Inspection on 09/01/07 for Britannia Lodge

This inspection was carried out on 9th January 2007.

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 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Britannia Lodge 07/01/08

Britannia Lodge 18/01/06

Britannia Lodge 30/08/05

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 Inspection 9th January 2007 10:00 Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 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 Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 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 Adults 18-65. 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. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Britannia Lodge Address 1 Ailsa Road Westcliff On Sea Essex SS0 8BJ 01702 432927 01702 432927 nurselynne@hotmail.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company Name of registered manager Type of registration No. of places registered (if applicable) Wardour Group Ltd Ms Linda Knight Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Britannia Lodge is an established residential care home with nursing for those with enduring mental health care needs. The cost of care at this home ranges from £835 – £952 per week. 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 DS0000060903.V326675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection site visit took place over a seven-hour period on one day. The site visit consisted of a tour of the home, talking with staff and residents, observing the care given and reading of documents. All the residents were seen and some were spoken to. The manager of the home was on duty and assisted with the inspection. In addition the pre-inspection questionnaire and survey forms that were received also contributed to this report. The inspector would like to thank the staff and residents for their help and hospitality during the visit. What the service does well: What has improved since the last inspection? The home’s environment is being upgraded for the benefit of the residents. The sitting room has new carpets and chairs. Residents’ bedrooms have been decorated. The front of the home is tidy in appearance. A gardener visits every week and the back garden is neat and tidy for the residents to sit outside. One resident commented on how much they were looking forward to using the new smoking cabin. When the heating is installed residents will be able to use this area instead of the dining area. The kitchen has also been upgraded and is now clean and hygienic. For the safety of moving residents the home have invested in a new hoist. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a comprehensive assessment procedure undertaken by the manager to ensure that the home can meet the resident’s needs EVIDENCE: Information in the statement of purpose and service user guide has been updated and all residents have a contract with the home. Three residents files were checked. They all contained a nursing needs assessment and an assessment on admission that was comprehensive. The home encourage trial visits and invite a prospective resident to view the home before moving in. A resident spoken to was unable to recall visiting the home before moving in however the manager remembered the visit taking place. When checking the resident’s file there was no recorded evidence of this activity taking place. This information was fed back to the manager who agreed to record introductory visits to the home. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have good support from staff with day-to-day decisions however, unrevised care plans and a lack of documentation for the use of restraint is a risk area to residents and staff.. EVIDENCE: Of the three care files checked all had a care plan that had been updated monthly with a written review of care. However one care plan did not evidence the changes in a resident’s condition. The changes had been recorded in the monthly summary and amendments made to the care plan. However the care plan did not reflect the resident’s current needs. For example changes in mobility. Another care file had a detailed care plan but had no risk assessment on the method and management of restraint. Residents’ were complimentary about the staff saying that they were “treated well” Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 10 There is evidence that staff sit with the resident to discuss their care plans and these are held safely in the office. There was no evidence that residents hold an individual care plan other than the one held in the office. Staff will help residents to make their own decisions as needed. For example residents have chosen their own colour schemes for their rooms. The home have also undertaken risk assessments for residents’ money to ensure that this is spent in an appropriate way. Some residents can budget their own money whilst others have a daily allowance to spend as they choose. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ can expect a routine lifestyle and good food. EVIDENCE: No residents attend day care services. One resident was offered but refused to attend. There is a schedule of activities displayed in the dining area, however this is loosely followed. On the day of inspection residents were mainly occupying themselves for example knitting. Some were playing board games with staff and in the afternoon two residents went out with staff to the shops. From the six residents surveys that were received five out of six said that they could do what they wanted within the home. Generally activities are undertaken on a one-to-one basis and are undertaken according to the resident’s ability and motivation. Some activities such as art therapy have been dropped from the schedule as residents’ motivation for it dwindled The home encourages family contact and has an open visitors policy. Residents’ confirmed that they receive visitors and go out on leave. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 12 Through observation staff were seen to talk with the residents and spend time with them. A resident choose to be on their own and staff were aware of this preference not to mix with other residents. Other residents said they enjoyed “listening to the football on the radio” on a Saturday afternoon together. There is free access to all areas of the home apart from the laundry and kitchen areas. For health and safety reasons access is allowed to these areas with the supervision of a member of staff. Residents’ are able to lock their own rooms and receive their own mail. Meals are served at a regular time with the hot meal of the day a lunch time. Residents confirmed that they enjoy the food saying that it was “good”. One resident that needed assistance with feeding was not hurried. A member of staff was seen to talk to the resident and stay with them until they had finished. Since the last inspection the home have a new cook. Residents confirmed that they help chose the menu and have tea and coffee between meals. Currently the home has residents’ that need a diabetic diet. No other special diets are required, however the home could cater for different diets if needed. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ physical and mental health are looked after well by trained nurses and motivated support workers. Medication systems and practices are properly managed. EVIDENCE: There was evidence in the residents care files that they had good access to other health professionals. Also for the staff there were information leaflets on various conditions. Staff spoken to are also motivated to learn more about healthcare conditions and described the manager as informative on health care. Residents confirmed that they can get up and go to bed when they choose. That staff help them when they need it. From observation residents were appropriately dressed in their own style and staff assisted them in a respectful way. Improvements requested at the last inspection for medication have been implemented and there is a safe system of managing medication in the home. Currently there is no contract for the disposal of medication. This was discussed with the manager who agreed to attend to this. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints policy and adult protection policy are satisfactory EVIDENCE: There have not been any complaints about the home since the last inspection. The manager has updated the complaints policy and this is available and in an accessible place. From the six resident surveys that were received all said that they knew how to complain and four said that they always felt listened to and two said that they usually felt listened to. Residents were aware of whom to speak to if they have a problem. There have not been any allegations of abuse at the home. Staff have received protection of vulnerable adults training and there is a policy on adult abuse. An anonymous call was received by the Commission for Social Care Inspection regarding residents paying more than the purchase price for their toiletries at the home’s shop. This was investigated at the inspection and recommendations were made. These were to: Ensure that the cost price of the toiletries could be matched to the purchase price that the resident pays in the home. That the money accumulated from the sale of the toiletries is accounted for. That there is an audit trail ensuring that this profit goes back into providing activities for the residents. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29, and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment for the residents is comfortable and continues to improve EVIDENCE: The front of the home has been upgraded and now looks tidy and well looked after. At the back of the property there is now a new smoking cabin. The residents commented that they were looking forward to using it when the heating is installed. There is new carpet in the lounge with new furniture and the dining room has new flooring. Residents were involved in this process by choosing fabric and carpet from samples that were bought into the home. Work has been done to upgrade the kitchen, with new units and tiled walls. A recent environmental health inspection was satisfied with the improvements to the kitchen and food storage areas. The home environment is being improved, however there are still areas that are waiting to be decorated and furnishings renewed. For example one Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 16 resident’s bedroom had a torn bed base and marked carpet. The paintwork on the walls was chipped and the sink unit badly worn. The home have invested in a new hoist for the purposes of moving and handling. The passenger lift is in good working order and regularly maintained. There is an assisted bath that is clean and well maintained. The laundry area is secure and resident’s said that they were satisfied with the laundry at the home. The home employs a cleaner and generally hygiene around the home is good. There are no odours in the home and waste is disposed of properly. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 17 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels and training are good, however the recruitment process is not sufficiently robust. EVIDENCE: Staff were observed to treat residents’ in a respectful manner and four out of six residents reported that carers always listen to them. Excluding the manager there are twelve care staff working at the home. Ten of these staff hold a National Vocational Qualification (NVQ) in care. The manager also has attained the NVQ4, managers award. Two staff were spoken to during the inspection. Both were enthusiastic about their work and had a commitment to improve the lives of the residents. The home offer regular training and staff confirmed that they had been on training courses. The staff also commented that manager passes on her knowledge of mental health during meetings. For the care of the residents the home have four staff on in the morning and three staff in the afternoon. At night there are two staff. A qualified nurse is Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 18 always on duty in the home. Nurses are qualified in the field of general and mental health, increasing the expertise of the staff group. Three recruitment records were checked. One did not have any identification on file and one did not have references on file. All had a criminal records bureau (CRB) check however a protection of vulnerable adults check had not been requested as part of this CRB check. Staff undertake the skills for care induction programme. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 19 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is competent and runs the home with the resident’s health and safety in mind. However because the quality monitoring system is incomplete the home cannot measure it’s success in achieving the aims of the service it provides. EVIDENCE: The manager has the experience and skills needed to run the home and is a qualified nurse in the field of mental health. Work on quality assurance is underway to gain the views of residents and others that visit the home. However as yet there is no report available for this year that collates the views of residents and others regarding how they view the service that Britannia Lodge offers. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 20 A random selection of safety certificates was inspected and these were all up to date. There have not been any security issues at the home. Records are kept of accidents or incidents that occur in the home. The manager is aware of the health and safety responsibilities in the home. Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 3 2 3 3 x 4 2 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 2 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 22 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 Standard YA6 Regulation 15(2)(b) Requirement The Registered Person must ensure that care plans reflect service users needs.. The Registered Person must ensure that a risk assessment is available for the method and management of restraint. The Registered Person must ensure that resident’s bedrooms are redecorated and furnishings upgraded. The Registered Person must ensure that all the information required by regulation for recruitment is gained. This is with regard to requesting a protection of vulnerable adults check along with the CRB check. The Registered person must undertake a quality assurance review and formulate the information into a report. The report must be sent to the Commission for Social Care Inspection. Timescale of 30/11/06 not met DS0000060903.V326675.R01.S.doc Timescale for action 23/03/07 2 YA9 13(4)(c). 13(7) 23/03/07 3 YA24 23(2)(d) 23/03/07 4 YA34 19, Schedule 2 23/03/07 5 YA39 24 23/03/07 Britannia Lodge Version 5.2 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 Refer to Standard YA4 Good Practice Recommendations The manager should keep a record of pre admission assessments and introductory visits that prospective residents make to the home. The manager should establish other forms of therapy that the residents would like to undertake now Art therapy is not available. The manager should ensure that the recently established shop accounts are monitored. The manager should ensure that the residents choose how the profits from the shop are spent. YA13 YA23 YA23 Britannia Lodge DS0000060903.V326675.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000060903.V326675.R01.S.doc Version 5.2 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. 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