Inspection on 05/07/05 for Caxton Lodge

This inspection was carried out on 5th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 01/12/05

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 Ruth Edgington Unannounced 5 July 2005 9.30am th 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. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Caxton Lodge Address 25 Caxton Avenue Blackpool Lancashire FY2 9AP 01253 356100 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) Mrs Isobel Conner Mr Nicholas Conner CRH 11 Category(ies) of DE 11 registration, with number of places Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2/12/04 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 F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that commenced at 9.30am and took place over 4 hrs. The Inspector spoke to three visitors, the homeowner, manager and one member of staff. 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. The Inspector looked at a selection of residents and staff records and a general look around the home. An additional unannounced inspection was carried out in February 2005 to monitor the response of the home to the requirements and recommendations made following the inspection undertaken in December 2004. What the service does well: The residents in this care home are well looked after. The management and staff liaise very well with the relatives who are encouraged to be involved in the care provided. One relative spoken to confirmed that they are kept up to date and fully involved and said, ‘ they are kindness itself and the care is excellent.’ Another resident was due to have a very special birthday and their relative confirmed that a party had been arranged by the home, in addition to a family party. The Inspector saw that relatives visiting the home were kept informed of the care being given. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 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 contacting your local CSCI office. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 7 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 Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 8 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) 3 The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of two residents were looked at in detail and were found to contain a full assessment of needs that had been completed before they were admitted to the home, therefore ensuring the home could meet the needs of these residents. The Inspector noted that the manager had written to the resident or their relative to confirm that the home could meet these assessed needs. The Inspector also looked at information that had been recorded about a prospective resident and was able to confirm that the assessment and admission process was being followed correctly. A relative spoken to during the inspection said that they had been fully involved in the assessment and admission of their relative to the home and were happy that the resident’s needs were being met. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 9 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 & 10 Promotion of health is taken seriously, however shortfalls in the recording of information could potentially put residents at risk. EVIDENCE: Records are kept for each resident including a care plan setting out in detail the action that needed to be taken to ensure that all aspects of health, personal and social care needs of the residents were met. The Inspector found that in some cases the recording of information had not been kept up to date, which could result in the needs of the residents not being met. However through discussions with the management and visiting relatives, the Inspector was able to confirm that the management and staff fully understood the needs of the individual residents through being very much ‘hands on’ and their priority was meeting the residents’ needs. The Inspector was informed that in the case of one resident it was felt that their needs could be met more appropriately by moving to a particular home in which a relative lived and in this way they would have daily contact with someone that they knew well. The Inspector found evidence that the resident, Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 10 management of the prospective home and social worker had all been involved in this decision. Because of the inability of the residents to communicate well, their participation in the inspection was limited, however the Inspector was able to obtain some comments from residents, which were very positive and relatives visiting at the time confirmed these. During the inspection the Inspector observed the caring approach of all the staff towards the residents and was able to confirm that the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 11 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) 13 & 15 Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Dietary needs of residents are well catered for with a balanced and varied selection of food available to meet individual tastes and choices. EVIDENCE: There are no restrictions on visiting and relatives are actively encouraged to be involved in the care provided. Over the period of the inspection the Inspector was able to watch visitors coming and going and saw the positive relationships between them and the management. The Inspector spoke to one relative who she had spoken to on a previous inspection and they said that they were apprehensive at first about care homes but that they were made to feel very welcome and could not fault the care given. They said that the homeowner “deserved a medal” and always had a smile on her face and that the manager “would do anything for you”. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 12 Arrangements are made to enable relatives to have a meal if required. The Inspector observed visitors being asked if they wished to have a drink and it was obvious that this was a regular occurrence because the manager knew exactly what they liked to drink. The Inspector examined the menus and record of meals provided, which were varied and well balanced. The evening meal was the main meal of the day, which the management felt to be more beneficial in meeting the needs of persons with Alzheimer’s disease. Special diets were provided, which at the time of the inspection included diabetic diets. Examination of care plan showed that the likes, dislikes and dietary needs of the residents were recorded. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 13 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) None of the above standards were looked at during this inspection. EVIDENCE: Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 14 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) 19 & 26. The standard of the environment within the home is good and provides the residents with a safe and homely place to live, however attention is required to the garden area to make it safe and secure for residents. EVIDENCE: From observations made during the inspection the Inspector was able to evidence that a safe, comfortable and homely atmosphere was provided in the home. Bedrooms were individualised and residents had personal belongings around them to make them fell at home. One relative said, “This is home from home”. The communal areas meet the needs of the residents both individually and collectively. Since the previous inspection all radiators had been fitted with appropriate guards and some redecoration had been carried out. Whilst the garden area was enclosed from the road, residents could wander onto the driveway where the vehicles of the management were parked. The manager agreed that this could be a possible risk to residents and agreed to Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 15 erect fencing, which would totally enclose the garden area and ensure the safety of residents whilst in the garden. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 16 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 Shortfalls in the recruitment of staff and the number of staff employed could potentially leave residents at risk. EVIDENCE: The management of the home are very much “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. A relative told the Inspector that they worked very hard but that they felt that there should be more staff. Since the previous inspection only one new member of staff has been employed. This person had worked at the home for many years and had left to take up a registered managers position in another care home, whilst also providing backup in the home if required. The Inspector noted that they had brought with them all their employment information from the previous home and that the manager had set up an employment file for them, which contained a completed application form which should have been sent to the Criminal Records Bureau (CRB) for clearance. The manager was reminded that before any member of staff could be start work they must obtain the required clearance through the CRB. Evidence was seen through the examination of training records that relevant training was ongoing. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 17 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) 31 &33. 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. EVIDENCE: The registered manager has obtained a diploma in management and is presently undertaking level 4 NVQ (National Vocational Qualification) in management and care. He has also undertaken relevant training to meet the changing needs of the residents. The Inspector discussed with the manager and homeowner the fact that the limited number of staff employed was affecting the time available to carry 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. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 18 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. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 19 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 3 x x x x x Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 20 Yes 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 7 Regulation 15 Requirement Timescale for action 15/09/05 2. 19 23 3. 27 18 4. 29 19 Full and satisfactory information must be recorded on the residents plan of care in relation to their health and welfare needs, The registered provider must 15/09/05 ensure that the grounds are safe for use by the residents.(Timescale of 28/02/05 not met) The registered provider must 5/07/05 ensure at all times suitably qualified, competent and experinced staff are working in the home in sufficient numbers as are appropriate for the health and welfare of the residents. (Timescale of 28/02/05 not met) The registered provider must 5/07/05 ensure that the required documentation in respect of persons working in the care home is retained in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 21 No. 1. Refer to Standard 31 Good Practice Recommendations The registered manager should complete the required level 4 NVQ . Caxton Lodge F57 F09 S9874 Caxton Lodge V218765 050706 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor Unit 1 Tustin Court Portway 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. 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