Inspection on 24/05/05 for Bemerton Lodge

This inspection was carried out on 24th 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 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

Bemerton Lodge 22/05/08

Bemerton Lodge 06/06/06

Bemerton Lodge 22/11/05

Bemerton Lodge 10/02/05

Bemerton Lodge 23/08/04

Bemerton Lodge 26/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bemerton Lodge Christie Miller Road Salisbury Wiltshire SP2 7EN Lead Inspector Roy Gregory Unannounced 24 and 25th May 2005 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. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bemerton Lodge Address Christie Miller Road Salisbury Wiltshire EP2 7EN 01722 324085 01722 324561 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) The Orders of St John Care Trust (Registration application pending for Heather Mudie) Care Home 56 Category(ies) of 20 DE(E) Dementia - over 65 registration, with number 36 OP Old age of places Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 10th February 2005 Brief Description of the Service: Bemerton Lodge is a purpose-built home for up to 56 Older People, 20 places being registered for people who have dementia. The home is one of a number in Wiltshire owned and managed by the Orders of St John Care Trust. The home was built in the 1970’s and there are intentions to redevelop the site with a modern replacement. Nevertheless, the home has received refurbishments in a number of areas during the past two years, including redecoration of every bedroom. The accommodation is arranged over two floors, connected by passenger lift. A choice of communal accommodation is afforded by a variety of sitting and dining rooms. Additional day centre facilities are located in an adjoining building. Bemerton Lodge is located in attractive grounds in a residential area, north of Salisbury city centre. There is car parking on site, and it is near a bus route. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Roy Gregory between 9:30 a.m. and 4:45 p.m. on Tuesday 24th May, and 9:10 a.m. and 4:15 p.m. on Wednesday 25th May 2005. The inspector spoke at length with seven residents, including sharing lunch in the dining room with two service users staying at Bemerton Lodge for intermediate care. The manager, Heather Mudie, was available during some of the inspection, whilst there were conversations with other staff including the activities co-ordinator and handyman, and two care leaders. The inspector had the benefit of meeting with a visiting GP. A further visit was made on 20th June 2005 to monitor one matter identified at the inspection. The inspector selected a number of care plans to compare observations of care, and residents’ perceptions, with written records. Other records consulted included those relevant to recruitment, staffing and health and safety. Most of the building was visited and a number of individual rooms were seen with the consent of their occupants. The inspector sat in on a care staff shift handover. What the service does well: What has improved since the last inspection? In response to requirements at the previous inspection in February 2005, pressure area assessments of residents have been completed and, where appropriate, they have been linked to care plans to minimise risk of pressure sores developing. Cleaning and making good of poor surfaces in bathrooms and toilets have improved. Mrs Mudie, the manager, has applied for registration. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.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. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.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 Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.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) 1 - 6 There is a clear admissions policy and procedure in place, including provision of appropriate information. The standard of assessment is effective, prospective residents and their families being involved in the process and able to visit the home, such that admissions are linked to the range of needs for which the home can provide. Residents admitted for intermediate care receive a tailored and coherent service that enables a return to independent living. EVIDENCE: A resident who had recently moved in said that if anything, she had had too much information around the time of admission, although she recognised the reasons for this and saw it as having enabled her family to assist her in her decisions and choice about the move. Mrs Mudie confirmed that previous inspection reports are supplied to all potential residents, together with a welcome pack. Mrs Mudie was working on the latter to improve its accessibility. The resident saw the Trust’s “residents’ handbook” as a source of information should she need it during her time in the home. On the basis of information supplied and assessment of her needs by Mrs Mudie, the resident felt confident of why she had entered residential care, and that the home could meet her needs. Assessment of prospective residents is based on a combination of information gathering forms, which lead straight into commencement of a care Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 9 plan for individuals admitted. Visits to the home by prospective residents and/or their supporters are encouraged. The inspector saw the form used for private contracts; it was a clear document, specifying what services are covered by fees, and in what circumstances the contract could be terminated or fees raised. In partnership with the NHS, Bemerton Lodge provides up to six bedrooms for Intermediate Care, i.e. a rehabilitation facility between a stay in hospital and a return home. Specialist support, e.g. physiotherapy and occupational therapy, is provided from outside, whilst intermediate care residents receive meals and care from home staff. There were three such residents during the inspection period. Each was fully aware of the reasons for their placement and of their respective tailored rehabilitation plans. They had received a leaflet from the hospital about the intermediate care facility, and said they had also received much verbal information and reassurance. The leaflet had a formal look, and would have benefited from larger print and pictorial content, including a map: none of the residents at this time was from Salisbury, and they did not know where they were in relation to the city centre or main routes. Mrs Mudie said she intends the welcome pack in development will be made available to Intermediate Care users. This group of residents regarded the accommodation provided as functional but appropriate to a short stay. They were aware of their freedom to use the communal facilities of the home, whilst the grouping of their rooms enabled a sense of shared purpose and motivation. In staff handover, and discussions with individual staff, it was clear they understood the needs and rehabilitation aims of the Intermediate Care residents, whilst good working relationships with the visiting health professionals were evident, with an emphasis on working towards target dates for individuals to return home. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 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 & 10 The care provided to residents is guided by care plans, which receive review regularly and in response to significant change. Residents feel justifiably confident in responses to health needs. Residents value provisions made for their privacy. EVIDENCE: “Long term needs assessments” reflected the people to whom they related, whilst short-term care plans, used to guide regular care provision, were sensitive and well constructed. Where pressure area risk assessments produced a high-risk score, this linked to an element in the care plan about how to monitor and minimise the risk. A review of an assessment had been prompted by alertness to a resident spending increasing time with restricted mobility, which in turn had led to referral to the district nurse and provision of preventative equipment. Daily records appeared objective and demonstrated the provision of care in line with care plans. In two instances where home staff were questioning the ability of the home to continue to meet needs, the reasons behind this uncertainty could be tracked through the nature of records kept, including records of inter-disciplinary and family meetings held in response to identified concerns. Care plans showed evidence of resident agreement by signature, although many residents did not recall much about direct involvement in the process. One, however, said he regarded his care Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 11 plan as a joint endeavour with the care staff, probably assisted by his plan being devised to achieve goals. There was plentiful evidence that professional attention was quickly procured in response to health concerns. For example, an observation of an emergent chest problem had led to a GP visit and receipt of an antibiotic prescription the same day. A visiting GP considered staff to be very alert and responsive to medical conditions, and he trusted their abilities to co-operate with treatment ordered. The inspector also observed a professional interchange between a care leader and district nurse. Residents felt confident that their health needs were well taken care of. All residents spoken to were complimentary of the nature of care offered by care and housekeeping staff, including respect for privacy. For example, all spoke of staff knocking before entering rooms, and one said staff were good at gauging how best to approach people according to time of day or mood. One care plan seen had identified ways specifically to support a resident in maintaining dignity. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 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 & 15 Residents have access to varied activities, by personal choice and related to needs and expressed preferences. Contacts with the wider community are supported. Good quality meals are served. EVIDENCE: The home has the benefit of a part-time activities co-ordinator, whose enthusiasm and degree of engagement was remarked by residents and staff alike. She has built up a picture of favoured activities and interests of individual residents. An arts and crafts room receives some use, but there is a preference to offer group and individual activities around the sitting rooms. The co-ordinator sets a daily programme at the beginning of each week, then visits residents individually to explain and invite participation. Currently popular were quizzes, garden activities and flower arranging. The co-ordinator also helped individuals pursue interests by obtaining library books for them, alongside evidently furthering her own knowledge base for her role. The home’s previous promotion of regular and one-off activities outside the home, such as a monthly market outing, has been sustained. Other staff spoke of benefits seen as a result of greater emphasis on activities provision: more staff time for other care tasks, more for key workers and residents to talk about, residents being more stimulated generally. One resident in particular was identified as having changed from lethargy and dependence to being gregarious and taking a pride in themselves. The resident agreed this view, which was reflected through care notes, but their care plan, Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 13 in common with others, did not identify the needs that might be addressed through providing appropriate activities. The activities co-ordinator and manager separately spoke of their intention to ensure activities provision will become more closely related to care planning. Visitors were present in the home throughout the day. One resident spoke of having visitors join her for meals. The garden was a popular venue for entertaining visitors. An intermediate care resident was pleased that arrangements were in hand for him to have a visit from his dog. The inspector joined a midday meal, where there was a choice of a curry or fishcakes with fresh vegetables, followed by a choice of sweet, including a diabetic sweet. Second helpings were offered and service was unobtrusive and pleasant. All residents spoken to were very complimentary of the quality of meals. The provider trust requires catering staff to undertake regular food satisfaction surveys with table groups of residents, records of which showed that where concerns were raised, resolutions were sought. For example, there had as a result been more variety of diabetic sweets and cakes, and a change in arrangements for service of hot teas. It was not evident from these records that opinions on breakfasts and teas were routinely pursued, although the inspector found high satisfaction levels, including an observation on the ready availability of fruit. The menu for the day was written up in the dining rooms, but those residents near to the inspector were not aware of this and thus had not looked prior to the meal. Care plans included nutritional guidance where appropriate and for one service user there was evidence of food intake monitoring at dietician request, by agreement with the resident and their GP. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 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 There are good formal and informal means for receipt of complaints, which receive appropriate investigation and action. Civic rights are recognised and protected. Staff awareness of indicators of possible abuse, and of procedures for response, gives rise to a protective environment. EVIDENCE: There is good guidance on complaints to residents and staff by way of the provider Trust’s complaints procedures, which were seen to be working efficiently. A resident told the inspector she would refer to the residents’ handbook for details of the procedure were she to need it, although she felt confident that any staff member would ensure any concern would be responded to appropriately, with the key worker as first port of call. In fact, all complaints are recorded within the procedures, whether or not they require the manager to refer them to a higher level of authority. Findings are shown and these are fed back to complainants. Recent complaints had been about cleaning standards in a bedroom, and effects of one resident’s behaviour upon quality of life for others. A staff meeting in January 2005 had included discussion of a multi-faceted complaint (on most of which no conclusions could be drawn), identifying learning points for staff and reminding them of the workings of the complaints procedures. The inspector also saw evidence of receipt of compliments about the service. There are details posted in the home about a local advocacy service. Mrs Mudie spoke of the involvement of an advocate with a resident with dementia. At the recent general election, many residents voted by post as arranged by the administrator, and some were assisted to vote in person. Training in abuse awareness and alerting procedures is provided by the Trust both as part of induction procedures for all new staff, and as a continuously Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 15 available course. A carer confirmed both having attended such a course, and received the “No Secrets” guidance to local inter-agency procedures. Mrs Mudie provides a copy of this to all new staff, as confirmed by a carer. When there had been a theft reported within the home in March 2005, Mrs Mudie had notified the Police and agreed measures to take. A resident told the inspector he experienced a high degree of trust with the care staff, and as a result felt he was in a secure environment. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 & 26 The environment is welcoming and safe, but with some furniture renewal necessary and a need to secure residents’ comfort in one area. Residents have made themselves very much at home in their own rooms, whilst also benefiting from a range of attractive communal facilities. Housekeeping staff and the handyman maintain a clean, attractive home. EVIDENCE: The Orders of St John Care Trust has a programme of routine maintenance for all its properties through contractors, as a result of which identified works take place as needed. The handyman had made progress on decorating work identified by himself and the manager, with two corridors being the next priorities. Bathrooms and toilets had received a range of homely and “fun” touches. The manager was aware that some of the latter would need to be monitored to ensure they did not engender confusion for residents with visual difficulties and dementia. The home is well provided with communal spaces. The sitting rooms have good furniture and décor, but the smaller ones were surprisingly little used. The Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 17 dining rooms are spread through the home, thus allowing for relatively small groups to enjoy mealtimes. They would benefit from more modern dining furniture in some locations, some chairs being badly scuffed. The inspector also considered these older chairs to have very low backs for the resident group, but the manager was able to comment on advice received from an occupational therapist in relation to previous raised concerns, that provision of more dining chairs with arms would be more appropriate. A copy of an order for new dining chairs has been provided. Residents said they were satisfied with personal rooms, many choosing to spend substantial time in them, although many of the rooms are quite small and thus crowded where residents had chosen to bring a lot of personal possessions with them. One resident had a possible need of a larger bed, which had been identified in care notes, and was wondering what had become of the matter. The intermediate care residents felt it would have been hard to adjust long-term to the size of rooms offered, particularly without en-suite facilities, a factor also mentioned by a permanent resident. Others considered toilet provision to be adequate, although with high reliance on commode use at night. One part of the home has a high ceiling with roof lights that admit extensive glare from the sun, with resultant high temperatures. There is an air circulation system, which the handyman was satisfied was working to its capacity, but already in 2005 on a hot day, routine temperature monitoring had shown a temperature of 80°F. Previous inspections have drawn attention to this problem, and the visiting GP said it was his only concern about the home, that many residents lacked the ability to draw attention to related discomfort or to move away to more comfortable surroundings. The handyman and inspector shared the view that the air circulation system was likely to have little effect without screening of the glass where the sun shines in. The inspector made a visit to the home at 1:00 p.m. on 20th June specifically to see how this part of the home was functioning on a very hot day. The handyman had made a neat job of putting up some shading, and two standing electric fans were in use in addition to the air circulation system. The temperature was 80°F, but the absence of glare made conditions noticeably more bearable. Mrs Mudie advised that a buildings officer of the Trust was due to visit that day to investigate more permanent options for the room. Standards of cleanliness were high throughout. A resident paid tribute to the constant efforts of housekeeping staff, not least through a period of an infection outbreak earlier in the year. A care leader takes lead responsibility for infection control procedures in the home. It was evident that protective aprons and gloves were routinely used and there was a sound procedure for washing and return of commode liners. The laundry was clean and well organised. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 - 30 Residents benefit from well trained staff, in whom they place confidence. Staffing is sufficient to meet the activities needs of residents, care needs at night, and the domestic needs of the home, but residents day-time care needs can be compromised by low numbers of care staff. The process of staff recruitment ensures that all the checks and references necessary to protect service users are in place. EVIDENCE: The staffing rota aims to provide six care staff on morning shifts and five on evening shifts, these figures including a care leader, whose duties usually entail administrative time away from service user contact. For the 28 shifts (i.e. two weeks) preceding the inspection, the number of care staff had slipped to four on four occasions, a level the manager conceded was dangerously low for a 56-place home. She said late notification of sickness absence was particularly difficult to cover, even from agencies. The activities co-ordinator’s 20 hours are additional to the care rota and are not used to supplement care tasks. Residents were very pleased with the nature of care they received from staff and reported no delays in responses to call bells, but they saw them as always busy and one resident regretted the availability of a bath being restricted to once a week. The visiting GP also saw staff as under constant pressure. The inspector is aware at the time of writing that the Orders of St John Trust is reviewing care staffing levels in all its Wiltshire homes. Quality of work suggested that ancillary staffing was at an appropriate level. At night, three waking care staff are provided, these also having some domestic duties out of hearing of residents. Any shortfalls in night staffing were generally made up from among the home’s own care staff. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 19 Recruitment records for all staff commenced since previous inspection were in order, showing adherence to required safety checks including following up of references supplied or of issues highlighted in applications and interviews. Training records were extremely well organised, allowing the manager to ensure each staff member is up to date with mandatory training requirements and has the opportunity to undertake additional training such as supervision skills. Thus there is very high compliance with essential training including first aid, abuse awareness and food handling. A number of staff have also undertaken a Trust dementia workshop, with others due to do it. Two care leaders have respectively achieved NVQ in care to levels 3 and 4, whilst two care staff have achieved level 2 with a further 5 expected to do so by August 2005 and others working towards it. Take up by night staff is disproportionately low. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, & 38 Staff project an attitude of shared endeavour whilst residents express confidence in the staff and management. The provider Trust has put a quality assurance system in place, within which the home has achieved to a high standard. Health & safety of residents and staff is well provided for. EVIDENCE: Mrs Mudie is well qualified for her role and has brought about significant improvements in the care planning and recording processes in the home, thus enhancing the identification of residents’ social and health needs. In staff shift handovers, observations and opinions of all staff were valued and demonstrated a shared emphasis on providing quality care. The home had a certificate for having recently achieved a recognised quality assurance standard, although it was recognised this involved little direct involvement of residents. However, residents considered themselves well informed about matters of importance to them in the home, by way of individual care reviews, Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 21 monthly newsletters and residents’ meetings. The latter were fully minuted and covered a variety of two-way issues including food and activities. A care leader described her designated responsibilities for health & safety matters. These included a wide range of risk assessments that were readily available to staff. There were good records of fire drills and of fire instructions being given to visiting contractors, and fire training for all staff was arranged for the near future. There had been a lapse in checking of fire exits. Hoists had been recently serviced. The gas safety certificate was slightly out of date, but this had already been reported for attention by Mrs Mudie. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 3 x x 2 2 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x x 3 Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 23 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 Regulation Requirement (Requirement withdrawn following discussion with home manager. This related to replacement of dining chairs; the inspector acknowledges appropriate actions had been taken at the time of the inspection, including ordering of new chairs). There must be a professional assessment of the size of bed needed for an identified service user, and appropriate provision made in response. There must be a permanent solution to reducing the excessive temperatures in Wing 6 Timescale for action 2. 24 16 (2)(c) 31st July 2005 3. 25 23 (2)(p) Action plan by 31st July 2005 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 1, 6 12 Good Practice Recommendations Users of the Intermediate Care facility should be given more readable and pictorial information about the home. Care plans should demonstrate how activities needs are D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 24 Bemerton Lodge 3. 4. 15 15 identified and addressed. Consider how to present menu information in a way that service users will find helpful. Make sure meals surveys include consideration of meals other than the midday meal. Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Bemerton Lodge D51_S28264_BEMERTONLODGE_v191935_100505Stage4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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