Inspection on 12/04/07 for Chadwick Lodge Residential Home

This inspection was carried out on 12th April 2007.

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

Chadwick Lodge Residential Home 13/06/06

Chadwick Lodge Residential Home 20/12/05

Chadwick Lodge Residential Home 27/09/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Chadwick Lodge Residential Home Chadwick Lodge 8 Chadwick Road Westcliff-on-sea Essex SS0 8LS Lead Inspector Ms Vicky Dutton Unannounced Inspection 12th April 2007 08:00 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 Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chadwick Lodge Residential Home Address Chadwick Lodge 8 Chadwick Road Westcliff-on-sea Essex SS0 8LS 01702 331599 01702 331599 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) More Care (Home Counties) Limited Mr Peter Roger Cordery Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Old age (over 65) not falling within any other category (OP) (15) Dementia - over 65 years of age (DE(E) (15) Age: Over 65 years of age Total number to be accommodated shall not exceed 15. Date of last inspection 13th June 2006 Brief Description of the Service: Chadwick Lodge provides personal care and accommodation for fifteen older people. The home is also registered to provide care for residents who have dementia. The building is a three story property with the second floor being private accommodation. Most accommodation is in single bedrooms, some of which have en suite facilities. The home has two shared bedrooms. There is spacious open plan communal accommodation. Chadwick Lodge has a large and pleasant garden which is well maintained. A minibus is available. The home is situated close to local transport links. Day care places are also offered at Chadwick Lodge. Separate accommodation is provided in the home’s grounds for day care. The facility does not currently fall within the remit of the inspection process. Previous inspection reports were not readily available for residents or visitors to the care home. The registered person said that this was available on request and held in the home’s office. It was agreed that copies of reports will now be made more freely available by being placed in the lobby area of the home. The home’s Statement of Purpose and Service Users Guide, (Dated March 2005) were available in the home’s entrance hall (see standard one.) The current scale of charges as quoted in the home’s Pre Inspection Questionnaire and confirmed at the site visit are £390.45 as a contract price and £421.27 as a private rate. Additional charges to residents include chiropody and hairdressing. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over a seven hour period. At this inspection all the key standards, and the home’s progress against requirement’s from the last inspection. Prior to the site visit the home had submitted a pre-inspection questionnaire (PIQ), and provided additional information that assisted with the inspection process. At the site visit a partial tour of the premises took place, care, staff, medication and other records and documentation were selected and various elements of these assessed. A staff ‘handover’ session was attended. During the site visit residents and some of the home’s staff were spoken with. As part of this key inspection questionnaires were sent out in the post to health and social care professionals. Visitors and residents questionnaires were made available at the home. Staff surveys were given out during the site visit. The views expressed at the site visit and survey responses have been incorporated into this report. Chadwick Lodge is a smaller home with one registered provider/manager. For ease of reading the registered provider/manager has been referred to throughout this report as ‘the manager.’ The inspector was assisted at the site visit by the manager and other members of the staff team. Feedback on findings was given throughout the visit, and summarised at the end of the visit. The opportunity for discussion or clarification was given. A feedback card on the inspection process was sent to the home after the site visit. The inspector would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: Staff at the home are caring and welcoming. Those residents who could not express an opinion appeared relaxed and well cared for. Other residents made positive comments about the management and staff at Chadwick Lodge. One said ‘I could not wish for anything more, the staff are marvellous and very kind.’ Positive comments were also made about the food at the home. Visitors are always made welcome at the home. People felt that the home had an open, warm and welcoming atmosphere. Medication is managed well at the home. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information made available to people about the home needs to be improved to assist them in making choices. People have their needs assessed before moving into the home. This process needs to be carried out to a consistent standard, with documentation that will assist care planning maintained. Staff at the home do not all have sufficient specialist training in some areas to ensure that they can fully meet residents needs. EVIDENCE: The home’s Statement of Purpose and Service Users Guide date from March 2005. The manager said that the documents were currently being reviewed and rewritten so that they comply with current Regulations, and reflect changes at the home. When visitors came to view the home for a potential placement they were given a copy of an old and brief leaflet about the home. It was confirmed that people are not usually given copies of the home’s service Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 9 users guide. The manager said that when the service users guide had been reviewed this would happen. Survey responses and discussion showed that most people did feel that they had received enough information about the home before they moved in. One resident confirmed that they had visited the home and spent a day there before a respite placement was arranged. The files of three recently admitted residents were viewed. Some information was available in each file from a hospital or social work source, but only one showed that the home had carried out their own pre-admission assessment of needs. The manager said that an assessment had been completed for each resident, but did not know where the documentation was. The manager confirmed that the home do not yet put in writing to the resident/relative that a needs assessment has taken place, and confirm that the home is able to meet those needs. Recently admitted residents, other residents spoken with, and feedback on surveys was that residents feel their needs are met by the home. The home is registered to provide care for residents who have dementia, and a significant percentage of residents at the home, including recent admissions have dementia. Only three staff at the home have received training in dementia care. Neither of the home’s regular night staff, who work on their own, have been trained in dementia care. This has the potential to compromise the care offered to residents. Staff training in this area needs to be improved so that residents with this condition receive skilled care at all times. Intermediate care is not provided at Chadwick Lodge. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. To ensure that residents receive good care that is delivered consistently and safely care planning needs to be improved. Healthcare at the home is generally good. Medication is well managed. Residents are treated with respect by staff. EVIDENCE: Feedback from residents and relatives showed that they felt that their/relatives care needs are met by staff at the home. Comments such as ‘the care is excellent and I have no complaints,’ and ‘the carers and manager are very kind and aware of the needs of the residents’ were made. Staff spoken with demonstrated a good knowledge of the residents as individuals. Observations of care showed that staff had a good basic understanding of residents’ needs. As part of this site visit a number of care plans were viewed. Care planning to meet the needs of residents had been an ongoing concern at the home, and was the subject of enforcement action by CSCI during 2006. At this site visit improvements made in care planning information had been maintained for established residents. However findings were disappointing in respect of new residents. A resident admitted to the home for respite care two weeks prior to Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 11 the site visit had no care plans in place, (and no assessment information available.) A senior member of staff at the home said that they had not realised that people having respite care at the home should have a plan of care in place. Another resident admitted a month before the site visit also had no care plans in place, although the risk assessment sections of the care file had been completed. This could place residents at risk and lead to their care needs not being fully assessed or met. Care plans and associated assessments and information were in place for a resident admitted four months ago. However this did not provide complete information. The resident was using bed rails, there was no assessment or care planning process in place in relation to this, placing the resident at risk. The manager undertook to address the shortfalls identified urgently. It was stated that the manager and a senior member of staff are shortly to complete a training course in care planning, and that this would improve and refine care planning practices at the home. Due to the size and complexity of care planning information, daily records such as nutrition records and daily observations are kept in separate individual files to care planning information. This needs to be monitored to ensure that care staff still use care planning information and keep up to date with residents’ changing needs. Records and events/observations on the day of the site visit showed that staff are quick to react to residents’ changing health care needs. Residents and relatives were very happy with this aspect of care at the home. Relatives also felt that they were kept well informed of any changes in condition. ‘I have always been advised immediately if there has been a fall or if my relative has had to be taken to hospital.’ Access to optical, chiropody and local health care services was identified in care files. District nurses attend the home on a daily basis to attend to specific residents’ health needs. Residents’ needs in relation to pressure area care is assessed, but work is needed to ensure that residents have their needs met by this information being taken forward. For example one resident was assessed as being ‘at risk’ on the pressure sore assessment tool, but there was no care plan in place or remedial actions identified to reduce the risk and so safeguard the resident. Medication at the home is mostly managed through a monitored dosage system (blister packs.) Aspects of the system sampled at the site visit were satisfactory, and showed that medication is managed safely to protect residents. Staff administering medication have received training from the supplying pharmacist. Minor points of best practice such as double signing handwritten entries on medication administration records were highlighted to a senior member of staff. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 12 During the site visit staff were observed to treat residents with courtesy and respect. Dignity was preserved when personal care tasks were being undertaken. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not yet fully meet residents’ expectations in relation to social activity/occupation, based on individually assessed needs. Visitors are always made welcome. Food provided by the home currently meets residents’ needs and expectations. EVIDENCE: Residents’ preferences in terms of activities and daily routines such as rising and retiring times are recorded to some degree in care records through the use of a set format questionnaire. Information or preferences gathered were not consistently carried forward onto care planning sections, meaning that residents’ interests and preferences may not be fully supported or carried out. Activities are undertaken on an ad hoc basis. During the site visit staff did spend a lot of time interacting with residents, and residents were well supervised and supported during the day. Stimulation provided was mostly with music and dancing. While some residents clearly enjoyed this, others appeared disengaged, and one complained about the music. One resident said that there were never activities arranged that they enjoyed. Another resident said that they liked the television, but they were sitting in a chair from where Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 14 the television could not be properly seen. Resident participation/engagement in activity/occupation is not routinely recorded to gauge the success or suitability of activities in meeting residents’ needs and preferences. ‘Activities sheets’ are provided within the care planning system but recording is inadequate. One resident had five ‘activities’ recorded since mid December with a last entry made in January. Chadwick Lodge is registered to provide care for residents with dementia. As previously stated the level of staff training in dementia care is low, although one member of staff has completed a two day training course in ‘Dementia and Activities.’ The home still needs to work on evidencing that resident’s social and occupational needs are assessed in a meaningful way in order that stimulation and occupation is tailored to their needs. The manager gave examples, that showed how residents are offered the opportunity to fulfil their spiritual needs. One resident confirmed that they were regularly visited by a minister. Activity equipment is available, occasional entertainers visit the home. Chadwick Lodge has a minibus available to support community access. One resident attends an external day centre on one day a week. On my arrival at the home at 07.50 nine residents were up and dressed in the home’s lounge area, having been got up by night staff. They said that they had already had their breakfast. Staff said that residents were assisted up according to their choice. Residents who were able to express an opinion felt that they were offered choices in their daily routines. Visiting at the home is open and there are no restrictions. One visitor said that ‘there is a warm and hospitable atmosphere about the place which is good for the residents and visitors alike.’ No residents at the home manage their own finances. All are supported in this by their families or the Local Authority. The manager was aware of advocacy services and had tried (unsuccessfully due to a shortage of advocates,) to use this service to support residents at the home. Information on advocacy services was not readily available to residents and their relatives. The manager undertook to address this. Residents are able to bring in personal possessions with them. The home is currently without an established cook. A new cook has been recruited and is due to start soon. In the meantime an agency member of staff prepares the main lunchtime meal, with breakfast and tea being prepared and served by care staff. The home’s menus are currently being reviewed and changed to a six weekly menu plan. Residents spoken with said that the food provided by the home was good, and that they were offered choice. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents or their families can raise concerns about the service. Residents are protected by staff being trained and aware of adult protection issues. EVIDENCE: The home has a complaints procedure in place and available to residents and others. The manager was advised that the procedure should be revised in the light of guidance given in a previous CSCI newsletter. This relates to which agencies complaints should be referred to and investigated by. No complaints had been received by the home or CSCI since the previous inspection. Residents and relatives said that they knew how to raise concerns and would feel confident in doing so. One said ‘ I feel confident that I can discuss any concerns I might have and know I will be listened to.’ Another said ‘I am encouraged to discuss any concerns I might have with the carers or the manager.’ Information was noted to be on display for staff relating to adult protection and whistle blowing. Most staff at the home have received training in adult protection and those spoken with had a good awareness of this area. So far four staff at the home have received training in managing challenging behaviour. Only one resident presents behavioural issues. These are understood by staff, appropriate care planning information and safeguards are in place. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment provided for residents at the home needs further improvements in order to fully meet their needs. EVIDENCE: The home is situated in a pleasant residential area. The manager is gradually undertaking a refurbishment of the premises. Since the previous inspection most bedrooms at the home have been redecorated and refurnished. A bathroom and toilet have redesigned and refitted. These works are slowly improving the environment for residents, although much remains to be done. The home has pleasant grounds for residents to enjoy. As part of this site visit a tour of the premises was undertaken. Full details of findings were fed back to the manager. The home’s communal areas are open plan and include a conservatory, lounge and dining areas. A separate small lounge is available. This room was Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 17 previously used by residents who smoked. The home has now taken the decision to be a non-smoking building. The home’s conservatory is currently cluttered and not fully useable by residents. This is due to the refurbishment process and the area being used for temporary storage. Lighting in some areas, particularly the dining area is poor. This may make it more difficult for residents with poor vision to eat and drink. The manager outlined plans to address this by additional lighting being provided. To assist residents with dementia the home has started to develop some orientation signage. This is at an early stage. Signage and other aspects of creating a good environment for those with dementia will need to be kept in mind as the refurbishment works continue. Through redecoration and refurnishing residents bedrooms have improved. Those spoken with were satisfied with the accommodation provided. The manager said that residents had been encouraged to choose the colour for their rooms. Following redecoration most rooms are quite bare, and would benefit from some homely touches being added in accordance with residents’ choices. The manager outlined plans to further bring up the standard of residents’ rooms by the provision of door locks and lockable storage. Since the previous site visit a new boiler has been installed at the home providing water at a better temperature for residents. The remaining uncovered radiators have been fitted with covers to keep residents safe. At the site visit the home was free from offensive odours. Although the home’s laundry provides adequate equipment, the laundry area itself is in need of cleaning, to maintain adequate infection control, and refurbishment. The floor is poor in some areas, and breaking away in front of one machine. Debris was building up behind the machines, the sink was hard to access due to the storage of large containers, and the water took a long time to run hot. An open bin contained used gloves and other rubbish. The adjacent staff toilet/changing area is in a similarly poor condition. The manager said that the refurbishment of these areas is planned and will take place soon. Five staff at the home have yet to complete training in infection control. A tour of the premises highlighted that adequate hand washing/drying facilities were not always available in toilets or en suite areas. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are properly recruited and receive initial training to help them to care properly for residents. EVIDENCE: Residents and relatives gave positive feedback about staff and management at the home. One said, ‘the carers and manager are very kind and aware of the needs of the residents.’ The home maintains staffing levels at three care staff, one of whom is a senior in charge, on duty at all times during the day. At night the home has one awake night staff, and one person sleeping in. Dependency levels at the home are mixed, but as identified on the home’s PIQ, the majority are considered to have high to medium levels of dependency. Staff and the manager felt that current staffing levels are sufficient to meet the residents’ needs. Residents who were able to respond felt that there were always or usually staff available when they needed them. The home has a stable core group of staff, but some agency staff are used to cover shortfalls in the home’s rota. The manager said that they try to get consistency and have the same staff from the agency. At the moment the home only employs a cook for a few hours a day. Domestic cover is provided for four hours each day on a Monday to Friday basis. This means that care Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 19 staff must complete additional kitchen and laundry tasks over and above their caring role. It was reported that two staff at the home hold a National Vocational Qualification (NVQ) at level two or above. A further four staff are currently undertaking NVQ at level two. The home have yet to achieve the National Minimum Standard of having 50 of care staff trained to NVQ level two or above. The files of two recently recruited staff were viewed to see if recruitment in the home is carried out to a standard that meets requirements and protects residents. In general recruitment practices were satisfactory, and it was clear through verbal information given that the manager tries to gather all the relevant information. However the home needs to ensure consistency and record that they have explored any gaps in employment history, reasons why references have not been obtained from most recent employer, and not rely too heavily on ‘personal’ references. Only one agency is used to provide staff for the home. This agency have given a written guarantee that any staff provided have been properly recruited and have had all appropriate checks carried out. For best practice the required information should also be checked by the home. Since the previous inspection the home have started to use an induction training pack that the manager said is in line with Skills for Care standards. This was in the process of being completed for recently recruited staff. Training at the home is ongoing, with many subjects being covered ‘in house’, using bought in training packages. A staff training file showed that many appropriate subjects are covered, although shortfalls have been identified elsewhere in relation to dementia and moving and handling training. Staff spoken with confirmed that they had undertaken different training courses both internally and as provided by the Local Authority. A relative felt that ‘the regular staff have the skills, knowledge and experience, which over the time I have been visiting the home has gradually grown and improved.’ Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management at the home is continuing to develop the service and make improvements. Quality assurance strategies are being developed so that others views about the service are sought. Development is needed to make sure that staff receive robust and regular training in moving and handling so that they can care safely for residents. EVIDENCE: The manager has now owned and managed the home for nearly two years. During this time progress in making the required improvements, and achieving consistent compliance with Regulation at the home has been slow. Findings at this site visit have however shown continued progress, and outcomes for residents are improving. Feedback about the registered provider/manager was positive and people recognised the gradual improvements at the home. ‘I was Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 21 concerned a year or so ago at the lack of genuine communication between the owner/manager and myself. However there is now a much more open and friendly atmosphere in the home. An open door policy is in place and I feel I can discuss anything.’ The home’s Certificate of Registration had a condition on it that the manager should undertake a relevant qualification within one year of registration. This was not achieved. It is understood that the manager is now about to undertake the Registered Managers Award/NVQ level four. The home has now undertaken some quality assurance work. Surveys were sent out to relatives at the end of last year. It was said that residents are spoken with on a one to one basis to see if they are happy with the service. The manager has sought advocacy assistance to try and provide an independent view/voice for those residents who are unable to express their opinion, or who have no regular contact with their families. This has been unsuccessful due to a lack of advocates in the area. The home needs to continue to develop quality assurance strategies that incorporate the views of all people involved with the home. Findings should help to inform an annual development plan for the home and develop the service for the benefit of residents. The manager confirmed that the home do not hold any monies for residents at the home, but that all finances are dealt with through families or The Court of Protection, who manage the affairs of three residents at the home. The pre-inspection questionnaire completed by the home showed that systems and services in the home are checked and maintained. It was indicated that the home’s electrical wiring check had taken place in June 2006, but the certificate for this could not be found. It was agreed that this would be faxed to CSCI when located. The home’s fire records were satisfactory and included a comprehensive fire risk assessment for the home completed by an external agency. Staff training in moving and handling was inadequate. Only two staff have received training/update training within the last year to ensure that residents are cared for safely, and staff safe from injury. It was seen that one member of senior staff has completed training to be a trainer/assessor in moving and handling. It was reported that they have completed part one of the moving and handling training with staff, and that the second part would take place soon. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 22 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 2 X 2 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X 2 X 2 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 23 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 OP4 Regulation 18 Requirement Staff must be trained in dementia care, so that residents who have dementia receive skilled care based on current knowledge and models of best practice. Previous requirements have been made about this with unmet compliance dates of 01/01/06, 10/03/06 and 01/09/06 not met. 2. OP7 15 Each resident must have a care plan formulated and in place in a timely manner following their admission to the home. This must identify their assessed needs and give clear guidance to staff as to how and when these needs are to be met. As far as possible they must be compiled in consultation with the residents and/or their supporters. Previous requirements and enforcement action has been taken in relation to care planning. Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 24 Timescale for action 01/08/07 01/06/07 3. OP8 12(1) Where risk/care assessments highlight specific areas of risk for individual residents such as pressure areas or the use of bed rails, care planning should incorporate this and staff be aware of the actions necessary to make sure that residents are cared for safely. Management of the home must effectively promote adequate infection control by ensuring the laundry and staff area is kept clean, well maintained and hazard free. Staff must be regularly trained/updated in moving and handling techniques, so that their practice is up to date and protects residents. 01/06/07 4. OP26 13(3) 01/08/07 5. OP38 13(5) 01/06/07 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 OP1 Good Practice Recommendations The home should make sure that information available about the home is up to date and given out to potential residents/their families. The manager should make sure that proper documentation is maintained showing that residents needs have been properly assessed before they move into the home. The manager should monitor that care staff actively use residents care plans and do not focus on completion of ‘the care plan diary’ 2. OP3 3. OP7 Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 25 4. OP12 Management at the home should continue to develop meaningful activities for all residents based on their individually assessed needs. Management at the home should monitor daily routines to make sure that they are in accordance with residents’ needs and preferences. This with particular reference to those who may not be able to actively express their views. The homes conservatory should be cleared as soon as possible so that residents can use this area safely again. Lighting in communal areas should be improved to assist residents who may have poor vision. Management at the home should consider how best to environmentally assist residents with dementia, and incorporate this into the refurbishment programme. Management at the home should consult with residents and give them assistance in making their bedrooms more homely and welcoming. 50 of care staff should be trained to NVQ level 2 or above. The registered person should continue to develop quality assurance strategies and involve residents and other stakeholders in expressing their views and being able to affect the way that the service is delivered. 5. OP12 6. OP20 7. OP22 8. OP24 9. 10. OP28 OP33 Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 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 © 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 Chadwick Lodge Residential Home DS0000063515.V335942.R01.S.doc Version 5.2 Page 27 - 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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