Inspection on 20/08/09 for Bowland Lodge

This inspection was carried out on 20th August 2009.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bowland Lodge 17/09/09

Bowland Lodge 20/09/07

Bowland Lodge 25/07/06

Bowland Lodge 26/01/06

Bowland Lodge 27/09/05

Bowland Lodge 05/10/04

Bowland Lodge 22/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Random inspection report Care homes for older people Name: Address: Bowland Lodge Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Alan Baxter Date: 2 4 0 8 2 0 0 9 Information about the care home Name of care home: Address: Bowland Lodge Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP 01912734187 F/P01912734187 lindaparkin@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Ram Perkesh Malhotra,Mr Darshen Kumar Malhotra care home 36 Number of places (if applicable): Under 65 Over 65 12 21 dementia old age, not falling within any other category Conditions of registration: 3 0 One OP bed to be used to accommodate a named person in category DE, for a period of eight months from 5th December 2005 Date of last inspection Brief description of the care home Bowland Lodge is a care home that provides personal care to 36 older people and people with dementia. The home is located within a residential area of the west end of Newcastle upon Tyne. The three-storey property is converted from two adjacent Victorian houses. A new passenger lift has recently been installed. There is easy access by public transport and to local amenities and shops. The fees payable are from #373 to #383 per week, with extra payments for Care Homes for Older People Page 2 of 13 Brief description of the care home hairdressing, toiletries and newspapers. Care Homes for Older People Page 3 of 13 What we found: This random unannounced inspection of Bowland Lodge care home took place on Thursday 20th August 2009, with follow-up visits on Friday 21st and Monday 24th August. It was triggered by concerns raised by officers of Tyne & Wear Fire and Rescue Service who had attended the home on the evening of Tuesday 18th August in response to an emergency services call regarding a fire. This fire resulted in the hospitalization of a resident, who subsequently died. A member of staff had also received minor burns whilst bravely putting out the flames. Fire officers expressed concerns that a fire exit was padlocked shut at the time that they were called out to the home, thus endangering the safety of residents, staff and fire fighters. They were also concerned that the night staffing levels were insufficient to conduct an evacuation of the home at night. Code B notices were served, under the Police and Criminal Evidence Act, regarding the copying of relevant documentation during the inspection. Fire officers undertook a joint inspection of the building with the CQC manager and regulatory inspector, and with the registered manager, on Thursday 20th August. They described how they had found the fire door at the north end of the annex corridor padlocked shut, and had had to remove the padlock to make the fire exit accessible. In addition, this corridor had no partitions. Fire would therefore have been able to spread unhindered to other parts of the building. Therefore, a horizontal evacuation of the building would not be possible. Bedroom 17, where the fire had started, had been sealed by Police as a potential crime scene. The carpet outside this bedroom had burn marks. Externally, building works to extend the home were found. They were not cordoned off in any way. The floor levels of internal corridor/fire door and the ground outside were significantly different, leading to an obvious risk of falling or tripping on the way out. A temporary ramp had been installed by the builders the previous day, but this constituted a trip hazard in itself. Other trip hazards noted in what was one of the fire escape routes from the home were uneven flagstones, raised manholes and drain covers, and the lack of appropriate emergency lighting. These issues have since been reported to the councils building control section, and to the Health and Safety Executive. No contingency safety plans were available to show how the responsible individuals intended to maintain the safety of people using the home whilst building works were underway. Internally, new locks had just been fitted to all the various linen storage areas, which had previously been accessible to all. An immediate requirement was issued to the manager, requiring her to keep laundry/linen cupboards locked. Care Homes for Older People Page 4 of 13 Other significant fire hazards pointed out by fire officers included the many voids within the building and the partly-boxed pipe work, both of which would allow fire to travel swiftly between different parts of the building. Fire detection in these areas was inadequate. A fire escape route from the first floor was unsafe due its steepness and the fact that it led directly into the kitchen. There was a lack of compartmentalization around passenger lift doors, and insufficient fire proofing of the lift motor room. Upholstered armchairs in these areas were also a fire hazard (they have since been removed). All the above issues were discussed at length with the responsible persons and the manager on Friday 21st August, and pointed out to them in a tour of the building with fire officers and CQC officers. Further immediate remedial work was requested in the fire escape route area to the rear of the building, and this was carried out. Emergency lighting had been purchased the previous day and was due to be fitted shortly. The need to improve access to and from the fire escape door at the south end of the annex corridor was pointed out. The area of building construction work had been cordoned off. Other issues of poor maintenance and general neglect of the building, such as threadbare carpets, water damage to walls and ceilings of bedrooms 21 and 23, doors not closing into rebates, damaged door handles and mismatched bathroom suites, and unsound window frames throughout the building, were noted. The responsible persons said that they would carry out any work asked of them, and referred to the recent installation of a new fire alarm system as evidence of their commitment to the home. Also, that they had contracted with the company employed to build the extension to the home to undertake risk assessments and to carry out any health and safety work necessary. The same afternoon, fire officers Clarke and Hands outlined to the responsible persons the legal steps that they were intending to take, specifically enforcement action under the Fire Regulatory Reform Order 2005, and explained that this would include the need to interview them under caution. Their rights of appeal were explained to them. The urgent need for a comprehensive professional fire safety survey was re-iterated, as was the need to improve fire training and night staffing levels. Specific areas for work, such as the need to upgrade fire doors, install roof compartments, compartmentalize corridors and protect lift areas, were explained. The homes policy on residents smoking should also be reviewed. At the time of the fire (9:15 pm) two night staff had been on duty. One received minor burns to the hand that necessitated him going to hospital, leaving one member of staff for a short period before the manager arrived to take charge that evening. Staff rotas for the previous 12 weeks were provided by the manager. She stated that she had made the decision to reduce the night staff to two because current residents did not require much help during the night. She said that six residents needed some help through the night, and that some residents had asked not to be disturbed during the night. She had made no record of how this decision had been reached. The manager had increased the number of night staff to three after the fire, but was advised that she needed to review night staffing because of the risks imposed by the layout of the building and in light of the issues raised by the Fire and Rescue service. The manager was able to demonstrate that she was already in the process of recruiting new Care Homes for Older People Page 5 of 13 staff. She had no administrative support at the time of this inspection, but has since had such support agreed by the responsible persons. As an interim measure, the responsible persons asked for advice on minimum staff levels at night, and agreed to put six staff on nights until further notice. Fire records showed that the alarm system is regularly checked. The manager holds regular fire training sessions. Staff were aware able to describe what was expected of them in the case of a fire, but they also said that they had never actually carried out an evacuation of the home in practice. Staff said that residents do not usually react when the fire alarms are sounded. The manager said that she had not been given anything other than basic fire safety training herself, and agreed that she needed more advance training in order to fully train her staff. Risk assessments are in place, and these related to individual residents needs. However, a general approach to the fire safety of the premises is not highlighted, and the assessments need to be revised to reflect this. The manager was in the process of completing a new fire risk assessment of the premises; she was advised to get professional help with this. The manager was informed that she must continuously monitor the dependency levels of the resident group, and adjust staffing levels accordingly. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15.2 Care plans must be updated 30/11/2007 in line with changes noted in their monthly evaluations. 2 15 16.2 A four-week menu must be introduced, with vegetables specified on the menu. The menu must be followed unless there is good reason. 30/09/2007 3 30 18.1 All staff must be brought up to date with statutory training needs. All staff must have an individual training and development plan. 31/03/2008 4 30 18.1 31/12/2007 Care Homes for Older People Page 7 of 13 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 19 23 Make good the surface of the 20/08/2009 make shift ramp leading from the north end of the homes annex to remove the trip hazard and ensure sufficent lighting along the pathway/escape route. This is to improve the safety of service users. 2 20 23 Remove fire risks in the form 21/08/2009 of soft furnishings/chairs in corridors and the large chest of drawers containing laundry outside room 23. Investigate cause of damp/water damage in rooms 21 and 23. This is to improve the safety and comfort of service users. 3 27 18 Review night time staffing 20/08/2009 and increase number of staff at night. This is to improve the safety of service users. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The registered persons must 30/09/2009 ensure that the building complies with the Page 8 of 13 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action requirements of the local fire service. This is to improve the safety of service users. 2 19 23 The registered persons must 30/09/2009 ensure that the grounds of the home are kept safe and accessible to all service users, particularly with regard to egress from fire exits. This is to improve the safety of service users. The registered persons must 30/09/2009 ensure that a programme of routine maintenance and renewal of the fabric of the building and decoration is produced and implemented with records kept. In particular, window frames must be replaced, fire doors upgraded with smoke seals, water damage repaired, unsuitable baths replaced, and carpets replaced where necessary. This is to improve the safety and comfort of service users. 4 22 23 The registered persons must 30/09/2009 ensure that grab rails, hoists and any other aids assessed as being necessary are provided in bathrooms and toilets used by service users. This is to improve the safety and accessibility of facilities Care Homes for Older People Page 9 of 13 3 19 23 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action in the home. 5 23 23 The registered persons must 30/09/2009 ensure that the external grounds are made safe for use by residents and are appropriately maintained. In particular, the current building works adjacent to the home must be properly cordoned off. This is to improve the safety of service users. 6 25 23 The registered persons must 30/09/2009 ensure that emergency lighting is provided throughout the home, including all external fire escape routes. This is to improve the safety of service users. 7 27 18 The manager must keep 30/09/2009 staffing levels constantly under review, and must staff the home according to the assessed needs of service users, on the basis of an at least monthly review of dependency. This is to improve the safety of service users. 8 31 23 The registered manager 30/10/2009 must undertake further fire safety training to allow her to give the appropriate level of training to her staff. This is to improve the safety Care Homes for Older People Page 10 of 13 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action of service users and staff. 9 38 23 The registered manager must ensure that all staff have a full understanding of the appropriate fire procedures and carry out periodic practices of such procedures. This is to improve the safety of service users and staff. 10 38 13 The registered persons must 30/09/2009 ensure that the health and safety of residents and staff is maintained by providing a safe environment. This is to improve the safety of service users. 11 38 13 The registered manager must ensure that appropriately detailed risk assessments are carried out for all safe working practice topics and that any significant finding of risk are recorded and addressed. This is to improve the safety of the service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 30/09/2009 30/09/2009 1 19 The manager was advised to get professional help when undertaking a fire risk assessment of the premises. Care Homes for Older People Page 11 of 13 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 2 33 When any construction work to the building is being carried out, the responsible persons and the registered manager should ensure that maintaining the quality of life for the residents is the foremost consideration at all times. Fire risk and other risk assessments should clearly take into account the current dependency levels of the resident group and the current staffing levels when reaching their judgments. 3 38 Care Homes for Older People Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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