clean and free from offensive odours throughout. The laundry facilities were well organised and met the National Minimum Standard. The large well laid out landscaped gardens are very attractive and there are well maintained paths and shady areas for residents to sit.
Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 13 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, 29 &30. Staff are employed in sufficient numbers to meet the needs of residents. Residents’ benefit from having skilled experienced and friendly staff that have a good understanding of their needs. The procedures for the recruitment of staff are consistent and safeguard residents living at the home. EVIDENCE: The manager aims to provide 6 carers on duty between 8am-1pm, 4 between 1pm and 7pm and 2 waking carers on duty between 10 pm an 7.am. During the visit staff spent time with residents and responded to their needs promptly. The providers and manager are committed to providing training for all staff at Adelaide Lodge. The manager has compiled a training matrix which confirmed staff had attended a variety of relevant training sessions. All staff were confident that they were able to meet the needs of the residents at the home. All staff are given induction and foundation training. The home has recruited only one person since the last inspection. The file for this person was looked at and confirmed that police checks, references and proof of identity had been obtained prior to them taking up employment at the home. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 14 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) 33, 35 & 38 The manager provides clear leadership and guidance to staff to ensure that residents receive consistent care in a safe environment. EVIDENCE: The providers and manager give a clear lead and direction to staff. The manager, and director of care, have completed the Registered Managers Award and are currently undertaking an NVQ4 in care. Residents confirmed that the providers and manager are approachable and seek to ensure that all their needs are met. The systems for resident, staff and relatives consultation are good with evidence that indicates residents’ views are both sought and acted upon. A recent survey undertaken in February highlighted “ pot holes” in the parking area. The management of Adelaide Lodge immediately acted this upon and repairs were undertaken. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 15 Monthly management meeting reports are sent to the CSCI, the quality of these reports is excellent. The manager does not deal with residents’ finances. Personal allowances are kept for some residents and accurate records and receipts are kept of all transactions. Safe working practices are employed and risk assessments are undertaken. The home has an excellent procedure for the management of accidents that occur in the home. 24 members of staff have an up to date First Aid Certificate which ensures that there is always a trained member of staff on duty. All staff undertake manual handling training annually. Records show that staff undertake regular training in the prevention of fire. Fire alarms and emergency lighting are regularly checked. All documents and records were well documented and stored securely. Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 16 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 17 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 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. 1. Refer to Standard Good Practice Recommendations Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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. Extracts may not be used or reproduced without the express permission of CSCI Adelaide Lodge D54 D06 S45372 Adelaide Lodge V230715 010805 Stage 4.doc Version 1.40 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
