Inspection on 24/05/06 for Appleby Lodge

This inspection was carried out on 24th May 2006.

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

Appleby Lodge 03/07/08

Appleby Lodge 12/07/07

Appleby Lodge 27/10/05

Appleby Lodge 10/05/05

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 Key Unannounced Inspection 24th May 2006 09:00 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 Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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 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) 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 DS0000008945.V293571.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th October 2005 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 garden is wheelchair accessible. 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 is fully wheelchair accessible. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place as a key unannounced inspection. The registered manager was on duty during the course of the inspection. All the service users spoken to during the course of the inspection expressed very positive comments on the standard of care that they are receiving. What the service does well: What has improved since the last inspection? What they could do better: The registered manager works extremely hard to deliver a good standard of care at Appleby and there is no doubt that this is the case from the service Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 6 user comments. She must now concentrate on meeting important standards that are presently not being met, for example staff supervision and obtaining her registered managers award qualification. A discussion took place with the registered manager on the way forward to meet these standards. It is also noted that Regulation 26 reports from the registered provider are not being received at the CSCI. This is included in this inspection report as a statutory requirement. 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 DS0000008945.V293571.R01.S.doc Version 5.1 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 Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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): 1,2,3,4 and 5 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 contract of care that details the terms and conditions of the placement should be amended to include a reference to current rather than old legislation and the CSCI rather than the NCSC. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 9 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 (OP) not falling within any other category. No emergency admissions take 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 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 the staff employed in the home receive regular training to ensure that they can meet the care needs of the service users being admitted to the home. Service users and their representatives are able to visit Appleby Lodge before they have to make a decision to move in. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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): 7,8,9 and 10 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. One good practice recommendation is made for medication administration. 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. Separate daily records support the care plans. The community nursing service are regular visitors to the home. Pressure relieving equipments is provided along with aids and adaptations as required. Care planning documentation evidences health care professional involvement to include opticians and chiropodists. Medication administration records were found to be completed appropriately as was the storage and administration of the medication. Senior staff have Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 11 medication responsibilities. It is recommended that a controlled drug register is purchased to record accurately a balance audit on a particular drug. Staff were observed at all times to treat the service users with respect and dignity and comments from the service users confirmed these observations. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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): 12,13,14 and 15 Routines and activities are suitable to meet individual service users needs. Service users can receive their visitors when they choose. The meals in the home are very good with special diets catered for and a choice offered at all meals. EVIDENCE: Service users are able to chose when they go to bed and how they spend their day. Some formal activities are arranged to include music and reminiscence sessions. Monthly visits to the home occur from the Church of England and the Methodist Minister. A number of service users are independently mobile and enjoy spending time in the gardens and having a daily walk. Suitable arrangements are in place for service users to receive visitors and daily records evidence when visitors have been received. Information is available on advocacy services should this be required for a service user. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 13 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 roast chicken or ham/corned beef. The main meal for the evening was a ploughmans. Wine is offered to the service users on a Sunday and the bar in the home is used when required. Local produce is used to include meat and vegetables. In addition to cooking meals for the home the cooks provide meals that are then delivered into the local community. An inspection of the kitchen by the District Council Environmental Health Officer took place on the 22nd February 2005. This was found to be satisfactory. 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 DS0000008945.V293571.R01.S.doc Version 5.1 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): 16 and 18 As identified in the inspection report of the 27th October 2005 some amendment is required to the registered provider’s complaints procedure so it meets the requirements of legislation. The home has in place adult protection policies and procedures and staff are provided with training to increase their knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The registered provider has developed a generally suitable policy and procedure how service users, and other stakeholders, can make a complaint. This has been issued to service users (and where appropriate their representatives) as part of the service user guide. However as identified in the inspection report of the 27th October 2005, the complaints procedure still requires some amendment to state that service users can refer a complaint to the CSCI at any time. To do this correct information must be in the complaints policy and procedure to include for example the phone number of the CSCI. The home has in place an adult protection policy and procedure. The staff are on a rolling programme to attend the adult protection training presently being provided by the Adult Social Care Department of Cornwall County Council. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Appleby Lodge is a very pleasant, clean, comfortable and homely home. All the service users spoken to during the course of the inspection expressed very positive comments on their environment. EVIDENCE: Appleby Lodge is a single storey building with level access throughout and the front entrance has a ramp for wheel chair use. Furnishings and decorations are satisfactory. The home has a spacious lounge where service users can choose to relax. Other facilities include a dining room, and suitable bathrooms and toilets. The home was found to be very clean on the day of the inspection. The property has a pleasant, level back garden which service users can use and there is a pathway which allows the service users to walk around the grounds should they so wish. All maintenance records for the safe running of the home are in place. This includes the machines for the laundry. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 16 Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Staffing levels are appropriate to meet the needs of the service users. The staff team are a very stable group with few 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. Recruitment procedures are used infrequently as the staff team are very stable with no vacancies generally being the norm. Staff are encouraged to complete an NVQ qualification. Copies of certificates are kept in the home. Statutory training to include moving and handling, first aid and health and safety is up to date. It is noted that fire drill training to staff must be updated to meet the requirements of Cornwall County Council Fire Department recommendations. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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): 31,33,35,36 and 38 The registered manager and her team are providing a good standard of care at Appleby Lodge. Unfortunately due to the demands of time some important standards are not evidenced as being met and attention must be directed to this. EVIDENCE: The registered manager is qualified at NVQ level 3 and has 6 years experience as a manager of the home. She is still undertaking studies to obtain the registered managers award. Priority should be given to completing this qualification as soon as is possible. The manager is very much a hands on manager directly involved in the delivery of care. She is supervising her staff verbally but it is important that the supervision of staff is recorded as taking place. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 19 It is noted that the CSCI are not receiving the registered providers monthly reports of her visit to the home. It would be helpful if these reports could include the support that the registered provider is offering to the registered manager to meet outstanding requirements. The service users either manage 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. There is no evidence in place at this time in regard to meeting standard 33. A quality monitoring/audit of the running of the home to evidence that the home is being run in the best interests of the service users should take place as soon as is possible. The statutory requirement of the inspection report dated the 27th October 2005 has been met. It is though important to ensure that staff receive appropriate fire drill training to ensure the health and safety and welfare of the service users. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x x x x 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 2 x 2 x 3 2 2 2 Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 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 OP16 Regulation 22 Requirement The complaints procedure requires amendment to state service users (and other stakeholders) can refer a complaint to CSCI at any stage, should the complainant wish to do so. The requirement has not been met from the previous inspection: Previous date 01/01/06. Therefore new timescale as been agreed. Timescale for action 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP2 Good Practice Recommendations To amend the contract of care with updated legislation and change of name from NCSC to CSCI. DS0000008945.V293571.R01.S.doc Version 5.1 Page 22 Appleby Lodge 2. 3. 4. 5. 6. 1 OP30 OP36 OP33 OP31 OP37 OP9 To update fire drill training to staff as recommended by Cornwall County Council Fire Department. To evidence that staff are being supervised. To evidence through monitoring systems that the home is being run in the best interests of the service users. To complete studies to obtain the registered managers award as soon as is possible. To provide to the CSCI monthly Regulation 26 reports. To purchase a controlled drug register and record as discussed for a particular medication. Appleby Lodge DS0000008945.V293571.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection St Austell Office 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. 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