Inspection on 30/08/05 for Britannia Lodge

This inspection was carried out on 30th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Britannia Lodge 07/01/08

Britannia Lodge 09/01/07

Britannia Lodge 18/01/06

Britannia Lodge 01/02/05

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 Britannia Lodge 1 Ailsa Road Westcliff-on-Sea Essex SS0 8BJ Lead Inspector Nicola Dowling Unannounced 30 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Britannia Lodge Address 1 Ailsa Road Westcliff-on-Sea Essex SS0 8BJ 01702 432927 01702 432927 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) Wardour Group Ltd Ms Linda Knight CRHN 15 Category(ies) of Mental Disorder, MD, 14 registration, with number Mental Disorder - Over 65 MD(E), 1 of places Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1.02.05 Brief Description of the Service: Briatannia Lodge is an established residential care home with nursing for those with enduring mental health care needs. The home is registered to accommodate those who are admitted under section 7 and section 25 of the Mental Health Act 1983. The home is a modified traditional residential property situated within a residential area. It is in close proximity to local bus and train routes and to local amenities including local and main shopping areas of both Southend and Westcliff. The home is registered for 15 residents. The residents accommodation is situated on both floors and assisted access is provided by a passenger lift. There are single and double bedrooms. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and residents, observing the care given, and reading of documents. As there were no relatives at the home during the inspection their views have not contributed to this inspection report. The home had a warm and relaxed atmosphere. Five of the residents were spoken with and each said that they were generally happy with the home and the way staff cared for them. The home has vacancies for three residents. What the service does well: What has improved since the last inspection? What they could do better: The décor and furniture in the home are tired and worn and need replacing. There remains an odour from one bedroom that can be smelt in the hallway and front lobby of the home. There was a mixed reaction to the food served. Some residents did not like the food whilst others did. There is a choice of food and fresh fruit is available yet some residents would like this area to improve. As yet the home do not have a quality assurance system in place that would gain the views of the residents in areas such as this. The written information on some residents care was not up to date and did not Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 6 reflect the care that is given at the home. Residents’ care has been reviewed however the care plan was not rewritten to show the change in circumstances. 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. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 7 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 Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 8 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 and 5 The assessment for prospective new residents good however, no terms and conditions of stay leave residents unaware of their rights at the home. EVIDENCE: A trial period for a new resident was clearly documented and the assessment and history of the resident was informative. This information gave a good understanding of the residents’ current mental health problems and the staff were aware of the residents behaviour. The residents family were also involved in the moving in process. However there were no contracts found in the residents’ files detailing their terms and conditions of stay. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 9 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 and 9 Care plans are not reflecting the changing need of the resident or care that is provided in the home. Documentation is lacking in detail regarding the action taken to minimize risk for residents. EVIDENCE: Two residents files were inspected. One file did not have a care plan that was written by staff at Britannia Lodge. This file did not contain a risk plan formulated by the home identifying risk behaviours and how the home staff should manage the problem. Although this documentation was missing, the staff on duty were aware of the needs of this resident and what they had to do to care for her and keep her safe. The other file inspected evidenced that the resident had suffered a number of falls in the past six months. There had been no amendment to the care plan to indicate that this resident was at risk of falls or how these falls should be managed. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 10 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) 13, 15, and 17 There is a variety of activities that is centred on the residents enjoyment of them. A variety of nutritious food is offered but not always enjoyed by the residents. EVIDENCE: Residents were happy with the activities that are provided by the home. Residents can also take part in domestic chores in the home if they wish to or if they are in good enough health. Day trips out have been arranged and residents have the freedom to come and go from the home as they choose. Some residents need to be accompanied out and staff are available to do that with them. Families are welcomed into the home and residents go out with their relatives if they choose. There was mixed opinion about the food offered. All the residents liked the cook as he was friendly and spent time talking with the residents. However some residents felt the food was very good and others wanted different food from the choices offered. All residents agreed that they had sufficient quantity of food and plenty of drinks throughout the day. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 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) 19 and 20 The physical and psychological care of the residents is well managed EVIDENCE: There is good management of the physical care of the residents, for example regular screening for associated problems with Diabetes as well as monitoring the condition in the home. Psychological care is monitored with residents reviews taking place with their psychiatrist and social worker. Staff in the home are aware of the medicines given for psychiatric conditions and the side effects that theses have. Not all residents have their picture on their medicine card in the home. This is because of their mental health problem. The manager will address this issue when residents are well enough to agree to it. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 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) 22 and 23 Satisfactory arrangements are in place for the protection of the residents. The complaint procedure is sufficient but written in all text will make it difficult for residents to follow. EVIDENCE: Staff spoken with were aware of abuse and had received training in this topic. There have not been any complaints about the home since the last inspection. The complaints procedure was displayed and is in a text format. The manager is in the process of changing this into a format that is suitable for all residents to follow. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 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 and 30 The décor and furniture in the home is worn and of poor quality. The standard of hygiene is good. EVIDENCE: The home have a list of improvements and work is being undertaken on various rooms and equipment. However the décor of the bedrooms is poor and furniture is old and worn and needs replacing. Apart from the maintenance plan two areas were found to need attention. This was a torn area of lino in the residents’ toilet that is a potential trip hazard. Also the bedroom of one resident although clean, smells strongly of urine. This smell has now manifested itself in the hallway of the home and unless dispelled will detract from the new work that is planned. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 14 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) 35 Staff have relevant training in the care needs of the residents they look after. EVIDENCE: Staff have access to training outside of the home and have undertaken various courses in care for example, managing aggressive behaviour and NVQ’s. The home manager also uses the staff meeting as a learning forum and the minutes of the meeting supported this. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 15 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) 39 and 42 The home is well managed however as yet there is no quality assurance system that seeks the views of the residents. EVIDENCE: No surveys have been undertaken to find out the residents view of the care that they receive at the home. There is also no evidence of feedback from relatives or other professionals that would give an indication of the performance of the home. A random sample of safety certificates were checked and these all indicated that safety checks had been carried out. Accident records for residents had been recorded but not reported to the Commission for Social Care Inspection. Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 16 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 3 x x 2 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 x 3 x 2 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Britannia Lodge Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 17 yes 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. 2. Standard 5 6 Regulation 5(b)(c) 15(2)(b) Requirement All residents must have an up to date contract Time scale of 30.3.05 not met The registered person must ensure that new residents have a written plan of care that has been drawn up by the home. The registered person must ensure that risk assessments are detailed and up to date. The registered person must continue to develope the complaints procedure so that it is in a format suitable for the residents to understand. The registered person must ensure that the ripped flooring in a downstairs toilet is made safe. The registered person must ensure that the odour in a residents bedroom is dispelled All staff must be employed using sound recruitment practices. Not inspected The registered person must develop a quality assurance system which includes residents, relatives and others. The registered person must ensure that the Commission for Social Care Inspection are Timescale for action 31.10.05 31.10.05 3. 4. 9 22 13(4)(b) (c) 22(2) 31.10.05 31.10.05 5. 6. 7. 8. 24 24 34 39 13(4)(a) 16(2)(k) 19 24 31.10.05 31.10.05 31.10.05 31.10.05 9. 42 37 31.10.05 Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 18 notified of all events reportable under regulation 37 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 17 20 Good Practice Recommendations The home should evidence that the residents have been consulted regarding their chice of food A photograph should be taken of the residents and attached to their medicine card. This is to be done at a time when it does not disrupt the residents mental health condition. The practice fire drills should detail those that took part in it. 3. 42 Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Britannia Lodge I56-I06 S60903 Britannia Lodge V247189 300805 Stage 4.doc Version 1.40 Page 20 - 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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