Inspection on 10/05/07 for Aspen Lodge Care Home

This inspection was carried out on 10th May 2007.

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

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Byars Care Home

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

CARE HOMES FOR OLDER PEOPLE Aspen Lodge Care Home Aspen Lodge Care Home Yarborough Road Skegness Lincolnshire PE25 2NX Lead Inspector Toby Payne Key Unannounced Inspection 10th May 2007 08:25 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 Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aspen Lodge Care Home Address Aspen Lodge Care Home Yarborough Road Skegness Lincolnshire PE25 2NX 01754 610320 01754 769606 Aspen.Lodge@fshc.co.uk 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) Doulton Court Limited Mrs Katrina Morris Care Home 52 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (45), Physical disability (2) Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Aspen Lodge Care Home is registered to provide personal care and accommodation for service users of both sexes in the following categories: Dementia over 65 years of age DE(E) (4) Mental disorder excluding Learning Disability or Dementia (1) Old age not falling into any other category OP (45) Physical disability PD (1) The maximum number of service users that may be accommodated at Aspen Lodge Care Home is 52 New service 2. Date of last inspection Brief Description of the Service: Aspen Lodge Care Home is purpose built and provides personal and nursing care for up to 52 people. The home is situated in a residential area one and half miles from the town of Skegness. The home is a two-storey building providing 26 single bedrooms and 13 twin bedrooms, of which 6 twin bedrooms are en-suite. Rooms on the first floor are served by a shaft lift and stair lift. There are 4 self-contained bungalows within the grounds, each with bedroom, bathroom, lounge and small kitchen. The accommodates service users from 40 years of age upwards with various health care needs such as physical disability, dementia and old age. There are car parking spaces to the front of the home and the home has garden and patio areas. Most referrals come from Social Services or by personal recommendation. Current fees on the 10/5/2007 ranged from £348 to £505 each week. Extras were, hairdressing £2.50 to £14, chiropody £10 and newspapers, magazines, some activities (trips to shows) and transport by taxi to GP surgeries. This information was also available at the front entrance to the home, where there were also leaflets displayed about physical conditions, adult protection and the company Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and started at 8.25 am. It was undertaken using a review of all the information available to the inspector about Aspen Lodge Care Home. We spoke with 6 residents, 3 visitors, 5 staff and manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. The inspector also examined a pre-inspection questionnaire, which had been completed by the manager. A comment card was received from one resident. 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. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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 Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. EVIDENCE: Since the last key inspection the commission had reregistered the home. The service therefore was a new one despite no changes to the manager. The statement of purpose and service user’s guide had been reviewed to include this information. A copy of the service user’s guide was given to each new resident. . The reception area was welcoming with comfortable seating areas. The manager carried out a comprehensive dependency assessment on each person coming into the home, which was the base of the care plan. The manager was aware and was conscious that the home was able to meet all the assessed needs of people coming into the home. All people would then receive written confirmation that based on the assessment the home could meet their needs. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 9 The home did not provide intermediate care. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and detailed care planning system in this home. The health and welfare needs of people living in the home were fully met. Medication is safely and correctly administered. EVIDENCE: All residents had care plans, which described their health and welfare needs. Care records included admission details including a photograph for identification purposes, admission details, assessment of daily living activities, personal history, moving handling assessment, risk assessment, care plan and daily report. There were clear records outlining the resident’s care and welfare needs. Efforts have been made to include residents wherever possible in identifying their care needs and being involved in reviews of their care. There was evidence to show that care plans were up to date and reviewed. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 11 Care records were well maintained and the manager had audited each care plan monthly since January 2007. From this an action plan had been developed to identify improvements. The records also showed that wherever possible residents/family had been involved in identifying care issues. There was written consent to the use of bed protective rails. There were clear records of medication being received into the home and the monitored dosage system was being used. Staff had been trained about the system and the manager and a senior care assistant had received training on safe handling of medication. Further training on this subject was to be provided in June 2007. Medication was administered by nurses and senior care assistants who had been assessed as competent to administer medication by the manager. The manager also undertook monthly audits of the medication. We observed a medication round. Medication was correctly administered. On some records there were very specific instructions about medication issues and what the best method was to administer medication. Throughout the inspection, staff worked in a professional and calm manner showing respect to each person. Every resident who spoke to us had praise for the staff and their approach. Comments were, “I can’t fault anything”, “the staff are brilliant” and “If I need anything the staff will be there”. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities were varied and provide daily stimulation and interest for people living in the home. Visitors were made to feel welcome. Meals provided were nutritious and varied. EVIDENCE: There was an activities programme displayed on the resident’s notice board outside the 2 lounges on the ground and first floors. The programme for May 2007 outlined a varied programme of activities. On the day of the inspection there was a planned social outing to a bird sanctuary. Separate staff were employed for activities. There were minutes of the last resident’s meeting on the notice board. This took place on the 22/4/2007. The minutes showed praise for the food, housekeeping (cleanliness of the rooms) and activities. There was information that light refreshments were available between meals and forthcoming events. The information was clear, well presented and up to date. A resident spoke of how staff helped and supported her doing things which she wished to do. Staff respected resident’s rights and choices. All the residents expressed satisfaction with the food. We saw meals being served in both dining rooms. Catering staff who were wearing clean catering uniforms served food from hot trolleys. Tables were laid with clean tablecloths Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 13 and tablemats. Staff took the plates to the residents and assisted in a discreet manner. There was a relaxing atmosphere with staff encouraging residents and talking and laughing with them. In one dining room music was playing. Food was well served with a choice. Residents commented, “The food is just the way I like it” and the food is excellent”. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. Staff were recruited correctly to ensure that residents were protected from abuse. EVIDENCE: Since the last key inspection 6 complaints had been received by the home. The complaints register showed a clear audit trail. Each complaint was acknowledged, investigated and responded to the complainant by the regional manager. The complaints procedure was available in the service user’s guide and displayed on notice boards throughout the home. None of the residents, staff or visitors had any complaints. All were complimentary about the staff and manager. The commission had received no complaints and there were no adult protection issues. Complaints were also monitored every 3 months. Staff were aware of their role in adult protection and what constituted abuse. Staff had received training on adult protection and further training was to be provided in August 2007. This is also was covered for all new staff in the new comprehensive induction We observed during the inspection that staff were polite and respectful when talking to or undertaking care duties with residents. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents lived in clean, well decorated, homely and safe accommodation. Any maintenance was promptly addressed. The lift provided for residents is no longer suitable for the people living in the home. EVIDENCE: All areas of the home were clean and well decorated. Every resident was complimentary about the home. They had positive remarks about the laundry “returned the same day” and cleanliness of their rooms “cleaned every day”. There was an identified decoration programme. New carpets had been laid, rooms redecorated and new bedroom furniture provided. There was a new mobile hoist, sit on weighing scales and ironing press. There was however still concern about the state of the lift. The lift was serviced, new parts installed and a weight test carried in December 2006 and a further service was due in June 2007. However, the timetable to install a Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 16 new lift had not taken place. We received a detailed letter in November 2006 from the company, which gave a timetable for full installation in April 2007. At the inspection, we were unable to find out when the lift would be installed. Although the lift was safe, it was no longer fit for purpose as it was not large enough. Residents commented about the lift and there was a notice advising that no one should use the lift without the assistance of staff. The manager felt a new lift was still required. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was adequately staffed with employees who were experienced and competent to care for older people. A wide range of in-house training and training in care was provided. Residents are protected by robust recruitment practices. EVIDENCE: Residents did not express any worries about the level or availability of staff. Staff were seen to promptly attend to residents needs. Residents commented, “staff know my needs, are respectful towards me and listen to me”. The manager monitored the dependency of people living in the home and was able to employ more staff where required. Staff and residents were satisfied about the levels of staff in the home. There was also a deputy manager who worked closely with the manager. Training since October 2006 had included, fire training, moving and handling, first aid, safe guarding adults, infection control and health and safety. Further training was to be provided in June 2007 covering safe handling of medicines, wound care and customer care. New comprehensive induction standards for all new care workers had been introduced. The workbook/induction was to cover a period of 12 weeks and staff would work with a mentor. Recruitment ecords for two staff were examined. We saw clear and detailed records for each person. Each person had a 3 day induction programme. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 18 There were 20 of care staff who had obtained a qualification in care (National Vocational Qualification). There were 2 staff who were waiting to start NVQ level 2. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well lead by a competent, well trained and committed manager. This in turn had given rise to a confident, supported and trained staff team. Records show that residents’ health and general welfare and safety are promoted. The home ensures that that the residents have the opportunity to voice their views and opinions. EVIDENCE: The manager had wide experience as a nurse and manager and had a management qualification. She led a very committed team of staff. All staff and residents commented about her presence in the home and how approachable and supportive she was. Residents commented “Katrina is a lovely person” and “I have confidence in the staff”. Staff also confirmed this view and spoke as “working as a team” which was evident. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 20 There were no negative comments about anything in the home apart from the lift. There were leaflets in the reception area of the home inviting any comments. The manager worked alongside staff. There were staff and residents meetings. Since the last inspection the company had introduced Total Quality Audit Process in March 2007. This was a very comprehensive auditing system. Internal audits carried out by the manager included medication, kitchen, health and safety and care plans. The home received monthly monitoring visits by the regional manager. Most staff were receiving regular formal supervision and felt supported. There was an equality and diversity policy. There were no issues of concern and the manager showed awareness of equality and diversity and knew how to seek advice if it was required. Accurate records were kept of resident’s monies, which were computer records with receipts and tallies. The records were well maintained and managed by the receptionist. . There were very comprehensive maintenance records, which were well maintained. There were a variety of pressure relieving mattresses. Staff had gloves, aprons and alcohol hand washes. There were also detailed health and safety policies Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 21 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 x 3 x x 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 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 4 X 3 X 3 X X 3 Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 22 YES 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 OP22 Regulation 23(2)(n) Requirement There must be a suitable lift for all people in the home. This will ensure that all their mobility needs are safely met in a dignified and respectful manner. Timescale for action 10/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2 Refer to Standard OP30 Good Practice Recommendations The training provided in the home should include awareness of disability. Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Aspen Lodge Care Home DS0000068507.V336637.R01.S.doc Version 5.2 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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