Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Caxton Lodge 25 Caxton Avenue Blackpool Lancashire FY2 9AP The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Pauline Caulfield Date: 0 4 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Caxton Lodge 25 Caxton Avenue Blackpool Lancashire FY2 9AP 01253356100 01253356100 nichconnor@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Isobel Conner care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 7 Over 65 0 Conditions of registration: The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Dementia - Code DE The maximum number of service users who can be accommodated is: 7 Date of last inspection Brief description of the care home 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 seven persons, who have dementia. There are seven single bedrooms, none of which have en-suite facilities. The home has a separate lounge and dining room and sufficient toilet and bathing facilities to meet the needs of the residents. There is a passenger lift, which enables residents to move between the ground and first floor easily. A copy of the Statement of Purpose/ Service User Guide is available for anyone making enquiries about the home. In addition there is a Brochure, copies of which are kept in the entrance hall of the home. The written information explains the care service Care Homes for Older People Page 2 of 12 that is offered and what the residents can expect if they decide to live at the home. A copy of the latest report is available for relatives to read if they so wish. Information received on 15th December 2008 showed that the fees for care at the home are 346 pounds per week which includes payment for chiropody and hairdressing. Care Homes for Older People Page 3 of 12 What we found:
The reason for this inspection was to check that the good 2 star rating given at the last key inspection is still valid and that nothing has changed. We looked at all the key standards. The outcome is as follows and shows that although some areas of record keeping need attention the outcome for residents is still good and the good 2 star rating is still valid. We case tracked two residents. This included looking at case tracked residents care records and the environment they live in, talking to the residents and the staff supporting them and observing staff interactions with them. This is not to the exclusion of other residents who were also spoken to. Prospective residents are assessed, before admission so that staff are aware of their specific care needs and know whether they can meet these. The manager informs the prospective resident in writing whether Caxton Lodge staff can meet their needs. A relative said that he visited the home and knew straight away that this was the home. Another relative said I was so upset when they said my wife had to go into care and then we found here. I was so pleased. Care plans were in place and very detailed for both residents but they were not regularly updated. The manager said that because they were so detailed and took so long to update these were not always done. Care plans must be kept up to date so everyone has detailed knowledge of residents care. We told the manager that it was better to have less detailed but up to date and accurate care plans than incredibly detailed ones that were not up to date. The manager said that there had not been any changes in residents health or support needs or changes would have been recorded. Talking to staff and to a relative it is clear that staff and the manager were well aware of care needs and were able to provide even small details about individual residents care and support needs, likes and dislikes. However care plan information is needed so no information is missed or forgotten and all staff have access to all information at all times. Staff are very knowledgeable about residents but better records need keeping. Recording in care/diary notes is not good with very limited information in place. At present staff use one communication book to write all information resident or home or staff related. this is not good practice and reduces the confidentiality of information. Also individual records/reports on residents are written infrequently and some time can lapse with no mention of the wellbeing of a resident. Resident records should be individual and should be completed regularly with the author of the record signing with full name. The manager said that he would ensure that he completed records in future. None of the residents case tracked had been involved in any accident and no-one in the home had fallen recently, but the manager was aware of the need to audit to see if any lessons could be learnt or accidents reduced if accidents/falls occurred. Risks assessments were in place for all residents but had not been updated recently so risk management is less effective. However as with the care plans, staff have detailed knowledge about residents needs and any risk areas. Care Homes for Older People Page 4 of 12 Medication was appropriately administered, signed and stored but the manager had not been recording the disposal of medication. A record of medication being disposed of should be kept. There was no key on the MAR sheet although it was recorded when a resident refused medication. The home needs a key on the medication record. Creams, drops and ointments were dated on opening but liquid medication was not and should be. Residents have access to appropriate health services. There are regular GP and District Nurses visits. Residents said staff were wonderful, kind and caring. Residents and relatives were very positive about the care they received. One resident said of the home Its smashing. The relative of a resident said, She couldnt be better looked after if she was in a top London hotel. They are wonderful here. He also said, I help give her some tea and they give me my tea every day. They are good to us both. Residents said staff were helpful and were available when needed. One resident said, They are perfect hundred percent. You cant beat that can you? Caxton Lodge can accommodate a maximum of seven residents although the owners have applied to CSCI to increase this to nine residents. Along with this increase there will be an extra lounge which will give more space for activities. The home has the feel of an ordinary home. There are some activities but most time is spent with residents and staff chatting together. Residents said staff always have time to chat and sit with them. The manager said there are craft activities, adding these will increase once the other lounge is operational as there will be more space to do activities. There are also large board games available. Routines in the home are flexible and residents spoken to said that they can choose when they get up and go to bed and whether they want to join in activities. Residents said they are treated with respect by staff. There is one set meal provided at each meal. However anyone who does not want this is offered alternatives and staff are well aware of residents likes and dislikes. The main meal is in the evening with a snack type lunch and sweet at lunchtime. During the inspection one lady was made her lunch - soup and sandwiches, a little earlier than everyone else. Soon after other residents came into the dining room and joined her. The owner said this was because the resident ate slowly but didnt finish her meal if she was last at the table. They found that she was happy to start her meal early and finished when others did. Lunch was a cheerful affair with residents chatting to each other and to staff. Residents received lots of care and attention. There was discussion over the planned evening meal - fish and that this had been caught by a residents son the previous day. The resident was very proud of this and said how much he was looking forward to eating his sons catch. Residents said how great Caxton Lodge and the small staff team were and how well cared for they were. Couldnt be better looked after. and It is wonderful her with everyone so kind. Care Homes for Older People Page 5 of 12 Relatives are welcomed at any time. One relative said, The staff are so wonderful, they let me have my tea here every day. They check I am alright as well. There were dishes of sweets placed about the home and bowls of fruit that residents were able to takes as they wanted. One resident said to us These are nice sweets. Do you want one and a cup of tea with us? Caxton Lodge is very homely there are birds and some fish kept in the home. There is also a small cat staying in the home for a short time. Residents said they like having animals in the home as it feels more like an ordinary house. All current residents are nominally Christian or have no religious persuasion. Residents who want to can see the ministers of their choice. The manager said they could support residents of other religions if requested. Residents spoken to said they knew who to complain to if they had any concerns but they were happy in Caxton Lodge. A relative spoken to said he would tell the manager if he had any concerns but he hadnt needed to so far. There have been no complaints since the last inspection but the manager and the owners are around most of the time and minor niggles are dealt with early and dont become bigger issues. The manager said staff have received some safeguarding adults training and have an understanding of the action to be taken if they are alerted to a safeguarding issue. We toured the home and found the environment comfortable, homely, clean, tidy and well maintained. The manager plans to increase the number of ground floor bedrooms by one and the communal space in the home. There will be an additional large L shaped lounge which will more than double communal space. There will also be a small office and the current office will become a walk through seating area. The new bathroom downstairs downstairs and a wet room upstairs has been well received by residents. The plans to transfer the current laundry, which is small, to a garage and the laundry room to a corridor leading to the new laundry are ongoing. There is new furniture and a new carpet in the downstairs bedroom and a new electric bed for the resident who is waiting to move from an upstairs bedroom in to the ground floor one. The new lounge also has new decor and carpet and there is a patio area to the rear of the lounge. Residents said the home was comfortable. One resident said, My room is lovely, it is so comfortable. Aids and adaptations are in place to help residents get about more easily and to be as safe and as independent as they can be. Specialist aids for pressure care and mobility aids were seen as we were touring the building. Residents spoken to as we toured the building were complimentary about the staff. One resident said, They look after us so well here. It is nearly like being at home. Another resident said, They are so kind. It is lovely here. A lot of the staff have worked in the home for several years and there is only a small staff turnover. This ensures that staff are familiar with residents and their care needs and residents know the people caring for them. Staff rotas showed sufficient staff on Care Homes for Older People Page 6 of 12 duty doing the inspection . As well as the manager and both owners there was one other carer on duty for some of the inspection. Rotas showed a minimum of two staff on duty during the day and one waking night staff at night. Staff stay on later than usual if needed for activities or resident support. Residents, relatives and staff felt that there were sufficient numbers of staff on duty to provide good care. No staff recruitment records were checked as there had been no new staff since the last key inspection. Staff training records were seen. Although not quite up to date they had sufficient detail and more recent training information was quickly to hand. All staff have moving and handling training and medication training. Three out of the four staff employed in the home have now completed National Vocational Qualifications (NVQ). This is a national qualification in care which provides staff with up to date knowledge of good care practice. There are staff meetings but these are not very often but with such a small team they do meet up less formally on a regular basis. The staff job description is user friendly and explains what duties staff will do and outlines the working day. Supervision is carried out but not as often as it should be. Staff supervision allows the member of staff and manager or other nominated person to meet regularly and look at the member of staffs care practice and the care practice in the home, and any improvements that can be made. They also look at future plans in the home, training and the individuals career developments. The manager has now completed the registered managers award. He ensures that he updates his skills and knowledge so that he is familiar with any developments in care practice. Systems are in place for quality assurance. The home has met the standards for investors in people which is a national quality assurance award. There are some staff meeting and issues discussed affect the care practice in the home. The fire risk assessment is in place. The manager said that there are regular fire alarm and emergency light checks but these are not recorded. It is good practice to record regular visual fire safety checks. The external fire company the home uses was visiting home the day after the inspection to check all current and additional fire points and the nurse call was also being checked. Health and safety checks are in place. We observed good moving and handling techniques using appropriate equipment and good care practices throughout the inspection. What the care home does well:
The residents in this home are well cared for. We observed staff chatting to residents frequently. Staff were polite and friendly as they went about their duties. Residents are given enough information about the home before admission so they can decide whether they want to live in the home. Staff meet residents to assess their care and support needs before deciding if the home can meet their needs effectively. Staff are knowledgeable about residents needs and residents said they are very happy Care Homes for Older People Page 7 of 12 in the home. One resident said, Couldnt be better looked after. and another resident added, They are perfect hundred percent. You cant beat that can you? Residents health needs are well, met district nurses visit as needed and most medication administration is managed well. Routines in the home are quite flexible and residents spoken to said that they can choose when they get up and go to bed and whether they want to join in activities. Meals are varied and well presented. Special diets are provided as needed . Residents feel they are listened to and any concerns acted upon. The home is clean, tidy and well maintained and the refurbished bathroom and shower room and the planned additional space helps make Caxton Lodge a pleasant place to live. One resident said her room was lovely and comfortable. Staff training is good. This keeps staff skills and knowledge up to date. The manager is approachable and residents and relatives said he is always willing to help. Systems are in place for quality assurance including investors in people to ensure care practice is up to date and effective. There are some staff meeting and the manager regularly talks to residents and relatives to check they are happy with the care provided. 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 2. Care Homes for Older People Page 8 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 9 13(2) A record must be kept of all medication received and disposed of to ensure that there is no mishandling and residents are protected by the procedures in place. 30/06/2007 Care Homes for Older People Page 9 of 12 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 1 7 15 Residents care plans must be 02/01/2009 reviewed and updated regularly This is so that everyone involved has detailed information about residents needs. 2 9 13 A record must be kept of all medication received and disposed of. This is to ensure that there is no mishandling and residents are protected by the procedures in place. 02/01/2009 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 9 Liquid medication should be dated when opened so that a clear record is in place making sure that residents are protected by the medication procedure. Staff should improve residents records so that they are frequent, detailed and confidential and all staff have up to date written information.
Page 10 of 12 2 10 Care Homes for Older People 3 38 Fire safety checks should be recorded so it is clear that these have been checked and appear in good working order and assist with keeping residents safe. Care Homes for Older People Page 11 of 12 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. 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 12 of 12 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
