Inspection on 20/09/05 for Carlisle Lodge

This inspection was carried out on 20th 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

Carlisle Lodge 09/01/07

Carlisle Lodge 06/02/06

Carlisle Lodge 15/02/05

Carlisle Lodge 29/09/04

Carlisle Lodge 12/06/03

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 Carlisle Lodge 103 Carlisle Road Eastbourne East Sussex BN20 7TD Lead Inspector Debbie Calveley Unannounced Inspection 20th September 2005 08:30 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 Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlisle Lodge Address 103 Carlisle Road Eastbourne East Sussex BN20 7TD 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) 01323-646149 01323-730321 The Croll Group Miss Diane Lawson Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-two (22). Service users must be aged sixty-five (65) years and over on admission. 15th February 2005 Date of last inspection Brief Description of the Service: Carlisle Lodge is a detached property situated in a residential area, formerly a large family home that has been extended and adapted for its present use. The home is registered at present to provide care with nursing for twenty-two service users. A recent variation has been applied for which will decrease the provision of beds to twenty. The home offers eighteen single rooms, thirteen with ensuite bathrooms, further upgrading will increase the ensuite facilities and one shared room. There are ample bathing facilities provided with the necessary specialised equipment to meet the needs of the residents accommodated in the home. The communal areas are pleasantly decorated and consist of a conservatory, a lounge area and a dining room. The home has been extensively upgraded and offers attractive, warm accommodation with good quality furniture. The home is situated approximately 1 mile from Eastbourne town centre and the sea front. Meads village provides the nearest shops, the bus runs along the main Meads Road and these are approximately ½ mile away. The car park at the front of the home has been cleared and has increased the parking facility. A large well maintained garden is situated at the rear of the home. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 20 September 2005. It commenced at 08.30 am, and took place over five hours. There were nineteen service users in the home at this time. The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for twelve residents and informal interviews with eight residents, two visitors and four members of staff. The overall quality of care provided at Carlisle Lodge was observed to be of a good standard and the outcome for residents living in the home is one of warmth and comfort. What the service does well: What has improved since the last inspection? Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 6 The upgrading of the home is on going and at present there is one shared room. 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. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 and 5. The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. A contract/statement of terms and conditions is given to all residents on admission, which confirms the facilities offered and care agreed. A pre-admission assessment is undertaken on all prospective residents before admission to ensure the home can offer them the care they require. EVIDENCE: The Statement of Purpose and Service Users Guide were viewed, it was found to be up to date and contained information that prospective residents need to make an informed choice of where to live. As mentioned at the last inspection, once the upgrading of the premises is completed, there will need to be an updating of the Statement of Purpose and Service Users Guide to reflect the room occupancy and sharing facility. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 9 There is a written contract/statement of terms and conditions that all residents receive on admission to the home. This contract is confirmation of the room booked, the type of admission, either respite or permanent and the fees to be paid. Five pre-admission assessments were viewed, and were found fully completed and informative. The assessment takes place at the prospective residents’ place of residence, and involve the relatives whenever possible and input from other relevant professionals is sought when required. Three residents spoken with said they remembered someone from the home coming to see them before they left hospital and felt it was helpful to have met someone from the home before they arrived. Two residents could not remember being involved, but thought that their families had been involved at the time. As previously mentioned the pre-admission assessment identifies any specific needs of the prospective resident and this informs the admission process. These can then be discussed with the resident and their representative to ensure that the home can meet their needs. The Statement of Purpose also gives information regarding the services they provide. Prospective residents can visit the home to meet residents, to look at rooms that are available and the facilities provided before they make any decision regarding accepting a place. Unplanned admissions are avoided whenever possible but should they occur, then an assessment is undertaken within forty eight hours and a GP is requested to visit as soon as possible. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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, and 10. All residents have an individual care plan, which meets their health, social and recreational needs. The health needs of the residents are met, and there are appropriate risk assessments in place which evidence regular review. The medication systems in place are well managed, promoting good health and the safety of the residents. The residents are treated with respect and courtesy in all aspects of their care. EVIDENCE: Five care plans were viewed and the care tracked from pre-admission to the delivery of care. They were found to be simple in format, clear and informative. All were found to have a comprehensive plan of care, which is generated from the initial pre-admission assessment. The care plans clearly identify the specific health, personal and social care needs of the residents. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 11 The care plans and risk assessments are reviewed and updated on a regular basis. Consultation with other professionals were documented. There is evidence of resident/representative consultation in individual plans. From the information gathered from the care plans and then meeting those residents, it was found that the health needs of the service users were met. Specialist equipment was found in place where required, e.g. air mattresses, cushions and various hoists with different slings. One resident said “staff were very thoughtful” and always made sure she had everything she needed” as she was unable to leave her bed. Another said that she felt she “was well looked after”. Another said, “ this is my home now and they look after me very well”. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 and 15 The residents are enabled to exercise the choice and control of their every day life. The activities in the home meet the individual preferences of the residents. The dietary needs of residents are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: All residents spoken to, were aware of the activities offered and were complimentary regarding the range provided, and all that attended thoroughly enjoyed them. An activity programme is in place and demonstrates a variety of events, which are scheduled to take place over the forthcoming month. The activity programme is given to all residents on a monthly basis and also displayed in the home. Two residents showed some painting work that they had done which are now displayed on the walls, and one resident talked about the on going work they were doing. Two residents talked with said that they missed the last activity co-ordinator but thought the new one was very nice, one resident talked of the outings she had been on, and another was seen to be playing scrabble on a one to one basis before the scheduled group activities. It was confirmed by talking to residents that the routines of daily Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 13 living have a degree of flexibility; residents can request meals at a different time if they are going out and in their preference for getting up and for going to bed. One resident who chooses to remain in bed due to her physical disabilities said that she “doesn’t get bored, staff pop in a lot, she watches the dogs play in the garden and considers her life to be comfortable, her daughter brings in books and she does her Times crossword everyday”. Another said that “she can choose what she does on a day to day basis and the staff go out of their way to support her” There is open visiting and one relative said they were welcomed to the home, whenever they visited. On the day of the inspection one resident was celebrating her hundredth birthday and the home’s staff helped her celebrate, there was a photograph session where she was presented with her telegram and then sparkling wine for all residents with lunch. Residents are able to handle their own finances if they wish to, and if they are able. In every bedroom there is a lockable facility to safeguard valuables. All residents are made aware of an advocacy service provided by Age Concern. Four residents were aware of this service. Furniture and other belongings are welcomed by the home if the resident wishes to bring them with them. Certain rooms have been personalised. The menus demonstrated choice and variety and indicated a well balanced diet. The menus rotate on a four weekly basis and change according to the seasons. Fresh fruit is always available. The residents were forthcoming in their views of the food, and the majority said the choice was good and the food was always tasty. Three residents said they “choose their meal, but don’t always remember what they chose”, but said, “the food is good”. One resident was not as complimentary regarding food, and said it was “just alright”. The food seen on the day of the inspection was attractively served and appeared nutritious and wholesome. The residents were seen to enjoy the meal. It was discussed that the dining room is not used to its full potential, and the manager said it depended on the residents where they took their meal and the majority chose to eat in the lounge or in their bedroom. The more heavily dependent residents were seen being assisted with their meal in a respectful manner. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 and 18. The complaint procedure is clearly detailed in the Statement of Purpose and Services Users guide and is available to residents and their families enabling them to share their concerns formally and confidentially. Staff interviewed had a good understanding and knowledge of Adult Protection policies and procedures, which protect the residents from harm and abuse. EVIDENCE: There are appropriate policies and procedures in place and it was confirmed that these are followed when investigating any concerns raised at the home. The staff interviewed were knowledgeable of the complaint procedure and of how to start the process if the manager is not available. Two of the residents referred to the service users guide when asked if they knew how to make a complaint, whilst one resident said she didn’t know of a proper procedure, but would go the senior nurse and that it would be dealt with”. There have been no complaints received by the CSCI. The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable service users. There is on-going training for all staff in Adult Protection. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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, 20, 21, 22, 23, 24, 25 and 26. The home provides a comfortable, clean and safe environment for those living there and for those visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. There is specialist equipment in the home for residents’ use to maximise their independence. EVIDENCE: The home has continued with its programme of upgrading and is tastefully decorated and the furniture is of a good quality and tones in with the new décor. The lounge, dining room and conservatory area are comfortable, homely and well used. The home environment presents as well maintained and comfortable, the colour schemes have been used give a feeling of warmth. The residents are encouraged and enabled to personalise their rooms with furniture and pictures, Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 16 and this was evident during the visit. All personal items are listed in the individual care plans. All service users are offered the choice of having a lock and key for their bedroom, risk assessments are in place for this. All rooms have a lockable facility for the storage of personal items and valuables. Magnetic door guards are fitted on all private accommodation. There is a range of toilet and bathing facilities situated throughout the home to meet the needs of the service users. A new shower room is in place on the upper floor. The home has not been assessed by an occupational therapist, or other qualified persons, but the staff in the home are knowledgeable of the disability equipment available and the home has hoists, grab rails, raised toilet seats and access to all areas of the home is provided by lifts. It is demonstrated in the care plans and risk assessments that all service users are independently assessed for individual needs and the staff are aware of where to procure specialised equipment. There are toilet, washing and bathing facilities to meet the needs of the service users, including showers and assisted baths. Specialised equipment to encourage independence is provided e.g. handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. A call bell facility is in place and during the inspection the call bells were found in reach of the residents. Those residents that can’t physically ring for help have an appropriate risk assessment in place. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Beds and chairs were seen to be placed appropriately for maximum benefit of those wishing to read. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. Sluice areas and equipment was clean and hygienic. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 and 30. Staffing levels were adequate to meet the assessed needs of the residents. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their designated roles. Staff are provided with training pertinent to meeting the needs of the residents and to do their jobs competently. EVIDENCE: The staffing levels on the day of the inspection were seen to be adequate for the assessed needs of the residents. The morning staff consisted of the manager who was supernummery, a senior registered nurse (deputy manager), four carers, and the activity co-ordinator. There was also adequate ancillary staff to ensure that the home is kept clean and safe. The staff spoken to said they felt the staffing levels were sufficient to ensure a good standard of care. They also said that if more staff were needed for a poorly resident it would be provided. One resident said that she never had” to wait long if she rang for assistance” and during the inspection there was a prompt response to all call bells. All new staff receive an induction and foundation training in line with the National Training Organisation and fully meets the specifications and targets set by the National Training Organisation. Staff training is on going. Three Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 18 members of staff said that the training in the home is “very good, lots of it” and that they receive regular supervision. The staff feel that they are well supported and that the training available to them helps them meet the needs of the service users in the home. There is on-going enrolling on the NVQ programme and all staff receive encouragement and support to enrol. One resident said, “ the staff are very good, nothing is too much trouble,” another said, “ staff are very helpful” and ”they know how to look after me”. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 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): 36 and 38. All staff receive formal supervision at least six times a year and this promotes good practice and provides a support system for staff. There are policies and procedures in place that safeguard residents’ rights and best interests. The environment and the working practices of the staff protect and promote the residents health, safety and welfare needs. EVIDENCE: The home has produced a training programme that is suitable for the staff and for the needs of the residents. The staff-training schedule displayed a wide variety of training for the staff. Staff are supported by the management team on a daily basis and more formally through supervision. Staff spoken to confirmed they received Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 20 supervision and annual appraisals. They are in a written format and copies are kept in the staff files. The manager confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies, the manual is available to all and clearly defined. Staff again, were able to discuss the training they received and said that the manager kept them up to date with changes to policies in connection with their job description. The home has in-house trainers for the mandatory training of moving and handling, food hygiene and health and safety. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. The home has a comprehensive set of policies and procedures, which govern the running of the home. All records in the home are up-to-date, accurate and held in accordance with the requirements of the Data Protection Act 1998. Records are kept in lockable cabinets in the office. The home has policies and procedures on dealing with confidential records as a point of reference for staff. All relevant legislation and procedures are in place in respect of Health and safety. Good practice was observed throughout the inspection in respect of the safety of residents when being moved and transferred. Fire precautions were seen to be adhered to and staff showed a good knowledge of the mandatory training that is required. Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x 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 4 3 3 3 3 3 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 X X X X X 3 3 3 Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 22 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. Refer to Standard Good Practice Recommendations Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Carlisle Lodge DS0000013971.V253046.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!