Inspection on 27/10/05 for Appleby Lodge

This inspection was carried out on 27th October 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 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 Ian Wright Unannounced Inspection 27th October 2005 10:10 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.V252530.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. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 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.V252530.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 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.V252530.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four and a half hours. The inspection was unannounced. The inspector was able to speak to the majority of service users. The inspector also met with Ms Janice Rider-the registered manager. The inspector examined the care and business records, and inspected the building. What the service does well: What has improved since the last inspection? 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 DS0000008945.V252530.R01.S.doc Version 5.0 Page 6 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.V252530.R01.S.doc Version 5.0 Page 7 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): 3,5 A suitable pre admission assessment procedure is in operation to enable the registered persons to ascertain whether they can meet service users needs. Service users and their representatives are able to visit before formal admission is arranged. EVIDENCE: Mrs Rider outlined a suitable process of assessment for service users who have recently moved into the home. Assessments were appropriately documented. Suitable care plans are subsequently developed from initial assessments. Service users and their representatives are able to visit before they have to make a decision to move in. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 8 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, 10 Service users personal and health care needs are met appropriately. EVIDENCE: Care plans inspected were comprehensive to enable staff to provide service users with appropriate care. Care plans are regularly reviewed. Suitable links have been developed with GP’s, district nurses etc. Interventions by health care professionals are documented. Mrs Rider said support from external professionals is to a good standard. The inspector spoke to several service users who said their rights were respected, and they were treated with dignity by staff. Issues regarding respect and dignity are covered in individual staff induction. Staff were observed working with service users in an appropriate manner. All service users personal care appeared to be maintained to a high standard. Service users confirmed they felt their personal care was carried out according to their wishes. Locks are fitted on the inside of bedroom doors. Staff always knock on service users bedroom doors. Service users choose their own clothes- and these are all Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 9 marked so people’s clothing does not get mixed up. Service users receive their own mail-and are given appropriate assistance with it as necessary. All bedrooms have a telephone socket. Service users are able to use the home’s telephone if they wish. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 10 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 Routines and activities are suitable to meet individual service users needs. Service users can receive visitors when they choose. Appropriate procedures are in place to assist service users to maintain autonomy and choice. EVIDENCE: Service users said they could get up and go to bed when they wished, and have autonomy how they organised their time. Some formal activities are arranged. These include music and reminiscence sessions. Some service users go to a weekly disabled persons club. Monthly visits occur from the Church of England Vicar, and the Methodist Minister. Activities are arranged at Christmas. A volunteer comes weekly and plays cards with some service users. There are no regular outings arranged. Although the majority of service users the inspector spoke to said they were quite happy to occupy themselves and did not get bored, a minority said they would like more activities. There seemed appropriate interaction between service users and staff. Suitable arrangements are in place for service users to receive visitors. Service users can meet with their visitors either in their bedrooms, the dining room or the lounge. Staff look after some service users moneys. Appropriate records are maintained regarding these. Records are kept of fees paid. Information is Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 11 provided regarding advocacy services. Service users are able to bring their own personal possessions with them when they come to live in the home. Service users are able to access their personal records if they wish. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 12 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, 17 Some amendment is required to the registered provider’s complaints procedure so it meets the standard. Service users legal rights are protected. 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 the complaints procedure does require some amendment to state service users can refer a complaint to CSCI at any stage, should the complainant wish to do so. The registered persons or CSCI have not received any complaints. Service users legal rights are protected. Postal votes are arranged for service users. Information is provided in the hall of the home regarding advocacy services. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 13 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, 20, 21, 23, 24, 26 Appleby Lodge provides suitable facilities to meet the needs of service users. The home is well maintained, clean, comfortable and homely. EVIDENCE: The property is suitably maintained, appears to be safe, is comfortable and homely. Furnishings and decorations are satisfactory. The home has a lounge where service users can choose to relax. Other facilities include a dining room, and suitable bathrooms and toilets. The home was clean and hygienic on the day of inspection. The property has a pleasant, level back garden, which service users can use. A new pathway has just been laid to enable service users to walk around the grounds. Bedrooms are appropriate to meet the needs of service users. All are decorated to suit individual tastes. Service users can lock their bedrooms from inside. Size of bedrooms and communal areas are satisfactory. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 14 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 Suitable staffing levels are provided to care for service users. The registered provider has a suitable approach of ensuring 50 of staff have a National Vocational Qualification (NVQ) EVIDENCE: At least two care staff are on duty from 0700 to 1900. From 0900 to 1100 a third carer is also employed. One waking night and one sleep in member of staff are on duty at night. Suitable cleaning and kitchen staff are also employed. There are currently no staff vacancies and staff turnover is low. Staff are encouraged to complete an NVQ qualification. Of 14 staff employed 6 currently have NVQ 2, and 3 staff are working towards NVQ 2. Copies of certificates are kept in the home. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 15 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): 36, 37, 38 Staff are appropriately supervised. Records, policies and procedures are maintained to a good standard. Health and safety standards are generally satisfactory although some improvements are required in this area. EVIDENCE: Staff are appropriately supervised by the manager and senior staff on a dayto-day basis. The manager has regular supervision meetings with night staff. Appropriate documentation is maintained. Health and safety precautions are generally satisfactory. For example fire prevention and gas equipment are appropriately tested. The electrical hardwire circuit has been appropriately tested. Portable electrical equipment must be tested between 1-2 years in line with Health and Safety Executive Guidelines. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 16 The Environmental Health Officer has visited the home in February 2005, and found precautions generally satisfactory. A sample of water was tested regarding Legionella within the last 12 months. However a more detailed risk assessment regarding the prevention of Legionella must be produced. Health and safety risk assessments must be expanded and reviewed at least annually. Although staff training records were not inspected on this occasion, the registered manager outlined a satisfactory health and safety training programme for staff employed. Apart from omissions detailed above records, policies and procedures have been developed to a good standard. Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 17 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 x 3 3 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x 3 3 2 Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO 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 following health and safety precautions must be improved: • A comprehensive risk assessment regarding Legionella must be developed. • Health and safety risk assessments must be developed regarding risks to staff, visitors and service users. • Portable Electrical Appliances must be tested between 1-2 years in line with HSE guidance. Timescale for action 01/01/06 2 OP38 13, 23 01/01/06 Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 19 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 Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Appleby Lodge DS0000008945.V252530.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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