Inspection on 09/09/05 for Byron Lodge Residential Nursing Home

This inspection was carried out on 9th September 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

Byron Lodge Residential Nursing... 14/03/07

Byron Lodge Residential Nursing... 28/04/05

Byron Lodge Residential Nursing... 15/02/05

Byron Lodge Residential Nursing... 17/06/04

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 Byron Lodge Residential Nursing Home 105-107 Rock Avenue Gillingham Kent ME7 5PX Lead Inspector Lucy Ansell Announced 9 September 2005 10.00am 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. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Byron Lodge Residential Care Home Address 105-107 Rock Avenue Gillingham Kent ME7 5PX 01634 855136 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) Dr Prathap Padmanabhan Jana Mrs Jyothi P Jana Mrs Margaret Joy Spurgeon Care Home 28 Category(ies) of OP Old age - 28 registration, with number of places Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 April 2005 Brief Description of the Service: Byron Lodge is a privately owned, purpose built, 28 bedded home, providing 24 hour nursing care to older people. The service users’ accommodation is sited on three floors with a passenger lift to all floors. There are a variety of aids and adaptations around the home, which enable more independence for the residents. All areas of the home used by the residents are wheel chair accessibleThe home is situated in a residential area close to Gillingham and Chatham town centres. . The home is located on a main bus route and within walking distance of shops and a Post Office. The home has an attractive garden to the rear of the property and also some limited parking facilities. Parking on the road is time restricted.Dr and Mrs Jana own the home, one of three in the area. A registered nurse manages the home and there is an additional qualified staff on duty at all times, as well as care staff. The home also employs domestic and catering staff. At the time of this inspection 27 service users were living in the home and there was one vacancy. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place on 9th September 2005 by one inspector Lucy Ansell. The Inspector agreed and explained the inspection process with the Registered Owner and the manager. Documentation and records were read, including care plans. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises was undertaken. The focus of the inspection was to assess the Home in accordance to the National Minimum Standards for older persons and to seek resident’s and representatives views of the home. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full and the last report should be read in conjunction to obtain a full picture. What the service does well: The plans of care indicated in detail the care required to meet the individual needs of the residents. The care plans seen were of a high quality and exceeded the required standard. It was noted that staff regularly review all aspects of the care plan recording outcomes and making changes, as required, daily logs were informative and comprehensive. On inspecting the home it was apparent that staff maintain a high level of cleanliness and a high level of decorative order was maintained throughout the home. The home have shown a high commitment to giving the staff sufficient skills and knowledge to ensure the service users are well cared for. The home has achieved 95 of their staff having gained the NVQ level 2 in care or above. The home provides a comprehensive induction package for all new staff. The home has a comprehensive and robust policy and procedure on recruitment that they follow meticulously. The information retained by the home on staff files is kept well maintained. There was good feedback from the service users, relatives, Care managers and health professionals and the home was recognised as being on the whole excellent. The manager and her staff approachable and the home well managed. Service users were complimentary about the staff and about the way in which their service was provided. The food was also praised as “excellent and very tasty”. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 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 Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 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) 1,2,5 Prospective service users and their relatives have access to the information they require to make an informed choice about the home. Service users benefit from a comprehensive assessment of their needs prior to moving into the home that ensures their assessed needs can be met. EVIDENCE: The home now has its statement of purpose and service users guide as two separate formats. They were clear and concise with all relevant information included, and are now used for their correct purpose of informing residents prior to choosing a home and as a source of reference after moving into the home. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contracts, which were very detailed and signed by the resident or their representative. The Local Authority contracts with the home were also seen, these all appeared to cover overall care provided and fees payable. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 9 The pre-assessment paperwork seen was very detailed and had been updated to include the date, signature, care manager details and the place where the interview was conducted. A good practice recommendation was made to provide evidence of trial visits being offered and when relatives came for an initial visit whether service users were also invited. The home does not offer intermediate care, but has got five short-term beds that are pre-paid for by Medway council. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 10 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) 7-10 Residents benefit from a high standard of care planning and are treated with respect and dignity. All residents benefit from being consulted regarding their wishes concerning terminal care and arrangements after death. EVIDENCE: Residents care plans were looked at; these were detailed records that contained good personal and health care recording. The health needs of residents are well met with evidence of good multi-disciplinary working taking place on a regular basis. The risk assessments were clear and concise and evidence was seen they are reviewed regularly. The home has asked all residents sharing a room whether they are happy with this agreement and this is now recorded on their care plan. Evidence was seen that reviews of the care plans are taking place regularly. The manager has in place a system to monitor all care plans after the staff have completed their reviews. The home operates a key worker system where residents have an identified staff member. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 11 The staff are now recording enough detail in the daily report, it was also noted that when events and care delivery occurs throughout the day a detailed and comprehensive record is kept with good use of times. The home promotes and maintains residents health through supporting and facilitating medical appointments as required. The home is well able to manage residents with pressure areas with treatment and also support from the tissue viability nurse. The home has good links with other professionals and the home can offer a choice of G.Ps from the many surgeries situated locally. The staff on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. Residents gave positive feedback during the inspection about the approach of the staff team, comments included “nothing is too much trouble for the girls” and “they are made very comfortable”. In the residents shared rooms it was noted that privacy curtains were in place that ensured privacy and dignity for the occupier. Residents are consulted regarding their wishes concerning terminal care and arrangements after death and this is recorded on their care plans. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 12 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) 15 Residents’ dietary needs are well met and they enjoy an excellent varied and well-planned menu. EVIDENCE: The home has a new activity co-ordinator starting next week, it was agreed to let them settle in before looking at these standards. The residents spoken to did not complain about the levels of activities in the home. A quiz was running on the morning of the inspection, which was enjoyed, and to look at standards on activities on the next visit. A number of residents spoken to in the home who commented on the food said how good it was and that they welcomed the daily choices offered. Evidence was seen of the four-week menu, which offered variety, and of stocked larders and fresh food orders. The cook was able to tell me that everything is freshly made, it is rare for something to be brought ready made except pastry. The kitchen seen just before a meal was served was uncluttered, and spotlessly clean and tidy. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 13 Residents were observed during meal- time and choice and variety was seen with several residents having different meals to the one offered. The inspector enjoyed the same meal as the residents and this was very good. The residents are also offered several choices if they did not like something and fresh cakes and fruit are always available. The day’s menu choice is now displayed in the lounge where the residents are able to see it. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 14 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) 17,18 The resident’s benefit from all staff knowing how to report appropriately any possible abuse, and what immediate action to be taken to protect residents. Residents’ legal rights are protected. EVIDENCE: The residents at the home were all able if they wished to participate in the last elections. Many residents used postal votes and the activity co-ordinator walked some residents up to the polling station, which is very close by. The home has access to an available advocacy service if no family or care manager is available to fulfil this role. The home ensures the residents are safeguarded from any abuse, neglect or harm by robust policies for the home. The owner gives training for all staff at induction, then they attend courses in the Local Authorities protocols on Adult Protection, as well as having a copy of the updated policy on file. Staffs when questioned were able to give comprehensive replies to what they would do in case of suspected harm to a resident. The home has a whistle blowing policy. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 15 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) 21,22,24,25,26 Resident’s benefit from living in a safe, well maintained, clean and homely environment in which there are high standards of décor, furnishings and fittings. EVIDENCE: The home has 22 bedrooms, 9 of which have ensuite toilet facilities; and 3 double rooms, all of which have en-suites. Over the three floors there are 7 communal toilets and 4 bathrooms with assisted electric baths, and 1 shower. There is a large comfortable communal lounge/dining room on the ground floor. On the second floor was a further quiet lounge and a visitor’s room. Bedrooms seen had all been personalised by the service users. The rooms were all clean and well decorated with matching quilts and curtains. Bedrooms have sufficient space to accommodate the required furniture. The home has very high standards of cleanliness and no odours were detected anywhere in the house. The home has a rolling pattern of maintenance and 6 bedrooms Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 16 have recently been decorated and carpets have been changed that were looking worn. The home has a separate laundry room, which met infection control requirements. The kitchen was viewed and the flooring, which needed replacing around the sink area, had been completed. The home has three sluice rooms and a large basement which doubles as a storage space and a staff room. Hand washing facilities are prominently sited and the provision of protective clothing was clearly seen. The home has a 6 monthly contract for servicing for the hoists and parker baths. The maintenance man checks and services all the wheel chairs and recorded evidence needs to be kept of this. Call systems were seen in all the rooms and provided in communal areas. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 17 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) 28,29 Residents benefit from the home’s recruitment policies and procedures. The residents are cared for by competent staff that receives regular, on-going training. EVIDENCE: Staff rotas were seen and evidenced that staffing was suitable to provide appropriate shift cover. The home does not use agency staff and has its own bank of care staff to call on. 2 qualified nurses and 5 carers staff the home on the morning shift, then in the afternoons by 1 qualified nurse and 4 carers and in the evenings 3 waking staff. The home also employs a Cook, Handyman, activity co-ordinator and several domestic staff for cleaning and laundry. A number of staff files were sampled, which included all types of staff, who had been at the home for varying lengths of time. The files seen did contain all the correct information. Evidence was seen of actual photos of staff; rather than relying on a blurred copy of the passport photo, which had been happening. The reference request now asks managers to confirm dates that an employee worked for the said firm. Good practice was seen of recording dates when asking for any references or CRBs and then consequently when received. Evidence was not seen of interview notes on one of the files and staff needs to be aware of also recording these even if someone is not suitable for the job. All staff had completed CRB disclosures. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 18 The home is to be commended on its active role in securing training, or staff having completed NVQ’s level 2 and 3, for 99 of its staff. The training body the home uses has awarded the home employer of the month as it has 100 attendance and for excellent support given in all aspects of training. The home has a very robust and inclusive induction programme and another good Practice noted was getting all new staff to sign key policies and have a copy for them selves. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 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 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) 32, 33,36,37,38 The residents benefit from having a well supported and well led staff team who are appropriately supervised. The residents’ best interests are safeguarded by the homes policies and procedure and their health, safety and welfare are promoted and protected. EVIDENCE: The manager was seen to communicate a clear sense of leadership and direction to her staff. The process of management appeared to be open and transparent. Staff indicated that they felt part of a good team and this was due to the way the home was managed. The manager is also able to lead by example and many of the good practices seen in the home come from good leadership. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 20 The home’s latest quality assurance and quality-monitoring questionnaire that went out was received back from 25 residents out of a possible 27 residents. Most had overall positive comments when received back and the results are available with any aims and outcomes raised for residents and their families to see. The owner carries out monthly reviews of the home and writes a report, she also speaks to residents and workers to obtain their views and will visit at varying times. The manager ensures supervision is carried out at least six times a year and this is split between herself and her deputies to complete this. The manager also carries out unobserved supervision of the staff while they are working and this needs to be recorded, as on the whole she is very pleased with the high standard of work. The manger receives informal supervision from the owner but it would be good practice to receive some practice based formal supervision. The homes record keeping is effective and efficient with reviews of policies and procedures happening yearly, good record keeping for the residents, which safeguard their rights and best interests. Individual records and home records are kept secure up to date, in good order and used in accordance with the Data Protection Act. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION x x 3 3 x 4 4 4 STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x 4 3 x x 3 3 x Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 22 No 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 Regulation Requirement Timescale for action 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. Refer to Standard OP5 OP29 OP36 Good Practice Recommendations A good practice recommendation is made to record trial visits being offered and when relatives came for an initial visit A good practice recommendation is made to ensure a record is kept of all interview notes made. A good practice recommendation is made to ensure the manager recieves formal supervision which is practice based. Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 23 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 Byron Lodge Residential Nursing Home H56-H06 S26156 Byron Lodge V239457 090905 Stage 4.doc Version 1.40 Page 24 - 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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