Inspection on 09/05/05 for Astral Lodge Residential Home

This inspection was carried out on 9th May 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

Astral Lodge Residential Home 12/11/07

Astral Lodge Residential Home 28/11/06

Astral Lodge Residential Home 21/09/05

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 35 Ailsa Road Westcliff-on-Sea Essex SS0 8BJ Lead Inspector Christine Bennett Unannounced 9th May 2005 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 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 I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Astral Lodge Address 35 Ailsa Lodge Westcliff-on-Sea Essex SS0 8BJ 01702 345409 01702 340262 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Navneet Singh Johar Mrs Aunjali Johar CRH Care Home 14 Category(ies) of DE(E) Dementia - over 65 (4) registration, with number OP Old Age (14) of places Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Number of service users to whom personal care is to be provided shall not exceed 14 (fourteen) 2. Accommodation and personal care may be provided to no more than 14 older people over the age of 65 years (OP). 3. Accommodation and personal care may be provided to no more than 4 service users over 65 with Dementia (OP). 4. Total number of persons over 65 years to be accommodated must not exceed 14. 5. To provide suitable changing and storage facilities for staff within 12 months of registration. 6. To provide thermostatic heating controls so that heating on radiators can be individually controlled in service users bedrooms within one month of registration. Date of last inspection 22nd November 2004 Brief Description of the Service: Astral Lodge is a small family run care home and is registered for fourteen elderly male and female people age sixty five years and over. The home also caters for people with dementia and is registered to up to four people with dementia within this number. The home is conveniently located in a pleasant residential area of Westcliff which 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 with ten single bedrooms and two twin bedrooms. Residents can access the first floor via a passenger lift. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 9th May 2005 lasting 7 hours. The inspection process included discussions with the acting manager, three members of staff, four visitors and seven residents. There was also a tour of the premises and a sample of records and policies were examined. Discussion of the inspection findings took place with the acting manager and guidance was given. What the service does well: What has improved since the last inspection? The acting manager has been reviewing the care plans of the residents to include more detail and therefore improve information available for staff giving care, and to better reflect the standard of care being given. A member of staff has recently been put in charge of activities and spoke with enthusiasm about things she has done and hopes to do to keep the residents occupied. They have all recently planted sunflower seeds and are having a competition to see which one grows the fastest. Some of the residents were chatting and laughing about who would win this competition. The acting manager is in the process of organising residents’ meetings in order to involve them more in the day to day running of the home. The acting manager has put in an application to be the registered manager of the home. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 6 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. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 standard(s) 3 The admission procedure ensures that individual needs can be met. EVIDENCE: Residents and relatives confirmed that they were able to visit the home prior to admission. One relative said that she had left her father in the home to have lunch and spend time with the residents before picking him up later that day. Evidence was seen in the care plans of detailed pre admission assessments and the acting manager was visiting a resident in hospital that day to assess if the home could accommodate her needs. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 The home has made improvements in the care planning process. Residents are looked after well in respect of their health and personal care. Some aspects of medication recording need to be addressed to make them clear and comprehensive. EVIDENCE: Care plans are in the process of being developed by the acting manager. They were clear and comprehensive and there was evidence of regular reviews involving residents and relatives. However nutritional charts must be developed to indicate what each resident eats. Two residents appeared to be very thin and frail, and although their weights had been recorded monthly, there was no indication to show how much they ate at each meal. The acting manager confirmed that these two residents had a healthy appetite but it was not evidenced in records. Three residents had recently had falls necessitating hospital treatment. The acting manager must ensure their risk assessments are reviewed prior to discharge. Medication storage and records were checked. The acting manager said the links with their present pharmacist were under review. Recording of medication was not clear and three records were checked but all appeared to be inaccurate. There was no indication that residents’ health was being Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 10 compromised but recording must be more accurate for checking. All residents had a detailed profile with picture identification and care plans included reasons for medication and any side effects. After discussion with the acting manager, it was decided that the storage of controlled medication should be in a metal cupboard, which complies with Misuse of Drugs Regulations 1973. It was suggested that training of medication administration should be updated. Residents and visitors spoke positively about the personal and health care received in the home. They felt that they were treated with respect and observation confirmed that staff were polite and respectful when dealing with people. A visitor commented “they can’t do enough for you”. One resident was admitted to the home with a pressure sore which is being treated by the District Nurse. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 standard(s) 12,13,15 Residents are being supported to pursue interests, with visitors encouraged and quality food provided in adequate quantities. EVIDENCE: A staff member has recently been appointed to be the activities coordinator for the home. She spoke enthusiastically about her role and has numerous ideas for forthcoming events. She confirmed that the acting manager and provider are supportive and money is available to develop her ideas. Residents confirmed that they read, knit, do quizzes, have manicures and the hairdresser visits regularly. Exercises are done every morning and there is an activity during the afternoon. A clothes party was being held the following day and a musician is coming next week. A visitor said his mother sometimes makes cakes and many residents go out with their visitors. The residents had all planted sunflowers and a competition was being held to see which one grew the fastest. This stimulated conversation amongst the residents. One resident has a phone in her bedroom and her son was reassured that he could phone his mother every night. Most residents were complimentary about the food the home offered, although one resident commented it was “samey”. There was no choice on the lunchtime menu although the acting manager said they know the residents likes and dislikes and would offer an alternative. A resident confirmed that if he didn’t like the meal “they would give me something else”. On discussion Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 12 with the acting manager, she confirmed it was something she intends to discuss at a forthcoming residents’ meeting. Lunch was observed and looked appetising and in adequate quantities. The home was given details of the National Association for Providers of Activities for Older People, who might assist them in developing the occupation of the residents. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 standard(s) 16,18 Not all staff were aware of issues relating to the protection of vulnerable adults. The complaints procedure is satisfactory and residents and relatives feel that their views are listened to and acted upon. EVIDENCE: One member of staff did not understand the term “Whistleblowing” and some members of staff have not had prevention abuse training, although the acting manager was able to evidence that there is POVA training available for staff in the near future. This has the potential to put residents at risk if staff do not know the policies on dealing with abuse. The home has a detailed complaints procedure. No complaints have been received by the CSCI. One relative complained to the acting manager about inappropriate behaviour by a resident that was causing distress to another resident. The home was able to rectify this problem and the relative confirmed that the home had dealt with the problem sensitively and appropriately to her satisfaction. Both residents, staff and visitors spoke of the approachability of the acting manager and the registered providers and felt that any problems would be acted upon and sorted out. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 standard(s) 19,20,24,25,26 The home presents as a homely comfortable environment. Hazards seen in the home could leave the residents at risk. EVIDENCE: The home presents as a warm friendly place with a resident commenting “it’s good living here”. In general it is well maintained, comfortable, clean with no unpleasant odours. Upstairs windows have restrictors fitted to provide a safe environment but the door in the upstairs hallway, which leads on to a balcony was unlocked. Equally the bedroom next door had a large window and another door leading onto the same balcony. This door was locked but had the key in it. As the home is registered for four people with dementia this could present as a risk. The laundry area is on the ground level. This is not locked and there are two steps down on opening the door, which in turn leads to two doors enabling access to the outside of the building. One of these doors was found to be unlocked and although the other was locked, the keys were on a shelf next to the door. The laundry also contains the cupboard containing hazardous substances and this has no lock. This area was discussed with the acting manager who confirmed that there were confused people living in the Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 15 home, and this could potentially put them at risk. Although the provider has recently put safety valves on the taps, water in three bedrooms was being delivered at 54 degrees. This was pointed out to the acting manager. A fire door was propped open with a wedge. The registered provider said this is being addressed. Plans are being made for an unused bathroom to be made into a staff room. As this bathroom is at present unused, it is important to run the taps weekly and a leaflet was left with the acting manager regarding the risk of Legionella. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The procedure for the recruitment of staff is robust, but the induction training and on going specialist training was not adequate to protect residents EVIDENCE: The file of a new member of staff was studied and evidenced a satisfactory recruitment process. References obtained should have more detail relating to the position of the person providing the reference. The home is fully staffed and do not use agency staff. The rota was accurate with one member of the night staff working excessive hours. Care staff are responsible for the cooking, cleaning and laundry within the home and on going assessment of residents’ needs must take place to ensure staffing levels continue to be appropriate. Three members of staff have completed NVQ level 2 training and one has completed level 3 training. Whilst the home is committed to training, there were areas that showed shortfalls. A new member of staff had not had manual handling training, and there had been no updating on medication training. The acting manager is keen to address this area of concern and was able to evidence a programme of training for the coming year. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 The acting manager is slowly making improvements and is keen to address any shortfalls in standards to improve the quality of care offered to residents. EVIDENCE: The registered providers have recently applied for a senior care worker to become the registered manager. This person has eight years experience of working in the home and completes her NVQ level 4 in management in June 2005. She has also done additional training in some areas to develop her skills. Staff, residents and visitors spoke positively about her, saying she is approachable and felt confident in her ability to manage the home. She is committed to making improvements to meet regulation standards. Her future plans include residents meetings to ensure they are involved in the day to day running of the home. Staff meetings are held every 3 months, formal supervision for individual staff every two months and a relatives survey is sent out twice a year. She will supply a report to CSCI in respect of any review relating to the above. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 18 This acting manager must ensure the health and safety of residents by addressing areas of concern highlighted in this report. An example of this is the security of the premises and the residents. Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x x 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 2 x x 3 x 2 Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 20 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 9 Regulation 13(2) Timescale for action The registered person shall make 1/7/05 arrangements for recording, safekeeping and safe administration of medication The registered person shall by training of staff prevent service users being placed at risk of harm or abuse The registered person shall ensure that all parts of the home are free from hazards to residents safety. The registered person shall provide facilities for staff and take adequate precautions against the risk of fire. The registered person shall ensure that unnecessary risks to the safety of residents is eliminated. This relates to the temperature of the water being delivered in some bedrooms. The registered person shall ensure that staff receive training appropriate to the work they are to perform. 1/7/05 Requirement 2. 18 13(6) 3. 19 38 13(4)23(3 )(4) 1/9/05 4. 25 13(4) 1/7/05 5. 30 18(1) 1/7/05 Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 21 6. 33 24 The registered person shall establish a system to review and improve the quality of care and supply to the Commission a report. The registered person shall ensure that all parts of the home are free from hazards to the residents safety. Nutritional records must be developed further to include sufficient detail of food eaten to ensure they reflect a nutritious diet and any special dietary needs are being met. 1/9/05 7. 38 13(4)(a) 1/7/05 8. 8 17 Schedule 4 13 1/7/05 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. 2. 3. Refer to Standard 9 Good Practice Recommendations It is recommended that residents wishes in respect of end of life issues be recorded in their care plan Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex, SS2 6BG 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 Astral Lodge I56 S57745 Astral Lodge V226128 090505 Stage 4.doc Version 1.30 Page 23 - 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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