Inspection on 23/01/06 for Autumn Lodge

This inspection was carried out on 23rd January 2006.

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 28/09/07

Autumn Lodge 23/05/06

Autumn Lodge 17/10/05

Autumn Lodge 21/02/05

Autumn Lodge 10/08/04

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

CARE HOMES FOR OLDER PEOPLE Autumn Lodge 35-37 Rutland Gardens Hove East Sussex BN3 5PD Lead Inspector James Houston Unannounced Inspection 23rd January 2006 9:15 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 Autumn Lodge DS0000014177.V265372.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. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Autumn Lodge Address 35-37 Rutland Gardens Hove East Sussex BN3 5PD 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) 01273 271786 Mrs Sheila Clare Bravery Ms Maria Theresa Howe Care Home 35 Category(ies) of Dementia (35) registration, with number of places Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is thirtyfive (35). Service users must be older people aged sixty-five (65) years or over. Up to thirty-three (33) service users with a dementia type illness to be accommodated. One (1) service user with a dementia type illness and one (1) service user without a dementia type illness or two (2) service users without a dementia type illness may be accommodated in the designated respite flat. 17th October 2005 Date of last inspection Brief Description of the Service: Autumn Lodge is a private care home registered to provide care and accommodation for up to 33 older people with a dementia type illness; there is also a respite flat available for couples where a person with dementia can be cared for by their relative. Most of the care is long-term; however, the home does also offer respite and holiday care. The home does not provide nursing care. The home is located in a residential area close to the centre of Hove, with all local amenities and the seafront close by. The area is well served with bus and rail services, and parking is available on the private forecourt and in the street outside. The home also has its own mini-bus for outings. It has also received a Clean Food Award from Brighton and Hove City Council. The property comprises three converted houses that have been linked together, and service user accommodation, including 23 single and five shared bedrooms, plus the respite flat, is arranged on three floors that are accessed by a passenger lift or stairs. There is also a stair lift to the first floor in the ‘wing’. Communal areas include a large sitting and dining room, further lounges, two conservatories and an attractive courtyard area with a fishpond and an aviary. Autumn Lodge DS0000014177.V265372.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 during the morning and afternoon of the twenty third of January 2006. Before the inspection the inspector read papers held by the Commission of Social Care Inspection and prepared those sections of the standards to be inspected. During the inspection the inspector met with the registered manager, the assistant manager, six residents and three staff. A tour was made of most of the premises, and a variety of records including four care plans, and some policies and procedures were read. The inspection took place over 6.7 hours. After the inspection the inspector spoke with three relatives. Since the last inspection the acting manager has been registered by the Commission for Social Care Inspection. Thirty-three residents were resident in the home on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 6 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 Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 7 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): 1,2,5 and 6. The home gives full information to prospective residents and their representatives and encourages visits to the home by them prior to admission to assist them with the decision whether or not to enter the home. EVIDENCE: The home’s statement of purpose and service users’ guide give the required information. The manager replaced an older inspection report with the current one during the inspection. The manager said that residents and or their representatives are invited to visit the home prior to admission-relatives confirmed this-and that she visits prospective residents in their own homes or in the setting where they then are. Emergency and respite admissions are admitted from time to time. Records inspected showed that a contract is made between the resident and the home, and that a copy signed by the resident’s representative is held on file in the home. The home does not provide intermediate care. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 8 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): 7,8 and 11. Plans of care need some attention. The healthcare needs of residents and the needs of ill or dying residents are well met. EVIDENCE: Each resident has an individual care plan drawn up with the resident and their family. Four care plans were read and not all were found to be reviewed monthly. Some detail was not correctly completed and the recommendation the made at the previous inspection that staff receive training on how to record fully is repeated. Records inspected showed that staff make thorough arrangements for the health care needs of residents. Residents and staff said that that contact is made with health care staff when needed. Risk assessments regarding continence, skin condition and weight are made as needed. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 9 The home has suitable policies regarding the care of ill and dying residents and staff confirmed that they are aware of them. Records inspected showed that the home has suitable systems to ensure the wishes of residents and/or their representatives regarding arrangements to be made after their death are carried out. The home with healthcare support cares for residents as long as possible. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 10 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): 14 and 15. Meals provided for residents are excellent. Residents are helped to exercise choice and control over their lives. EVIDENCE: All residents, due to their condition, are unable to handle their financial affairs. The manager gave an assurance that the home has available for families, if needed, information regarding external agents (eg advocates) who could act in their interests. Residents confirmed that they had been able to bring in personal possessions with them. The home’s chef has been in post for over a year and residents and their relatives spoke very highly of the food. Relatives said that they are welcome to eat meals with their residents. The chef said that he has the resources to provide a high standard of food, and that diabetic and vegetarian diets are catered for. Records inspected showed that food served and alternatives given are fully recorded. A staff member was seen to have the time to assist discreetly a resident with their meal. The meal served was seen to be well presented, and to offer ample quantities. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 11 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): 18 Policies and procedures ensure that residents are protected from abuse. EVIDENCE: The home has clear and comprehensive guidelines for identifying and reporting adult protection issues, and a rolling programme of adult protection training is carried out by the home. A recommendation was made at the last inspection that the manager undertake further training in this area, and this is scheduled for next week. Staff have had training in dealing with challenging behaviour. The home has a suitable policy about staff receiving gifts and bequests from residents and this is part of the staff handbook that staff receive on appointment. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 12 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): 19,20,21,22,23 and 24. The home provides a good homely environment for residents that is safe and well maintained. EVIDENCE: The home is well furnished and decorated. It has its own maintenance staff member who was on duty during the inspection and dealt immediately with one item, a bedroom door that did not unlock easily. Staff said that the system of recording in a maintenance book items needing attention works well. The home meets the requirements of the local fire brigade officer and environmental health officer. The home has ample communal space including lounge/dining areas, two conservatories, and a patio area with a fishpond and an aviary. The home has a passenger lift that goes to all floors, and the wing has a stair lift, with a portable ramp also available if necessary. There is a call system to each room and the communal areas. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 13 All bedrooms meet the minimum space requirements. Some bedrooms are fully en-suite. All others have at least a hand-basin. There are two bathrooms with bath-hoists. One of these hoists broke down two days ago and will be repaired urgently. Residents said that staff have the time to bath them as needed and staff confirmed this. There is also a walk-in shower for residents with mobility problems. Residents said that they like their bedrooms and that they have been able to bring in small items of their own into the home. Several bedrooms are shared and screens are available to ensure the privacy of residents in them. Rooms are lockable. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 14 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 and 30. The home has a well-trained and competent staff group. EVIDENCE: The home has a large staff group due to its size, layout, and category of registration. There are normally five care staff on duty during the day and three waking staff at night. The home employs sufficient ancillary staff including housekeeping and laundry staff, a secretary and maintenance staff, and the chef and kitchen staff. A rota was available for inspection. Staff meetings are held regularly with attendance being logged. Minutes are taken and these were made available to the inspector. The manager said that she and her assistant manager share on call duties and that a representative of the home’s owners is available to them at all times for advice. The manager gave an assurance that staff left in charge of the home are aged at least 21 years of age. Residents said that they find staff helpful. Relatives said that the home has a stable staff group who are kind pleasant and very caring. Each staff member has an individual training file and a staff member confirmed that they complete a six-week induction course. There is a rolling programme of in-house and external training. The home uses a “training matrix at a glance” to monitor that staff are completing core-training updates as required. A large group of staff are currently working their way through a course on Dementia. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 15 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): 33,35,36 and 38. The home has good quality assurance processes. The systems for holding residents’ valuables and monies and supervising staff are thorough. The health and safety of residents and staff are protected. EVIDENCE: The owners make regular monthly inspection visits on the home, reporting on their findings. In addition the manager confirmed that fortnightly checks also continue to be made by an independent representative. The owner also holds regular residents’ meetings and the minutes of these were made available to the inspector. Families and professionals are invited from time to time to complete satisfaction questionnaires and the manager intends to send these out again soon. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 16 The home has a financial controller who deals with residents’ accounts. Records are kept on a computer system. Monies held for residents are securely held in a small safe and for two records inspected at random the amount of monies held tallied with the record of transactions. Advice was given about one aspect. Staff said that they receive regular supervision and those records inspected showed that staff receive supervision at the recommended frequency of at least six times a year. The home out carries out regular inspections of the premises to ensure that the premises are safe and the manager confirmed that the full risk assessment for the building is about to be redone. Certificates inspected showed that the home’s gas and electrical installations are regularly inspected, as are the portable electrical appliances. The home’s maintenance officer confirmed that he regularly tests the temperature of hot water at the point of delivery to residents and records the results. Records inspected confirmed this. The home has a matrix of core training for health and safety matters and a regular rolling programme of update training is available. It is recommended that the home ensure that all staff attend as needed. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 17 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 3 3 3 3 3 3 3 X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 3 Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 OP38 Good Practice Recommendations Review care plans monthly, and continue training on recording for staff. Staff to attend core training over time as needed. Autumn Lodge DS0000014177.V265372.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 DS0000014177.V265372.R01.S.doc Version 5.0 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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