Inspection on 23/01/06 for Alma Lodge Residential Care Home

This inspection was carried out on 23rd January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alma Lodge Residential Care Home 30/10/07

Alma Lodge Residential Care Home 03/07/06

Alma Lodge Residential Care Home 26/07/05

Alma Lodge Residential Care Home 13/10/04

Alma Lodge Residential Care Home 25/05/04

Similar services:

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Alma Lodge Residential Care Home 5 Staveley Road Eastbourne East Sussex BN20 7LH Lead Inspector Gwyneth Bryant Announced Inspection 10:00 23 January 2006 rd 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 Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alma Lodge Residential Care Home Address 5 Staveley Road Eastbourne East Sussex BN20 7LH 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) 01323 734208 Mr Ahmed Owasil Mrs Dawn Owasil Mr Ahmed Owasil Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fourteen (14). Service users to be aged sixty-five (65) years or over on admission. The home is permitted to accommodate one named service user who is under the age of sixty-five (65) years on admission. 26th July 2005 Date of last inspection Brief Description of the Service: Alma Lodge is a family-run service which is registered to provide residential care to fourteen older people. The home is a two-storey detached property situated in a quiet residential area of The Meads in Eastbourne. The home is located in close proximity to the seafront and the town centre is approximately one mile away. Service user accommodation consists of nine single rooms and three shared rooms. Communal areas comprise of a lounge/dining room and a conservatory. Service users who smoke may do so in the conservatory. The home has a lift which enables service users to access both floors of the home, although there are three steps on the first floor to reach the bathroom and toilet. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over 5.5 hours. There were eleven service users in residence on the day. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect additional standards. Four service users were spoken with and took place with one member of staff and the Registered Providers/Managers. A tour of the premises was undertaken and a range of documentation viewed including care plans, training and medication records. This is the second inspection of this year and therefore this report should be read in conjunction with the report from the unannounced inspection carried out on 26 July 2005. What the service does well: What has improved since the last inspection? What they could do better: The level of care provided at the home is good, but the paperwork in place does not reflect the work staff undertake. The danger of not maintaining accurate records is always that people may not receive safe and consistent care and that changes in needs cannot be tracked. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 6 Risk assessments for those service users with particular conditions need to be expanded to include the management of the risk to ensure service users receive consistent care. All service users need to be weighed monthly and action taken when weight gain/loss noted to ensure service users nutritional needs are met. Staff training needs to be updated for all staff in infection control, moving and handling and the safe handling of medication as part of the foundation training programme. The implementation of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service and ensure it is run in service users best interests. 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. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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 Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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 and 5. Standard 6 is not applicable. Service users benefit from detailed information that enables them to decide if the Alma Lodge can meet their needs. Service users benefit from the opportunity to assess the suitability of the home prior to admission. Satisfactory pre-admission assessments are carried out prior to service users moving into the home that ensure that their assessed needs can be met. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that ensure service users are clear about the services provided at the home. A detailed contract that includes terms and conditions is provided for all service users ensuring their legal rights are protected. Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective service users. Prospective service users are encouraged to visit the home prior to admission to assess the suitability of the placement. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 The care planning system is clear and consistent and provides staff with most of the information they need to satisfactorily meet service users’ needs. Service users would be better protected if risk assessments included management of the risk. Service users are protected by satisfactory systems for the recording, handling and storing of medication. Service users’ healthcare needs are met and their privacy and dignity is protected. EVIDENCE: A sample of care plans were viewed and found to be detailed and clearly identify service users care needs. It is evident that pre-admission information is used effectively in the formation of care plans. The manager and staff have a good understanding of service users needs and were able to discuss them and explain the support that is provided. However, care plans do not fully reflect the work carried out by staff. An example is of service users whose leisure interest is reading but are identified as having poor sight. The home provides talking books and large print books but this is not recorded in care plans. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 10 When service users are noted to have lost/gained weight, care plans need to include actions to be taken to address this. The Manager had taken photographs of each service user but had yet to include them in individual care plans. This needs to be carried out without delay to facilitate identification for new staff and visiting professionals. Risk assessments in respect of service users disabilities are carried out and are regularly reviewed. Risk assessments need to be expanded to include how the risk is to be managed to ensure staff provide consistent care. The one service user who was particularly unwell required regular turning and food/fluid charts maintained. The charts were maintained but this was not recorded in the care plan. The danger of not recording how needs are met is that new staff may not be aware that such charts are maintained. Service users are registered with GP’s and can access allied health professionals as required, including, optician and chiropodist. Medication records and storage arrangements were viewed and both aspects were satisfactory. Medication administration charts were up to date, accurate and clear. Staff who administer medication have been trained in the past but it is good practice to ensure training is repeated annually to update skills and knowledge. Staff were observed to treat service users with care and respect and it was evident that staff and service users are comfortable with each other. Service users spoken with confirmed they are enabled to make choices about their daily lives. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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, 14 and 15 Service users benefit from a range of activities both within and outside the home. The routines of the home enable service users to exercise choice and control over their daily lives. The meals are good offering both choice and variety and catering for special dietary needs. EVIDENCE: There has been an improvement in the range of leisure and social activities provided. An activities programme is displayed in the lounge and in the afternoon staff carry out various activities such as bingo, skittles and manicures. The programme is changed according to service users preference. Service users spoken with said they are encouraged to go out for walks to the seafront, town centre or just a stroll round the garden. The ethos of the home is to promote service user choice in all aspects of their daily lives and all service users are provided with a key to their room. They are encouraged to continue with their social and leisure activities in the community. One service user spoken with said she remains undecided about having her room re-decorated and it was clear she felt comfortable discussing this with the Manager. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 12 The home offers a four week rolling menu and alternatives are offered at each mealtime. The daily menu is displayed in the communal areas and a list of service users likes/dislikes is displayed in the kitchen. Service users are encouraged to eat in the communal dining room but may eat in their rooms if they wish. Those spoken with said the food was good. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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 and 18 The home has a satisfactory complaints procedure with evidence that service users feel that their views are listened to and acted upon. Systems are in place to protect service users from all forms of abuse. EVIDENCE: The complaints book was viewed and it was evident that all complaints, however minor, are recorded as are actions taken and outcomes. The CSCI have not received any complaints about the home. Since the last inspection the Manager has updated the homes policies and procedures on Adult Protection to include the details of POVA. All staff have been asked to be familiar with these documents and the Manager has carried out some training to ensure staff have sufficient information to protect service users. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 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 and 25 Service users benefit from a safe, attractive and well maintained environment. Service users’ bedrooms are comfortable and they are able to bring in their own possessions EVIDENCE: A tour of the premises was carried out and all parts of the home are well maintained, including the gardens and décor is also good. All repairs and maintenance is carried out promptly and satisfactorily. Service users are encouraged to personalise their rooms and many have done so with ornaments and pictures. Service users spoken with clearly treated the home as their own and in particular their own bedrooms reflected their preferences in terms of layout and decoration. All floors of the home are accessible via the passenger lift A although there are some internal steps to one communal bathroom. Aids and adaptations have been provided as required and guards have been fitted to all radiators. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 There is a competent and effective staff team who work positively to ensure service users have a good quality of life. Staff recruitment and induction are robust and offer protection to service users living at the home. EVIDENCE: There are two carers on duty during each daytime shift and one waking carer on duty at night. In addition there is one staff on call at night. When service users needs increase the Manager or the other Registered Provider undertake extra hours to ensure care needs are met. Personnel documents for the two recently recruited carers were viewed and this documentation showed that appropriate checks were undertaken including two written references and a Criminal Records Bureau check prior to appointment. At the last inspection a good practice recommendation was made that terms and conditions of employment be issued to all staff. This has not yet been achieved. The Manager said she is in the process of obtaining a sample staff contract from a relevant professional association. Two staff have achieved NVQ 2 or above and the home is on target to ensure 50 of staff achieve this qualification by 2007. There is a detailed staff induction training programme in place and this needs to be extended to include foundation training unless staff are in the process of gaining an NVQ qualification. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 36 and 38 The manager provides clear leadership throughout the home and service users benefit from a well supported team of staff. The introduction of formal quality monitoring systems would enable the Provider to critically evaluate the service and take action where required. There are systems in place that safeguard most aspects of the health, safety and welfare of service users. EVIDENCE: The Manager has a number of years experience in the care industry and holds the Registered Managers Award and an NVQ 4 in care. She is knowledgeable about service users care needs and undertakes additional training to ensure she updates her skills and knowledge. . The introduction of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service and ensure it is run Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 17 in service users best interests. The Registered Provider/Manager are both aware of what evidence needs to be gathered to evaluate the service and work has begun to collate this information. Surveys for service users and other stakeholders have been created to inform the quality monitoring process. Staff supervision records were viewed and it was evident that these sessions are used effectively to identify training needs and maintain good communication between staff and management. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. A written risk assessment of the grounds and premises in respect of safe working practices has been undertaken and certificates to demonstrate that bath hoists, gas appliances and passenger lifts are safe were available. Smoke alarms and emergency lighting are also tested regularly ensuring the safety of both residents and staff. Since the last inspection the outcome of fire drills have been recorded and action taken when shortfalls have been identified. On the day of the inspection a fire safety officer from East Sussex Fire and Rescue Service visited the home to advise on all aspects of fire safety. His inspection found that, generally the fire procedures and practices are good. All staff have been trained in infection control, manual handling and food hygiene in the past and this needs to be updated annually to ensure staff remain aware of current good practice. The Manager confirmed that one first aider was on duty at each shift. The Registered Providers have undertaken training in care practices and will cascade training to staff as required. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 3 X 2 Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? yes 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. 2. Standard OP7 OP7 Regulation 13(4bc) 15(1) 13(4bc) Requirement Care plans need to include information on how needs are to be met. Risk assessments for service users with particular disabilities, including tissue breakdown must be expanded to include the management of the risk. All service users need to be weighed monthly and records maintained of action taken when weight gain/loss noted as required under Schedule 3 (o) Timescale for action 31/03/06 31/03/06 3. OP8 Reg 17(1a) 31/03/06 4 5 OP33 OP38 24 (1ab) (2)(3) 6 OP38 That formal quality monitoring 31/03/06 and quality assurance systems be created and implemented 13(5)16 That up to date training be 31/03/06 (2j)18(1a) provided for staff in infection control, manual handling and safe handling of medication. 13(4)(ac) There must be records in place 31/03/06 to demonstrate that portable appliance testing has been carried out by a suitably qualified person. (timescale of 15/11/05 not met) Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 20 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. 2 3 Refer to Standard OP29 OP30 OP38 Good Practice Recommendations That staff receive statements of terms and conditions of employment. (This was a recommendation made at the previous inspection). That a foundation training programme is introduced for staff not undertaking NVQ training. The owners should introduce their new health and safety audit as soon as possible. Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Alma Lodge Residential Care Home DS0000021023.V275358.R01.S.doc Version 5.1 Page 22 - 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. 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