Inspection on 01/12/05 for Caxton Lodge

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Caxton Lodge 04/12/08

Caxton Lodge 04/06/07

Caxton Lodge 07/06/06

Caxton Lodge 05/07/05

Caxton Lodge 02/12/04

Caxton Lodge 19/04/04

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

CARE HOMES FOR OLDER PEOPLE Caxton Lodge 25 Caxton Avenue Blackpool Lancashire FY2 9AP Lead Inspector Mrs Ruth Edgington Unannounced Inspection 09:30 1 December 2005 st 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 Caxton Lodge DS0000009874.V257516.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. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Caxton Lodge Address 25 Caxton Avenue Blackpool Lancashire FY2 9AP 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) 01253 356100 01253 356100 caxtonlodge123@aol.com Mrs Isobel Conner Mr Nicholas Conner Care Home 11 Category(ies) of Dementia (11) registration, with number of places Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5/07/05 Brief Description of the Service: Caxton Lodge is situated in a residential area between Bispham and Norbreck, within easy access of shops and local amenities. The home can accommodate a maximum of eleven elderly persons, who have dementia. All bedrooms are for single occupation, none of which have en-suite facilities. The home has two lounge and dining areas and sufficient toilet and bathing facilities to meet the needs of the residents. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and commenced at 9.30am and took place over 3 hours. The Inspector spoke to two visitors, the homeowner, manager and one staff member. Although the residents’ abilities to communicate varied greatly and in the main was very limited, the Inspector was able to gain information by their comments and through observations made throughout the inspection. During the inspection the Inspector looked at a number of records including those of a selection of residents and staff. The Inspector also had a general look around the home and spent time observing the daily activities in the home. Although the Inspector identified several areas that required attention, from the information gained through discussions with relatives and observations made, the care of the residents was not in question. What the service does well: The residents in this home are well looked after. The management and staff liaise well with the relatives who are encouraged to be involved in the care provided. The Inspector spoke to two visitors who confirmed that they were kept well informed of the care being given. One visitor said, “ the staff are very kind, nothing is to much trouble” A relative spoken to during a previous inspection said that they were still very happy with the care being given and visited most days. The Inspector was able to witness the positive relationship between the relative and management. The Inspector also received positive comments in a questionnaire that had been completed by a doctor who regularly visits the home. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 6 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 Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 8 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 Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 9 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): These standards were not inspected during this inspection. EVIDENCE: Caxton Lodge DS0000009874.V257516.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&9 Promotion of health is taken seriously, however shortfalls in the recording of daily information, reviewing of care plans and the systems in place for the administrating of medication could potentially put residents at risk. EVIDENCE: The Inspector examined the records of two residents who had been admitted since the previous inspection and found that the information being recorded had improved. However the Inspector found that the care plans in operation were not being reviewed frequently enough to provide written confirmation that the needs of the residents were being met. The management continue to be very much ‘hands on’ and from discussions and observations during the inspection, there was no evidence to indicate that the residents needs were not being met. Comments made by visitors were very positive and the Inspector was able to evidence that they were kept informed of any matters relating to the individual resident. The Inspector also found that the individual daily records sheets that had been commenced previously were no longer being used. The manager was advised Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 11 that the way in which information about individual residents is recorded on a daily basis does not comply with the Data Protection Act. The home uses a monitored dosage system for the administration of medication, however the Inspector noted that the medication was being put into individual pots before being given to residents. The manager was informed that this practice was not acceptable and could place residents at risk. The medication records were examined and found to be up to date. Caxton Lodge DS0000009874.V257516.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 & 14 The social, cultural, religious and recreational interest and needs of the individual residents continue to be met, within their capabilities. The control and choice that residents have over their lives is dependent on their ability to understand and exercise their rights EVIDENCE: The Inspector found that the residents’ documentation contained information about their likes, dislikes, interests and abilities to make decisions for themselves. The Inspector noted that there were a variety of games, puzzles and other recreational equipment around the home for residents to use if they wished to. One resident was seen playing with a puzzle during the inspection, however in the main the resident have very limited ability to undertake any activities even with the assistance of the staff. Reminiscence books and music are used to encourage discussions with the residents. The home has many visitors on a daily basis, who spend time with their relative. The Inspector spoke to one visitor who said that they visited every Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 13 day, stayed for their meals and were brought and taken home by the manager or staff if their family was unable to this. The management and staff rely very much on information obtained from the residents’ relatives and friends to help them act in the best interests of the residents. A tour of the home confirmed that residents are able to bring in with them personal possessions in order that they feel at home. Caxton Lodge DS0000009874.V257516.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 & 18 The arrangements in place for handling complaints ensure that people feel confident that their complaints will be listened to and taken seriously. Procedures for dealing with and reporting abuse procedure were satisfactory ensuring that people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents and their relatives on admission and a copy is displayed in the hallway. The visitors spoken to said that they would complain to the homeowner or manager if they had any concerns, but they were very satisfied with the care and attention that the residents received. On visitor said “If there was anything wrong in this home I would see it, I would tell you and not be afraid to do so”. The home keeps record of any complaints and compliments made. Many compliments have been made but no complaints. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 15 The home has a procedure in place for dealing with allegations of abuse. The management and staff had a god understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 16 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 Improvements have been made to the garden area, which now ensures a safe and secure for the residents. A programme of redecoration and maintenance is required to ensure that the residents continue to live in a safe and homely environment. EVIDENCE: At the time pf the previous inspection concerns were raised about the safety of the residents who go into the garden and could wander into the road. As requested the homeowner has erected a fence and gate, which ensures the safety of the residents when in the garden. During a general tour of the home the impression gained was that there were areas of the home, which were showing signs of becoming signs of becoming ‘tired’. The manager agreed to produce a programme of maintenance and decoration. Caxton Lodge DS0000009874.V257516.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): 27,29 & 30 Shortfalls in the recruitment of staff, formal induction and the number of staff employed could potentially leave residents at risk. EVIDENCE: The management of the home continue to be “hands on” and although they prefer to be involved in this way, the low staffing levels have been caused by them not being able to recruit the calibre of staff who they feel would be able to provide the care required. Since the previous inspection two new members of staff has been employed. The Inspector examined these staff files, which contained the necessary documentation, except for clearance through the Criminal Records Bureau (CRB) or POVA (Protection of Vulnerable Adults) requested by Caxton Lodge. The Inspector evidenced that the clearances had been applied for before the staff commenced employment but that the forms had been returned as they had not been completed correctly and the manager was in the process of submitting these again. The Inspector found that both files contained a copy of a CRB clearance that the staff had obtained whilst in their previous employment, both were within the last six months. The manager was reminded that CRB clearances are not portable from one employment to another and that all staff should be cleared through POVA before they can start work and then only if supervised at all times. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 18 Whilst the management work along side the staff and induct staff in all aspects of the work, there was no written evidence in the staff files examined that formal induction was taking place. Evidence was seen through the examination of training records that relevant training was ongoing. Caxton Lodge DS0000009874.V257516.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): 31, 35, 36 & 38 The management are committed to proving good care however additional support is needed to enable the manager carry out his role, which includes correctly maintaining records to ensure that the care needs of the residents are being met. The home is run in the best interests of the residents. EVIDENCE: The registered manager has a diploma in management and is presently undertaking level 4 NVQ (National Vocational Qualification) in management and care, which he is confident will be completed by April 2006. He has also undertaken relevant training to meet the changing needs of the residents. The Inspector again discussed with the manager and homeowner the fact that the limited number of staff employed was affecting the time available to carry Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 20 out management tasks. The homeowner stated that she would make every attempt to resolve the situation in order that the manager could use his time more affectively.. The manager confirmed that he recognised that the shortfall in the staffing levels affected his ability to use his time more effectively. The Inspector was unable to find written evidence that staff receive formal supervision and the manager stated that the management work very close to the staff but records were not completed, as the standards require. From comments received throughout the inspection the Inspector was able to evidence that whatever shortfalls there were in the home, the needs of the residents came first. The Inspector was also able to observe the caring approach of management and staff towards the residents. Visitors spoken to were very complementary about the home and the way in which the residents are cared for and had no concerns over the health and welfare of the residents. The Inspector examined the residents’ financial records and found that the home did not handle any monies on behalf of the residents. The relatives provide the support that the resident require in this matter. The inspection of records confirmed that all equipment is regularly serviced and training in relation to health and safety was ongoing. Caxton Lodge DS0000009874.V257516.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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 3 2 2 3 Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The registered provider must ensure that care plans are reviewed at least once per month. The registered provider must ensure that medication is given to residents directly from the container in which it is dispensed by the chemist. The registered provider must ensure that at all times suitably qualified, competent and experienced staff are working in the home in sufficient numbers as are appropriate for the health and welfare of the residents. (Timescale of 5/07/05 not met.) All staff must have a satisfactory check from the Criminal Records Bureau and POVA check in place before commencing employment. The registered provider must ensure that individual residents and staff records are maintained and kept up to date. Timescale for action 01/12/05 2 OP9 13 01/12/05 3 OP27 18 01/02/06 4 OP29 19 01/12/05 5 OP37 17 01/02/06 Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 23 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 2 3 4 Refer to Standard OP19 OP30 OP31 OP36 Good Practice Recommendations A planned programme of maintenance and redecoration of the home should be produced. All new staff should receive formal induction training to NTO specifications within six weeks of appointment to the home. The registered manager should complete the required level 4 NVQ. All care staff should receive formal supervision at least six times per year. Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Caxton Lodge DS0000009874.V257516.R01.S.doc Version 5.0 Page 25 - 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. 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