CARE HOMES FOR OLDER PEOPLE
Cavell Lodge 5 Blenheim Chase Leigh-On-Sea Essex SS9 3BZ Lead Inspector
Valerie Buckle Unannounced Friday 20th May 2005 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 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. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Cavell Lodge Address 5 Blenheim Chase Leigh-On-Sea Essex SS9 3BZ 01702 480660 01702 474316 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Corvell Health Care Limited Mrs Lisa Patricia Aitken CRH Care Home 36 Category(ies) of DE(E) Dementia- over 65 (6) registration, with number OP Old Age (36) of places Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Total number of service users for whom personal care is to be provided shall not exceed 36. 2. Personal care can be provided for up to 36 older people over the age of 65 years of age. 3. Personal care can be provided for up to 6 people who have dementia and are over 65 years of age. Date of last inspection 7th March 2005 Brief Description of the Service: Cavell Lodge provides care and accommodation for thirty six older people of whom up to six may suffer from dementia. The home particularly caters for residents with medium to low dependency needs. The home is purpose built and provides a high standard of accommodation. There are thirty two single and two double rooms situated on three floors of the home, all have en-suite facilities. There is access to all floors via a passenger lift. Residents have a choice of several pleasant lounges plus an attractive dining room. The home also has a small quiet lounge, a visitors room and a hairdressing salon. There is a large well maintained garden for residents to use and a large summerhouse. Off road parking of available. The home is situated close to a bus route, in a residential area and is close to local parts and woodland. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was Unannounced and took place over three hours in the home. There was a tour of the premises, and inspection of some records and documentation. Four members of staff were spoken with and five residents spoke about their life in the home. The manager assisted in the process of the inspection. The four requirement and two good practice recommendations from the last inspection were met. There were no requirements arising from this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1.3 and 4. Prospective residents have the appropriate information to make a choice about living in the home. Detailed assessments are made before residents are admitted to the home. EVIDENCE: The homes Statement of Purpose and service user guide include all the required information. All residents, new residents and people making enquires about the home requires copies of this information. Initial assessments and a planned admission ensure that new residents needs and wishes are properly assessed before moving into the home. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7,8,9,11. Resident’s health and personal care needs appropriately met. Cares plans in place at the home were detailed and covered all areas of residents needs. Systems are in place to ensure the safe use and storage of medication. EVIDENCE: The care planning system has been revised. The new system involves all aspects of the resident’s life. Residents have access to Health Care services and are able to keep their own doctor when ever possible. Systems are in place to record incidents and accidents. A medication policy and procedure is in place and this has been revised. Urgent action has been taken by the manager to remedy all the issues that were identified at the last inspection. Medication was seen to be appropriately recorded and safely stored in the treatment room, which is kept locked. Residents who choose to, have their last wishes recorded in the care plan. The manager stated that the policy of the home is to care for and support residents who are unwell, with dignity and respect until such time that they require nursing care.
Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 12,15 Daily routines in the home are flexible. Activities take place daily and residents take part in activities of their choice. Suggestions about activities are discussed at the Residents Meetings. EVIDENCE: Improvements have been made in providing activities and a member of staff has been nominated as the activities co-ordinator. Residents are involved in choosing and requesting activities of their choice. Discussions about activities take place at regular residents meetings. Requests from residents include: flower arranging, trips to Marks & Spencer’s, strawberry teas, trips out and tea dances. There are regular visits from a local church, mobile library and a fashion show which displays clothes suitable for residents. The menu was seen to be varied and nutritious. Residents commented that the standard of cooking was good and there was always a choice. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 16 18 The home has a detailed complaints procedure, which is accessible to the residents at the home. There are systems in place to protect residents from abuse. EVIDENCE: There have been no recorded complaints; the complaints procedure is included in the service users guide and displayed in the home. All staff have completed training on the Protection of Vulnerable Adults. The home has policies and procedures in place and staff employed have completed CRB and POVA checks. All residents have family or friends to support them and there is an advocacy service available. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 11 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 standard(s) Cavell Lodge continues to provide a high standard of care and accommodation to the residents. The attractive gardens are well maintained and accessible to all residents. EVIDENCE: The home is decorated, furnished and maintained to a high standard. The home is light and airy with domestic style lighting on the halls and bedrooms. All the bedrooms are personalised to the choice of the residents and have ensuite facilities. The communal areas were spacious and comfortable with a separate visitor’s room and a quiet lounge. A hairdressing salon is also available. The attractive gardens were well maintained and accessible to the residents. The laundry room, although quite small, was clean and fresh. Residents said the home is very comfortable, and that the staff are friendly and caring. One resident said her bedroom was a good size and she enjoyed the food and that meetings take place with staff and residents. Families and friends are made very welcome. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The staff team are qualified and experienced to do their job. The stable staff team have worked at the home for a number of years, and are committed to caring for the residents. EVIDENCE: There are forty-two members of staff employed at the home and the staffing rota showed that there are at least six staff on duty throughout the day. There is a robust recruitment procedure in place; all new staff undertake a programme of induction. At last 70 of the staff team are NVQ trained and records of staff training showed that regular training takes place which covers specific areas which are relevant to the needs of residents placed at the home. The four staff commented that the manager of the home is supportive and there are lots of training courses available. They all expressed satisfaction of working at the home and said the atmosphere is relaxed and friendly. Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35,37,38 The home is well managed; the manager is committed to providing a good service and high standard of accommodation and care. The home is financially viable; systems are in place to protect the health, safety and welfare of residents and staff. The home has procedures in place to safeguard resident’s money. EVIDENCE: The manager is experienced and well trained. In addition to NVQ4 in care and management, she attends further training courses. Staff comments were “the manager is very approachable and open to discuss any issues raised”. All staff receive regular supervision and training. Informal and formal meetings take place regularly, meetings with staff, residents and their families. Six monthly questionnaires on the quality of the home are completed by residents and their families. Most residents’ pocket money is kept in the safe with their individual records. Some residents keep their money in a lockable drawer in their room.
Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 4 4 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 x 3 x 3 3 Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 15 NO Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Cavell Lodge I56 I06 S15423 Cavell Lodge V226247 200505 Stage 4.doc Version 1.30 Page 16 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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