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Inspection on 18/10/05 for Alistre Lodge Nursing Home

Also see our care home review for Alistre Lodge Nursing Home for more information

This inspection was carried out on 18th October 2005.

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.

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

Hill Lodge has undergone some changes since the new owner has bought the home and all for the benefit and delight of the residents. The manager and her staff pride themselves in providing a family style care home where individual needs and wishes are paramount and this in general is achieved.

What has improved since the last inspection?

The staff files have much improved with all files looked at during the inspection in good order and contained the information and documentation required to ensure that the calibre of staff employed at the home is high.

What the care home could do better:

The Statement of Purpose and the service uses guide do not accurately reflect the aims and objectivities of the home. It is a document that could be much improved. Residents spoken with were unclear what a Statement of Purpose or Service Users Guide was and this needs to be improved.Residents were seen sitting on incontinence sheets irrespective weather they needed them or not and this is not acceptable. The manager must ensure that individual needs of the residents are looked at when deciding any procedure. Some residents complained to the inspector that the conservatory was cold and with such a large and popular area for sitting in it is important that the area is kept warm.

CARE HOMES FOR OLDER PEOPLE Hill Lodge Nursing Home 67 St Annes Road East St Annes on Sea Lancashire FY8 1UR Lead Inspector Elaine Clare Unannounced Inspection 18th October 2005 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 Hill Lodge Nursing Home DS0000063623.V252130.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. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hill Lodge Nursing Home Address 67 St Annes Road East St Annes on Sea Lancashire FY8 1UR 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) 01253-726786 J Parker (Care) Limited Miss Charlotte Clements Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (1) of places Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. The home is registered for a maximum of 25 service users to include: 24 service users in the category of OP (Old Age) and 1 named service user under 65 years of age in the category PD (Physical Disability). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th June 2005 2. Date of last inspection Brief Description of the Service: Hill lodge Care Home with Nursing offers care and nursing to 25 residents within the category of Old Age: within the registered number of 25, the home may also accommodate one named person under the age of 65 years of age. There are 14 single bedrooms, one of which is ensuite and 5 double rooms, three of which are ensuite. There are adequate toilet and bathing facilities as well as three lounge spaces. The home is situated within ten minutes walk of St.Annes and is within reach of local shops, post office and churches. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during a weekday in October 2005. The inspector looked at care documentation, spoke with several residents and enjoyed lunch with some visitors to the home. Time was spent touring the home and speaking with the registered manager. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and the service uses guide do not accurately reflect the aims and objectivities of the home. It is a document that could be much improved. Residents spoken with were unclear what a Statement of Purpose or Service Users Guide was and this needs to be improved. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 6 Residents were seen sitting on incontinence sheets irrespective weather they needed them or not and this is not acceptable. The manager must ensure that individual needs of the residents are looked at when deciding any procedure. Some residents complained to the inspector that the conservatory was cold and with such a large and popular area for sitting in it is important that the area is kept warm. 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. Hill Lodge Nursing Home DS0000063623.V252130.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 Hill Lodge Nursing Home DS0000063623.V252130.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): 1,2,3,4,5 Prospective and current residents do not have good information they need to make an informed choice about the home. EVIDENCE: The Statement of Purpose is not currently in existence in a style that is required under the Care Standards Act 2000. The Statement of Purpose should give residents the aims, objectives, philosophy of care, services and facilities and terms and conditions of the home. A new resident admitted into the home recently was unaware of what a Statement of Purpose was or indeed the additional supporting document the service users guide. A new service users guide had been developed but there were a number of omissions. The registered manager needs to look carefully at the National Minimal Standards to assess the current service users guide with the one currently in use at Hill lodge and make the necessary changes. The afternoon of the inspection saw a new resident being admitted into the home. The inspector had the opportunity to view the care documentation and Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 9 assessment of the new arrival and felt that a thorough and good assessment had taken place by the qualified member of staff. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 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 the following standard(s): 7,9,10 Health and personal care, which a resident receives within Hill Lodge, is based on their individual needs. EVIDENCE: The residents plan of care is drawn up from the comprehensive assessment completed on the resident prior to admission. The care plan sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the resident are met. The care plan was seen to be regularly reviewed but the development of the care plan alongside the resident could be improved. A qualified member of staff administers medication in the home at all times. The home has a policy and staff adheres to procedures, the receipt, recording, storage, handling, administration and the new requirements with regards to the disposal of medication. The community pharmacist had undertaken an audit inspection recently and a report was available to the inspector. The visit had raised no areas of concern. Hill Lodge Nursing Home DS0000063623.V252130.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): 12,13,14,15 Residents in the home are offered a varied social life, with some residents enjoying an active organised programme and others enjoying a level of privacy and independence. EVIDENCE: The home enjoys regular planed visits from outside entertainers which residents commented on positively to the inspector. Other activities are organised including trips out of the home into the surrounding area. One or two residents enjoy the freedom of going into the town independently, something that is much appreciated by them both. The care documentation within the home has an area, which the nurse can complete with regards to the social interests both past and present of the resident. This allows the staff and the resident to explore the level of social activity the residents would like. Residents spoke how families and loved ones are very much encouraged to visit and participate in the home. Relativities made comments to the inspector, which were positive, and the visiting policy in the home. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 12 During the tour of the home it was discovered that all residents were sitting on continence sheets. These sheets are used to protect the furniture should a resident have an ‘accident’. However it was clear that some residents didn’t warrant this safeguard and were finding it most uncomfortable to sit on. It is important for the manager to conduct the home so as to maximise resident’s capacity to exercise personal autonomy and choice. The inspector enjoyed a wholesome, nutritious and appealing meal at lunchtime with residents and visitors. The chef in the home is very much respected throughout the home with all residents having positive comments to say about him. Hill Lodge Nursing Home DS0000063623.V252130.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): 16 The home has an effective complaints procedure which residents feel able use and are confident about making constructive suggestions. EVIDENCE: The home has a simple, clear complaints procedure, which includes stages, and timescales for the process and any complaints are dealt with promptly and effectively. A record is kept of any complaints made which includes details of any investigations. The complaint procedure informs the complainant the choice to refer the complaint direct to the Commission Social Care Inspection (CSCI). Hill Lodge Nursing Home DS0000063623.V252130.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): 19,20,23,24,25 The home sets out to offer family – like care in an environment that offers good communal focus. EVIDENCE: The location of the home is in within easy access to St.Annes town centre with some residents choosing to walk into town from the home. The layout allows residents easy of access is safe and is in the process of being redecorated throughout. The smaller lounge and hall have been totally refurbished and residents can enjoy a quiet communal space to receive visitors and read. Residents enjoy a mixture of single and double rooms, which have furniture and fittings to give the resident comfort and privacy. Some residents made the inspector aware that the conservatory was cold. This is a large area, which is used by the majority of residents as a sitting area. The Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 15 inspector confirmed that it was cold after spending some time in the area. This was spoken about with the manager and it was promised to be addressed promptly. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 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 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): 29 The manager undertakes thorough checks on all staff employed at the home to ensure residents are kept safe. EVIDENCE: A staff rota showed which staff are on duty at any time during the day and night. The ratios of care staff to residents must be determined according to the assessed needs of residents. Domestic staff are employed and were observed during the visit. Staffing files had much improved following the last inspection and the examination of three files found that all necessary documentation to ensure that residents are protected were in place. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 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 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): 34,35 The financial procedures and services users’ money are safeguarded but the registered manager. EVIDENCE: There is suitable accounting and financial procedures in place to ensure that there is effective and efficient management of the business. The home is in the process of being refurbished and money is being spent on the home to make it comfortable for the residents. An insurance certificate is on display to demonstrate that the home is covered against any loss or damage. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 18 Hill Lodge does not deal with any resident’s money and no money is handled by the manager or staff. Residents receive any money via a third party either a relative or a legal representative. Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 19 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 X X 3 3 2 X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X X X Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 20 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 OP1 Regulation 4 Requirement The registered manager must produce a satisfactory Statement of Purpose and service users guide that meet all the requirements listed within Schedule 1. The registered manager must make proper provision for the health and welfare of the residents taking into account their individual wishes and feelings. The registered manager must ensure that the heating is at a suitable temperature throughout the home. Timescale for action 13/01/06 2. OP14 12 13/01/06 3. OP25 23 13/01/06 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 Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 21 Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Hill Lodge Nursing Home DS0000063623.V252130.R01.S.doc Version 5.0 Page 23 - 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. 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