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Inspection on 18/07/05 for Blacklake Lodge Residential Home

Also see our care home review for Blacklake Lodge Residential Home for more information

This inspection was carried out on 18th July 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.

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

In relation specifically to the two bungalows, this service provides an opportunity for people who are no longer able to manage their own needs, to be supported in a greater degree of privacy and independence than if they were in communal accommodation. Thus in the past, married couples have been able to continue to live together with greater privacy in one of the bungalows, than they otherwise would have been able to do.

What has improved since the last inspection?

As the last inspection concentrated almost exclusively on the main building, and this inspection has concentration almost exclusively on the bungalows, it is difficult to make comparison and identify areas of improvement.

What the care home could do better:

With regard to the accommodation of younger adults, their needs to be a much greater depth of risk assessment, and ensuing care plans, to meet the needs of the individuals being accommodated. This will be explored more fully in the main body of the report.

CARE HOME ADULTS 18-65 Blacklake Lodge Residential Home 85 Hilderstone Road Meir Heath Stoke on Trent Staffordshire ST3 7NS Lead Inspector Berwyn Babb Unannounced 18 July 2005 15:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Blacklake Lodge Residential Home Address 85 Hilderstone Road Meir Heath Stoke on Trent Staffordshire ST3 7NS 01782 388881 01782 396597 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Eric John Dudley Mr Eric John Dudley Care Home 39 DE(E) OP PD PD(E) Category(ies) of 11 registration, with number 39 of places 10 39 Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 10 PD - 2 Minimum age 30 on admission and 8 minimum age 50 on admission Date of last inspection 21 March 2005 Brief Description of the Service: Blacklake Lodge is an extended detached house which provides 24 hour residential care for up to 39 older people, all of whom may have a physical disability, and 11 dementia. Additionally there is registration for 10 younger adults with physical disability. Located just off the Hilderstone Road and surrounded by open country, it is less than a mile from Mere Heath where there are local shops. More extensive services are available at either Longton or Stone. A bus service passes the home and the nearest railway station is two miles distance as Blyth Bridge. The accommodation includes two units built independently of the main property but also serviced with 24 hour care. The home offers a perminant service to elderly and physically disabled people of both sexes and when a bed is available will also provide restbite care in the same categories. The home has 35 single rooms and two shared rooms, 31 of the single rooms have ensuite facilities, as have the shared rooms. All rooms meet current size requirements, and eight of the single rooms are large enough to be used for wheel chair accommodation. Bathrooms and toilets are to be found conviently located around the home. Two comunal lounge areas are provided, and two dining areas. Extensive gardens surround the home and there is substantial off road parking. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection focused primarily on the care and accommodation provided in the two bungalows, that are annexed to the house. The majority of the issues identified relate to the care of a younger adult, and for that reason this report has been produced on the younger adult format, only adding older persons standards where these were necessary. On arrival at the home it was found that the proprietor / manager Mr Eric Dudley was absent on holiday, and the home was being run by Ms Claire Blackhurst who usually acts as Night Care Senior. There were four other members of staff on duty at the time and the inspector received courteous assistance from all these ladies, as well as positive and open responses to his questions. The approach to the home was in good order as was the exterior of all buildings seen, with the exception of one bedroom to be commented on later all accommodation was similarly well maintained. 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. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 In relation to the particular service user in this category, it is felt that the incompleteness of the pre-admission multi-disciplinary multi-agency planning failed to take into account full the needs and aspirations of that resident. EVIDENCE: The inspector spent a considerable amount of time talking to one resident, talking with his permission to staff about this resident, and then examining the documentation, care plans etc that were being held on his behalf. Contained in these documents were two assessments less than three months old one less than a month old, and within them area of need had been identified that were not translated into acceptable care plans for this gentleman. Record was also found in the documents of an extremely serious risk that was mentioned in neither of the assessments, nor was it covered by any care plan in the home. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 The judgement is that on the evidence collected the individual residents could have been consulted more fully on all aspects of the life they wish to live within the home, and that they could have been supported more appropriately to take risks as part of their independent lifestyle. EVIDENCE: During a close examination of the care plans for one service user in conjunction with a discussion with that person, revealed that he felt that the activities being organised in the home were irrelevant to his particular needs and choices. Attention has already been drawn to the serious risks evident from documentation, for which no risk assessment and care plan was found. It is particularly concerning as this relates to the danger of self-harm resulting from facets of the condition, which this particular gentleman has been diagnosed with. It was further concerning that a risk assessment had identified a danger of unintentional damage to the person whilst mobilising, without any formal care plan being in place, to advise staff of how to assist this gentleman or observe and monitor him, whilst he was taking the regular exercise to which he had become accustomed. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 17 From the evidence obtained on the day recommendations will be made on how to improve the relevance of activities, leisure, and diet, whose needs and choices differ from or are greater than the majority of residents in the home. EVIDENCE: This evidence is based on discussion with a service user, with members of staff, and from documentation held in the home. The documentation shows that an activities person is engaged for part of the week, and was providing age appropriate activities for the majority of the residents at Blacklake Lodge. However, discussion with a younger resident and with staff, demonstrated that in the month since his admission, no satisfactory program had been generated to fulfil his need for meaningful occupation. This gentleman was spending most of his time isolated in his bungalow, where he entertained himself with a collection of videotapes that he was able to watch. He did not feel drawn to the activities taking place in the main house, as he felt these were mainly targeted at older people, and not of interest to himself. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 10 In discussion with the resident and with staff, it was established that he had dietary needs that included the requirement to monitor and maintain a sufficient food input. The inspector felt that comments in daily record where an insufficient response to this need and that a risk assessment should have produced a care plan to be reviewed regularly and monitored by all staff. The care and concern of the staff to ensure he had alternative food, was seen in action during the inspection. However, given that this is a possible risk to his known condition, the inspector felt that professional dietary advice needed to be sort, and a much more robust care plan produced, which included the results of discussion with the resident, about what he would actually like to eat. A recommendation to this effect will be found at the end of this report. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20 From the evidence gathered during this inspection residents appeared to be satisfied with the way they were receiving personal care and support, and no concerns were identified in relation to the storage and administration of medication. EVIDENCE: The inspector undertook a close examination of a randomly chosen sample of medication administration records without finding any discrepancies, or anything that would cause concern. In discussion with staff he identified that those people named as able to administer medication had received training, and reported having excellent liaison with the local pharmacist, who was ready to advise them on any aspects of medication they felt unsure about. Services users in both the older persons and younger adults categories ensured the inspector that the staff at the home met their personal needs with dignity, and with a warmth and good nature that they appreciated. These views confirmed the observations of the inspector regarding the sensitivity and professionalism of the Senior Carer attending the needs of the resident whom he was interviewing. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 From the evidence gathered it was apparent that those staff on duty were extremely aware of the possibilities of abuse of residence and equally extremely determined to see that it would not happen. EVIDENCE: The inspector carried out a formal interview with a senior member of staff during which the subject of the protection of vulnerable adults was discussed in some detail. Not only was this person well aware of the procedure that needed to be followed should abuse be suspected, but also knew of a wide range of situations that would constitute an abuse of one of her residents. During the discussion she correctly identified that anybody whether visitor, relative, staff or fellow resident, could be capable of perpetrating an abuse on one of the vulnerable residents of Blacklake Lodge. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28 From observation and discussion it appeared that the home premise were suitable, comfortable, and with one exception in a bedroom identified, well maintained, and the two bungalows which formed the focus of this inspection were handsomely furnished with communal space. EVIDENCE: A requirement will be made in this report with regard to one service user identified to staff at the time of the inspection. It was found in his bedroom that the carpet had reached the point beyond which it was no longer capable of being restored to acceptable condition by cleaning. It was therefore required that this carpet be replaced. Similarly there was an armchair in that room, the condition of which was unacceptable. Given the residents choice to remain in the room for much of his time, it is even more important that armchair should be replaced without delay. It was of concern to note that this gentleman was spending his time in a chair designed for use in the garden, and for which no risk assessment or recommendation by an appropriate professional could be found in his care plan. Staff interviewed were unaware of the origin of the chair, and believed he had purchased it himself. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 14 With the exception noted above, the state of the accommodation examined was well in line with the recommendation of the minimum standards, and communal space in the two bungalows was generous, including well equip kitchens and bathrooms and WC. The bathing arrangements in one bungalow were a domestic bath, and in the other there was a modern shower facility. Residents of both bungalows confirmed these to be to their liking. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36 Staff were being supervised adequately and appropriately, and there were sufficient numbers to ensure competent support to the residents of the home. EVIDENCE: On arriving at the home the inspector was shown into the Care Office, where the senior carer in charge was currently undertaking supervision with members of staff. He was shown rotas that confirmed extra staff having been on duty for an extended period of handover that afternoon, to allow this supervision to take place without leaving the floor of the home short of carers. In discussion with both the senior in change and then later with another member of care staff he was able to determine that this was carried out regularly, and that it included both monitoring of the work of the individual, and any identified training needs, or personal or profession items that they wish to bring to the attention of the supervisor. During the course of the inspection staff were observed to be meeting both the regular needs of residents and, to be responding to residents summoning them vie the call system with specific or particular needs. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 16 Whilst much has been made earlier about the lack of care plan evidence for the specific needs of individual residents. There is no such criticism of the spontaneous attention being given to them by the care staff on duty at Blacklake Lodge at the time of this inspection. They confirmed that they had regular staff meeting, and records examined revealed that contact had been made recently with relevant professionals, to gain advice in respect of current good practice regarding the care of the person with dementia. Those carers interviewed were committed to a training program to equip them to carry out their tasks effectively and appropriately, and held all their studying for relevant NVQ level certificates. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41, 42 The evidence confirms that the registered care manager is currently qualified and experienced to run the home and meet its stated aims and purposes. Records were observed to be being kept in such a way that they protected the confidentiality of residents, and with the specific exception of the risk assessment referred to earlier, policies, procedure and practice were seen to be promoting the health, safety and welfare of people living in the home. EVIDENCE: During this inspection the care manager was not present in the home and was away on holiday. However, he has many years experience running this particular home, also being the proprietor. He has indicated in conversations with the inspector steps that he proposes to take to ensure that the home is managed by a suitably qualified person after 31st December 2005 when there will be a requirement for that person to be qualified in both management and care to NVQ level 4. Two members of current staff are pursuing this route. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 18 The care records, policies and procedures of the home comer were examined in the office in the main building which is kept locked when not being used, and with the exception of those matters identified in requirements, the documents examined were set out and maintained in an appropriate and up-to-date way, and residents confirmed that they were aware of their existence, but showed no interest in them. The inspector examined fire precaution records that were up-to-date and met the standard required, the medication administration record which similarly conformed with requirements, as did the accident book, complaints book, record of staff and residents meetings, and a randomly chosen selection of residents care plans. The inspector also made a cursory examination of the main building and a much more detailed inspection of the two bungalows without identifying anything other that those items named in requirements. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 3 3 x x Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Blacklake Lodge Residential Home Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 3 x E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 20 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 2 Regulation 14 Requirement Timescale for action 18.08.05 2. 6 15.1 3. 7 13.4b 4. 9 15.1 Residents shall only be admitted to the home following the production of a care plan that identifies and makes provision for all their assessed needs, risks and choices. The service users plan should 18.08.05 always identify risks such as self-harm, and contain a plan of care for enabling staff to monitor and manage such identified risks. Residents care plans must 18.08.05 demonstate the full range of their individual choices, and where these have been restricted by decisions made by other people, those decisions are also recorded. Where an assessment indicates 18.08.05 that there is a risk, there shall be a care plan for that risk which has been discussed with the resident, and any relavent specialists in the field, and that risk management strategies have been agreed, and staff informed of the protocols they are to follow, to enable the resident to enjoy the maximum independence balanced with Version 1.40 Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Page 21 their personal safety. 5. 26 The registered person must replace the carpet in the bedroom indentified at the time of the inspection with one that is of an acceptable standard. The registered person must also replace the armchair in the same bedroom and ensure that this replacement is also of an acceptable standard. The registered person must not permit the use of furniture that has not been assessed as being suitable for the purpose it is undertaking, and where this is the choice of the individual resident, it must be recorded with the appropriate risk assessments in the care plan. 18.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations The registered person is recommended to ensure that the style of decoration is compatable with the age and choices of each individual resident. Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Blacklake Lodge Residential Home E51-E09 S4918 Blacklake Lodge V241177 180705 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. Re-publishing this information is in breach of the terms of use of that website. 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