Inspection on 03/05/05 for Bowles Lodge

This inspection was carried out on 3rd 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

Bowles Lodge 24/09/08

Bowles Lodge 11/04/07

Bowles Lodge 05/09/05

Bowles Lodge 21/12/04

Bowles Lodge 13/08/04

Bowles Lodge 04/11/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Bowles Lodge All Saints Road Hawkhurst Kent TN18 4HT Lead Inspector Gary Bartlett Unannounced 3 May 2005 13:30 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 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. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bowles Lodge Address All Saints Road Hawkhurst Kent TN18 4HT 01580 752775 01580 754622 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) Kent County Council Mrs Beverley Seal CRH Care Home 36 Category(ies) of OP Old Age (36) registration, with number of places Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 December 2004 Brief Description of the Service: Bowles Lodge is a Linked Service Centre owned and operated by Kent County Council. It offers residential care for 36 older people and there is a day centre on the site. The Home is a detached, purpose built, premises on one level with 34 single bedrooms and one shared bedroom. There are staff call points and television points in all bedrooms. There are telephone points in some bedrooms and at other places around the Home. There is a large garden to the rear of the building and car parking to the front. Bowles Lodge is located near to the centre of Hawkhurst village with easy access to bus services. The nearest shops and other amenities including churches, library, chemist, post office and public houses are within half a mile.The Home’s senior staffing team comprises the Manager, a Senior Team Leader and Team Leaders. The Home employs Care Workers who work a roster that gives 24-hour cover and additional staff for catering, domestic and administration duties. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 ½ hours. Seven residents were spoken with. Many judgements about the quality of life for residents were made from observation, inspecting parts of the premises, reading records and speaking with the Senior Team Leader, two Team Leaders, care and ancillary staff. The tour of parts of the premises included the lounges, laundry, bathrooms, toilets and several bedrooms. The records inspected included care plans, staff rosters, training records and some procedures. All staff were very helpful during the inspection. What the service does well: What has improved since the last inspection? There had been some improvements to care plans and risk assessments though this needed to be further developed. There have been some attempts to improve the water supply but this had been only partially successful. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 6 Staff practices in respect of infection control had improved and security of the sluice room doors had been enhanced with the fitting of keypad locks. A new system of formal staff supervision and appraisal was being implemented. 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. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.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 Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.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) These Standards were not inspected EVIDENCE: Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 9 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 and 10 Residents were benefiting from staff having a clearer understanding of their care needs through a gradual improvement in care plans and risk assessments, although further and more consistent improvement was required. Residents had access to health care services. Staff treated residents with respect and maintained their privacy and dignity. EVIDENCE: Three care plans were inspected and staff were spoken with about them. New care plans were being introduced along with more comprehensive risk assessments. Staff were being trained and supervised in this. Whilst there were tangible improvements, staff acknowledged further work was required. Records seen and discussion with staff and residents indicated that residents were able to have access to Doctors, Community Nurses, Dentists, Chiropodists etc as and when required. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 10 From observation and discussion with residents it was evident their privacy and dignity were maintained as best as possible by staff. One resident said “staff are kind, even when very busy”. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 11 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) These Standards were not inspected EVIDENCE: Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 12 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, 17 and 18 Residents felt safe in that if they could complain if they had need to and any complaint would be treated seriously. Residents legal rights were maintained Residents were safeguarded from abuse, discrimination and neglect. EVIDENCE: The complaints procedure was seen to be available to residents and their families. Residents spoken with said they knew they could make a complaint when necessary but “I’ve not had anything to complain about” and “one or two little grumbles but they have always been sorted out quickly”. Records of complaints were not inspected. A senior staff member stated all permanent residents were on the electoral roll and mostly used postal votes. Some residents spoken with were aware of the forthcoming general election and the expressed view from one resident that “none of them are worth ****** voting for” seemed to be the general consensus of opinion. There were Adult Protection procedures at the Home and records seen indicated staff training in abuse awareness. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 13 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, 22, 24, 25 and 26 Residents generally enjoyed a clean environment and those spoken with liked the Home. Toilet facilities were not adequate for wheelchair users and caused embarrassment and inconvenience. The environment did not ensure residents’ comfort and safety. EVIDENCE: At the time of inspection those parts of the Home inspected were clean and free from unpleasant odours. There was a large, well tended, garden with wheelchair access. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 14 The Home was close to the village centre where there are shops, public transport and other amenities. The Home comprised four units. An internal fire-door that could only be opened from one side connected rooms 1 and 2 of each unit. The necessity of keeping these doors free from obstruction meant that it was difficult to furnish the rooms in such a manner that complied with the Standards and allowed the service users clear floor space. This would be particularly problematic if the occupant used a mobility aid. The Inspector again questioned whether the room occupants would be able to operate the fire-door opening device in an emergency. A senior staff member stated these matters had been referred to Kent County Council but was unaware of any resultant directives. The Home was purpose built and allowed ease of access to most parts for residents with mobility difficulties. As noted in previous inspection reports, a wheelchair-dependant resident had described how the toilets were too small to accommodate their wheelchair or allow sufficient room for manoeuvring. Consequently the resident had to leave the toilet door open when using the facility. Residents said the toilet facilities were sited conveniently close to the communal living areas. The staff call system was fitted to all parts of the Home that was used by residents. The sluices were appropriately sited. Residents told the Inspector that their bedrooms were comfortable and they thought them to be adequately furnished. Residents’ safety in one communal area was put at risk through a decommissioned water heater causing obstruction for people using a sink and damaged work surfaces and units in the kitchenettes. A senior staff member described how proposals for improvement and quotes had been submitted to Kent County Council and the Home was waiting for a response. The Inspector was pleased to see replacement bins had been provided in the sluices and staff practices had improved to maintain infection control. The laundry was clean although it was seen that parts of the walls needed to be repaired to ensure adequate cleanliness. This also applied to the walls of some toilets. It was seen that the water supply to various parts of the Home was still problematic with low water pressure or no hot water supply at all, despite recent remedial work. The Home was centrally heated throughout. Some of the radiators were still in need of being guarded or fitted with individual thermostatic control valves to ensure they were safe for residents. Emergency lighting was provided and residents said there was adequate amounts natural of light. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 15 Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 16 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) These Standards were not inspected EVIDENCE: Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 17 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) 36 Residents benefited from a comprehensive induction programme for new staff and a new staff supervision and appraisal system. EVIDENCE: A new staff member described the induction programme they were undertaking that included familiarisation with the premises, the residents and the policies and procedures used to ensure the well being of the residents. The new staff member was required to shadow experienced staff members and was regularly supervised by senior staff. Staff spoke of a staff supervision and appraisal system recently introduced to ensure residents’ care needs were being met through good practice. Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 18 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 3 2 2 3 2 2 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x 3 x x Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 19 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 7 Regulation 15(2), 17 Schedule 3, Schedule 4 13(4) Requirement “The registered person shall maintain records as specified in Schedules 3 and 4. The registered person shall keep the Service User’s plan under review” in that the care plans must be descriptive of the care to be given The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible elimated in that risk assessments must be more comprehensive “The registered person shall ensure that the Home is conducted so as to make proper provision for the care of Service Users and that suitable equipment and facilities are provided for Service Users who are old, infirm or physically disabled” and “The registered provider shall make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of the Service User” in that appropriate toilet facilities must be provided Timescale for action Action plan to be received by CSCI by 30/05/05 2. 7 Action plan to be received by CSCI by 30/05/05 To be completed by 01/08/05 or sooner 3. 21 12(4)(a) 23(2)(n) Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 20 4. 19, 25 13(4) 5. 25, 26 12(1)(a) 23(2)(c)(j ) 6. 24, 26 12(1), 13(3)(4)( c) 16(2)(j) for wheelchair –dependant Service Users. This remained a requirement from previous inspections “The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated (and shall make suitable arrangements for the training of staff in first aid)” in that: 1. All radiators must be guarded or operated at low surface temperatures. 2. The decommissioned water heater in the kitchenette area must be removed. 3. All toilet support frames must be securely fixed. “The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users”“The registered person shall having regard to the number and needs of the ensure that equipment provided at the care home for use by service users or persons who work at the Home is maintained in good working order” In that an adequate supply of water must be available to all parts of the Home. This was being addressed, however this remained a requirement from previous inspections “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home”, in that: 1. The walls of the laundry and, where necessary, of toilets must To be completed by 01/08/05 or sooner Action plan to be received by CSCI by 30/05/05 To be completed by 01/08/05 or sooner Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 21 be made good to promote infection control and adequate hygiene standards. 2. Adequate water supplies must be provided to the toilets for hand-washing. 3. The work surfaces and surrounding areas of the kitchenettes must be made good to maintain food hygiene standards. Actions 2 and 3 remained requirements form previous inspections 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 19 Good Practice Recommendations It is recommended the suitability of the use of room 1 of each unit as a bedroom is reviewed in view of the necessity of keeping the internal fire- doors free from obstruction and the resultant difficulty in furnishing them in such a manner that complies with the Standards and allows the service users clear floor space. This remained a recommendation from the previous inspection. It is strongly recommended the Home assesses the suitability of the opening device of the internal fire-doors connecting bedrooms 1 and 2 of each unit. This remained a recommendation from the previous inspection. It is strongly recommended a dedicated hand-wash basin be supplied in the laundry It is strongly recommended that hospital style beds are only used where assessed as being necessary to meet the service users needs 2. 19 3. 4. 26 24 Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Bowles Lodge H56-HO6 S37778 Bowles Lodge V219972 030505 Stage 4.doc Version 1.30 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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