Inspection on 03/07/06 for Alma Lodge Residential Care Home

This inspection was carried out on 3rd July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alma Lodge Residential Care Home 30/10/07

Alma Lodge Residential Care Home 23/01/06

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 Paul Taylor Key Unannounced Inspection 3rd July 2006 10:30 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 Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 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.V298487.R01.S.doc Version 5.2 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 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.V298487.R01.S.doc Version 5.2 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. 23rd January 2006 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. There is an assisted bathroom with a built in hoist and the home also has a mobile hoist. The cost of rooms is between £352 and £410 per week. The home does not advertise, people who are living there found out about the home via word of mouth or via the contracts unit for East Sussex Social Services Department. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place at Alma Lodge on Monday 3rd July 2006. The inspection started at 10.30 a.m. and finished at 5 p.m. During the inspection the Inspector met with the registered manager, the deputy manager, three members of staff, two visitors to the home, a visiting community nurse and four service users. Additionally the Inspector examined three care plans, records of medication, fire safety records, risk assessments, a survey sent out to relatives and professionals and staff recruitment records. The Inspector received four completed questionnaires from service users and a written pre inspection questionnaire from the registered manager. The Inspector also referred to the previous inspection report completed by the Commission for Social Care Inspection in January this year. What the service does well: What has improved since the last inspection? Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 6 Requirements made at the last inspection in January have been responded to by the proprietors. Service users are weighed regularly, care plans are detailed and the quality assurance system ensures that service users, visitors and professionals are given the opportunity to voice their opinions on the running of the home. Additionally the quality assurance system has ensured that risk assessments are maintained for both individuals and the environment. The system also ensures that an audit is kept to ensure that all safety checks are completed in the home. Members of staff now have written contracts in place and the training taking place in the home has included adult protection training, moving and handling training and training in infection control. 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 DS0000021023.V298487.R01.S.doc Version 5.2 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.V298487.R01.S.doc Version 5.2 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process of service users is thorough and ensures that only individuals whose needs can be met in the home are admitted. EVIDENCE: The Inspector examined three pre admission assessments. These were detailed and contained information about the service users needs and how the home was intending to meet them. The Inspector met with four of the service users resident as well as two visitors to the home. One of the visitors confirmed that she had visited the home prior to her mother being admitted and that the registered manager had visited her mother in hospital as part of the assessment process. Two of the service users confirmed that they had visited the home prior to moving in. The home does not provided intermediate care. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal care and dignity of the service users are respected, monitored and ensured by the staff working in the home. EVIDENCE: The Inspector examined three pre admission assessments and the care plans that had been formulated based on the assessments. The care plans were detailed and ensured that all aspects of the health, personal and social care needs of each individual had been addressed. There was evidence of monthly reviews by the registered manager to ensure that the care plans were up to date and to monitor what had changed for the service users and how that was being responded to by the home. There was also written evidence that there had been annual reviews of the care plans and that relatives and professionals such as social workers had been involved in the process where appropriate. One service user told the Inspector that she knew she had a care plan and knew that she could have input if she wished. The health care needs of each service user are outlined in their care plans. These included records of medical appointments and how individual conditions Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 10 such as diabetes were being monitored. The Inspector met with a visiting community nurse who said that the service user she was visiting was being well cared for and that the staff were knowledgeable about cross infection and how to ensure that the service user was being properly monitored. Service users are now weighed on a regular basis following a requirement made for this to be achieved at the last inspection in January this year. Each service user has a risk assessment in place with regards to monitoring falls and this included risk assessments of the environment and their rooms to ensure that risks were minimised. Medication is stored in a locked metal cabinet. The Inspector examined the records of medication administered and these were appropriately completed and reflected what was outlined in the care plans. The registered manager and her deputy reported that they receive good advice from a local pharmacist; however, it has been some time that they received formal training in the administration of medication. The Inspector recommends that whoever is responsible for the administration of medication in the home receives refresher training. Outlines and guidance for personal care are contained in the service users care plans. All the service users who met with the Inspector said that the staff treat them respectfully and that their dignity is upheld. Members of staff on duty were seen to knock on service users doors before entering their bedrooms. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 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,and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are a variety of activities available to service users and this gives them the opportunity to socialise and to be stimulated. Visitors are made welcome and this ensures that service users keep in contact with those important to them. The menu is varied and the dietary needs of service users are known to the staff in the home, this ensures that they eat healthily. EVIDENCE: There was a timetable of weekly activities displayed on the wall of the service users lounge. Activities provided in the home include bingo, a quiz, magnetic darts, board games, puzzles and visits from a local church group and some students from a local school. During the weekend prior to the inspection the service users had watched World Cup football whilst they were under a gazebo in the garden and the television had been moved on to the veranda. The service users who met with the Inspector said that they knew there were planned activities for them if they wished to partake but that they also had their choice of not partaking respected. All the service users said that they receive visitors and that there are no restrictions on this. The Inspector met with two visitors who said that they are Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 12 always made to feel welcome and that they can approach the manager or staff if they want to discuss anything. As mentioned earlier, a local church group and some students from a local school visit the service users. Additionally a church minister visits the home on a monthly basis. The home does not handle the financial affairs of the service users. Service users confirmed that their choice and autonomy is respected and that their views are respected, one service user told the Inspector ‘They always listen to me.’ The Inspector examined a four-week rolling menu. The food offered is varied and comments made to the Inspector consisted of: ‘Food is good, we get a variety’, ‘It’s good food served nicely’, ‘The food is on the whole o.k. it’s quite alright.’ Dietary needs of service users as well as their likes and dislikes are written on a board in the kitchen. The menu is adapted to meet the needs and preferences of service users, for example, one service user does not have fish on a Friday despite it being on the menu; during the inspection a service user was receiving additional helpings of ice cream as her appetite had decreased in the very hot weather. The members of staff also knew who needed their food chopping finely and who needed assistance with eating. The dining area is situated at the far end of the large lounge on the ground floor. Most service users eat in the dining room although those who wish to eat in the privacy of their rooms can do so if they wish. One service user told the Inspector ‘I have breakfast in bed.’ Snacks are available for the service users if they want them; one service user told the Inspector that she had been made sandwiches one evening when she felt peckish. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users safety is maintained by a staff team who are aware of their obligations with regards to adult protection. The complaints system operated in the home is easily accessed by the service users and the atmosphere created by the manager and staff means that service users are confident and able to make complaints. EVIDENCE: All the service users who met with the Inspector were aware of how to complain and said that they felt the staff and managers in the home were approachable if they wanted to complain about anything. The Inspector examined the complaints log and found that there had been four minor complaints made in the home since the last inspection of the home in January 2006. The complaints had been dealt with quickly by the manager and included a service user complaining about her mattress which was then replaced, a service user complaining about a blocked sink which was then cleared by a plumber and a service user complaining about a fox making a noise in the garden at night. The fact that service users were able to complain about these matters reflects very positively on the staff and managers of the home. The Inspector met with three members of staff as well as the deputy manager and registered manager during the course of the inspection. Everyone who met with the Inspector was aware of what to do in the event that they had concerns over a service user’s wellbeing. Some members of staff had attended adult protection training in May 2006 and the Inspector saw a Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 14 training plan that included planned adult protection training for the all the staff that had not attended the May training, this was planned to take place in July 2006. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 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 the following standard(s): 19 and 25. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a rolling plan of refurbishment and maintenance that means that service users are living in a clean and safe environment. EVIDENCE: The Inspector undertook a tour of the premises and found the home to be clean and generally well maintained. A toilet seat in the bathroom on the first floor was in need of replacement and there was a cracked pane of glass in the sun lounge overlooking the garden. There was a record of repairs and maintenance kept up to date by the manager and there was a rolling programme of redecoration for the bedrooms. The garden was well kept and tidy and is accessible via two steps from the veranda or via the front door ramps if the service user needs to be transported in a wheelchair. The home has been subjected to a safety check by a fire officer in January 2006 and the fire risk assessment and premises were found to be acceptable. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 16 An environmental health officer had inspected the kitchen shortly before this inspection and had found things to be satisfactory. The home has policy and guidance on the control of infection and there was a plan in place for the whole staff team to undertake infection control training in July 2006. Additionally the home has procedures in place regarding the handling and disposal of soiled laundry and incontinence products. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing complement has enough numbers and there is ongoing training to ensure that service users receive the care and support they need from a competent and committed staff team. EVIDENCE: The Inspector examined a staff rota. There were two members of staff plus the deputy manager on duty at the time of the inspection. Members of staff who met with the Inspector said that there were enough staff on duty to respond to service users needs and requests. Service users who met with the Inspector said that the staff respond to their requests and are polite and respectful in their approach. The manager and deputy manager provide assistance to staff on duty when this is required. One of the proprietors sleeps in the premises every night to provide assistance to the waking night care officer if it is required. Out of the staffing complement of seven members of staff, four had N.V.Q. Level 2 in Care and two were undergoing the N.V.Q. training. Two staff recruitment records were examined by the Inspector. These had all the required checks in place such as POVA and Criminal Records Bureau check. The staff also had two written references in place. Members of staff now have written contracts of employment in place, this was a recommendation following the inspection completed in January 2006. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 18 There is an ongoing staff development and training programme to complement the N.V.Q. training. Examples of training attended and planned included manual handling, adult protection, nutrition of the elderly and food hygiene. The Inspector saw a copy of an induction programme that had been set out to National Training Organisation specifications; however, this programme was not being used at the time of the inspection as there were no members of staff undergoing an induction. The manager said that this system will be used when new members of staff join the team. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 19 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): 31,33,34,35,36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the approachability of the managers means that both staff and service users feel confident in giving their views on the running of the home. Safety checks and checks of records are kept up to date to ensure that service users are kept safe. EVIDENCE: The Inspector met with the registered manager and deputy manager during the inspection. Both are experienced in caring for the elderly and both have attained the Registered Managers Award. There was evidence that both attend ongoing training in subjects such adult protection and moving and handling. The quality assurance system operated in the home showed that both service users and stakeholders such as relatives, social workers and doctors had been approached for their views in a survey. Additionally, there was evidence of Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 20 regular and comprehensive monitoring of records such as care plans, fire drill and equipment checks, fridge and freezer temperatures, water temperatures, gas certificate, electrical certificate and risk assessments pertinent to the environment as well as individual service users. There was also a record of accidents. All the records examined were up to date and accurate. The quality assurance system operated in the home is an improvement made since the last inspection when a requirement was made that this be implemented. The certificate of Public Liability Insurance displayed in the staff room had expired. The registered manager said that there is insurance in place but the certificate had not been put up. It is a requirement that this is done as soon as possible. As mentioned earlier in the report, the home does not involve itself in managing the finances of service users. The Inspector examined records of supervision. These confirmed that members of staff receive supervision at least six times a year. There was a board in the staff room which recorded when supervision was due for members of staff. Staff who met with the Inspector said that apart from the formal supervision they receive they also receive ongoing advice and support from the manager and her deputy who they reported as being very approachable. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 2 3 X X 3 Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 22 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. 2. 3. Standard OP19 OP19 OP34 Regulation 23 (2) (b) 23 (2) (b) 25 (1) (e) Requirement That the toilet in the bathroom on the first floor is replaced or repaired. That the cracked panes of glass in the sun lounge are replaced. That an up to date public liability insurance certificate is put on display. Timescale for action 14/08/06 14/08/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations That refresher training is provided to all members of staff who administer medication. Alma Lodge Residential Care Home DS0000021023.V298487.R01.S.doc Version 5.2 Page 23 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.V298487.R01.S.doc Version 5.2 Page 24 - 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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