Inspection on 11/08/05 for Autumn Lodge

This inspection was carried out on 11th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Autumn Lodge 30/11/06

Autumn Lodge 09/02/06

Autumn Lodge 07/03/05

Autumn Lodge 23/08/04

Autumn Lodge 23/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Autumn Lodge 41 Moss Lane Orrell Park Liverpool L9 8AB Lead Inspector Leila Mavropoulou Announced Thursday, 11 August 2005 9.30 am th 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. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Autumn Lodge Address 41 Moss Lane, Orrell Park, Liverpool, L9 8AB 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) 0151 525 0555 Mr Delpinto Mrs Kathryn Delpinto PC Care Home Only 34 Category(ies) of OP Old Age 34 registration, with number of places Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To provide care for thirty-three older persons (aged over 65 years) and one named person with dementia, excluding learning difficulty or mental disorder over 65 years of age Date of last inspection 7th March 2005 Brief Description of the Service: The home is situated in the Orrel Park area of Liverpool and is easily accessible by public transport. Shops and other community facilities are located within a short walking distance from the home. Autumn Lodge provides support and personal care to 33 older people. All accommodation is provided in single bedrooms and the home has many aids to promote its residents independence and safety such as: passenger lift, assisted baths, call system etc. The home is staffed at all times, many of whom have completed the NVQ level 2 care award. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which lasted for six hours. During this time six residents, four staff members, two visitors and the management were spoken to find out their views about the home. In addition some residents and staff files were inspected together with other records such as fire records, menus etc to show that the home were meeting the needs of the residents and its legal obligations. What the service does well: What has improved since the last inspection? Since the last inspection eight bedrooms, the staff room and the top floor bathroom and toilet have been redecorated. Some staff have attending a Activities Co-ordinator training course, Protection of Vulnerable Adults, food hygiene and one staff is working towards the NVQ level 2 Care Award and another towards the NVQ level 4 award. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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) 1,3,4,6 The staff at the care home carries out their own assessment of the prospective resident needs to ensure that the home would be able to meet their assessed needs. EVIDENCE: The home has a detailed Statement of Purpose giving prospective residents the initial information they require to assess if the services and facilities provided at Autumn Lodge would meet their needs. Discussion with the manager and details in the residents’ files show that prospective residents are invited to care home to view the home and the accommodation available and to meet other residents and staff. During this visit the manager would make an assessment of the resident of needs in the home environment, using the Care Management Plan as a guide to the resident’s needs. This is to ensure that the home has the necessary staff skills, aids etc to meet the needs of the resident. Thus, enabling the manager to ensure that the necessary services and aids require to promoting the resident health and safety are in place prior to their admission. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 9 The home does not provide intermediate care. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The staff at the care home monitors closely the emotional and physical health needs of the residents to ensure that they receive the necessary treatment and support promptly to promote their health and wellbeing. EVIDENCE: The staff monitor closely the health needs of the residents through observation and the information in their care plans to ensure that that their health needs are met. The residents care plans are detailed and well maintain. The resident’s key worker review their care plan monthly to make certain that they continue to reflect the resident needs. Short-term care plans are develop to show how minor ailments care would be provided, together with risk assessments. The residents’ records show that staff act promptly on outcomes identified in the resident’s reviews by organising visits from other health professionals and implementing changes in the resident’s care plan to promote their physical and emotional well being. The resident’s care is formally review six weeks after admission by social services or the home depending on the funding arrangement of the resident. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 11 Formal reviews are held at the home six monthly where family members are invited to discuss the resident’s care. The manager should review the method of recording of important conversations with the resident’s next of kin or significant others when there are changes in the resident care. The resident’s files inspected showed that they access routine check up from the dentist, optician, chiropodist etc. Aids provided in the home specifically for a resident is instigated by a visit from the resident GP and equipment is supplied and fitted by a competent health professional when necessary. Normally, this is via the district nurse and the occupational therapist. Some of the service users have regular assessment from the continence nurse to ensure that they use suitable continence aids to promote their dignity and health. The staff administers most of the residents’ medication. However, residents wishing to administer their own medication would be able to do so after the staff assesses their capability and the risk. The home record keeping of resident medication administered is well maintained and accurate. The current system used by the home in the administration of residents’ medication makes it very difficult to maintain an accurate record of residents medication received into the care home and quite inflexible as it does not promote resident’s choice in this area very easily. The manager should review this area of their care practice. Observation of staff assisting the residents with various aspects of daily living showed that the residents were treated with respect and dignity. This was evidenced by assistance given at mealtimes discreetly, by knocking on residents door before entering, the manner in which staff spoke to the residents etc. The service users were all smartly dressed reflecting their taste and preferences and were addressed in the way they preferred e.g. abbreviation of their name or by their middle name etc. as evidenced when inspecting the residents’ file. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The residents exercise choice over all aspects of their daily lives and are supported to maintain contact with the community and their family to promote their emotional/psychological well being. EVIDENCE: Observation and discussion with the residents and staff confirm that the residents’ determine their daily routine. Observation during the inspection showed that the residents could choose to be on their own or to participate in activities provided by the staff at the care home. These included bingo, Karaoke, knitting group, outings, baking etc. Recently, some staff attended an Activities Co-ordinator course to improve the quality and range of social activities provided at the home. The home organises group outings to the theatre, shopping centres and other places of interests to the residents after discussion at the residents meetings as evidenced by discussion with the residents. The home has an unrestricted visiting policy and residents are able to choose where to see their visitors. The staff would support the residents to maintain their own finance by following the home’s Management of resident money, valuables and financial affairs procedure. Currently, the residents manage their finances Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 13 independently or through their family or solicitor. A secure place is provided for residents to store valuables and monies in accordance with the home’s policy. The staff would give the resident a receipt for item handed over for safekeeping. Where items are bought on behalf of the residents a written record is maintained and receipts are kept. The home has a rotating four weekly menu, which is reviewed to reflect seasonal vegetables and fruit. Alternatives are always available, which is also displayed with the menu. The portions of food of food provided at the home are large and well presented. The residents spoken to said “that the food was good and had no complaints about the food, as there is always plenty and it is good”. The home would cater for residents requiring a special diet e.g. diabetic diet. Observation of the way in which staff assisted residents during the lunchtime meal was discreet, thus promoting their dignity and independence. The staffing level at lunchtime was adequate to provide the necessary assistance to residents. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has various policies and procedures in place to protect its residents from all forms of abuse. EVIDENCE: The home has a complaints procedure, which the management encourage residents and their family to use. Discussion, with visitors indicated that it is not necessary to use the complaints procedures as they just have to mention any concerns to the staff or the management team and their concerns are addressed. All staff have access to the homes policy on the protection of vulnerable adults at all times and some staff have attended external training courses on the Protection of Vulnerable Adults. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22,24,25,26 The home is well maintained internally and externally to promote the safety of the residents. EVIDENCE: The home is well maintained both internally and externally and benefits from a planned maintenance and renewal programme. Since the last inspection eight bedrooms have been redecorated, the staff room and the top floor toilet and bathroom. The residents can access all parts of the home easily by the passenger lift and the wide corridors and doors particularly in the new part of the home. In addition the home provide various aids such as: assisted baths, grab rails, call system to promote the resident’s independence safely. The home is centrally heated throughout and the residents’ bedrooms are well ventilated. Emergency lighting is provided throughout the home, which is tested regularly as evidenced in the home’s fire logbook. The fire officer Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 16 inspected the home in February 2005 and the recommendations made have been met. The residents’ bedrooms are pleasantly decorated and where possible the resident is involved in choosing the wallpaper by samples of wallpaper being brought into the home. Residents are encouraged to bring into the home items of furniture providing they comply with fire regulations to make their personal space more homely. The laundry is sited away from the food preparation area and policies and procedures are in place to prevent the spread of infection. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 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 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, The home has an experienced and stable staff group who provide a good quality and continuity of care to the residents. EVIDENCE: The home strives to protect its residents through implementing fully its’ recruitment procedure as evidence by the staff records. The staff files inspected showed two written references and a Criminal Records Bureau check were obtained prior to staff commencing employment at the care home. The staff at the care home is inducted into their role and a record is kept of areas discussed. However, the manager should review the home’s induction process to ensure staff understanding of the information given during induction. The staffing level in the care home reflect the level of residents activity throughout the day and a rota is kept of all hours worked by staff and in what capacity. Discussion with staff and entries in the residents files show that the staff are aware of the limitation of their knowledge and skills and would seek advice from other health professionals such as: District Nurse, GP, Community Psychairtric Nurse, Continence Adviser etc as required. Over 50 of the staff working at Autumn Lodge have obtained the NVQ level 2 qualification in care. In addition to care staff the home employs sufficient staff to carry out domestic and catering duties. Areas of the home inspected were found to be clean and free from malodour. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 18 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) 32,33,34,35,36,37,38 The management of the home promote the safety of the residents through regularly reviewing all aspect of the homes operation. EVIDENCE: Discussion and observation with the manager showed that she is approachable and accessible to residents, their family and to staff at all times. There is a strong sense of direction and leadership by the manager in promoting residents’ choice and independence, as observed in the manner in which she assisted and spoke to the residents. Discussion with the manager and staff indicated that they work as a team to meet the needs of the residents, which was evident from the feedback from the residents’ records. The manager supervises staff on a daily basis to ensure that they are carrying out their roles and responsibilities in accordance with the home’s policies and procedures and the resident’s care plan and where necessary address any issues appropriately. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 19 However, currently formal “one to one” supervision does not given, only an annual staff appraisal. The manager should consider implementing formal supervision to meet the requirement of the National Minimum Standards. The home has developed a quality assurance system whereby, questionnaires are sent out to the residents and their family to provide feedback on the quality of the care provided. The completed questionnaires are evaluated to identify ways in which the service could be improved. The home complies with any requirements within the given timescales given by the Commission. The pre-inspection questionnaire completed by the manager for the inspector showed that the home’s policies are reviewed at regular intervals to ensure that they continue to comply with current legislation and best practice. The home has a current Public Liability Insurance displayed and discussion with the manager indicated that records are kept of all expenditure in the care home for accounting purposes. The records are well maintained in the care home and residents are able to access their records in accordance with the home’s policy on access of information. It was observed that residents’ records were kept in a secure place. The health and safety of the residents is promoted through the staff receiving appropriate training in food hygiene, first aid, moving and handling and fire awareness, which are kept up to date by attending refreshers courses. In addition regular routine maintenance to the building and servicing of equipment is carried out in accordance with the manufacturer instructions or Health and Safety Executive such as maintaining records of all accidents/incidents to residents and staff. The home informs the Commission of any significant event in the care home. Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 20 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 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 3 3 2 3 3 Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 21 no 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 Requirement The registered person shall maintain a record of all service users medication received into the care home. N/A Timescale for action 30th October 2005 N/A 2. N/A N/A 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 7 Good Practice Recommendations The registered person should review the method of recording important conversations with the resident’s next of kin, or significant others when significant changes in any aspect of the resident care is given. The registered person should review the system of medication to promote service users choice. The registered manager should ensure that staff receive at least six one to one supervision a year to comply with the requirement of this standard. 2. 3. 9 36 Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 Autumn Lodge F52 F02 S25326 Autumn Lodge V233257 110805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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