Inspection on 15/08/06 for Cambrian Lodge

This inspection was carried out on 15th August 2006.

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

Cambrian Lodge 05/09/07

Cambrian Lodge 19/09/05

Cambrian Lodge 13/10/04

Cambrian Lodge 01/06/04

Cambrian Lodge 28/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cambrian Lodge 4 Battery Road Portishead North Somerset BS20 7HP Lead Inspector Stephen Humphreys Unannounced Inspection 11:30 15 August and 25 September 2006 th th 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 Cambrian Lodge DS0000041626.V308822.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 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. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cambrian Lodge Address 4 Battery Road Portishead North Somerset BS20 7HP 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) 01275 848844 01275 849649 christina@welling-care-homes.co.uk Welling Ltd Mrs Karen Wendy Cox Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 28 persons aged 65 years and over requiring personal care. 19th September 2005 Date of last inspection Brief Description of the Service: Cambrian Lodge provides personal care for up to 28 older people. The home is located in a residential area close to the lake grounds in Portishead. Cambrian Lodge is a period property, with a purpose built extension owned by Welling Limited to which Mr Beale is the managing director. Two passenger lifts offer easy access to all areas of the home. Car parking is provided at the front of the building, and there is a pleasant garden and patio to the rear. Accommodation is offered in 22 single and 3 double rooms. At present no rooms are shared and en-suite facilities are provided in 11 of these. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection carried out at Cambrian Lodge care home by the Commission for Social Care Inspection using the Inspecting for Better Lives methodology. The methodology used at this inspection will result in the service being given a rating of, excellent, good, adequate or poor. The frequency of inspections will be determined by the rating. This inspection was a key inspection at which all the core national minimum standards were assessed. The inspection was carried out in two stages. Records, medication and a tour of the home were undertaken during a visit on the 15th August 2006. The second visit on the 25th September 2006 involved talking in detail to staff and residents and case tracking resident’s care. At the time of the visit there were 24 residents in the home. Karen Cox the registered manager was in the home and very helpful as was all other staff during the inspection. The format of the inspection involved talking to residents, relatives and staff during the site visit and observation of care delivery. Pre-inspection surveys were carried out amongst residents and visiting professionals. The results of the surveys were discussed with the registered manager. What the service does well: Cambrian Lodge has an environment that is warm and well maintained. The décor of the home is pleasing and pleasant. Furnishing and fittings are all in good condition. Staff are pleasant, respectful and work together as a team. The service is well managed through strong leadership and support to staff. Staff receive support through supervision and organised training. The organisation places high importance on staff development and training. Records are well managed and complete. The care delivery is of a high standard and includes social as well as personal care. Residents reported their satisfaction with the quality of care delivered and complemented all staff and the comfort of the home. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 the following standard(s): 1,2,3,4 The quality in this outcome group is good. Prospective residents and their relatives will be provided with information on the service to enable them to make a choice. EVIDENCE: A copy of the statement of purpose and service user guide is available and on display in the entrance foyer of the home. The statement of purpose / service user guide is detailed and up to date, describing the facilities and services available in the home. Copies of the statement of purpose / service user guide were visible in all the residents rooms visited. Two residents visited in their rooms were able to show the inspector their copies and said they refer to them for the meals of the day as they contain the four week menus. The menus in the statement of purpose / service user guide are updated at regular intervals. Other information leaflets on care home life and advocacy were on display in the home near to the main entrance and on the notice board outside the carer’s office. Photographs of staff members are on display near the main Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 9 entrance and other photographs of activities and outings are displayed in the lounge for all to see. The inspector was able to review resident contracts during the visit. The registered provider has agreed service contracts with social services around the south west region. The contracts reviewed as part of the case tracking exercise were signed and contained information about fees and the obligations of the provider and resident. The contract terms and conditions were clear and understandable. The fees for the home are from £368 to £420 per week. The registered manager carries out a needs based pre-admission assessment on all prospective residents. Admissions to the home take place once the registered manager is confident the residents care needs can be met. The registered provider writes to new residents / relatives to confirm the home can meet their individual needs. Several residents met by the inspector recalled being visited by the manager to discus moving into Cambrian Lodge and about whether the home could meet their care needs. Offers to look round the home are made, this enables prospective residents to meet other residents, see the facilities offered and look around the accommodation available. The care needs assessment carried out by social workers was found in the individuals care plan. The staff group is very experienced in caring for older persons personal care needs. The staff group includes persons from the European community. The registered manager is managing the cultural diversity and integration very well. Staff whose first language is not English are helped to attend English language lessons at the local college. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10,11 The quality in this outcome group is good. Resident’s can be confident that their care needs will be met by trained carers and other healthcare professionals. EVIDENCE: The registered manager has developed a strong focus of involving residents in all aspects of their health and social care. All residents have a detailed care plan that contains all the information carers need to meet the individuals social and personal care needs. Evidence was found in the care plans of resident’s case tracked to confirm person centred care is carried out. The care plan is a working tool and clearly understood by the carers. Risk assessments were filed in the care plans reviewed however residents said they have as much independence as they want within the bounds of their ability, and retain responsibility for many of their personal care tasks. The care plan of one resident who is unable to speak detailed the individual’s communication programme, developed for staff by the speech & language therapist. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 11 Another resident who had difficulties with movement was receiving occupational therapy and physiotherapy. Health care professionals such as GP’s and district nurses visit the home as required to carry out health care checks and offer advice to staff. Para-medical professionals such as opticians, Occupational therapist, Physiotherapist, audiologist visit the home as required or when residents are referred by a consultant at the hospital. Staff keep a check on residents hearing aids to ensure they are working effectively. The medication procedure, receipt, storage, administration and disposal were assessed. The inspector observed the administration of medicines during the visit. The medicines for daily use are stored in locked medicine trolleys that are secured to a solid wall. Controlled drugs are kept in a locked cabinet secured to a solid wall. The controlled drugs were counted and found to correspond with the recorded number in the controlled drugs register. The staff who administer medication have received appropriate accredited training and a list of specimen signatures were recorded in the medicine administration record. The medicine administration record was checked and completed correctly. A list of residents who were self medicating was filed in the medicine administration record along with the self-medication risk assessment. The receipt of medicines was recorded in the medicine administration record and hand written prescriptions had been signed by two persons. Disposal of medicines follows the written procedure. Residents who described their day-to-day routines said the staff did everything they could to assist them should they need help. Staff were observed knocking and waiting for responses prior to entering rooms and residents felt that sufficient account is made to ensure their dignity and privacy is maintained. Comments from residents included “my privacy is respected” and “staff always knock before they come in”. The care plan documentation is designed so that the questions regarding resident’s wishes in the event of their death can be discussed and documented. In discussion with the registered manager she is aware that this area needs to be addressed however she has not got round to doing this yet. During the visit two relatives expressed their gratitude towards care staff who had carried out end of life care respectfully and sensitively. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 The quality in this outcome group is good. Residents can be assured that they will be encouraged and supported to follow their preferred life style in the home. Residents will be provided with choices in all aspects of home life. EVIDENCE: The inspector spent time with up to twelve of the residents during the visits. Each had differing responses to the activities they would wish to take part in, if at all. Residents were observed in the lounge during the morning and enjoyed chatting with each other and at meal times and retiring to their private rooms to rest, watch television, listen to music or knit during the afternoon. Two residents who the inspector spoke to said they liked to go out to the tea dance in the afternoon retaining links with friends and the local community links. Residents confirmed they are visited by relatives some going out to lunch, or just to sit and enjoy each other’s company. The options to see relatives can be in the privacy of the bedroom or out in the garden weather permitting. The inspector spent time talking to residents about their experiences of living at the home. Comments received indicated that residents have excellent Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 13 relationships with the staff. One resident said that ‘this really is a home from home’ Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 the following standard(s): 16,17,18 The quality in this outcome group is good. Residents can be assured of protection through good selection policies and a commitment to staff training by the registered provider EVIDENCE: The service has a clear developed complaints procedure that is made available to residents and relatives through the statement of purpose and displayed in the home. A copy of the statement of purpose was found in each room visited and residents spoken to said that were aware of how to make any concerns known to the manager. None of the residents said they would inform outside agencies and only one said they would tell their relative if they had any concerns. The Commission for Social Care Inspection has not received any complaints or concerns since the last inspection. The registered manager promotes the resident’s individual rights in the home. Information leaflets were available on how to contact advocacy agencies, and resident’s can vote at political elections if they chose. The registered manager and members of staff were able to state the actions they would take if they had received a concern or complaint. Staff were also able to state the actions necessary regarding any incident of abuse. Staff have all received training Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 the following standard(s): 19,26 The quality in this outcome group is good. Residents can be assured of a warm and clean environment. EVIDENCE: Ground floor – the home is clean and warm. Entrance hall – visitors book and a copy of the statement of purpose / service user guide are on display. Information leaflets pertaining to advocates and other care home information are available for visitors and residents. A copy of the complaints procedure is displayed along with menus and the activities programme. Lounges and other communal rooms were clean and the carpets were clean. No smells anywhere. Furniture and fittings were all in good condition. The décor of the home and rooms was very good. Equipment maintenance records are up to date. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 16 Laundry – 2 washers 1 dryer – in good working condition Laundry was being stored correctly and tidy. COSHH data sheets were available. Resident’s clothing is stored in separate baskets in an airing cupboard and dresses hung to prevent creasing. The flowing hot water temperatures recorded in bathrooms and residents rooms was above 43C. Bathrooms and wash hand basins must be fitted with thermostatic regulator valves. Plastic jugs were observed to be in communal bathrooms however it is good practice to identify in an indelible ink there respective purpose. This is to prevent the jugs used for hair rinsing being used to empty catheter bags into. The infection control practices in the home were observed to be satisfactory. The use of liquid soap in communal toilets and bathrooms was noted. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 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 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): 27,28,29,30 The quality in this outcome group is good. Residents are cared for by skilled and experienced care staff. EVIDENCE: 66 of the staff have either completed or about to complete their NVQ training. The registered manager has introduced a mentor / buddy system for new staff. The numbers of staff on duty are adequate to meet the needs of the residents. There appears to be very little turn over in staff grades. The duty rotas checked confirmed the number and the persons on duty. Residents spoken to said they were very happy with the staff and that staff were all very respectful. The staff files confirmed that the service’s recruitment and selection procedure is robust. References and CRB disclosures were obtained for each new employee. Staff training records were reviewed. Training is a high priority to the registered provider that is commended. Statutory training and personal development training is available to staff. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 18 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): 31,33,36,38 The quality in this outcome group is good. The residents can be assured of strong leadership and protection from robust policies and procedures. All statutory records are completed and up to date. EVIDENCE: The registered manager has been in the home for several years and has developed a competent and caring ethos in the home. Residents spoken to voiced their gratitude to the registered manager and her staff. The personal and social care delivered is of a high standard. The registered manager and registered provider have introduced a quality assurance system, carrying out regular audits including accident reports and medicines. Evidence of graphical output for management purposes was seen. The registered manager has regular staff supervision sessions. The supervision includes issues relating the management of equality and diversity in the home. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 19 The registered manager provides assistance to all the overseas staff to assist them to settle into the home and local community. Staff spoken to said they are able to discuss any problems with registered manager at supervision. Statutory records were checked and found to complete and up to date. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 20 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 4 4 4 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 x 3 Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 21 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. 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. Refer to Standard OP11 Good Practice Recommendations The registered manager should discuss and record residents wishes and arrangements for end of life events. Cambrian Lodge DS0000041626.V308822.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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