Inspection on 12/11/07 for Astral Lodge Residential Home

This inspection was carried out on 12th November 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

Astral Lodge Residential Home 28/11/06

Astral Lodge Residential Home 21/09/05

Astral Lodge Residential Home 09/05/05

Astral Lodge Residential Home 10/01/05

Astral Lodge Residential Home 06/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Astral Lodge Residential Home 35 Ailsa Road Westcliff On Sea Essex SS0 8BJ Lead Inspector Vicky Dutton Unannounced Inspection 12th November 2007 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 Astral Lodge Residential Home DS0000057745.V354701.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. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Astral Lodge Residential Home Address 35 Ailsa Road Westcliff On Sea Essex SS0 8BJ 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) 01702 345409 01702 340262 Mr Navneet Singh Johar Mrs Aunjali Johar Manager post vacant Care Home 14 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (14) of places Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Number of service users to whom personal care is to be provided shall not exceed 14 (fourteen). Accommodation and personal care may be provided to no more than 14 older people over the age of 65 years (OP). Accommodation and personal care may be provided to no more than 4 service users over 65 with Dementia (DE(E)). Total number of persons over 65 years to be accommodated must not exceed 14. To provide suitable changing and storage facilities for staff within 12 months of registration. 28th November 2006 Date of last inspection Brief Description of the Service: Astral Lodge is registered to provide care and accommodation for up to fourteen people. Within this number the home is registered to provide care for up to four people with dementia. The home is conveniently located in a pleasant residential area of Westcliff on Sea. The home is within easy access to shops, bus routes, main line stations, the seafront and Southend and Leigh town centres. Accommodation is provided on two floors in fourteen single bedrooms. Residents can access the first floor via a passenger lift. A copy of the Statement of Purpose, Service Users Guide and the last Inspection Report are available in the entrance hall of the home. A copy of the Service User Guide is also available in each bedroom. Fees, as confirmed at the site visit, range between £421.75 to £500.60 per week. Extras charged are for chiropody, hairdresser, toiletries and newspapers/magazines. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over a five and a half hour period. At this inspection all the key standards were considered. The home’s compliance with requirements made at the previous inspection was assessed. At the site visit a tour of the premises took place, care records, staff records, medication records and other documentation were selected and various elements of these assessed. Time was spent talking to, observing and interacting with residents at the home, and talking to staff and a visiting professional. Prior to the site visit the home had completed and sent in to CSCI their Annual Quality Assurance Assessment (AQAA). This outlined how the home feel they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives involved professionals and staff. At the site visit a notice was displayed advising people that an inspection was taking place, and with an open invitation to speak with the inspector at any time. The views expressed at the site visit and in survey responses have been incorporated into this report. The inspector was assisted at the site visit by the area manager, acting home manager, and other members of the staff team. Feedback on findings was provided throughout the inspection. The opportunity for discussion or clarification was given. The inspector would like to thank the management, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: Astral Lodge provides a small and homely environment for residents, and many people said what a warm and friendly feel the home had. They made comments such as, ‘the home appears to be very friendly,’ and ‘the atmosphere in the home is friendly and pleasant.’ A resident said ‘I am more than happy with everything.’ Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 6 Visitors are always made welcome at the home. One relative said ‘they encourage activities and the involvement of relatives.’ Another said that the home ‘always makes you welcome.’ The home generally has a stable group of care staff who know the residents well, and provide consistent care. People found the staff at the home good and made comments such as ‘the staff are approachable and helpful.’ Residents have the opportunity for exercise and activity every day. What has improved since the last inspection? What they could do better: Staff at the home do undertake training in core areas such as moving and handling, safeguarding adults and health and safety. Some staff have also completed National Vocational Qualifications. However residents’ care may be enhanced if staff training was more comprehensive. The home is registered to provide dementia care, therefore staff must be trained in this area so that they provide appropriate and consistent care based on current best practice. The home must be able to show that residents are protected by staff being recruited safely. Records must be maintained in the home to show that before staff start work, all appropriate checks have been undertaken. So that residents live in a safe and well maintained environment, the home need to develop ways to regularly monitor the premises and identify any potential hazards to residents or staff. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 8 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 Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 9 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): 1, 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People will receive a good level of information about the home to help them to make an informed choice about moving in. People can expect that their needs will be assessed before they move into the home. EVIDENCE: The home has a Statement of Purpose and Service Users Guide in place. The home’s service users guide viewed requires some updating to include details of fees payable, and to reflect the new premises layout and current management arrangements. People spoken with and survey responses showed that people who had moved into the home felt that they had received a good level of information, that had helped them to make an informed decision about moving in. The home uses a set format for pre-admission assessments, which provides a comprehensive picture of peoples needs. The most recent person to move into Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 10 the home had a well completed assessment on file that identified and assessed their care and social needs. Intermediate care is not provided at Astral Lodge Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to receive good personal and healthcare support that is generally well planned and meets their needs. They can be sure that their medication will be managed safely, and that staff will treat them respectfully. EVIDENCE: The home has a small and stable staff team who know residents well, and are aware of their needs. On surveys residents mostly felt that their needs are ‘usually’ met. A visiting professional felt that ‘the staff respond to the different needs of residents.’ One resident was impressed as they said ‘I don’t like tea, and they always remember that I only like coffee. I never have to tell them.’ The home’s care planning system provides a good basis for care to be delivered to residents. Care plans are kept under regular review. Risks associated with residents’ individual care needs were clearly assessed. Some improvements to the care planning system were discussed with the manager. These included ensuring that all residents’ needs including spiritual and behavioural needs are clearly identified in care planning. The current practice at the home is for daily records and activity records to be kept communally in Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 12 separate files from the individual care files. This practice may not encourage care staff to make full use of residents care plans, and keep updated in residents’ changing needs. Residents said that they always received the health care that they needed. Documentation and discussion showed that residents access services such as doctors, district nurses, chiropody and optical services to met their needs. Dental care is arranged as and when necessary. A visiting professional spoken with felt that the home communicated well and that the care in the home was good. Another felt that ‘there has been a recent improvement, and health care needs are now always met.’ Since the previous inspection the monitoring of residents health and wellbeing has been improved by the introduction of good nutrition records. Medication at the home is managed safely through a monitored dosage system. (blister packs.) The system was well maintained and no anomalies were noted. For residents who use medication that is prescribed for use on an ‘as required’ basis it was advised that protocols are put in place so that they are used consistently. Since the previous inspection the area manager has reviewed and updated policies and procedures relating to medication. They were aware of the new guidance recently published by the Royal Pharmaceutical Society in relation to managing medicines in care homes. This shows that the home keeps up to date and seeks to comply with current guidance. Staff receive training through the supplying pharmacist, and practice is monitored by management at the home. During the day staff were noted to treat residents respectfully, and ensure that their privacy was maintained. A visiting professional said ‘On visiting Astral Lodge, I have always felt that residents’ privacy and dignity is respected.’ Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to have opportunities for activity and occupation. They will always be able to enjoy having visitors, and have good food provided by the home. EVIDENCE: Residents spoken with, survey responses and the minutes of a recent residents’ meeting suggest that residents are happy with their life at the home, and the level of activity available to them. Care plan files include a sheet that identifies residents’ preferences at different times throughout the day, and showed that residents are encouraged to make choices in their daily lives. A daily programme of activities is in place and these are undertaken by staff at the home. In the mornings an exercise session is undertaken, with a different activity in the afternoon. On the day of the site visit this was a quiz, which was enjoyed by residents. As well as daily activities a schedule of monthly events was also on display for residents. Visiting at the home is open and residents confirmed that are able to enjoy having visitors at any time. A colourful ‘service users visiting policy’ notice was on display that advised residents that they could receive visitors at any Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 14 time, and where people could be entertained to give privacy. All relatives felt that the home was very warm and welcoming and made comments such as, ‘the atmosphere in the home is friendly, pleasant and welcoming.’ Information on advocacy was available in the home. Residents’ bedrooms showed that they are able to bring in personal possessions and items of furniture. Residents spoken with and responses on surveys showed that the food provided by the home is enjoyed by residents. They made positive comments such as ‘the food is very good’ and ‘I always enjoy the food.’ Lunch on the day of the site visit looked appetising and was plentiful. The home uses a four weekly rotating menu that provides a choice at each meal. Minutes of residents’ meetings showed that menus are discussed with residents, and changes made according to their wishes. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 15 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): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be sure that any concerns they raise will be listened to. Residents can also be confident that they will be cared for in a way that protects them from abuse, as staff have been trained and understand this aspect of care. EVIDENCE: The home has a clear complaints process in place that was available for residents and visitors. The manager was advised that this should be updated to include the contact details of the Local Authority. Survey responses showed that people were aware of the homes complaints process and would feel happy to raise any concerns. People who responded felt that the home ‘usually’ responded appropriately when they raised concerns. A suggestions box inviting comments is sited in the homes hallway. No concerns have been raised about the home with CSCI. The home has recorded three complaints since the previous inspection. Two of these related to care issues. These were managed appropriately. No safeguarding adults issues have been raised relating to Astral Lodge. Training records showed that staff have received training in this area. Staff spoken with were aware of safeguarding issues and of appropriate actions to take. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19, 25, 26. Residents live in a homely and comfortable home, that is kept clean and is generally suitable to meet their needs. EVIDENCE: Astral Lodge provides a comfortable and homely environment for residents. Residents spoken with said that they liked their rooms and were happy with the accommodation provided. The home has a garden area so that residents can enjoy an outside space. There are plans in hand to improve the garden for the benefit of residents by making it more accessible and ‘user friendly.’ Since the previous inspection new carpets have been fitted in corridor areas. Although not yet fully completed, a new bathroom suite has been fitted in the upstairs bathroom to improve the environment for residents. Some areas of the home would benefit from redecoration. Two commodes being used by residents were in a poor condition and needed to be replaced, and one Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 17 bedroom door was only a push door and was not fitted with door furnishings or lock. The area manager undertook to address these issues. The home has a handy person available to undertake minor repairs and decorating tasks. Since the previous inspection the home’s two shared rooms have been converted into single rooms, making all the home’s bedrooms into singles. Some building/decorating tasks from this work need to be completed. During the day of the site visit the temperature in the home was not constant throughout the day. During the afternoon some rooms/areas felt quite cold. A resident returned to the lounge area saying that their room was too cold. A resident’s room and the home being cold had been the subject of a recent complaint. It was confirmed that the heating in the home is not on a timer but on ‘constant.’ Following the inspection the heating was checked, turned off radiators turned on, and the thermostat turned up. Due to the nature of the heating system in the home residents cannot control the heating in their own rooms to their own taste. On the day of the site visit the home appeared clean, and there were no unpleasant odours. A relative said that the home ‘was kept beautifully clean,’ another felt that routines for deep cleaning were not always good enough. The area manager said this was being addressed and better cleaning routines being introduced. Residents on surveys felt that the home was ‘always’ fresh and clean. The home’s laundry area is adequate, but the floor needs attention so that it can be kept properly clean and hygienic. Records showed that staff have completed training in infection control. This will help to ensure that staff work appropriately and residents are protected. Appropriate protective clothing was available in the home. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents cannot be sure that sufficient staff will always be available to meet their needs. The staff that care for them will be caring and have a good level of basic training, but may not have undertaken training or developed skills to help them with any specific care needs such as dementia. EVIDENCE: At the site visit staffing levels at Astral Lodge were stated to vary throughout the day in the following way: During the morning until 14.00 three staff, (one of who is in charge.) From 14.00 to 18.00 three staff, from 18.00 to 20.00 two staff. At night there is one member of staff awake and one member of staff designated as a sleeping in person, (although others live on the premises.) The acting manager mostly works as part of the shift, but sometimes their hours are supernumerary. From viewing two weeks rotas, staffing levels do vary. On most days afternoon levels of staff drop to two from 14.00 or 17.00. Care staff at the home also undertake cooking, cleaning and laundry tasks, so may not always readily available to residents, particularly during the morning period. As at the previous inspection a number of staff felt that a cleaner should be employed, so that they could concentrate on caring for residents. The last inspection report said that this was being looked into, but this is not currently the case. A relative said of staff, ‘they are very kind and caring, but they seem to be permanently understaffed.’ Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 19 Residents felt that staff were ‘usually’ available when they needed them. The home has a stable group of core staff who have worked at the home for some time. This provides consistency and stability for residents. At the site visit and on surveys staff were positive about their role and felt that they were offered good training and were well supported. During the site visit residents were generally well supervised and supported. Management felt that staffing levels were sufficient to meet residents’ current needs, as dependency levels were quite low. The area manager said that staffing would be flexible, and gave a recent example of where staffing had been increased to support the needs of a resident. The home has nine staff employed in care positions. Of these four have a National Vocational Qualification (NVQ) in care level 2 or above. A further three staff are working towards NVQ’s This will provide a good knowledge base for staff and assist them in meeting residents’ needs. There have been no previous issues with recruitment at the home. Good procedures that protect residents have been in place. Staff on surveys confirmed that the home had carried out checks such as Criminal Records Bureau (CRB) checks and references before they started work at the home. However on this occasion at the site visit it was not possible to confirm that good practices have been maintained. It was reported that only one member of staff was new to the home since the previous inspection. They had previously worked in another home, owned by the registered providers, for about a year. A file was available for this member of staff but it did not hold all the required documentation. There was no application form and only one reference. The POVA first check and CRB Check dated from after the member of staffs recorded start date at Astral Loge, but ones from the previous home were not in place. The area manager thought that it might be that case that all records had not been transferred. This could not be verified during the site visit, but the area manager undertook to confirm this following the inspection. On the homes completed AQAA it was confirmed that the home carries out induction training with staff to Skills for Care standards. On surveys staff felt that their induction covered ‘most’ or ‘all’ the things that they had needed to know. The staff file viewed showed no evidence that an induction had taken place. Again the area manager thought that this was due to records from the previous home not having been transferred. Although staff felt that the training opportunities offered by the home were good, and a number of staff have completed NVQ training there are shortfalls. Training records showed that training is based around basic core knowledge such as fire, food hygiene and moving and handling. The home is currently registered to provide care for up to four residents who have care needs associated with dementia, only one member of staff is trained in this area and undertook a one day course in dementia and activities. One resident at the home uses two hearing aids, but no staff at the home have received training in sensory loss or other conditions of old age. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a generally well managed home where they can be sure that their views will be listened to. EVIDENCE: The provider is still trying to recruit a suitable manager for the home. In the meantime they have put strategies in place to ensure that the home continues to run smoothly. The deputy manager, who is working towards NVQ at level four, is acting up into the role of manager with support from the area manager. Other staff in the home have been given different areas of responsibility to support the acting manager. The home has strategies in place to monitor the quality of the service, and seek residents’ views on the service. Residents’ meetings are held on a regular Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 21 basis and minutes of these were seen. Residents spoken with and responses on surveys said that staff always listened to them and acted on what they said. The provider completes monthly visits to the home, as required by regulation, to monitor the service and seek residents’ views. The home conducts an annual quality survey. It was reported that these are usually done in January each year. Those on file were not dated. Residents’ money is held securely. Clear records are maintained and receipts retained for each transaction. Two residents monies were sampled and everything was satisfactory. The AQAA completed by the home shows that systems and services within the home are checked and maintained. A fire risk assessment was in place. In response to a recent fire service visit the home has fitted a new door entry system to the front door that will now automatically open should the alarms sound. Weekly tests take place of the fire system and emergency lighting. All staff have received recent fire training, but the last recorded drill in the home was in September 2006. Some potential health and safety issues were noted during this inspection. One radiator is not yet fitted with a suitable cover to reduce any risk to residents. Where covers are fitted these were not always secured to the wall properly. Safety cones were not used to ensure that residents did not walk into toilets/bathrooms where the floor was wet. Some electrical works needed completion, and the lack of window restrictors needed to be reviewed in a particular area of the home. The area manager undertook to address these issues urgently, and an electrician visited the home to complete tasks during the site visit. Staff records, staff surveys and the home’s training records showed that staff are kept up to date in core training areas such as moving and handling. Accident records were maintained. Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 22 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 19 Schedule 2 Requirement The home must be able to show that staff are recruited safely and that residents are fully protected. Full records in relation to staffs’ recruitment and employment as required by regulation must be maintained in the home. So that residents are cared for by well trained and competent staff they must receive training appropriate to their role. This refers to the need for staff to be trained in dementia care and other areas relevant to the needs of residents. This is a repeat requirement with the previous compliance date of 31/03/07 not met. 3. OP38 13(4)(a) So that residents live in a safe environment, health and safety at the home must be better monitored. There must be strategies in place so that issues such as those identified in the report are identified and dealt with in a timely manner. DS0000057745.V354701.R01.S.doc Timescale for action 01/01/08 2. OP30 18(1) (c)(i) 01/02/08 01/01/08 Astral Lodge Residential Home Version 5.2 Page 24 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 OP7 Good Practice Recommendations The practice of keeping daily records separate from residents’ care files should be reviewed to encourage staff to access all relevant information about residents, and promote a holistic approach to their care. Protocols for the use of medicines prescribed to be used ‘as and when required’ should be developed to provide a consistent approach to their use by staff. The home should be maintained at a comfortable temperature for residents. They should be able to control the heating in their own rooms. The floor in the laundry should be re-sealed so that it provides an impervious and readily cleanable surface to promote good infection control. Staffing levels at the home should be kept under review, and at all times be sufficient to meet the holistic needs of residents. Consideration should be given to the employment of cleaning staff. So that residents can be assured that staff will react appropriately in the event of an emergency all staff should attend regular fire drills. 2. OP9 3. OP25 4. OP26 5. OP27 6. OP38 Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Astral Lodge Residential Home DS0000057745.V354701.R01.S.doc Version 5.2 Page 26 - 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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