Inspection on 27/01/09 for Carmel Lodge

This inspection was carried out on 27th January 2009.

CSCI found this care home to be providing an Good service.

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

Carmel Lodge 30/01/07

Carmel Lodge 29/11/05

Carmel Lodge 29/06/05

Carmel Lodge 01/09/04

Carmel Lodge 28/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carmel Lodge 576 Harrogate Road Leeds West Yorkshire LS17 8DP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Paling     Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Carmel Lodge 576 Harrogate Road Leeds West Yorkshire LS17 8DP 01132371133 01132682822 carmel1@donisthorpehall.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Donisthorpe Hall Limited Name of registered manager (if applicable) Mr Tapera Robinson Mahachi Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: That the Manager, Mr T R Mahachi, registers to undertake a certified diploma course which relates specifically to adults with a diagnosis of dementia Date of last inspection Brief description of the care home Carmel Lodge is owned by Donisthorpe Hall (a company limited by guarantee) which operates under a registered Charitable Trust. The company also operates a larger care home nearby, Donisthorpe Hall. The home is a large detached house in the Moortown area of Leeds, which has been extended to provide residential accommodation for up to 21 people. The building was altered in recent years to make it a more secure environment for people diagnosed with dementia. The home has a passenger lift between the two floors. There are 19 single rooms and one shared room, all have en suite facilities. The dining room and lounge areas are on the ground floor. The home has off road parking to the front, with double gates to protect service users from the busy main road. The front door is operated by a digital lock which is only accessible to staff and visitors. A fence encloses a pleasant garden with a patio area. There are a Care Homes for Older People Page 4 of 25 care home 22 Over 65 22 0 Brief description of the care home range of amenities in the locality and it is well served by public transport. People living at the home have access to some of the activities provided at Donisthorpe Hall. The home operates for people who wish to follow a Jewish way of life. Fees range from four hundred and twenty eight pounds to six hundred and twenty pounds per week. Hairdressing, chiropody, clothing and toiletries are not included. This information was provided at the January 2009 visit and the home should be contacted directly for up to date information about charges. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit by one inspector who was at the home from 09:50 until 15:40 on the 27th January 2009. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. Care Homes for Older People Page 6 of 25 A number of documents were looked at during the visit and all areas of the home used by the people who lived there were visited. A good proportion of time was spent talking with the people at the home as well as with the manager and the staff. The manager was asked to complete an Annual Quality Assurance Assessment (AQAA) to provide additional information. This is a self-assessment of the service provided. We did not receive this in time to include any of the information in this report. Survey forms were sent out to the home before the inspection providing the opportunity for people at the home, visitors and healthcare professionals who visit to comment, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A number of surveys were returned by the time of this visit. Comments received appear in the body of the report. The last key inspection for this service was 30th January 2007. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information so that they can make up their mind about moving into the home. Everyone has their needs assessed before moving in. Evidence: There was a range of information available at the home. These included a Statement of Purpose, which is reveiwed on an annual basis and is also produced in an easy read version. This information is not freely available and has to be asked for via the office. It was stated in the Statement of Purpose that recent inspection reports are available at Donisthorpe Hall. These reports should be available at the home. The manager should look at ways of allowing people easier access to information about the home. Every room also has a Welcome Pack that contains a large print version of the Statement of Purpose as well as a range of useful information about the services and Care Homes for Older People Page 10 of 25 Evidence: facilities at the home. We suggested that the manager should refer to Schedule 1of The Care Homes Regulations to check that he has included all the required information in the documents provided for people. People said information they were given was - very,very good We looked at the records of a person who had only very recently moved into the home. This person was able to tell us that she was beginning to settle at the home. Her relative was also visiting and told us how delighted he was with how the staff were helping his mother to settle at the home. Staff seemed to already know her quite well. People have their needs assessed before admission. There is a document to be completed shortly after admission that provides information, which will contribute to care plans. The information was not detailed enough and should be expanded so that staff are provided with good detailed information in care plans about the care and support people need. For example, information around personal care was requires full assistance to dress and washes with assistance. There was no information about exactly what support was needed and what the person could do for themselves. This document was also undated and unsigned. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is enough detail in the care records for staff to know how to look after people properly. People are protected by safe medication procedures. Evidence: We looked in detail at the care of a small number of people living at the home. Everyone had care plans in place that give staff enough information about how to care for the people living at the home. Some of the care plans we looked at were undated and unsigned and it was not possible to tell is some of the plans had ever been completely reviewed and re-written for people who had been at the home for a number of years. Care plans could be more detailed about exactly what people can do. For example, minimal assistance recorded for one person for personal hygiene suggests that this person has ability in this area that staff should be working to maintain. In order to do so staff need more detail about this persons strengths. Care Homes for Older People Page 12 of 25 Evidence: We saw some good detailed and person centred information in night care plans about how people were overnight and how staff responded if people did not want to go to bed. Care plans also contained some good and specific information to help staff understand individual mental health needs and how to support people. We saw records of the input of other healthcare professionals that were clear and well recorded. There was a range of risk assessments completed for people, including nutritional risk assessments and the risk of falls. Care plans were reviewed but these reviews did not fully reflect the effectiveness of the plan of care for the previous month. Detailed reviews of care plans help to demonstrate the effectiveness of care plans and changing needs of people. People said - Very satisfied with the way mum has been treated to date Caring and supportive of my mother as an individual Health and well being have improved enormously since xxxx has been at Carmel Lodge Efficient and caring Daily records were kept and were detailed and showed how people spent their time and gave a picture of their health and well being. We saw staff approach people in a respectful manner and practices demonstrated that staff respect peoples dignity. Staff seem to know the people they care for very well. Observed medication practices were safe and staff all have training in the administration of medication before they take on this responsibility. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in maintaining contact with family and friends and to make choices. People are provided with a good and varied diet that takes into account individual choice. Evidence: People are supported in making choices about their daily lives and spending their time in the way they want. Staff seem to know the people they look after very well and understand specific behaviours shown by people. The atmosphere is relaxed, warm and welcoming. People were enjoying a late breakfast on our arrival at the home. Drinks were freely available throughout the day. Some people were doing some drawing, other were listening to music or watching television. Others spend time in their rooms. People are supported in going out when possible, one person goes out regularly with their family and others regularly go to Donisthorpe Hall to use the facilities there, which include a cinema. The tables in the dining room were attractively set for the lunchtime meal, making the meal an enjoyable occassion. Staff were patient and sensitive in encouraging people to Care Homes for Older People Page 14 of 25 Evidence: eat and finding an alternative for one person who did not want the meal as served. People commented on the kindness of staff and said that their relatives were well cared for. People seemed to be confident and content at the home. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust complaints procedure and people are listened to and issues are acted upon. People are protected by safeguarding procedures Evidence: The complaints procedure is available at the home and is included in the Welcome Packs. Survey information suggested that people knew how to raise any concerns. There was no information at the home to the number of complaints received or to demonstrate how they have been dealt with by the manager. We were told that this information is kept at the head office. A summary of any complaints recieved together with the action taken must be available for inspection at the home. All the staff received training about safeguarding vulnerable adults in November 2008. The manager is to attend local authority safeguarding training during February 2009. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and well maintained environment. Evidence: We visited all areas of the home used by the people who live there. All areas were clean and odour free. Bedrooms are comfortably furnished and the communal areas of the home are homely and appropriately furnished. There is access to the enclosed garden from the lounge. Work was well underway at the time of the visit on the garden area. A local authority grant has been awarded to provide a sensory garden which will be ready for use in the spring time. All laundry is done at Donisthorpe Hall. This arrangement had some problems initially with the time taken for it to be returned and the labelling of clothes. The manager told us that this has now improved. Since the previous visit facilities have been improved with a reduction in the number of shared rooms and greatly improved staff facilities. We observed good infection control practices over the course of the visit. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by trained and competant staff. There are enough staff to look after people properly. Evidence: Staff recruitment is done centrally via head office and recruitment records were not available at the home for inspection. The manager and chief executive of the company told us that all the required checks are completed before staff start work at the home. These checks include criminal record bureau checks and two written references. For people recruited from overseas local police checks are also done. There were enough staff available to look after the people living at the home. Care staff are well supported by kitchen and domestic staff meaning that they can concentrate on their caring duties. We observed that staff have a good understanding of the diverse needs of each person and showed warmth and genuine concern for people. Staff are well trained with the majority of staff having completed a National Vocational Qualification (NVQ) in care at level 2 and moving on to NVQ level 3. There is an annual training plan in place to make sure that staff have the skills to look after people properly. Care Homes for Older People Page 19 of 25 Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who live there. Evidence: The manager is a qualified nurse holding a qualifcation as Registered Nurse Mental Handicap (RNMH). He has also completed the Registered managers Award (RMA). He also told us that he has completed a number of short courses in Dementia care. The manager told us that there is a system of audits in place at the home. Senior staff from within the organisation get involved in completing the audits. We sat in on the handover held between shifts that makes sure staff are aware of any issues of changes in the care of people. This is good practice and the information passed between staff was detailed. We saw records made of accidents occurring to people who live at the home. Records Care Homes for Older People Page 21 of 25 Evidence: were detailed and completed well. However, a number of these should have been reported to us as required under Regulation 37 of The Care Homes Regulations, this is so that we are aware of significant events happening at the home. The manager was unclear about this saying that he passed accident reports to head office. Guidance on Regulation 37 notifcations was left with the manager. Satisfaction surveys are sent out from Head Office every 3 months but these are not specific to Carmel Lodge. Resident and relative meetings are held every 3 months at Donisthorpe Hall, again these are not specific to Carmel Lodge. We discussed with the manager the importance of making sure that people and their relatives are provided with the opportunity to voice their opinions about Carmel Lodge. This could be done informally, for example, through social events or by means of a Newsletter specific to Carmel Lodge. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care records should be further developed to make sure that there is a consistent level of detail about specific care and support for people. This is so that staff have all the information they need to care for people in the want they want. Monthly care plan reviews should provide an overview of the effectiveness of the plan over the previous month. This is so that peoples changing needs are accurately reflected. 2 16 Information about any concerns and complaints recieved at the home should be kept at the home for inspection purposes. This should also include detail of how they have been addressed. Opportunities should be provided for people who live at Carmel Lodge and their relatives to comment on the service they receive. Consideration should also be given for inhouse events to keep relatives and other informed and up to date with developments of the service at Carmel Lodge. The way accidents are recorded should be reviewed to make sure that notifcations are made to CSCI as required under Regulation 37 of The Care Homes Regulations 2001. 3 33 4 38 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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