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Inspection on 30/12/05 for Atherton Lodge Nursing Home

Also see our care home review for Atherton Lodge Nursing Home for more information

This inspection was carried out on 30th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a friendly and inclusive atmosphere at Atherton Lodge. Complaints are handled appropriately. The home has a stable, experienced and mature staff group and a high proportion of care staff have an NVQ qualification. The home owner visits regularly and is involved in the day to day running of the home. Residents` personal money is handled appropriately. Health and safety records are well maintained.

What has improved since the last inspection?

Work is progressing to provide an extension to the home and improve some of the existing facilities. Three new bedrooms are now in use and each of these has an en-suite toilet.

What the care home could do better:

Previous inspections have highlighted improvements needed to the environment, including the ground floor sluice which does not meet the required standard. These should be fully addressed when the extension is completed. Residents must always be protected from the danger of entrapment by bedrails, by ensuring that the rails fit properly onto the bed leaving no gaps, and that good quality protective covers are fitted at all times.

CARE HOMES FOR OLDER PEOPLE Atherton Lodge Nursing Home Atherton Lodge 202 Pooltown Road Ellesmere Port South Wirral CH65 7ED Lead Inspector Wendy Smith Unannounced Inspection 11:00 30 December 2005 th 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 Atherton Lodge Nursing Home DS0000018711.V272124.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. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Atherton Lodge Nursing Home Address Atherton Lodge 202 Pooltown Road Ellesmere Port South Wirral CH65 7ED 0151 3554089 0151 3560141 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) Par Nursing Homes Limited Mrs Sue Maudsley Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximm of 40 service users in the category OP (Old age not falling within any other category). The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 5th August 2005 3. Date of last inspection Brief Description of the Service: Atherton Lodge is a two-storey detached property that has been converted and extended into a care home with nursing for 40 older people. It is situated within a mile of Ellesmere Port town centre and close to local shops and amenities. Bedrooms are on both floors and are accessed by stairs, a passenger lift, a wheelchair lift and several ramps. There are both single and double bedrooms. On the ground floor there are three lounges and a dining room. Assisted baths and toilets are provided on both floors. There are attractive gardens with access for residents from the lounge, and ample parking space. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 30th December 2005 as part of the Commission for Social Care Inspection annual inspection programme. Only 35 places were available at the home at this time due to the alterations being carried out to the building. 35 residents were living at the home, of whom 28 were receiving nursing care and seven receiving personal care. Most of the key National Minimum Standards were inspected at the announced inspection on 5th August 2005 and were found to be met in full. A tour of the building was conducted, including all communal areas and some bedrooms. Time was spent in conversation with the manager and a sample of records was inspected. Some of the staff on duty, a number of residents and a visitor were also spoken with. A two storey extension is being added at the rear of the property, and part of this is planned to be a dementia care unit. What the service does well: What has improved since the last inspection? Work is progressing to provide an extension to the home and improve some of the existing facilities. Three new bedrooms are now in use and each of these has an en-suite toilet. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 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. Atherton Lodge Nursing Home DS0000018711.V272124.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 Atherton Lodge Nursing Home DS0000018711.V272124.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): Not inspected on this occasion. EVIDENCE: Atherton Lodge Nursing Home DS0000018711.V272124.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): 8 The health needs of residents are met in full, however residents were not always adequately protected from being injured by bedrails. EVIDENCE: At the time of the inspection 35 residents were living at the home. 28 of these people were receiving nursing care and seven receiving personal care. The manager said that no residents were very poorly at this time, however three frail residents were being cared for in bed for their own comfort. The manager said that no residents had a pressure sore. Two frail residents were spoken with in their bedrooms, they were comfortable, clean and appropriately dressed, and their rooms were warm. One of these residents had a fluid and position chart that demonstrated the care she had been given that morning. Both had bedrails in place and the metal rails were poorly covered with thinly padded covers that had not been fastened in place. There was also a wide gap between the bedrail and the top of the bed. A number of spaces were identified where a limb or neck could become trapped. See requirement Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 10 The home has a weekly visit by the nursing homes doctor and community nurses provide advice as needed regarding tissue viability, and prescribe dressings. Residents are assessed by the continence adviser and have access to the full range of community medical services. Atherton Lodge Nursing Home DS0000018711.V272124.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): 13 and 14. Visitors are made welcome at the home. Residents are able to exercise choices in daily living. EVIDENCE: There is usually a choice of three lounges for residents to sit in, however at this time one of the lounges was being used as a temporary bedroom. The new extension will also provide a conservatory. Staff and residents confirmed that residents can get up and go to bed at a time of their choosing. Only those residents who specifically chose to get up early are assisted to do so by night staff. Mealtimes can also be made flexible to suit the needs of residents. Residents and a visitor were spoken with in one of the lounges. The visitor was assisting his wife with her meal, and he had also been provided with lunch. He told the inspector that he visited every day and had no complaints. One of the residents said that she had enjoyed Christmas very much. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 12 Three residents were spoken with in their bedrooms. One of these residents told the inspector that she prefers to stay in her own room. She enjoys playing the keyboard that she has in her room and watching the television. She goes out to a church fellowship. She said that she had been amazed how good the staff were at Christmas, doing all their usual work and all the extras too, she said they were like a ‘well trained army’. Atherton Lodge Nursing Home DS0000018711.V272124.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 and 18. Complaints are handled appropriately. Residents are protected from abuse. EVIDENCE: The home has a complaints procedure that meets the required standard. One complaint was received earlier in the year, and this was dealt with appropriately. There have been no other complaints. A visitor spoken with said that he knows both of the senior members of staff and would address any complaints/concerns to them. The home has policies and procedures regarding the protection of vulnerable adults and senior staff have demonstrated their awareness of when the ‘No Secrets’ procedures should be implemented. The manager said that staff receive training regarding abuse as part of their induction programme and are to be provided with further training prior to the opening of the dementia care unit. Atherton Lodge Nursing Home DS0000018711.V272124.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 and 26. The environment is being improved. The home is clean EVIDENCE: An extension is being built at the rear of the property and should be completed in March or April. At the time of this inspection the roof was almost completed. The refurbishment programme has already provided a new laundry and three new bedrooms with en-suite toilet. Following completion of the extension there are plans to refurbish the existing building. All areas of the home were found to be clean and tidy. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 15 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 and 30 Staff are provided in appropriate numbers to meet the needs of residents. More than 50 of care staff have an NVQ qualification. Good recruitment procedures are in place. Training is provided to enable staff to work to a good standard. EVIDENCE: The home has a full team of staff and staff rotas showed that staffing levels are maintained to meet the needs of the residents. More than 50 of care staff have achieved an NVQ qualification and at the time of the inspection five care staff had almost completed NVQ level 3. No new staff have been employed since the last inspection. Criminal Records Bureau disclosures have been received for all staff. Satisfactory recruitment procedures are in place and the home manager is aware of the records required to be kept by the Care Homes Regulations. Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 16 An induction programme is followed for new staff. All staff were undertaking a 13 week infection control training course. One of the nurses was doing a tissue viability training course and another had already completed it. Further staff training is planned for the New Year including moving and handling updates, dementia care training and abuse training. Staff are paid for training time. Atherton Lodge Nursing Home DS0000018711.V272124.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): 33, 35 and 38. Internal quality assurance processes ensure that the home is run in the best interests of residents. Residents’ personal money is handled appropriately. Health and safety safeguards are in place. EVIDENCE: The home owner visits at least once each week and walks round the building and speaks with staff, residents and visitors. The home manager and deputy manager work alongside staff everyday, including Christmas and New Year, and are able to monitor practice in this way. The manager audits residents’ money, medicines, accident reports and care plans on a monthly basis. Residents and visitors spoken with on this and other inspections, confirmed Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 18 that they knew the manager and the deputy and would feel comfortable to approach them with any concerns or suggestions. Staff in the home are not involved with the financial affairs of any residents, however small amounts of personal spending money may be kept in the home’s safe. The nurse in charge has access to this. Records were inspected and found to be correct, with two signatures obtained for all transactions. The home owner has appointeeships for three residents under long standing arrangements. One resident has a solicitor to look after their finances and all others have relatives to assist them. Fire records and other health and safety records were inspected. These demonstrated that staff had received fire safety training and had attended fire drills. Fire extinguishers and alarm system had been tested. The maintenance person carries out a weekly bell test. The building has been tested for Legionella and asbestos. The maintenance person does regular hot water temperature testing. The gas certificate was renewed in August 2005 and the electrical installation certificate in 2003. Portable appliance testing was carried out in November 2005. Mobile hoists were serviced in August 2005 and passenger lifts in October 2005. The home’s insurers have carried out a risk assessment of the building. Risk assessments for working practices were done in 2002 and reviewed December 2004. Atherton Lodge Nursing Home DS0000018711.V272124.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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 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 X X 3 X 3 X X 3 Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 13 Requirement Residents must always be adequately protected from the risk of injury from bedrails. Timescale for action 30/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Atherton Lodge Nursing Home DS0000018711.V272124.R01.S.doc Version 5.0 Page 22 - 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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