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Inspection on 08/01/09 for Ancholme Lodge Care Home

Also see our care home review for Ancholme Lodge Care Home for more information

This inspection was carried out on 8th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ancholme Lodge Care Home Scawby Road Broughton Brigg North Lincolnshire DN20 0AF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rob Padwick     Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ancholme Lodge Care Home Scawby Road Broughton Brigg North Lincolnshire DN20 0AF 01652657349 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ancholme.lodge@hotmail.co.uk Mr Blabir Singh Lally Name of registered manager (if applicable) Caroline Gossop Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be admitted is : 24 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care need on admission to the home are within the following categories: Dementia - over 65 years of age - Code DE(E) Old age not falling within any other category: Code OP Date of last inspection Brief description of the care home Ancholme Lodge is registered for the care of 24 service users with residential care needs; four of these places are for service users with needs associated with dementia. The home is set on the outskirts of the village of Broughton, near the main town of Scunthorpe. It is a large older style Victorian building that has maintained a number of existing features. The accommodation is provided on two floors accessed by a Care Homes for Older People Page 4 of 26 care home 24 Over 65 13 24 0 0 Brief description of the care home passenger lift, stairs and a platform lift. All bedrooms are for single occupancy and the majority have en-suite facilities; all the rooms are individually furnished. There are a variety of communal sitting areas and a large dining area. The gardens are mainly paved and are accessible to service users. There is ample parking provided at the front of the building. The fees for the home range between 355 to 380 Pounds, which are reviewed annually. Additional charges include hairdressing and chiropody. The Service Users Guide and Statement of Purpose are on display in the main reception area and given to each prospective person seeking accommodation. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since its last key inspection, which took place on 10th January Care Homes for Older People Page 6 of 26 2007 and includes information gathered during a visit to the home. As part of the inspection process, we sent an a self assessment document that the registered person must complete and return to us. This should show how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the manager and information from this used as part of the inspection process. Other information used, included direct feedback from people living in the home, together with responses gained from relatives and professional staff, and official notifications received by the Commission for Social Care Inspection. This information helps us reach judgments about the service provided. The site visit took place on 8th January and lasted for 7.5 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to her, we talked staff who were on duty and people living in the home. We looked round the building, including bedrooms and shared areas and we inspected the records of peoples care, staff files, health and safety documents and other records that were kept by the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people living in the home are thoroughly assessed to make sure the service can meet these and information is available to help people thinking about using the service to reach an informed decision about it. Evidence: Information provided by the manager stated All perspective Service Users have their individual needs assessed prior to admission and that Service Users whose needs we are unable to meet are not admitted. We saw evidence of a thorough admission process for the service and case files belonging to people living in the home contained assessments about them, which had been carried out before they moved in to the service. Information about the home was displayed in the entrance corridor and the manager indicated this was given to people thinking about using the service, to help them to make an informed decision about it. Comments on questionnaires returned to us from people living in the home were generally very positive and confirmed they had Care Homes for Older People Page 10 of 26 Evidence: been issued with contracts between them and the service. We saw evidence in the records that people living in the home had been asked how well their admission to the home had been handled, together with action plans to improve the service where this was needed. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the health and personal care needs of people living in the home are appropriately supported, clearer information about their individual choices for these would help staff ensure their wishes and feelings are fully respected. Evidence: Casefiles belonging to people living in the home contained care plans that covered a range of their needs, together with assessments about elements of known risks and information for staff about the management of these. The manager indicated care plans were in the process of being standardised and whilst these were adequate for use, it is recommended they are further developed to provide further details on individual choices of people living in the home, concerning how they like to be supported together with information about their individual strengths, so staff can help maximise their independence. Staff told us the Management provide information on new service users or any changes and that care plans are regularly updated and reviewed. We saw evidence of this in the case files inspected together with monitoring of health conditions and actions taken concerning these. Information provided by the Care Homes for Older People Page 12 of 26 Evidence: manager indicated the home has good working relationships with health professionals in the community and both District and Community Psychiatric nurses who we spoke to confirmed this and indicated they had no concerns. The service has medication policies and procedures to ensure people living in the home are safeguarded from harm and we made requirements about recording of medication previously. We saw evidence of action taken to implement these and regular checks of the records were now being carried out. We observed staff carefully checking new medication onto the records and staff spoken to demonstrated sound knowledge on this aspect of practice. We made a requirement concerning the wishes of people living in the home following their death the last time we visited and saw evidence of satisfactory action taken about this. District nurses were very positive about the care provided to people who are terminally ill and confirmed sensitive arrangements were followed in this respect. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst a variety of opportunities were available for people living in the home to experience a lifestyle that meets their needs and wishes, further specialist activities would enable the wellbeing of people with dementia to be enhanced. Evidence: Information provided by the manager stated People living in the home have the right to choose their own daily routines and they are Encouraged to make choices in relation to getting up and going to bed. People living in the home confirmed this was the case and some were observed choosing to remain in the privacy of their rooms. A Community Psychiatric nurse commented positively on the service and told us Staff recognise symptoms and problems associated with various conditions of old age. People living in the home are able to participate in a range of activities such as house bingo, sing along sessions, film afternoons and visits from entertainers, however, there was some evidence this aspect of the service could be further developed, as a number of people were observed looking listless and bored. The manager told us she was aware of this issue and whilst an activities organiser had been recently appointed and a minibus obtained, it is recommended further action is taken to ensure those with dementia experience a lifestyle that meets their specialist needs. The home has good Care Homes for Older People Page 14 of 26 Evidence: links with the local community and we were told about fund raising events such as summer Fayres and fetes, which took place. The service has an open visiting policy that enables people living in the home to maintain links with friends and their families and a number of relatives were observed visiting during our visit. People living in the home indicated they enjoyed the meals provided and menus contained details of range of healthy nutritious home cooked meals with monitoring of aspects of diet. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The concerns of people living in the home are taken seriously and staff have been trained to make sure they know how to safeguard them from potential harm. Evidence: People living in the home indicated staff listened to them and that any concerns were taken seriously. The service has a comprehensive complaints policy and feedback about the home was generally positive. The Commission for Social Care Inspection had received no complaints about the service since the last time we visited and the complaints log contained evidence of actions taken by the manager to resolve the one complaint that had been received by the home in this time. People told us they felt safe living in the home and commented There is always somebody there. Policies were available to make sure people are safeguarded from harm and we saw evidence of staff training provided on this since the last time we visited. The Local Authority told us they had no concerns about the service and confirmed prompt action had been taken by the home to deal with a safeguarding issue, which had been appropriately referred to them. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the service provides a comfortable and homely environment for people living in the home, some further improvements to the standard of decor would enable better outcomes to be experienced. Evidence: The home occupies a large Victorian period building that has been converted for use and is domestically furnished and has a comfortable and homely atmosphere. There was evidence of a programme of ongoing repairs and we were told a new boiler system had been recently installed to ensure that water temperatures can be better regulated as was previously required. Replacement windows were in the process of being fitted in the kitchen and further work had been carried out to improve the shower area. Bedrooms inspected were individually decorated and we were told people living in the home are able to bring items of personal possessions with them. There was evidence of a strong commitment to infection control and the service had volunteered to take part in a pilot programme about this. A treatment room was available for District Nursing staff to use, however we were told further equipment was needed for this. Whilst the building was being kept clean and tidy on the day of our visit, some decorating work had been poorly completed and there was evidence the home would benefit from further development in this respect. A recommendation is made about this. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst staff are provided with training to help them to do their jobs, improved recruitment practices would enable people living in the home to be safeguarded better and ensure new staff are safe to work with them. Evidence: Comments received from people living in the home were generally very positive about the caring nature of the staff. Professionals associated with the home indicated staff communicated with them well and followed their advice and we observed staff interacting with people living in the home in a friendly and sensitive manner. We made a requirement the last time we visited to ensure sufficient staff are on duty to meet the needs of people living in the home and whilst the manager was reviewing staffing levels on a regular basis, it is recommended further action is taken about this as some people told us about times when additional staff were needed and we observed some people looking listless and bored as has previously been noted. The home has a generally very stable staff team and we saw evidence of a strong commitment to developing their skills. Staff told us about courses they had attended and staff files contained evidence of regular supervision and appraisals to ensure career development. A staff matrix was in place to ensure training needs can be updated and that others are planned as they are needed. Recruitment policies are in place to ensure staff are safe to work with people living in the home and whilst there was evidence Care Homes for Older People Page 19 of 26 Evidence: these were largely being followed correctly, there was some evidence this practice should be further improved. As two members of staff had recently been allowed to start work before a full Criminal Records Bureau check had been received for them. A recommendation is made about this. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst administrative systems were in place to enable the smooth running of the service, better consultation with people living in the home would help to ensure it is run in their best interests Evidence: People living in the home indicated the service was being generally well run and confirmed they could contribute ideas to help influence the service. It was evident the new manager was strongly committed to improving the home, whilst the previous manager was now taking on a more administrative role. Some people who we spoke to however, were somewhat confused over changes in the management arrangements and a recommendation is made about this to ensure a clear sense of direction can be maintained. Quality assurance systems were in place to check how well the service is meeting its aims and objectives, although the manager told us a business plan was still needed. Whilst there was evidence people living in the home and the staff are consulted about future developments for the service, some meetings with them were Care Homes for Older People Page 21 of 26 Evidence: not always occurring very often and a recommendation is made about this. The information provided in the self assessment for the home gave us a reasonable picture of the current situation within the service although there were areas where more supporting evidence would have helped illustrate how it was planning to improve. The records of money belonging to people living in the home were being accurately kept and there were invoices available to confirm transactions that had been made. Maintenance records contained evidence of regular checks of the building and there were certificates that confirmed the appropriate servicing of equipment. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The manager should ensure care plans are developed with further information about individual choices so that staff can maximise independence and ensure support provided meets the individual wishes and feelings of people living in the home. The Registered Person should continue to develop the activities in the home to ensure the specialist needs of people with dementia are better met. The Registered Person should ensure an up to date plan is developed to improve the environment with timescales for acheiving this. The Registered Person should ensure staffing levels are further reviewed to ensure sufficient staff are on duty to meet the individual needs of people living in the home. The Registered Person should ensure new care home workers are only allowed to start work in the home when both a full and satisfactory CRB and POVA check has been received for them. The Registered Person should ensure management arrangements enable a clear sense of direction to be provided for the service Page 24 of 26 2 12 3 19 4 27 5 29 6 31 Care Homes for Older People 7 8 33 33 The Registered Person should ensure that a business plan is developed for the home The Registered Person should ensure there are regular meetings with staff and people living in the home to enable good communication and enable them to be consulted about the home Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!