Inspection on 09/01/07 for Camden Lodge Residential Care Home

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 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

Camden Lodge Residential Care... 31/10/05

Camden Lodge Residential Care... 06/06/05

Camden Lodge Residential Care... 06/10/04

Camden Lodge Residential Care... 16/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Camden Lodge Residential Care Home 137 Palmerston Road London N22 8QX Lead Inspector Jackie Izzard Key Unannounced Inspection 9th January 2007 09:30 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 Camden Lodge Residential Care Home DS0000010654.V322981.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. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camden Lodge Residential Care Home Address 137 Palmerston Road London N22 8QX 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) 020 8829 9438 020 8829 9439 Mr Munundev Gunputh No registered manager Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2005 Brief Description of the Service: Camden Lodge is set in a residential street in Palmers Green close to local shops and amenities in Green Lanes. There are 24 registered places for people over the age of 65 who may have dementia. This home is purpose-built and has a lift and a garden. All bedrooms are single and have en suite toilet and washbasin. There are bedrooms on each of the three floors, and a large lounge/dining room on the ground floor. The registered provider owns four other homes in the area. The aims of the home include to offer a warm welcome, which combines comfort with the support of a caring professionals. The cost of placements was reported by the manager to be £361.90-508.61 per week. Following “Inspecting for Better Lives”, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted for seven and a half hours. The inspector looked at records, looked around the building and spent time talking to people living in the home and observing the way that staff were looking after them. The inspector also met privately with a relative of a resident to obtain her views of the care provided at the home. The inspector talked to the manager at length and followed up on the requirements made at the previous inspection to see what progress had been made in the home since October 2005. Written feedback about the home from seven relatives was also considered as part of the inspection. New requirements were made and discussed with the manager and the Area Manager at the end of the inspection. The registered manager left in November 2006 and the new manager started at this time. What the service does well: What has improved since the last inspection? What they could do better: The provider needs to make a number of improvements in the service offered to people living at this home. Two requirements made at the last inspection of the home have not yet been met, and have been restated in this report with a new timescale for compliance. In the timescale for action column, the date in ordinary type relates to the timescale given at the last inspection, the date in bold type relates to the new timescale. Further information regarding unmet requirements can be found in the relevant standard. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 6 Unmet requirements impact upon the health and safety of service users. Failure to comply with the timescales will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. Eighteen new requirements were made as a result of this inspection. The requirements, which are at the back of this report, are as follows; to ensure the home meets the needs of people from different ethnic communities; to provide enough money and staffing for residents to take part in a programme of activities, including activities in the community, to increase staffing levels to better meet residents’ needs, to assess people to see who may be at risk of developing a pressure sore and taking action to prevent this; to improve the menu; to ensure all staff have proper induction training and that nobody gives out medication until they have been trained to do so and to provide staff with regular professional supervision. The registered provider, Mr Gunputh, must also ensure that a previous requirement to ensure there are four staff on duty at all times during the day and evening and to carry out a review of staffing in the home is complied with. Three requirements about improving the management of service users’ money are made. Two requirements are made about staff recruitment after two staff were employed with references that did not match the employment history they had recorded on their application form. Requirements are also made to repair a broken sink; ensure fire doors are closed and ensure clinical waste (incontinence pads, etc) is stored safely. Bedside lighting must be provided for those who would like it and the gas appliances and hoists must be serviced. A copy of the home’s annual development plan must be sent to the CSCI. All the above requirements have been given a short timescale for compliance and will be closely monitored by the CSCI. 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. Camden Lodge Residential Care Home DS0000010654.V322981.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 Camden Lodge Residential Care Home DS0000010654.V322981.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can be assured that their needs have been assessed and been included in a plan of care for them. More attention to assessing their cultural and religious needs would benefit service users. EVIDENCE: The inspector looked at four service users’ files for evidence of an assessment of their needs. Three residents had their needs assessed before moving to the home. The assessments were of a good standard other than a lack of information about people’s cultural needs. Cultural needs were not fully assessed or recorded. A requirement is made to ensure cultural and religious needs are assessed and met. Food preferences were assessed and recorded for three of the four service users but inspection of the menus showed no Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 9 evidence that these needs were being met. This is addressed in the next section of this report. The fourth service user had an incomplete assessment but the manager was able to give detailed information about her needs and said that the assessment was still taking place. Camden Lodge does not provide intermediate care so standard 6 is not applicable to the home. Camden Lodge Residential Care Home DS0000010654.V322981.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and their needs are clearly set out in a plan of care to ensure that staff have guidance on how to meet their needs. Their health care needs are met and recorded with the exception of risk assessments for pressure sores. Service users are not currently fully protected by the home’s medication practices as staff were giving medication before receiving accredited training to do so. EVIDENCE: The inspector looked at a sample of four care plans and found the content to be good. The care plans gave a clear description of the person’s needs. These had been reviewed monthly as required at the last inspection of the home. The Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 11 inspector advised that staff record each month that no changes have been made to the care plans if this is the case. The inspector looked at the number of falls there had been in the home during the two months prior to this inspection. The manager had already assessed the circumstances in which people had fallen and had established that most falls were taking place during the early hours of the morning. He was addressing this and agreed to send the inspector written confirmation of what action he had taken to minimise the number of falls in the home. It was positive to see that the manager was undertaking unannounced visits to the home during the night to check that standards of care during the night were satisfactory. The previous manager was advised to contact a falls prevention advisor for guidance at the last inspection and to produce a falls prevention plan. The plan was completed but the new manager did not know if a falls prevention officer had been involved in the home. A recommendation is made to ask this person for any advice. The inspector informed the manager that one service user was wearing slippers which did not fit properly and which could cause her to fall. The inspector discussed night time care with the manager and looked at night care records. The manager had introduced an hourly recording chart at night to help assess how often service users use the toilet, are changed, fall, etc. the inspector was satisfied that the manager was paying close attention to the standard of care at night to see if any improvements are needed. A requirement is made to undertake a staffing review in the staffing section of this report which will assess whether night time staffing levels are adequate. The inspector looked at health records in four service users’ files to see if their health needs were properly met. It was found that health appointments to dentist, optician, GP and consultants were recorded and the manager was aware of each of the four people’s health needs and what action was being taken to address them. This was very positive. One area of concern was pressure care. It was reported that none of the service users had a pressure sore. However, only one had been assessed to see if she was at risk of developing pressure sores. After a complaint from a relative of an ex resident in April 2006, pressure care was an area which should have been addressed. The manager had found that these assessments were not in place and said he was about to initiate these assessments. It is of concern that this has not already been carried out. A requirement is made to carry out pressure care risk assessments and appropriate intervention in the care plan of all service users, prioritising those who have limited mobility and followed by those who sit in the same chair all day and who do not move to the table for meals. The inspector looked at a random small sample of medication administration sheets and found these to be completed properly. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 12 However, it was noted that a member of staff who had not received medication training was administering service users’ medication and a requirement was made that this staff member immediately cease giving medication until trained to do so. Only staff who have certificated medication training may administer medication. Medication was stored securely. The inspector received written comments about the home from seven relatives and spoke to one other relative in person. She also spoke with six service users and watched how staff treated them during the course of the day. There were no concerns about how service users were treated by staff and the inspector was told by three service users that they were treated with respect and their privacy was respected. The inspector observed staff assisting people to and from the toilet and noted that this was carried out with respect to people’s dignity and their right to privacy. Staff were observed to be speaking respectfully to all service users during this inspection. One service user was spoken to at length and this person said that staff treated people well. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users do not currently have enough stimulation or activities offered to them to ensure that their social and recreational needs are met. Cultural needs are not properly addressed in terms of activities or food provided. EVIDENCE: Service users maintain contact with family and friends and are supported to retain control over their finances if able. The inspector was informed that there is a fortnightly entertainer in the home and the manager said that staff carry out indoor activities in the afternoons. The activity programme was on the wall and recorded that there was gentle exercise to music for half an hour every morning, individual activities then an afternoon activity six days a week. The afternoon activities were Bingo, board games, arts and crafts, reminiscence and old movies. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 14 The inspector observed staff playing a ball game and walking with service users in the building but no other activity. The daily activity records for the past four weeks were inspected and these showed that other than handball/exercise, only one activity had been recorded for the whole month. This was two service users playing a game of dominoes. There was therefore no evidence that the activity programme was taking place and discussion with three service users confirmed to the inspector that it was not taking place. There had also been no outside trips despite a requirement being made to introduce an activity programme including trips outside the home in October 2005. Fifteen months later, no organised outing has taken place. The home is failing to meet people’s social and recreational needs. The requirement to implement an activity programme has been restated with a short timescale for implementation. The inspector advised that the provider should purchase or hire a suitable minibus to take service users out as some people have not left the building for a long time and told the inspector they would like to get out. Some service users were living a satisfactory quality of life with regular visits from family. One was able to go out alone and another was attending a culturally specific day service. Other service users said they would like to get out of the home and had little stimulation. Two said they were unhappy, one because his level of dependence had increased and he was unable to go for a walk in the garden on his own and the other because he said nothing was offered for him to do. The inspector observed staff interacting well with service users and spending time with them which was positive but they need guidance on appropriate activities. The majority of people have high care needs due to dementia or physical disability and they had limited opportunity to engage in any activity. Now that the home is registered to take people with dementia, activities suitable for these people need to be provided. There is little opportunity to go out of the home even to local shops, parks or cafes and those people who are not taken out by relatives may not leave the building at all other than attending medical appointments. A requirement is made for the second time made to produce an activity programme for the home which includes a variety of interesting activities that residents have been consulted on and send a copy to the CSCI. The registered provider will need to ensure that enough money is available to provide meaningful activities including trips out of the home and to ensure staffing levels are sufficient to support residents. The inspector looked at the planned menus, records of food actually provided, observed what was served for breakfast and lunch and spoke to a small sample of service users about the food provided. There is a four week menu which the manager said is being reviewed at the present time. Often only one choice of main meal is recorded on the menu but records showed that service can and do request alternatives to this. The inspector agreed with the manager that Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 15 two choices should be offered on the menu as otherwise, people who request alternatives may eat a less varied diet. The manager said he will send a copy of the new proposed menu to the inspector. The menu on the day of the inspection was recorded as steak and kidney pie/chicken pie with potato, carrots and peas and fresh fruit. The actual lunch served was sausages, mashed potato, carrots, cauliflower, peas and gravy followed by fruit. This was because the pies were not delivered in time. Those who did not want sausages had fried or boiled egg with mashed potato or chips and vegetables and one chose to have spaghetti with cheese sauce. Two people told the inspector they did not like the meals very much. Two specifically said they would prefer West Indian food. The inspector checked their assessments and care plans and saw that the home was aware that they preferred West Indian food. One other person’s file showed he preferred foods such as yam, plantain, salt fish and rice. Records of food provided showed little evidence of any culturally appropriate food for these service users or any others from different cultural backgrounds. The inspector was told that salt fish is cooked regularly but records did not indicate this and so the manager was told that records of food must be improved. A requirement is made to improve the meals and ensure cultural preferences are addressed and recorded properly. At least three, and possibly more, service users would prefer different food to that currently offered. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can be confident their complaints will be taken seriously. More rigorous risk assessment in the handling of service users’ money would better protect them from any risk of financial abuse. EVIDENCE: The last complaint recorded was March 2006. A more recent complaint was not recorded in the complaints book. The Area Manager told the inspector how this complaint had been dealt with which was appropriate but there was no record of it in the complaints book. The home had an appropriate complaints procedure. The inspector asked two service users if they knew how to make a complaint and both said that they did but had no serious concerns. The majority of relatives who responded to a questionnaire said they knew how to make a complaint. The inspector did not look at records of adult protection training for all staff as three randomly selected staff files did show evidence of this training. This training was found to be up to date in 2005. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 17 The inspector was informed that a member of staff had been given money by a service user in a private arrangement. Inspection of the policy regarding gifts and gratuities showed that to accept money from a service user is in contravention of the home’s policy. A requirement was made that this incident be investigated and CSCI informed of the outcome and that all staff are instructed in the gifts policy to ensure they are aware of it. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in an environment which is kept clean and comfortable for them, however their safety could be compromised by the wedging open of fire doors in the basement, which need to be kept closed to protect service users from risk of fire. EVIDENCE: The inspector carried out an inspection of the premises; including corridors, lounge, conservatory, garden, bathrooms, toilets, laundry, kitchen and a sample of bedrooms on each of the three floors. One sink was loose as it was coming away from the wall. Fire doors in the basement where the laundry and kitchen are situated were found to be wedged open. Requirements are Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 19 made to repair the sink and ensure fire doors are closed at all times or fitted with devices which close them automatically if the fire alarm is sounded. The home was clean and tidy throughout. The manager showed the inspector the home’s cleaning schedule which had recently been reviewed to improve the cleanliness of bedrooms. The chairs in the lounge had been cleaned and a new carpet purchased for that room. The seating in the lounge had been rearranged as a result of a requirement made at previous inspection of the home and the room looked more homely and less institutional. The manager said that the provider, Mr Gunputh, plans to redecorate the whole home starting later this month which is very positive. The bedrooms seen were clean and contained personal belongings. One bedroom seen had a bare light bulb. The manager said this may be because the service user’s vision has deteriorated. There was no bedside lighting. The inspector advised that it would be more appropriate to increase the bulb wattage than remove the light shade and leave the bulb hanging. A requirement is made to provide appropriate lighting as both bedside and overhead lighting should be provided. The laundry is sited in the basement. Clinical waste is stored in appropriate containers in the garden. The clinical waste bin was seen to be overflowing and a requirement is made to address this. The manager said that he was arranging for this to be addressed with Enfield Council. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. It is not known whether staffing levels meet service users’ needs as a review of staffing levels is overdue. The home’s recruitment practice in checking authenticity of references and its induction training both need improving so that service users can feel they are looked after by thoroughly vetted and trained staff. EVIDENCE: A requirement was made at the last inspection of the home to increase staff to four at all times and to undertake a review of staffing and send a copy to the CSCI, Staffing was increased to four during the day but the staffing review was not received by CSCI so this requirement is restated with a shorter timescale. The review must also address night time staffing as there are only two staff on duty at night. There is a cook and domestic cleaner on duty in the day as well as four care staff. Between 1 and 2pm the staffing has reduced to three and the inspector advised that this must be increased to four again until he results of the staffing review are known. The inspector also advised the Residential Care Forum staffing formula be used to review staffing levels needs for the home. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 21 The inspector examined five staff members’ files to look for evidence of proper safe recruitment and induction training. All five had completed an application form, four had an up to date Criminal Records Bureau disclosure and the other had a check against the Protection of Vulnerable Adults list but no CRB disclosure. Three had satisfactory references. Two did not have satisfactory references. Their references did not correspond with the employment they had recorded on their application forms. The job titles and employers did not match but these had been accepted as satisfactory references and both workers employed. A requirement is made to investigate the recruitment of these two staff members and report the outcome to the CSCI. The induction training provided to staff was of a basic level and did not meet the national minimum standard. A requirement is made to improve induction training. One staff was working as a shift leader with no evidence of induction in his/her staff file. The Area Manager informed the inspector that the home exceeds the requirement of 50 of staff to have completed NVQ 2 training though not all have received certificates yet. One staff member told the inspector that he was to begin NVQ 3 training this month. Other staff training was not inspected in detail but the inspector saw that the manager was recording the training that staff had attended. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users would benefit from better supervision being provided for staff which would help staff develop their knowledge of caring for older people. Service users’ requests for activities have not been acted on so this is an area which needs addressing urgently to assure service users that their views are listened to. EVIDENCE: The manager started in November as a temporary manager and it is not yet known if he will become the registered manager. He was able to demonstrate to the inspector changes he has made in the home and was aware of areas Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 23 which needed improvement. He has also managed care homes before so has the appropriate experience to run Camden Lodge. The inspector looked at the home’s winter quality assurance report. From this, report, service users had indicated that they were generally satisfied with the home but wanted more outside activities. It is a concern that the provider has not already responded to this as it was raised in October 2005. A requirement is made in this report to provide activities. The annual development plan has not yet been written but the Area Manager agreed to send a copy to the CSCI. The inspector examined the financial records for four service users. The cash held by the home for them balanced with the records in each case. Receipts were stored appropriately and money stored securely. There was evidence that service users are allowed to control their money if they wish to. For two of the four service users, the manager said that the provider has to invoice their local authority which acts as their appointee to claim their personal allowance. Both these people had not received all the personal allowance they were entitled to and a requirement is made to ensure this is rectified. A requirement is also made to carry out a risk assessment for a service user who gives staff money to go out and purchase things for him. The risk assessment should address whether the service user would be supported, if he wishes, to go out with staff to carry out his business. Another financial matter is addressed in the complaints and protection section of this report. Six staff files were inspected for evidence of regular supervision. This was not taking place frequently enough to meet the national minimum standard. This is of concern especially for new staff and staff who were promoted with no evidence of proper supervision or induction into their nr role. A requirement is made to improve supervision of staff. When looking at health and safety, the inspector looked at a sample of health and safety records relating to inspection of gas, electricity and equipment. In addition, records of maintenance of the building and equipment was inspected. The home’s electrical wiring was inspected in 2002 ands is due for inspection in September 2007. Electrical appliances were inspected in June 2006. Hoists were inspected in June 2006, the lift in July 2006 (due December 2006)and the gas appliances in September 2005. The gas and hoists were overdue for their inspection and a requirement is made to request those to be serviced. The other maintenance issues were up to date. The latest report by an Environmental Health Officer was read by the inspector and the manager was able to show that the actions identified in the report had been carried out. Staff training in health and safety topics was not addressed at this inspection. Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 24 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 X X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X x 2 Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? yes 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 OP4 Regulation 12(4)(b) Requirement The registered person must ensure that the home understands and meets the needs and preferences of people from different ethnic communities. Cultural and religious needs and preferences must be included in the service users’ plan of care and must be met. The registered person must ensure all service users are assessed to identify those at risk of developing pressure sores and record appropriate intervention in their care plans. Priority should be given to those known by the manager to be at risk, including those who spend all day, including mealtimes, in the same chair. The registered person must ensure that a specified staff member immediately cease administering medication until trained to do so. Only staff who have certificated medication training may administer DS0000010654.V322981.R01.S.doc Timescale for action 20/02/07 2. OP8 13(4)(c) 20/02/07 3. OP9 13(2) 09/01/07 Camden Lodge Residential Care Home Version 5.2 Page 26 4. OP12 16(2)(m) (n) medication. The registered person must consult residents and devise a programme of activities, including activities out in the community, and provide the necessary staffing levels and finances to implement this activity programme. A copy of the activity programme must be sent to the CSCI. 09/02/07 5. OP15 16(2)(i) This requirement is restated. Previous timescale of 31/03/06 not complied with. The registered persons must 16/02/07 ensure that the menu meets individual service users’ assessed and recorded personal and cultural requirements. Records of all food provided to service users must be kept and be available for inspection. The registered persons must investigate a financial transaction between a service user and staff member and report the outcome to the CSCI. In addition, all staff must be instructed in the home’s policy regarding gifts and gratuities and a record of this instruction kept. The registered persons must ensure the ground floor toilet sink is repaired. The registered persons must ensure that all fire doors are either fitted with a device which closes them automatically when the fire alarm sounds or are kept closed at all times. The registered persons must ensure that clinical waste is stored and disposed of safely. The registered persons must provide overhead and bedside lighting for those service users DS0000010654.V322981.R01.S.doc 6. OP18 13(6) 09/02/07 7. 8. OP19 OP19 13)(4)(a) 23(4)(c) (i) 31/01/07 02/02/07 9. 10. OP26 OP24 13(3) 23(2)(p) 09/02/07 20/02/07 Camden Lodge Residential Care Home Version 5.2 Page 27 11. OP27 18(1)(a) who would like it, prioritising those with a visual impairment. The registered person must provide four staff on duty at all times during the day and evening and carry out a review of staffing levels in the home. This requirement is restated as previous timescale of 01/12/05 not complied with. This review must include night staffing levels. The registered person must ensure that the recruitment of staff with references which do not match their employment history is investigated and the CSCI informed of the outcome in writing. The registered person must improve the recruitment procedure to ensure that he is satisfied as to the authenticity of references before any person is employed. The registered person must provide staff with an induction training which meets National Training organisation’s specification as specified in standard 30 of the National Minimum Standards for care homes for older people. The registered person must send a copy of the home’s annual development plan to the CSCI once this is completed. The registered person must enable service users to receive their personal allowance where this is part of their care plan. The registered person must carry out a risk assessment with regard to staff carrying out financial transactions on a specified service user’s behalf to protect both the service user and DS0000010654.V322981.R01.S.doc 09/02/07 12. OP29 19(4)(5) 09/02/07 13. OP29 19 (1)(c) 30/03/07 14. OP30 18(1)(c) (i) 01/04/07 15. OP33 24(2) 28/02/07 16. OP35 16(2)(l) 09/02/07 17. OP35 13(6) 09/02/07 Camden Lodge Residential Care Home Version 5.2 Page 28 18. OP36 18(2) 19. 20. OP38 OP38 23(2)(c) 23(2)(c) staff. A copy must be made available for inspection in the service user’s file. The registered person must 28/02/07 ensure all care staff receive formal supervision at least six times a year and that the supervision covers all aspects of practice, philosophy of care in the home and career development. Records must be kept of every session and be available for inspection. The registered person must 09/02/07 ensure that gas appliances are serviced. The registered person must 09/02/07 arrange for the home’s hoists/bath chairs to be serviced. 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 OP7 Good Practice Recommendations The registered person should arrange a review of the plan of care for a specified service user whose needs have changed to ensure that his sensory, cultural, dietary, religious and recreational needs are being addressed at this home. The registered person should consider buying or hiring suitable transport to enable people living at this home to get out into the community as they wish to do so. 2. OP12 Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 Camden Lodge Residential Care Home DS0000010654.V322981.R01.S.doc Version 5.2 Page 30 - 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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