Inspection on 11/11/05 for Angel Lodge

This inspection was carried out on 11th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Angel Lodge 27/07/07

Angel Lodge 17/08/06

Angel Lodge 12/04/05

Angel Lodge 13/01/05

Angel Lodge 12/07/04

Angel Lodge 02/03/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Angel Lodge 15-17 Eastwood Road Goodmayes Ilford Essex IG3 8UW Lead Inspector Ms Gwen Lording Unannounced Inspection 11 November 2005 10:00 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 Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Angel Lodge Address 15-17 Eastwood Road Goodmayes Ilford Essex IG3 8UW 020 8597 4399 020 8597 4399 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) Chana Bros Limited Mr. Amrik Singh Chana, Mr. Bhupinder Singh Chana Pauline Ann Baker Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2005 Brief Description of the Service: Angel Lodge is registered to provide personal care and accommodation for up to 20 service users over the age of 65 years who have related illnesses/ conditions. Five of the beds are contracted by the London Borough of Barking and Dagenham to provide admission for respite care. The home is owned and operated by a family business. The premises are situated in a residential area of Goodmayes, close to the busy Ilford High Road with access to shops and other community facilities. The home provides accommodation on two floors, which is mainly in single bedrooms with one double bedroom and there is a passenger lift. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.00 am. It took place over four hours during the morning and early afternoon. Discussion took place with the registered manager, the cook, laundry person and several members of care staff. The Inspector spoke to a number of residents in the lounge and two residents who were in their bedrooms. In addition the relative of a resident admitted for a period of respite care was spoken to get her views and comments about the care in the home. A tour of the home was made and a number of staff and care records were looked at. The Inspector took into account an issue concerning the cleanliness of the home, which had been drawn to the attention of the Commission via an anonymous letter of complaint received by the Commission the previous week. There was no evidence found to substantiate this complaint and the report will detail the findings to support this. This was the second statutory inspection visit in the inspection programme for 2005/6. Over the course of the two visits, all core standards have now been assessed. What the service does well: What has improved since the last inspection? Appropriate pre-admission assessments are now being carried out for all residents prior to them moving into the home or for a period of respire care. The manager has produced a very comprehensive document and all records inspected had assessment information recorded and the information had been Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 6 used to continue assessment following admission to the home and develop written care plans. There was a significant improvement noted in the standard of care planning. Care plans are being reviewed monthly and updated to reflect changing needs. Improvements have been made to the décor and some of the furnishings. One resident commented that the lounge is “Now so comfortable to relax in”. The outstanding work has been completed on the refurbishment of the kitchen and provides more suitable facilities for the preparation, cooking and storage of food. 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. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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 Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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): Standards 1 and 3. The Statement of Purpose and Service User Guide must be amended to include a complaints procedure that is simple to use and clear and accessible to residents and their relatives. Appropriate pre-admission assessments are carried out for all residents prior to them moving into the home or for a period of respite care. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. EVIDENCE: The home has a Statement of Purpose and Service User Guide, which contain information for current and prospective residents and their relatives/ representatives. Both documents include a copy of the complaints procedure however; the information must be amended to include information for referring a complaint to the Commission at any stage, should the complainant wish to do so. In addition the home’s policy states “All complaints are responded to in writing”. However, there was evidence to show that this does not always happen. At the last inspection a requirement was made for a full assessment to be undertaken for all residents, including those admitted for respite care. The Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 9 manager has produced a very comprehensive document and all records inspected had assessment information recorded and the information had been used to continue assessment following admission to the home and develop written care plans. The records showed that residents, where capable and their relatives/ representatives are involved in the assessment process. Where appropriate, information provided by the placing authority was also included on file. The home does not offer intermediate care. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 10 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): Standards 7, 8 and 9. Residents’ health, personal and social care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents; needs. There are clear medication policies and procedures for staff to follow. However, there are still some isolated inconsistencies in the recording of medication, which may result in unsafe practices. Residents are able to take responsibility for their own medication if they wish, but risk assessments must be undertaken and regularly reviewed to ensure residents are protected and changing needs identified. EVIDENCE: Individual plans of care were available for each resident. The records of five residents were examined, including the care plan of one resident admitted for a period of respite care. The records for these residents were found to be generally detailed and followed on from a full assessment of the residents’ needs. There was a significant improvement noted since the last inspection. There was evidence that care plans are reviewed on a monthly basis and Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 11 updated to reflect changing needs. The records indicated that residents are seen by other health care professionals such as chiropodists, dentists, specialist nurses and doctors. At the last inspection it was noted that care staff were reliant on daily entries in a ‘Communication’ book for information about residents care. All information is now communicated through the individual’s care plan and the ‘Communication’ book is used for general information purposes only or as a ‘prompt’ to remind staff to make reference to individual care plans. There are policies and procedures for the handling and recording of medicines in the home. At the last inspection there were discrepancies noted between the dates recorded on the Medication Administration Record (MAR) charts and the date of delivery of medicines to the home by the pharmacy. This issue has now been satisfactorily resolved by the manager and the dispensing pharmacist. There are still a number of isolated inconsistencies in the recording of medication not administered. The manager must ensure that all staff are aware of the consistent codes to be used to define when prescribed medication is either ‘not required, refused or omitted’ for an individual resident. One resident in the home currently takes responsibility for her own medication. A record is maintained of her current medication and a lockable facility is provided in which to store the medication in her room. The inspection of her file showed that a risk assessment had not been undertaken. The manager must ensure that a risk assessment is completed for all residents who wish to take responsibility for their own medication and that this risk assessment is regularly reviewed to ensure that any changing needs are identified and addressed. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 12 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): Standards 12 and 14 Residents are supported in maintaining their independence by handling their own financial affairs for as long as they wish to and have the capacity to do so. There is a varied programme of activities available, which suit individual needs, preferences and capacities. EVIDENCE: The Inspector observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for example choosing a drink or music to listen to, or taking a walk. Most of the resident’s financial affairs are handled by their relatives. However, there was evidence to show that some residents are provided with the support they need to handle their own financial affairs for as long as they wish and have the capacity to do so. There are contact details of advocates and other external agents available in the home, who will act in resident’s interests. The home does not have an activity organiser and staff take responsibility for organising activities inside and outside the home. Since the last inspection the manager has reviewed the range of activities available to residents in the Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 13 home, which includes a programme of regular professional entertainers visiting the home. A buffet lunch is provided and relatives are welcome to join in. residents spoken to said that they “enjoyed the entertainment, particularly the singers”. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 14 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): Standard 16 The information in the complaints policy/ procedure must be amended to provide residents and their relatives with the appropriate information to ensure that their complaints are dealt with promptly, effectively and to their satisfaction. EVIDENCE: The home has a complaints policy/ procedure and the records indicate the number of complaints received and includes details of the investigation, any action taken and the outcome for the complainant. The policy/ procedure must be amended to include information for referring a complaint to the Commission at any stage, should the complainant wish to do so. In addition the home’s policy states “All complaints are responded to in writing”. However, there was evidence to show that this does not always happen in line with the home’s policy. Those residents spoken to who were able to express a view said that they felt able to make complaints and raise issues if they needed to and would speak to “The manager or one of the carers”. An anonymous letter of complaint has been received by the Commission concerning the cleanliness of the home. The issues concerning the complaint and the findings of the Inspector are addressed within this report. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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): Standards 19, 20, 21, 25 and 26 Improvements have been made to the décor and some of the furnishings. This has significantly improved the quality of environment provided to people living in the home. The home is clean and there were no unpleasant odours. The refurbishment of the kitchen means that there are more suitable facilities and equipment for the preparation, cooking and storage of food. EVIDENCE: Since the last inspection the outstanding work on the refurbishment of the kitchen has been completed. This now provides the cook with more suitable equipment and facilities with which to prepare, cook and store food. The dining room, two lounges, two bedrooms and one bathroom have all been re-decorated since the last inspection and work has just commenced on the redecoration of the hall. The chairs in the lounges have been replaced and one resident commented that the small lounge is “ Now so comfortable to relax in”. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 16 One element of the complaint concerned the cleanliness of the home including the kitchen. On the day of the inspection all areas of the home were found to be clean, tidy and with no offensive odours. There was no evidence found to substantiate this element of the complaint. Another element of the complaint alleged that the water used for washing purposes was cold. As part of the inspection the records detailing the temperature of all hot water outlets in the home was examined. The temperature of some hot water outlets was also tested by “hand touch”. The laundry was visited and the procedure for washing foul laundry was discussed. It was noted that the appropriate temperature was being used to wash foul laundry on the day of the inspection. There was therefore no evidence found to substantiate this element of the complaint. The registered providers must make suitable arrangements for water heating and temperature checks to be undertaken for compliance with Legionella and ensure that the services and facilities comply with the Water Supply (Water Fittings) Regulations 1999. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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): Standards 28 and 30 Resident’s benefit from a committed staff team who have the skills and training to meet their needs. EVIDENCE: The home has a relatively stable workforce and in discussion with staff it was evident that they understand and fully support the main aims and values of the home. Staff files showed that two staff are qualified to NVQ level 3, twelve staff qualified to NVQ level 2 and the remaining four staff are working towards NVQ2. This equates to approximately 95 of care staff in the home being qualified to NVQ level 2 or above and this demonstrates a very positive commitment to training by the registered providers and the staff. One of the senior care staff is currently undertaking training in “Developing Dementia Training Skills”. Once this training is completed she will be able to implement a training programme for care staff in the home. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 18 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): Standards 31, 33, 35, 37 and 38 The management of the home is satisfactory overall but there is no effective system in place for the registered providers to check on the quality of care being provided to people living in the home. Where the money and valuables of individual residents is handled, there are secure facilities provided for their safekeeping. EVIDENCE: Regulation 26 visits are not being undertaken by the registered providers on a regular basis, nor are reports being submitted to the Commission as required by regulation. The registered provider needs to carry out regular checks on the quality of care being provided, ensuring that care is delivered in accordance with the individual care plans and wishes of residents. This needs to include asking residents and their relatives, and staff what they think about the service the home offers. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 19 This is an unmet requirement from the previous two inspections. Unmet requirements impact on the welfare and safety of residents, therefore continued failure to meet repeated requirements will lead to the Commission for Social Care Inspection considering enforcement action against the registered person(s). Most of the resident’s financial affairs are managed by their relatives/ representatives. There is a safe where money and valuables held on behalf of residents can be securely stored. Written records of all transactions are maintained and money is held in individual wallets. The manager does not hold appointeeship for any resident. Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 20 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 3 3 X X X 2 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 2 Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 21 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 OP33OP37 Regulation 17,24 & 26 Requirement A written report of each visit conducted by the responsible individual, as required by Regulation 26, must be provided to the Commission (Timescale of 28/02/05 and 31/05/05 not met) The Statement of Purpose and Service User Guide must include an amended copy of the complaints procedure. The manager must ensure that all staff are aware of the consistent codes to be used to define when prescribed medication is either ‘not required, refused or omitted’ for an individual resident. A risk assessment must be completed for all residents who wish to take responsibility for their own medication and that risk assessments are regularly reviewed. The home’s complaint policy must be amended to include information for referring a complaint to the Commission at any stage, should the complainant wish to do so. DS0000025883.V264665.R01.S.doc Timescale for action 16/12/05 2 OP1 4&5 23/12/05 3 OP9 13 23/12/05 4 OP9 13 23/12/05 5 OP16 22 23/12/05 Angel Lodge Version 5.0 Page 22 6 OP16 22 7 OP25OP38 13 & 16 All complaints must be responded to in writing, to ensure that the home’s practice is operating in line with the current policy. The registered providers must make suitable arrangements for water heating and temperature checks to be undertaken for compliance with Legionella and ensure that the services and facilities comply with the Water Supply (Water Fittings) Regulations 1999. A copy of the certificate of testing must be provided to the Commission. 23/12/05 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Angel Lodge DS0000025883.V264665.R01.S.doc Version 5.0 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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