Inspection on 10/05/05 for Appleby Lodge

This inspection was carried out on 10th May 2005.

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

Appleby Lodge 03/07/08

Appleby Lodge 12/07/07

Appleby Lodge 24/05/06

Appleby Lodge 27/10/05

Appleby Lodge 27/10/04

Appleby Lodge 06/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Appleby Lodge Hillside Launceston Road, Kelly Bray Callington, Cornwall PL17 8DU Lead Inspector Elaine Bruce Announced 10 May 2005 09:00 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Appleby Lodge Address Hillside Launceston Road Kelly Bray Callington Cornwall, PL17 8DU 01579 383979 01579 383108 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Appleby Rest Homes Limited Mrs Janice Rider Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27 October 2004 Brief Description of the Service: Appleby Lodge offers accommodation and personal care for up to eighteen older people. The single storey, purpose built home is situated in Kelly Bray, one mile away from the town of Callington. It is reached via a driveway that leads off from the main road. Car parking is available at the end of the driveway. A public house, post office, shop and Methodist Chapel are all within easy reach. The accommodation comprises of 18 single bedrooms, 2 bathrooms, 5 separate wcs, an office, a well equipped kitchen, an outside laundry area and a lounge/dining room with access to the patio and large well kept garden via french doors. The home has a no smoking policy. A variety of activities are offered to the service users and visitors are encouraged with no restrictions on visiting times.. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 10th May 2005 in just under 6 hours and was carried out as an announced inspection. A tour of the premises took place and service users and staff were spoken to. Care records, staff files and policies and procedures were inspected. Positive feed back comment cards were received from relatives before the inspection. All the service users spoken to expressed very positive comments on the standard of care that they are receiving at Appleby. The registered manager was present during the course of the inspection. What the service does well: What has improved since the last inspection? The registered provider is now providing regular reports to the Commission for Social Care Inspection of her statutory monthly visit to the home. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 4 The home’s statement of purpose and service user guide documentation provide prospective service users with details of what the home provides helping an informed decision about admission to the home. The registered manager assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The home has a statement of purpose document in place that meets all the requirements of The Care Homes Regulations (2001). The statement of purpose document is available in the home. A service user guide document has been distributed to all existing service users and all potential service user admissions also receive this documentation. The registered manager assesses all service users prior to admission to the home to ensure that all care needs can be met and that service users are older persons not falling within any other category. No emergency admissions take Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 9 place when the registered manager is not on duty. Documentation is in place to evidence that pre admission assessments are taking place. The home provides meals on wheels to the local community and some clients attend the home for a day care service. This allows these service users to be familiar with the home prior to admission. All staff employed in the home receive regular training to ensure they can meet the care needs of the service users being admitted to the home. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 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 standard(s) 7,8 and 9 The service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required. Medication is being administered correctly to the service users. EVIDENCE: Individual plans of care are in place for each service user. The service user and their representative are involved in care planning. Evidence is in place of regular monthly reviews. It is though recommended that consideration be given to reviewing the recording into one system rather than two that the home is presently using. The community nursing service are regular visitors to the home. Pressure relieving equipment is provided along with aids and adaptations as required. New equipment has recently been provided to include a hoist. On the day of the inspection the optician was in the home to see a number of the service users. The optician and his team were observed to have a good rapport with the service users. A medication policy and procedure is available in the home to guide staff on good practice. Accredited medication training is due to take place on the 25th Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 11 August 2005 (at a local college) for senior staff who have medication administration responsibilities. Medication administration records were found to be completed appropriately on the day of the inspection. It is recommended that medication is always stored in a locked facility. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 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 standard(s) 15 The meals provided in the home are very good with special diets catered for and a choice offered at all meals. EVIDENCE: A menu is prepared a month in advance that takes into account individuals’ choices and preferences. The main meal of the day on the day of the inspection was shepherds pie or spaghetti bolognaise. The manager spends time regularly with each service user to establish their likes and dislikes. Local fresh meat and vegetables are delivered twice weekly to the home. All the puddings are made with fresh ingredients. The home employs two long standing cooks and one new cook who have their basic food hygiene certificate qualifications. In addition to cooking meals for the home the cooks provide meals that are then delivered into the local community. Each service user spoken to during the course of the day expressed very positive comments on the standard of the meals in the home. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The home has a satisfactory complaints procedure provided to the service users in the service user guide. The home has in place adult protection policies and procedures but training should now be provided to staff to increase their knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has a complaints policy and procedure and each service user and their representative has received this documentation in their service user guide. It is recommended that further clarification is given to the response time in the documentation should a complaint be received. The home has received no complaints. The home has in place an adult protection policy and procedure and in some instances this information has been duplicated. It is recommended that this information be brought together and then staff re-read and sign to say that they have read the new policy and procedure. It is then appropriate for staff to receive training in this area which is presently being provided by the local social services department. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,24 and 26 The standard of the environment within Appleby Lodge is good providing service users with an attractive and homely place to live. EVIDENCE: Appleby Lodge is a single storey building with level access throughout and the front entrance has a ramp for wheel chair use. Externally and internally the home is well maintained with an ongoing programme of repair and decoration. An inspection of the premises by the County Fire Brigade was carried out on the 7th April 2005. The one requirement from this inspection has been addressed. The home has a central lounge and combined dining area providing the only internal communal area. The home operates a no smoking policy. The service users can access the patio and pleasant large gardens via the French doors leading from the lounge. The home provides furnished accommodation, although service users may bring their own furniture if they wish to personalise their rooms. They are Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 15 provided with lockable bedrooms doors that staff may access in the event of an emergency. The home employs a designated domestic assistant. The home was observed to be clean and well organised on the day of the inspection. The laundry was not inspected on this occasion. Staff are instructed to use disposable aprons and gloves for their duties and soap is available for regular hand washing. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Staffing levels are appropriate to meet the needs of the service users. The staff team are a stable group with few staff changes since the last inspection. Staff are provided with regular training to enable them to do their jobs. EVIDENCE: Two carers are on duty at all times with three carers on duty during the morning, which is peak activity period and supported by a cook, kitchen assistant, domestic and registered manager. There is one waking and one sleeping in staff member at night. It is recommended that the staffing rota clarifies the position of each staff member employed. Recruitment procedures are being followed correctly to include staff having to undergo an enhanced criminal bureau records check. In addition to written references are sought from previous employers. The staff team are a stable group with few staff changes since the last inspection. Statutory staff training to include moving and handling, first aid, fire drill and health and safety is all up to date. It is recommended that the staff induction training is evidenced as expanded over six weeks as required by The National Minimum Standards. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35 and 38 The registered manager provides leadership, guidance and direction to the stable staff team to ensure that the service users receive good care. EVIDENCE: The registered manager is qualified at NVQ level 3 and has 6 years experience as a manager of the home. She has plans to complete the registered managers award which she is presently undertaking at a local college. In addition to these studies she has undertaken statutory training to include first aid and medication training. She is very much a hands on manager directly involved in the delivery of care. In addition she has a lot of autonomy and financial responsibility. The registered provider is complying with the reports of their monthly visit to the home as required by legislation. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 18 The manager is aiming to have formal staff meetings every two months and the most recent staff meeting is due to be typed. The service users are to be involved in a quality monitoring system later in the year. The manager is to arrange for documentation to be received at the Commission for Social Care Inspection from the registered providers account. This will confirm the financial viability of the running of the home as required by legislation. The service users either manager their own money or this is done on their behalf by relatives and solicitors. Records of personal spending and money held by the home on behalf of the service users are appropriately maintained. More evidence is required for meeting the standard on staff supervision. This was discussed in detail with the manager on the way forward. Staff induction and training covers health and safety issues. Staff training opportunities are provided in moving and handling, fire safety, first aid, food hygiene and infection control. The servicing of equipment and safety checks are maintained. The accident records and other details are appropriately maintained. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 x 3 3 2 x 3 Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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. 2. 3. 4. 5. 6. 7. 8. Refer to Standard 7 9 16 18 18 27 30 36 Good Practice Recommendations To review the care plan recording and give consideration to using one system rather than the two that are presently being used. To stored all medication in a locked facility To review the details around the timescales in the complaints policy and procedure. To bring together adult protection policies and procedures into one document. To provide staff with adult protection protection training. To clarify on the staffing rota the position of the staff member employed. To expand the staff induction over six weeks. To ievidence that regular staff supervision is taking place. Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell, Cornwall PL25 4AD 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 Appleby Lodge D52-D04 S8945 Appleby Lodge V215654 100505 Stage 4.doc Version 1.30 Page 22 - 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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