Inspection on 15/04/08 for Amber Lodge

This inspection was carried out on 15th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Amber Lodge 19/04/07

Amber Lodge 07/06/06

Amber Lodge 08/11/05

Amber Lodge 19/07/05

Amber Lodge 22/10/04

Amber Lodge 12/05/04

Similar services:

Abbey The

Snydale Care Home

Whiteley House

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Amber Lodge 21 Thornhill Road Armley Leeds West Yorkshire LS12 4LL Lead Inspector Hebrew Rawlins Key Unannounced Inspection 15th April 2008 08:40 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 Amber Lodge DS0000001412.V362580.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. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amber Lodge Address 21 Thornhill Road Armley Leeds West Yorkshire LS12 4LL 0113 2633231 0113 2038556 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) Meridian Healthcare Ltd Mrs Lynne Dawson Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (40) Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The places for MD(E) are specifically for named service users Date of last inspection 19th April 2007 Brief Description of the Service: Amber Lodge is owned and managed by Meridian Healthcare Ltd. The home is a care home without nursing, registered to provide personal care for up to 40 older people. The building is a two-storey purpose built home situated in Wortley, near Armley. It has a garden to the rear of the building. A large car parking area is located at the front of the building therefore access is easy for those with mobility problems. Local shops and bus routes are also within easy access. For the people who use the service, their accommodation is provided on both floors. There are 38 single bedrooms and one double bedroom. All bedrooms have en-suite facilities. Lounge and dining areas are located on the two levels. There are three bathrooms, two of which have hoisting facilities, and two shower rooms. All laundering is undertaken on the premises. The people who use the service can access the garden through the dining room patio doors. The current scale of fees is £415.21 weekly. Additional charges are made for chiropody, hairdressing, newspapers and personal items. Copies of previous inspection reports are available in the home. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. Information about the inspection process can be found on our website www.csci.org.uk This visit was unannounced and carried out by one inspector who was at the home from 08.40 hours until 16.00 hours on 15th April 2008. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and wellbeing of the people who use the service and in accordance with requirements. Before the inspection, accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the inspection visit. During the visit, a number of documents were looked at and areas of the home used by the people living there were visited. A good proportion of time was spent talking with the people who live at the home as well as with the manager and staff. The manager had completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information about the home. Survey forms were sent out to the people who use the service, relatives, carers, general practitioners (GPs) and other healthcare professionals. Several were returned and information provided in this way will be reflected in the report. Feedback was given to the manager at the end of this inspection. What the service does well: People are encouraged to look round the home before making any decisions about moving in. One relative said, “I looked at other homes but choose Amber Lodge because it was close to the family home, it was new and there were no smells.” Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 6 The organisation has ensured that more than 50 of the care staff has achieved the National Vocational Training (NVQ) level 2 or above. Comments from relatives in returned survey cards included, “No matter what time of day we visit, everything in the care home is always well,” “Staff are caring and look after my mother very well”. Visitors are made to feel welcome. One relative said that whenever we visit staff are always helpful. The manager and staff try to provide people with accommodation to suit their individual needs, this enables them to have a better quality of life. What has improved since the last inspection? What they could do better: Some of the assessments looked at need to be more detailed and should provide more information about who was involved in the assessment process and who had supplied the information is also needed. Care plans must be reviewed and risk assessed more consistently otherwise people could be put at risk. Because of the risks associated with the use of bed safety rails, the home must make sure that they are the best option for people before they are put into use. When in use, proper safety and maintenance checks must take place. The care record should clearly show what action has been taken by staff to make sure people’s nutritional needs are met to prevent serious consequences to health. Medication record sheets must always be accurately completed otherwise people could be put at risk of being given medication more than once. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 7 The home must continue to work at developing more social and recreational activities for people living there. The staff kitchen is in need of a good clean. Some doors, wall and splash back tiles need attention. Towel rails are needed in all the en-suites throughout the home and the damaged doors and walls require attention. The organisation must review the present procedures for recording fees and the way people’s money is held in safekeeping. 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. The summary of this inspection report can be made available in other formats on request. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 8 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 Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have got enough information about the home and can visit to look round before deciding if it will be suitable for them. People’s needs are assessed and identified before they move into the home. But the quality of the information in the assessments varies and means that staff do not always have enough guidance about how to meet individuals needs. EVIDENCE: People who returned surveys to us said that they had received a contract and that they had enough information about the home before they moved in. During the visit, one relative told us that she had visited the home on behalf of her mother, had been given written information about the home and chosen it Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 10 because of the ‘warm atmosphere’. Another person said that her daughter had helped her choose the home, and that she was ‘very happy here’. We looked at ten care plans. In all cases a pre-admission assessment had carried out to make sure that the person’s needs could be met. Some assessments were more detailed than others, and there was no information about who was involved in the assessment process and who had supplied the information. This means that in some cases peoples needs might not be met because staff do not have all the information they need about how to meet the individuals needs. People spoken with said their needs were usually met and things are getting better. Positive comments from people included; ‘I am comfortable and they make me feel it’s my home’. A relative said ‘ I am very pleased with the care my relative is getting.’ Relatives said people are invited to visit the home and stay for a while before making any decision about moving in. The home does not provide intermediate care. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are in place that give staff some information about how to meet people’s needs, but more detail is needed to make sure that they get the care and support that they need. Risk assessments about keeping people safe are not always in place, such as the use of bedrails. This could put people at risk of harm. People could be at risk of medication errors because the home’s policies around dealing with medication safely are not always being followed. EVIDENCE: There have been many positive comments made by people living in the home and their relatives about the care provided. Examples ‘I am very happy living here’ and ‘they look after my mom real well’. Ten care records were looked at. Some of them did not have enough detailed information about individual preferences or how to meet their needs. Not all files had been fully reviewed. Risk assessments were inconsistent and did not Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 12 have information of how to minimise identified risks. Not all people had an assessment around mobility or use of bedrails. The care plan for a person using bed safety rails did not show if they were the most suitable option or when and how often safety checks would be carried out while they were in use. There was no nutritional assessment in one file looked at. In the care plan it said, “Food intake needs observing”. Yet there were no records to show that this person’s food intake was being monitored. The care plan should clearly show what action has been taken by staff to make sure this person’s nutritional needs are met and to prevent serious consequences to their health. Medication administration sheets were not always completed clearly for each person. The records should show when people refuse their medication and why. If this persists the GP should be informed otherwise peoples’ health could be at risk. There was evidence in all the records looked at that people have access to and visits from health care professionals such as an optician, chiropodist, district nurses and GPs. All the people who returned surveys indicated that they receive medical support when needed. Throughout the day staff were seen respecting the privacy and dignity of people. When talking to staff it was clear that they were aware of the importance of people being in control of their lives and maintaining as much independence as possible. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have control and choice in their lives, they have a healthy diet and their social and recreational needs are sometimes met. Visitors are made welcome. EVIDENCE: Through discussions with staff it was clear that they understand the importance of respecting people’s individual choices. Surveys and comments received from people and their relatives were mixed and reflected that the activities were still being developed. Several people living in the home are able to entertain themselves watching television, reading, or chatting with one another. For those people that are less able their records showed there is not much going on to stimulate or engage them. When looking at the care plans some of the activity records for people were blank. The activity sheets for March 2008 showed that one person had played Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 14 dominoes and another had been colouring. Apart from these entries the records were blank. One relative said, “I feel people are not offered enough stimulation on a day to day basis and those who don’t want to do anything should be encouraged”. During the inspection visit one person was entertaining two visitors in her bedroom. They said that they are always made to feel welcome. This view was confirmed during conversations with other relatives visiting. On the morning of the visit several people were doing “armchair exercises” with a staff member and early afternoon the home had booked an outside entertainer to encourage people to sing and dance. This was well attended and people said how much they enjoyed the music. All people who returned survey and those spoken with during the visit said that they always liked the meals, and comments included, “Excellent,” “I always look forward to my meals and enjoy them.” Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are comfortable in raising concerns and complaints to the management and the management will resolve the situation in the best interest of the person. Staff are aware of how to protect people from abuse. EVIDENCE: Returned surveys from people who live in the home showed that they know how to make a complaint. Relatives said they are clear about who to talk to if they have any issues or concerns. Two people who use the service said “the manager is good at listening and always tries to put things right”. The manager is aware of her responsibility to report any serious complaints to us and Adult Protection training has been given to staff. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24 and 26. People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a safe and well-maintained environment and some refurbishment and decoration is due to take place. EVIDENCE: It was not possible to look at all the rooms available during the site visit. Most of the bedrooms seen were decorated and furnished to a good standard. Those showing signs of wear and tear the manager said the organisation is building another home next door and once that is completed redecorating will take place. People living in the home said that they were pleased with their rooms and were glad to have many of their own personal belongings with them. Most areas of the home were clean and tidy. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 17 The staff kitchen is in need of a good clean. Some doors, wall and splash back tiles need attention. The manager is aware there are no towel rails in any of the en-suite in the home. She said this would be addressed once the work next door is complete. Returned surveys and conversations with people and their relatives told us that the home was clean and free from offensive odours. The laundry facilities are well equipped to meet the needs of the people in the home. The kitchen was clean and tidy throughout and the cook said all equipment was in working order. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing levels meet the needs of the people in the home. There is adequate training available to staff to equip them to do their job. Proper recruitment checks are made to make sure that people are safe and suitable to work with older people. EVIDENCE: All the people who returned surveys said that staff are always available when needed. A relative said, “There is always staff around to answer questions or concerns.” The manager said that 73 of staff have an NVQ (National Vocational Qualification). The staff have undertaken a number of training courses in the last 12 months. This has included NVQ level 2, dementia, moving and handling and fire safety. The recruitment records for three members of staff were looked at. In all cases there was a completed application form, 2 written references, interview records and job descriptions. The CRB/POVA (Criminal Record Bureau/Protection of Vulnerable Adults) disclosures were obtained before the Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 19 offer of employment was made. The home receives information about POVA checks. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The interests of people living in the home are very important to the manager; she is working hard to make this a good home. There are areas where outcomes for people can be improved, particularly with regard to looking after medication safely, safe use of bedrails and improving range of social activities provided to people. EVIDENCE: The manager has many years of experience in the care of older people and holds the Registered Manager’s Award. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 21 The manager discussed the difficulties in organising meaningful meetings with people living in the home and their relatives. Due to a lack of response meetings are infrequent. The Annual Quality Assurance Assessment shows that maintenance and servicing of equipment takes place as necessary As identified earlier in this report the manager needs to address the poor practices in relation to the recording of medication, lack of maintenance checks on bed safety rails which can potentially affect the health and safety of people living in the home. Some of the people’s financial records held by the home were checked. Personal allowances are held on behalf of some people. Each has a book providing details of incomings, expenditure and balance. The record of fees paid by or on behalf of people is held and dealt with by the organisation’s head office. In addition, for the convenience of people some monies are held in one account so that the manager can access money on their behalf. This system allows people to get limited amount of interest on their savings account. Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 22 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 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 3 X 3 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 X 2 X X 3 Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 23 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. Standard OP3 Regulation 14 Requirement The preadmission assessments must be more detailed and include information about who was involved in the process and where the information came from. This will make sure that people’s needs are properly identified before they move into the home. Timescale for action 01/06/08 2. OP7 15 To make sure that people’s 01/06/08 changing needs are identified the care plans must be fully reviewed at regular intervals. Steps must be taken to make sure that using bedrails is the best option for the individual. Detailed risk assessments must be kept that clearly show how the decision to use them was arrived at, who was involved, that the individual and or their representative was involved, how often safety checks will be carried out and by who. 01/06/08 3. OP8 16 4. OP8 14 The care record should clearly 01/06/08 show what action has been taken DS0000001412.V362580.R01.S.doc Version 5.2 Page 24 Amber Lodge 5. OP9 13 Detailed records of assessments made and all actions taken to make sure that people’s nutritional needs are identified and met. This doesn’t make sense. Medication record sheets must always be accurately completed otherwise people could be put at risk of been given medication more than once. The home must continue to work at developing more social and recreational activities for people living there. The staff kitchen is in need of a good cleaning. Some doors, wall and splash back tiles need attention. Towel rails are needed in all the en-suites throughout the home and the damaged doors and walls require attention. The organisation must review the present procedures for recording fees and the way people’s money is held in safekeeping. Raised at previous inspections 31/08/06 01/06/08 6. OP12 16 01/06/08 7. OP19 23 01/06/08 8. OP35 17,20 01/06/08 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 Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Amber Lodge DS0000001412.V362580.R01.S.doc Version 5.2 Page 26 - 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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