Inspection on 21/10/05 for Appleton Lodge

This inspection was carried out on 21st 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Appleton Lodge 18/07/07

Appleton Lodge 26/09/06

Appleton Lodge 04/05/05

Appleton Lodge 22/09/04

Appleton Lodge 14/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Appleton Lodge Lingard Lane Bredbury Stockport Cheshire SK6 2QT Lead Inspector Sylvia Brown Unannounced Inspection 24th October 2005 08:30 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 Appleton Lodge DS0000008536.V261702.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. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Appleton Lodge Address Lingard Lane Bredbury Stockport Cheshire SK6 2QT 0161-430 6479 0161 406 6812 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) Southern Cross Healthcare Services Limited Dawn Haughton-Tarmey Care Home 30 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (10) Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maximum number registered - 30. Services users to include up to 30 (OP), up to 3 (DE)(E) and up to 10 PD(E). 4th May 2005 Date of last inspection Brief Description of the Service: Appleton Lodge is one of the care homes owned and run by Southern Cross Healthcare. The home is located in a semi-industrial and residential area. Public transport is convenient and enables visitors and more able residents to travel to local shopping areas. Appleton lodge is purpose built and stands in its own grounds along with another home owned by the company. Appleton Lodge offers all residents single bedroom accommodation, all with en-suite facilities. Accommodation is provided on two floors. Residents have the opportunity of sitting in various communal seating areas, one of which is designated for residents who prefer to smoke. The home has wide corridors and is able to support residents who use manual and electric wheelchairs. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Appleton Lodge was unannounced, commencing at 7:45am. The inspector had the opportunity to sit with residents and share one mealtime with them. Residents remarked positively on staff practices and how they are supported. Comments made are included in the report. The main emphasis of the inspection was to evaluate the home’s action towards meeting the requirements and recommendations arising from the last inspection. Since the last inspection a pharmacist inspector from the CSCI has visited the home to evaluate the home’s practices regarding medication management, administration and record keeping. An evaluation of the requirements and recommendations made by the pharmacy inspector was undertaken at this inspection. The registered manager made herself available throughout the inspection and received feedback on the inspector’s findings at the conclusion of the inspection. What the service does well: Residents stated they felt happy and contented living at the home and were pleased with the support they receive. The home manages to provide a homely environment and was clean and well presented throughout the inspection. The home is continuing to develop administration systems following the merger of Southern Cross Healthcare, Active Care Partnership and Highfield Care. The registered manager and staff team have managed the change of ownership well and worked hard to ensure that residents’ lives have not been disrupted or adversely affected by the changes. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 6 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. Appleton Lodge DS0000008536.V261702.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 Appleton Lodge DS0000008536.V261702.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): 3 & 5. Standard 6 is not applicable Residents have their needs assessed prior to moving into the home and are able to visit before making any decisions about their future. EVIDENCE: Evaluation of two residents’ files identified that the home continues to receive assessments from placing authorities regarding the prospective resident and complete their own assessment of need prior to the resident being accommodated. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 9 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 & 10 Residents have their health care needs recorded and receive support to, as far as possible, maintain good health. EVIDENCE: The new recording system within the home ensures that care plans are detailed and contain information about the residents’ needs and personal preferences when receiving care. Professional healthcare visits are recorded, as are treatments given. Residents informed the inspector that they felt well cared for and were confident that they would be looked after correctly if they were poorly. Evaluation of medication storage areas, records and administration practices identified improved practice. The home is compliant with regulations and standards and meets guidance set by the Royal Pharmaceutical Society. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 10 Daily records demonstrated the day to day lives and achievements of the residents and the support they received from care staff. Residents spoke fondly of all staff. Residents were able to explain night-time routines and the flexibility of the home to support them whenever required. Positive relationships were evident between residents and staff. Residents were well presented in clean and co-ordinated clothing. They confirmed that hairdressing services are available as they desire and that time and attention is given to nail care routines. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 11 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, 14 & 15 Residents are support to live, as far as possible, as they desire. EVIDENCE: Whilst sharing a meal time with residents, they informed the inspector that the meals served were ‘nice and tasty’. They explained that alternative choices were available and that they are able to choose when and where they have their breakfast and tea time meal. A number of residents were observed having breakfast within their rooms, whilst others chose to eat in the dining room. Residents’ preferred rising and retiring times were recorded on file and individual daily requests for rising were also recorded and met. Fluid intake and nutritional records were inconsistently maintained, in that, amounts required and provided were unclear. Friends and family members are able to meet with residents in private and are able, by prior arrangement, to share meal-times and social occasions. The visitors record indicated the frequency of visits and if residents leave the home for any length of time. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 12 The home employs an activities co-ordinator who consults with residents and provides an array of activities to meet their request. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18 Residents are protected by effective procedures relating to adult and complaints. protection EVIDENCE: Seven complaints have been recorded within the home’s complaints record since the last inspection. Records demonstrated that residents and relatives knew how to raise dissatisfactions, that they were taken seriously, the action taken to resolve issues and the outcomes after investigation. Adult protection training is currently being undertaken by all levels of staff with the registered manager and senior team having completed their training. Residents stated they felt safe and able to report any issues of concern to either care staff or the registered manager. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Appleton Lodge is able to meet residents’ individual and assessed needs. The maintenance of the environment was not wholly satisfactory. EVIDENCE: Appleton Lodge is spacious and able to support those who are less mobile and require wheelchairs. Aids and adaptations are available throughout the building, including handrails, hoists, lift and easy access to garden areas. Individual equipment is supplied as required, with professional support in place to ensure it meets the specific need of the resident and is maintained in a good safe condition. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 15 Decoration and carpeting are showing signs of wear and tear, culminating in the environment looking less cared for than previously. A number of lounge chairs require replacement, particularly those whose seat cushions require regular washing. One bathroom was identified as not being fit for use. The bath hoist was damaged and awaiting repair. Whilst the home does have a number of showering facilities, two bathrooms must be fit for use at all times. All bedrooms are en-suite. Residents stated they were able to bring small items from home and personalise their rooms as they wished. Two residents stated how nice their rooms were and that they enjoyed spending time alone in their rooms during the day. Records of personal possessions were on file which included fixtures and fittings brought in from the residents’ homes or given as gifts. The home maintains a good standard of cleanliness and was free from odours at the time of the inspection. It was clearly evident that domestic routine were adapted each day around the routines of residents and that there was minimal disruption to their lives whilst cleaning was undertaken. At the time of the inspection the handyperson was sick and it was anticipated that this would continue for some considerable time. There were no apparent arrangements in place to provide maintenance support, culminating in small repairs being outstanding and a number of light bulbs in need of replacement. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 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 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 & 30 Staff were in appropriate numbers to meet the needs of residents and are appropriately trained and competent to undertake the tasks required. EVIDENCE: Staff were observed commencing duty and receiving a formal handing over of information. When asked, staff were knowledgeable regarding residents’ welfare and individual preferences for support. Evaluation of two staff files identified that whilst recruitment procedures are followed, proof of identity was not retained nor was there a current photograph evident on file as required. Probationary periods were in place for new staff and induction programmes and essential training was being undertaken as required. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 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 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, 32, 33, 34, 35 & 38 Appleton Lodge is a well run and managed home which ensures, as far as possible, the health, safety and welfare of residents. EVIDENCE: The registered manager has the qualifications and experience to manage a care home and provide a good standard of support to all residents. Her leadership style enables staff to contribute their opinions on the service and develop best practice. The CSCI failed to receive the registered manager’s training audit, as required at the last inspection, therefore the requirement is repeated. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 18 Routines are developed and based around the needs and preferences of residents, who commented positively throughout the inspection about the care and support they received. The inspector noted that residents and relatives meetings had not been held for some time. Advocacy services are in place and residents receive support from family or legal representatives to manage their finances. Certificates of service were in place and records demonstrated the action taken to maintain fire safety and health and safety. The inspector observed one washing machine’s sluicing facility was not working and that staff within the laundry required some equipment to support them when moving, transferring and folding clothes, and for the safe storage of soiled cushions. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 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 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 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 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 X X 1 Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 20 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 OP15 Regulation 16(2)(1) Requirement The registered person must ensure that fluid and nutritional intake charts detail the required information to enable accurate evaluation of the information. The registered person must complete a full audit of the building and submit an action plan to the CSCI regarding the action to be taken to redecorate and upgrade where required. The registered person must ensure two bathrooms are available and fit for use at all times. The registered person must ensure that systems are in place to complete small repairs and undertake day to day maintenance tasks within the home. The registered person must ensure routines are in place within the laundry to reduce the risk of cross infection. (Previous timescale of 31/5/05 not met). Timescale for action 01/12/05 2 OP19 23(2)(b) (d) 01/12/05 3 OP21 23(2)(j) 10/11/05 4 OP24 23(2)(b) 01/12/05 5 OP26 13(2)(j) 01/12/05 Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 21 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. 6 Standard OP29 Regulation Schedule 2.1 Requirement The registered person must ensure that proof of identities are evident as being confirmed on staff files and current photographs retained. The registered person must provide an up to date training analysis and programme that ensure she continues with her learning and is qualified to undertake her roles and responsibilities. A copy of the registered manager’s training programme must be submitted to the CSCI for monitoring purposes. (Previous timescale of 15/07/05 not met). The registered person must ensure that equipment is maintained correctly within the laundry and that sufficient equipment is in place to support worker health and safety and decrease the risk of infection control. Timescale for action 01/12/05 7 OP31 10(3) 01/12/05 8 OP38 13(3) 01/01/06 Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 22 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 OP33 Good Practice Recommendations The registered person should ensure that residents and relatives are consulted about the service offered at the home. Appleton Lodge DS0000008536.V261702.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Appleton Lodge DS0000008536.V261702.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. 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