Inspection on 09/11/05 for Breck Lodge

This inspection was carried out on 9th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Breck Lodge 08/01/07

Breck Lodge 29/03/06

Breck Lodge 02/12/04

Breck Lodge 05/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Breck Lodge 78/80 Breck Road Poulton le Fylde Lancashire FY6 7HT Lead Inspector Mr Patrick Rooney Unannounced Inspection 9th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Breck Lodge Address 78/80 Breck Road Poulton le Fylde Lancashire FY6 7HT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01253 894567 Mrs Christine Dickinson Mr Simon Dickinson Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2004 Brief Description of the Service: Breck Lodge is registered with the Commission For Social Care Inspection to provide personal care for 15 service users of either sex aged 65 and above. The home is situated near to Poulton and is within easy reach of local shops and amenities. There is a main bus route near the home. It is a large detached property with a parking area at t he side of the home. There are pleasant garden areas at the rear of the home, which are accessible to service users. There are two lounges and a lounge/dining room. Resident’s private accommodation consists of 15 single rooms all of which have ensuite facilities. Residents are encouraged to retain their links with family and friends and every effort is made to ensure relationships, hobbies and interests are pursued. Relations and friends are always made welcome at the home and may see residents in private. Personal requirements of residents are catered for by staff, who receive training in all aspects of care for the older person. Any medical needs are managed by resident’s own general practitioners and district nursing staff. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over a period of five hours. The information in this report was gathered from discussion with staff on duty, examination of records, discussion with residents and a tour of the home. The care of four residents was tracked and those residents were interviewed privately regarding the care they receive. Another nine residents were spoken to in the lounges. Questionnaires were received from residents and relatives. Residents Comments received from residents regarding their care are, “ We can please ourselves what we do, staff encourage us, we have our independence”. “I have no complaints staff are always there to help you” Comments received from relatives are, “Staff are always helpful and supportive” “I am very satisfied with the way aunty is being cared for”. Since the last inspection there have been no complaints received regarding the home. What the service does well: Breck Lodge provides a pleasant safe environment for residents which gives them privacy of their own rooms or the use of several nicely furnished and decorated lounge areas. Initial assessments are good and contain good information about the care required for individual residents. Food provided by the home is all home cooked and of very good quality with alternatives always available. Residents told the inspector the food is very good and tasty. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: There has been a slippage in the recording and reviewing of care plans. These need to be recorded better and show the involvement of residents in the planning of care. There are concerns regarding the storage and administration of medication. At the time of the inspection medication was observed to be incorrectly administered in pots and without the MAR sheets. Controlled drugs were not stored correctly and there was no controlled drugs register. The pharmacy inspector was asked to carry out an inspection. This was done on 18th November 2005. This inspection also showed concerns about the administration of medication, including the fact that medication was given out and not being signed for. The pharmacy inspector made four statutory requirements and six good practice recommendations. Staff supervision requires attention as during the inspection there were no records of supervision available and staff said they did not have formal supervision sessions. During both the main inspection and the pharmacy inspection the inspectors found that there was no designated senior person on duty. It would appear that many of the issues listed above are due to the lack of a manager to run the home. There is no registered manager and the registered providers are not on the homes rotas to show that there is day-to-day management in the home. It is necessary for a suitably experienced and qualified manager to be registered to run the home. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 7 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. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 The admission and assessment procedure is clear and ensures the care needs of residents are met. Residents are provided with a service users guide and information to enable them to make an informed decision regarding accepting a place in the home. EVIDENCE: The home has good admission procedures to ensure resident’s needs are assessed and planned for. There are individual records kept for each resident. The inspector looked at the admission and care records for four residents. They or their representatives had been given the opportunity to look around the home and were given a service users guide. Each had received a contract and were given a settling in period prior to making a final decision about accepting a permanent place. The residents whose records were looked at Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 10 were seen and confirmed that a pre admission assessment of their needs had taken place and that assessed care needs are addressed. This was also confirmed from discussion with other residents. Comments received from residents regarding their care are, “ We can please ourselves what we do, staff encourage us, we have our independence”. “I have no complaints staff are always there to help you” Comments received from relatives are, “Staff are always helpful and supportive” “I am very satisfied with the way aunty is being cared for”. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 While there are care plans and residents said they are happy with the care they receive, the recording of care plans has slipped from previous inspections and do not show involvement of resident in this process. Staff are not following the correct procedures for administration and storage of medication. EVIDENCE: Comments from residents as recorded above show that there is satisfaction with care delivered by staff. However examination of records for four residents did not contain all information required on care plans. Residents or their representatives had not signed the care plans and reviews were not recorded as carried out. The inspector observed medication being given out in pots without records being checked. These medications had been transferred from original containers to the pots. There are residents currently having morphine patches applied. The inspector found that these were not stored correctly as they are a Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 12 controlled drug. There was no controlled drug register available for inspection. Following the inspection a request was made for the pharmacy inspector to visit. This visit was carried out on 18th November 2005 and found serious discrepancies in administration of medication. The pharmacy inspectors report is available and a follow up visit is planned. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Activities are provided both on an individual level and in organised entertainment sessions. Residents are enabled to maintain contacts with family, friends in privacy. There is a good variety of home cooked food available there are always alternatives available. EVIDENCE: The inspector saw a programme of activities and spoke to residents about what they do during the day. They spoke well about entertainers who come to the home. Those who wish can go on outings arranged by the home. Residents said they are encouraged to take part in activities and can choose to take part or not. Staff ensure all have the opportunity to become involved. The homes routines are flexible and take into consideration the individual needs and wishes of residents. Staff spoken to showed a good understanding of individual residents needs. Interests and hobbies are recorded in resident’s assessments and care plans. Residents recently had a tip out to Blackpool Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 14 lights one said, “I enjoyed the trip to Blackpool lights, we had a fish and chip supper out, which was very nice”. Visitors seen during the inspection said they are always made welcome at the home and can see their relatives in the privacy of their own rooms. Residents also said this was the case and questionnaires returned also confirmed this to be the case. The inspector observed residents having lunch, food served was of a very good standard and all was home made. Residents said they enjoy the food and always have alternatives if they ask. Menus and records of meals served showed a good variety of food is always available. One resident said “the food is excellent and is all home made” another said, “ the food is very tasty and we get a good variety of food which we like”. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 There is a complaints procedure, relatives and residents are confident that their concerns are listened to, taken seriously and acted upon. There is a vulnerable adults procedure that ensures people living at the home are protected from abuse. EVIDENCE: The inspector saw the complaints procedure this is made available to all residents and is contained in the service user guide. It is also posted on the homes notice board. There are also leaflets available giving information about independent advocacy. There have been no complaints recorded since the last inspection. Residents and their relatives told the inspector they are aware of the complaints procedure and it is contained in the service users guide. They said that they find the management of the home very approachable and that they are confident any concerns they raise are immediately dealt with. The inspector saw the homes vulnerable adults procedures including the whistle blowing policy. These are in line with the Department Of Health, ‘No Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 16 Secrets’ paper. Staff spoken to, were aware of the whistle blowing policy and said they would approach the manager if they had any concerns. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23 and 24 The home offers a good standard of décor and furnishings, which provide residents with a homely comfortable and safe environment. EVIDENCE: The inspector toured the home and viewed the rooms of residents, he observed them to be comfortably furnished and contained items residents were able to bring with them when they were admitted to the home. Public areas of the home were seen, and are comfortably furnished and decorated. Residents have a choice of lounges to sit in, with or without television. All residents spoken to say they were happy with accommodation provided by the home. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 The number of staff on duty is sufficient to meet the needs of residents. Staff are given the opportunity to do the NVQ 2 qualification in care. EVIDENCE: The inspector saw rotas spoke to staff and residents. Rotas showed that there is always sufficient staff on to meet the needs of residents. Questionnaires were received from eight residents and four relatives; these confirmed that there is always plenty of staff available. One resident said “there are always staff to help you”. Another said, “When I ring my buzzer staff come immediately”. Another said, “ Staff are always there and are very helpful”. Staff are given the opportunity to receive training in the care of the elderly, training records showed that there are currently 50 of staff qualified to NVQ level 2 and there are two staff doing this qualification. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32 and 36 Overall the residents benefit from good care and the registered providers are currently completing the Registered Managers Award, however the home should nominate a designated senior member of staff for management cover. EVIDENCE: On entering the home the inspector asked who was in charge and was told that all staff were working together and there was no senior on duty. This was the same when the pharmacy inspector visited on 18th November. Neither of the registered providers appear on the management rota. There is one senior carer who is not a registered manager. When the inspector asked for supervision records and how often this took place staff did not know and said they did not receive formal supervision. There were no supervision records available at the time of the inspection. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 20 There are several aspects of this inspection, which raise concerns regarding management procedures in the home. Care records, administration of medication and staff supervision. This points to the need for the home to ensure there is always a designated person covering management of the home. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X X 2 X X Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(a)(b0 Requirement The registered person must ensure all residents have a care plan which is reviewed monthly and involves the resident in the process The registered person must put in place a supervision system to ensure all staff receive formal supervision The registered person must ensure all medication is administered and recorded as prescribed The registered person must ensure all medication is securely stored at all times The registered person must ensure controlled drugs are handled and recorded accurately The registered person must ensure an accurate record of receipt is made for all medication kept in the home Timescale for action 31/01/06 2 OP36 18(2) 31/01/06 3 OP9 13(2) 04/01/06 4 5 6 OP9 OP9 OP9 13(2) 13(2) 13(2) 04/01/06 04/01/06 04/01/06 Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 23 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 3 4 5 6 8 9 Refer to Standard OP9 OP9 OP9 OP9 OP9 OP9 OP32 OP32 Good Practice Recommendations A photograph of each resident should be kept with the medication administration records. A list of authorised signatories along with sample initials should be kept with records All patient information leaflets should be obtained for all medication and retained for training and general information. Suitable warning signage should be obtained for oxygen. All handwritten medication administration records should be double-checked by another designated member of staff, two signatures should witness this checking. All medication packaging (non monitored dosage system) should be dated upon opening. The registered providers should ensure there is always management cover shown on the rota The registered providers should obtain the Registered Managers Award. Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Breck Lodge DS0000031837.V262298.R01.S.doc Version 5.0 Page 25 - 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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