CARE HOMES FOR OLDER PEOPLE
Albion Lodge Retirement Home Hanley Swan Worcester Worcestershire WR8 0DN Lead Inspector
Yvonne South Unannounced 5 May 2005 10:30 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. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Albion Lodge Retirement Home Address Hanley Swan Worcester WR8 0DN 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) 01684 310626 Mr Colin Darwent, Mrs Jean Mary Darwent, Mr Mark Robert Darwent, Mr Andrew John Darwent and Mrs Helen Ruth Smith Mr Andrew John Darwent Care Home 36 Category(ies) of OP Old Age - 36 registration, with number PD(E) Physical Disabilities (over 65) - 36 of places Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: In addition to those on the previous page the following registration conditions apply; 1.The home may accommodate one named person under the age of 65 years. 2.The home to be staffed as per the sample rosters and the levels are increased when necessary to meet the changing needs of the service users. Date of last inspection 18th November 2004 Brief Description of the Service: Albion Lodge is a large house in the village of Hanley Swan in Worcestershire. It is surrounded by a beautiful, well-maintained garden. This home is registered to provide care for a maximum of 30 older people with mild to moderate physical dependency needs. There are 28 single bedrooms and 4 double bedrooms. All rooms are fitted with en-suite facilities. Currently each double room is occupied by a service user who does not wish to share. The size of all bedrooms meets or exceeds the National Minimum Standards. The communal rooms comprise a spacious lounge / dining room, a bar lounge, a library and a conservatory. In addition there are assisted bathrooms, toilets and two shaft lifts. The Darwent family comprising Mr Colin Darwent, Mrs Jean Darwent, Mr Mark Darwent, Mr Andrew Darwent and Mrs Helen Smith own the home. Mr Andrew Darwent is the registered manager. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over four and a half hours and was the first inspection to take place during the year 1st April 2005 to 31st March 2006. The inspectors spoke with six service users, the registered manager, the assistant care manager and a senior deputy care manager. What the service does well:
Albion Lodge provides a comfortable home for people who need little or moderate assistance with their personal care. The facilities are of a high standard and are well furnished and decorated. The level gardens are superb and on the day of the inspection the wisteria adorning the front of the home was in full bloom. The staff are described by the people who live in the home as kind, sensitive, willing and respectful. Training is arranged so that they are competent to undertake their work. The atmosphere is friendly and communal activities are arranged for those who wish to join in. Outings are also organised to places of interest. People are supported if they wish to continue with private interests, and links are maintained with families and friends. Some people who spoke to the inspectors were most complimentary regarding the care they received. The home receives good support from health care professionals and the people have said that the care staff are able to provide relevant care in a competent and sensitive manner. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 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. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 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 Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 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) 1-5 Information was available to inform and assist service users make a choice of home however the documentation needed to be brought up to date. Assessments did not provide sufficient detail to inform staff of abilities and needs. EVIDENCE: The service users said that they had been given all the information they had needed in order to help them decide whether to move into the home. A copy of the Statement of Purpose was seen. This also incorporated most of the information that a Service Users’ Guide required with the exception of the service users’ views of the home and a copy of the latest inspection report. The document also needed to be updated to reflect the changes in the size of the home, the change from the National Care Standards Commission to the Commission for Social Care Inspection and the changes to the staff team, their training and qualifications. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 9 The Statement of the Terms and Conditions of Residency also needed minor amendments. It is suggested that the date these documents are brought into use is printed on them so that out of date editions are identifiable and can be destroyed. People who wished to move into the home were invited to visit and discuss their requirements. An assessment of their needs was undertaken during the visit. However the information contained in the assessment document was very limited and insufficient on which to build an initial care plan. A trial stay in the home took place during which the service user and the home could decide if the service was right for all concerned. All service users considered that they were well looked after and their needs were being met. Some people were most complimentary regarding the staff and the management. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 Health care was being provided in an efficient and kindly manner. Service users were not involved in the compilation or reviews of their care plans. Not all care plans contained sufficient detail to inform staff of care needs. Assessments and care plans were not available to address nutritional and pressure care needs. Service users were treated with respect and their right to privacy was respected. EVIDENCE: None of the people who spoke to the inspector had any memory of being involved in drawing up a care plan. Three care plans were seen. Two were short on detail while the third was excellent. Very brief notes had been made when plans were reviewed Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 11 The registered manager said that of late doctors from surgeries in Malvern had agreed to visit the home and this had widened the choice for service users. One person was disappointed that trained nurses were no longer employed in the home. He believed this had resulted in a lack of health care knowledge. However others did not hold this view. They praised the care and attention they had received and the prompt action taken when doctors and district nurses were needed. Daily records provided information that informed and guided staff in their duties. The records indicated that appropriate health consultation was taking place and care was being provided. Nutritional and pressure care assessments were not being undertaken on admission therefore decisions could not be made on the need for specific care plans. The home was well equipped and further specialist aids were available when needed through the district nurses. Medication was not fully assessed on this occasion as the pharmacy the service used was about to be changed to Boots The Chemist. Therefore an assessment will be carried out during the next inspection. Some people said that they were able to manage their own medication independently and others needed some help from the staff. All service users said that the staff were kind, tactful and sensitive of their feelings. Privacy was respected. All bedroom doors were fitted with approved locks and keys were available for bedroom doors, although not everyone appeared to be aware of this. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 12 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) 12,13,14,15 Service users had opportunities to exercise choice and control over their participation in a range of communal activities. Links were maintained with family and community. An acceptable variety and quantity of good quality nutritional meals were provided from which choices could be made. EVIDENCE: Service users said that a range of communal activities was provided in the home and in the community in which they could participate if they wished. On the day of the inspection an interdenominational service was being held in the lounge for people who wished to attend. Those who were not interested were able to retire to their rooms, the library, a bar lounge or the conservatory. People said that they enjoyed the opportunities for companionship and solitude. Within the home they were able to pursue their own interests such as reading, stamp collecting and coin collecting.
Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 13 Quizzes, exercise sessions and music events were organised. The registered manager said that the home was about to take delivery of a grand piano for the service users. The hairdresser regularly visited and family and visitors were always made to feel welcome. There was a superb level garden that was a pleasure to view and walk in. Outings further a-field were arranged but one service user said that it had been disappointing that on occasions these had been cancelled when original expressions of interest had been withdrawn. The opinion of the food varied from ‘quite good’ to ‘excellent’. Favourable comments were in the majority. One person considered that at times the food was not hot enough but everyone else was satisfied. Likewise one person considered the choice of puddings to be poor while everyone else who spoke to the inspectors said that there was a good choice throughout the menu and ample quantities were provided. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 14 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) 16,17,18. Service users were able to access the facilities that were established to enable and support people in making complaints and exercising their rights as citizens. Staff were able to consult policies and procedures concerned with the protection of vulnerable people. EVIDENCE: Everyone was aware of how to make a complaint should they feel the necessity and were confident that they would do so. Advice on how to make a complaint was included in the Statement of Purpose and the Terms and Conditions of Residency. A record of complaints was maintained. None had been received since 20.10.04. People were aware of their rights and several said that they had exercised their right to vote in the recent general election. Service users told the inspectors that they were able to manage their own finances independently or with the assistance of family members. Appropriate policies and procedures were available relating to Adult Protection. The manager said that staff were encouraged to read them and training videos were used. No issues had arisen. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 15 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) These standards were not assessed during this inspection. EVIDENCE: Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 16 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) These standards were not assessed during this inspection. However the three requirements relating to them that had been set following the previous inspection were checked for compliance. They had been met. EVIDENCE: The inspectors were shown that staff files contained photographs as required, a quality assurance system had been implemented and records were being maintained according to the regulations. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 17 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) These standards were not assessed during this inspection. However the requirement relating to them, that had been set following the previous inspection, was checked for compliance and was found to be met. EVIDENCE: A supervision programme had been set up but difficulties were being experienced in meeting the frequency required by the standard. Therefore this requirement has been repeated in this report. Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 19 Yes 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 1 Regulation 4,5 Requirement There must be an up to date Statement of Purpose and Service Users Guide and Terms and Conditions of Residence that includes all elements listed in the regulations and standards. Pre admission assessments must be undertaken in sufficient detail to enable an initial service users plan to be compiled. Timescale for action 1st September 2005 2. 3 14 1st September 2005 3. 7 15 1st The service users plans and reviews, based on detailed September assessments, must be drawn up 2005 with the involvement of the service users and set out in detail the action which needs to be taken by care staff to ensure all aspects of the health, personal and social care needs of the service user are met. 1st September 2005 4. 8 12, 13, 14 Service users must be assessed by a person trained to do so, to identify those people who are at risk of developing pressure sores in order that appropriate intervention can be recorded in their care plans and implemented.
E52 S18623 Albion Lodge V224113 050505.doc Albion Lodge Retirement Home Version 1.30 Page 20 5. 8 14 Nutritional screening must be undertaken on admission and subsequently on a periodic basis, a record maintained of nutrition, including weight gain or loss and appropriate action taken. Care staff must receive formal supervision at least six times a year. Supervision must include all aspects of practice, phylosophy of care in the home and career development needs. (Previous timescale of 31st December 2004 not met) 1st September 2005 6. 36 18 1st September 2005 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 Albion Lodge Retirement Home E52 S18623 Albion Lodge V224113 050505.doc Version 1.30 Page 21 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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