Inspection on 18/12/08 for Carmel Lodge Care Home

This inspection was carried out on 18th December 2008.

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

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carmel Lodge Care Home London Road Adlington Macclesfield Cheshire SK10 4NJ     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: Joan Adam     Date: 1 8 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 21 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 21 Information about the care home Name of care home: Address: Carmel Lodge Care Home London Road Adlington Macclesfield Cheshire SK10 4NJ 01625856790 01625858981 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Maria Mallaband Ltd care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Dementia over 65 years of age - Code DE (E) The maximum number of people who can be accommodated is: 36 Date of last inspection Brief description of the care home Carmel Lodge is a privatly owned purpose built care home which was regisitered in 2007. It has 36 single rooms all with an ensuite toilet. There are three lounges, two dining rooms and a safe enclosed garden available for residents and visitors. Toilets and bathrooms are located around the home. It is set on the outskirts of Poynton within walking distance of shops and amenities. 0 Over 65 36 Care Homes for Older People Page 4 of 21 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: We made an unannounced visit to Carmel Lodge on 18 December 2008. Carmel lodge is a re-registered service and this is the first visit by CSCI since the new registration. During the visit we spoke to the manager, some staff members and some residents and their views contributed to the report. Before the visit the manager was asked to complete a questionare called an Annual Quality Assurrance Assessment (AQAA) to provide us with up to date infromation about the home. Comments made to us and information received are detailed in the report. Care Homes for Older People Page 5 of 21 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 6 of 21 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 7 of 21 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 are assessed before they move in the home so that they know their needs can be met. Evidence: The care records of two people that have recently moved in to the home were looked at. They had been assessed by the manager before they went to live at Carmel Lodge so that they knew their needs could be met. This information was used to write a care plan for the resident. Documentation from Social services was present in the file. The home does not provide intermediate care so this standard does not apply. Care Homes for Older People Page 8 of 21 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. People who live at Carmel Lodge have their health,personal and social needs met in a dignified way and medicines are managed well so that they receive their medicines as prescribed. Evidence: Each person living at Carmel Lodge has a care plan that details their needs and gives information to staff about how their needs can be met. The care plans of five residents were looked at and the standard of four of the plans of care gave good guidance so that staff would know how to meet their needs. However, one care plan should contain more detail so that staff were aware of how this person needed prompting so that they could maintain their independence. A moving and handling assessment had been completed on each resident so that staff would know how to move them safely. A nutritional assessment had been filled in so that staff would know if the residents were at risk of loosing weight. Monthly weights were recorded in each plan. Care plans had been reviewed monthly but the documents only gave one line for staff to complete this so that a full picture of how the person had been that month could not be fully Care Homes for Older People Page 9 of 21 Evidence: recorded. New care plan documents were to be introduced by the company within the next few months which addressed this shortfall. The new documents were present in the home and staff were to start using these after receiving training. Daily record sheets were written each day by staff and showed day to day activity of each resident. All visits by health care professionals such as G.Ps, district nurses and optician were recorded. The general atmosphere in the home was warm and friendly and staff appeared to have good relationships with the people in their care and visitors at the home. Staff were seen to be supportive and answered residents with patience, taking the time to explain to them even if the same question was being asked repeatedly. Comments made by residents was this is a lovely place everyone is friendly they look after me Relatives commented they look after my relative well staff are helpful and friendly Medicines are managed well. Policies and procedures are in place for the safe management of medications and staff training has taken place so that staff are aware of their responsibilities regarding the safety of medicines in the home. The home uses a blister pack system for medication so that staff can see which medicines have been given out each day. All medication administration sheets had been completed. Care Homes for Older People Page 10 of 21 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 who live at Carmel Lodge are able to take part in a range of activities and mealtimes were a positive experience. Evidence: Two activity co-ordinators are employed at Carmel Lodge and the activities on offer are varied. People who live at the home are taken out on a one to one basis to local shops and for coffee on at least a weekly basis. Relatives were also seen to take the residents out for lunch or home for a few hours. The activities on offer are displayed in the home so that residents know what they can expect each day. A gardening club has been formed which is very popular and produce such as vegatables and herbs have been used in the kitchen and sold at the summer fayre. The manager hopes to have a green house in the spring so that this can be extended. Raised flower beds have been provided to make it easier for the people who live at the home to use the garden. One flower bed is a footstep garden where special plants are planted for residents who have left the home or passed away as a remeberance. Plants are also put in the garden to celibrate residents birthdays. A newspaper group is to be formed to stimulate discussions on topics in the news. The home has held themed barbacues such as a Bollywood party where all the staff dressed up. Care Homes for Older People Page 11 of 21 Evidence: The menus at the home are varied and residents are helped to choose what they want to eat at each meal. Homemade cakes and scones are on offer each day. People spoken with said the food is lovely I love the cakes we get the pies are not from a shop Care Homes for Older People Page 12 of 21 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. People who live at Carmel Lodge are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. Evidence: There is a complaints procedure at Carmel Lodge and the one complaint that had been made was recorded and fully addressed. People could be confident that their complaints would be listened to. Staff have received training about safeguarding people from abuse so that they know how to deal with any incident or suspicion of abuse. Care Homes for Older People Page 13 of 21 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. The home provides a good, clean environment for the people to live in. A more private area should be provided for staff to maintain the confidentiality of people who live at the home. Evidence: During the visit to the home we walked around the home and all areas were cleaned to a high standard with no odours present. The decor of the home was of a high standard and each bedroom was well personalised. The storage facilities at Carmel Lodge are poor and an upstairs bathroom was being used as storage for boxes of continence pads. The home has one small store room on the ground floor which is very full. It is recommended that areas within the home are assessed to enable more suitable storage be provided. The nurses stations on each floor are open desk areas with a filing cabinet and telephone in place. Residents often answer the telephone and when staff are using the phone conversations can be overheard by residents or visitors which means that confidential issues can not be discussed privately. It is recommended that these areas be assessed to enable them to be made more private to maintain the confidentiality for the residents. Care Homes for Older People Page 14 of 21 Care Homes for Older People Page 15 of 21 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. Enough staff are provide so that the needs of people living at the home are met and have attended training so they know how to care for people appropriately. recruitment procedures are thorough to make sure that new staff are suitable to work with the people who live at the home. Evidence: The staffing rota was looked at and showed there were appropriate staffing levels and skill mix deployed on each shift to enable the needs of residents to be met. The percentage of staff holding a National Vocational qualification (NVQ) level 2 in care is 80 . Training was in place with regard to moving and handling, safeguarding adults,fire safety and first aid. All staff have attended a basic course on insight in to dementia care and the majority of staff have attended an Asset course at Cheadle college for level 2 in dementia care. The recruitment files of four staff were checked. All the files contained relevant information required to enable the management to be aware that the person could work safely with elderly people. Care Homes for Older People Page 16 of 21 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 the views of people who live, work and visit the home are listened to. Evidence: The manager is experienced in care and management and has been registered with CSCI. She has completed the registered managers award. The organisition who owns the home has a number of quality assurance systems in place designed to identify strengths and areas of improvements, these included audits for areas such as medications, care plans and the environment. Staff spoken with felt that she was supportive. The staff are supported by regular formal supervision sessions so that they can discuss their development and improve their skills and competence. Regular staff meetings take place for all grades of staff and minutes are taken. Resident/relative meetings are also held on a regular basis and the manager has an open door policy. It was observed that the manager had a good relationship with relatives present on the day of the visit. Questionnaires are sent to relatives to check their satisfaction with the Care Homes for Older People Page 17 of 21 Evidence: home and a report of the findings were present in the service user guide. Comments such as the care and attention given to my relative has been excellent from day one staff are friendly and helpful to residents, were recorded. Regular fire drills and staff training sessions are held to make sure staff know what to do in case of fire and there was a record of the names of staff attending. The AQAA gave us details of when equipment in the home had been checked and serviced to make sure that it continues to be safe and effective. Small amounts of residents monies are held in the safe and all transactions are recorded so people who live at the home know their money is safe. There is a robust recruitment system in place so that all staff employed have the correct safety checks so that the manager knows they are safe to work with elderly people. Care Homes for Older People Page 18 of 21 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 19 of 21 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 19 It is recommended that the nurses station areas be assessed so that they provide a more private area so that resident confidentiality is maintained. It is recommended that the space in the home is assessed to find areas for storing items so that bathrooms are not used as store rooms. 2 21 Care Homes for Older People Page 20 of 21 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 © (2008) 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. Care Homes for Older People Page 21 of 21 - 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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