CARE HOMES FOR OLDER PEOPLE
Alma Lodge Residential Care Home 5 Staveley Road Eastbourne East Sussex BN20 7LH Lead Inspector
Caroline Johnson Unannounced 26 July 2005 10:00 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. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Alma Lodge Residential Care Home Address 5 Staveley Road Eastbourne East Sussex BN20 7LH 01323 734208 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) Mr Ahmed Owasil Mr Ahmed Owasil Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The maximum number of service users to be accommodated is fourteen (14) 2. Service users to be aged sixty-five (65) years or over on admission. 3. The home is permitted to accommodate one named service user who is under the age of sixty-five (65) on admission. Date of last inspection 13 October 2004 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 H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 11.00am until 2.00pm. During the inspection there was an opportunity to meet with four residents, three in the lounge and one in their bedroom. One member of staff was interviewed. A number of records were examined including, recruitment, staff training, residents’ finances and health and safety procedures. In addition the plans for the care to be provided for two residents were seen on this occasion. A full tour of the building was not undertaken. However, communal areas, two bedrooms and some of the bathrooms were seen. What the service does well: What has improved since the last inspection?
Two of the bedrooms have been redecorated. Two care staff have completed NVQ level two and one of these has started training for level three. In addition another two care staff are due to commence training to level two in September. A format for carrying out a detailed health and safety audit has been produced and will be implemented in due course. Although at the time of inspection none of the residents were prescribed controlled drugs, the home had, as required at the last inspection, reviewed their written procedures and revised their storage arrangements. A record is now maintained of service users’ personal belongings. Three staff received training in first aid and another two are due to receive training. In addition one of the owners has received training in fire safety and he will now cascade this training to the care staff. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 6 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. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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 Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) These standards were not inspected on this occasion. EVIDENCE: Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 7,9 Care plans seen included the detailed information to enable staff to meet the needs of the residents. The owners monitor closely the arrangements in place for the storage and handling of medication. The owners need to keep a written record of all medication returned to their pharmacy. EVIDENCE: Two care plans were seen during this inspection. Both included detailed information for staff to follow and they had been updated at regular intervals. Staff have received training in manual handling and there is also a video on the subject available for all staff to view. As recommended at the last inspection the home has reviewed their procedures for the storage of controlled medication and the measures in place were satisfactory. The home’s pharmacist visits the home every three months to monitor the system for storage and handling of medication. All staff have received training on the administration of medication but it is mainly the owners that share responsibility for administering medication. There is a returns book in place to record all medication returned to the local pharmacy but the last entry was in 2003.
Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 12,13 There is a good range of activities in place for the residents accommodated. EVIDENCE: There is a two weekly rota of activities, which includes activities such as carpet bowls, letter writing, manicures, music, bingo, videos, skittles and magnetic darts. The local church provides a non-denominational service in the home on a monthly basis. Staff advised that they occasionally take residents down to the seafront for a walk. Residents spoken very positively of the care provided. They stated that the food is very good. They praised the staff team for their work and said that their relatives are made very welcome when they visit the home. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 18 The home needs to update their policy in relation to abuse and to ensure that all staff are aware of the action that would be taken by the home and by Social Services following an allegation of abuse. EVIDENCE: A requirement was made at the last inspection of the home to update the home’s policy in relation to adult protection and prevention of abuse. This has yet to be carried out. A staff member spoken with was not fully clear about the steps that would be taken should an allegation of abuse be made. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 20,23,24,26 All areas of the home seen were clean. There was a warm and friendly atmosphere in the home and the accommodation provided was homely. EVIDENCE: A full tour of the building was not undertaken on this inspection. However the lounge and dining rooms were seen, along with a few of the bedrooms and the kitchen. All areas seen were clean and there were no unpleasant odours. Communal areas were homely and had been decorated to a good standard. Residents bedrooms had been personalised and residents spoken with stated that they were happy with their rooms. At the time of inspection the owners were redecorating one of the bedrooms on the first floor. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 27,28,29,30 Staffing levels are satisfactory. Recruitment procedures are thorough and staff receive training to enable them to perform their roles effectively. EVIDENCE: Throughout the day there are two care staff plus one of the owners on duty. At night there is a sleep-in member of staff plus one member of staff on call. At the time of inspection there were eleven residents one of whom was on holiday. There was one member of staff on long-term sick leave. This member of staff’s hours were being covered by the staff team. 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 advised that they would be ready to be issued to staff in September 2005. Recruitment records were seen in respect of two of the staff team. The home had followed their procedures and all necessary checks had been carried out. The home has recently recruited a new staff member who is due to start in the near future. They will complete the home’s detailed induction package. Two of the staff have completed NVQ level two and one of these staff members has started studying for level three. In addition another two care staff are due to commence training for level two in September. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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) 31,32,35,36,38 The home is run well and there are good systems in pace to ensure that this can happen. The frequency of supervision sessions for staff needs to increase. Fire safety procedures are generally satisfactory but more detailed records need to be kept in relation to fire drills. In addition the manager needs to discuss with staff the action they would take should the alarms sound at times when they are busy providing personal care to residents. The home has produced a very detailed health and safety audit tool but it still needs to be implemented. EVIDENCE: The manager and her deputy manager have both completed the Registered Manager’s Award. Staff spoken with during the inspection stated that they are well supported in their roles. They advised that they receive supervision informally. Records showed that the last supervision provided was in February 2005. The frequency of supervisions needs to be increased so that the home
Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 15 can keep on target with ensuring that all staff receive supervision at least six times a year. Since the last inspection three care staff have received training in first aid and another two care staff are due to attend a course in October. The manager advised that there is now always at least one member of staff on every shift trained in first aid. As required at the last inspection an inventory is now maintained of service users personal belongings. The home has limited involvement in the management of residents’ finances. All records seen in relation to finances were in order. Fire safety training was provided in July 2004 and the last drill was held in November 2004. The length of time it takes to carry out drills is not recorded and drills are not fully evaluated. Although there was detailed information provided in the staff room regarding evacuation procedures in the event of a fire, a staff member spoken with was not fully clear about the steps to be taken in certain circumstances. One of the owners has recently completed a fire safety, training course and he will cascade this training to all care staff in the coming weeks. There is a risk assessment for the building, which was carried out in July 2003 and reviewed periodically. The assessment is limited to a small number of areas. However, there is a new format in place for carrying out a health and safety audit of the building. The manager advised that they hope to implement the format in the near future. A maintenance book is kept detailing all tasks that require attention. The date that action is taken to address the issues raised is not currently recorded. The owner has carried out the portable appliance testing but there are no records in place to confirm this. A risk assessment has been carried out in relation to Legionella. As a result of the assessment a requirement was made to the home to change a pipe leading to one of the water tanks. This work has been carried out. Staff have received training in infection control, manual handling and food hygiene. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION x 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 3 x x 3 2 x 2 Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 17 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. 2. Standard 9 18 Regulation 13(2) Requirement Timescale for action 30 September 2005 30 September 2005 3. 38 4. 38 A record must be kept of all medication returned to the homes pharmacist. 13(6) The policies and procedures in respect of abuse must be updated to include details of POVA.The home must ensure all staff are familiar with the POVA guidance.(This was a requirement of the previous inspection. The timescale given was 1/12/04 23(4)(e) Records for fire drills must show the length of each fire drill and each drill must be fully evaluated. 13(4)(a)(c There must be records in place ) to demonstrate that portable appliance testing has been carried out by a suitably qualified person. 30 September 2005 15 November 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. Refer to Standard Good Practice Recommendations
H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 18 Alma Lodge Residential Care Home 1. 2. 3. 29 36 38 4. 5. 38 38 That staff receive statements of terms and conditions of employment. (This was a recommendation made at the previous inspection). The frequency of supervision should be increased to ensure that the home keeps on target to provide all care staff with at least six supervisions each year. In respect of fire safety the owners should discuss with staff the action that should be taken should the alarms sound at times when they are busy providing personal care to residents. The owners should introduce their new health and safety audit as soon as possible. In respect of the homes maintenance book, where action has been taken to address any issues raised by staff, the date the action was taken should be recorded. Alma Lodge Residential Care Home H59-H10 s21023 Alma Lodge v231775 260705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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