Inspection on 27/09/05 for Chadwick Lodge Residential Home

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chadwick Lodge Residential Home 12/04/07

Chadwick Lodge Residential Home 13/06/06

Chadwick Lodge Residential Home 20/12/05

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 27th September 2005 08:45 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.V252445.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. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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.V252445.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 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. The registered manager shall complete a recognised qualification (NVQ Level 4/Registered Managers Award) within 12 months of registration. This is the first inspection since the home was registered to the current provider in June 2005 Date of last inspection 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 suffer from 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 homes grounds for this, and the facility does not currently fall within the remit of the inspection process. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection since the home was registered to the current provider in June of this year. The inspection was unannounced and took place over six and three quarter hours. As two inspectors were present this equated to thirteen and a half hours of inspection time. On the day of inspection thirteen residents were being accommodated. At this inspection a tour of the building took place. Staff, care, medication and other records were inspected. Staff on duty were spoken with. One visitor and several residents were spoken with. During this inspection two immediate requirement forms were left with the registered person. These related to staffing levels and recruitment records. These forms mean that the registered person has to tell CSCI how they are going to resolve the issues identified and what action they have taken. What the service does well: What has improved since the last inspection? What they could do better: The new registered person has taken over a home where the CSCI had previous serious concerns and the former registered provider had their registration cancelled. There was therefore a significant agenda for action for the new registered person to address. The new registered person was aware of areas of concern from previous inspection reports and discussion with CSCI Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 6 staff. In spite of this, in the four months since registration progress seems slow, and this inspection report identifies many of the same issues again. Action must now be taken to address these and improve the standard of care and documentation. The home must make sure that they always meet with people and assess what their needs are before a move into the home is planned. Care planning must improve so that staff have enough information and know how to care properly for every resident from the beginning of their stay. Health care records must be properly maintained so that the home can be sure that these needs are being met. The home must do more to provide residents with activities and chances to be more fully occupied. The home needs to make sure that residents, visitors and staff know how to raise any concerns and have a proper process in place for dealing with these. Many areas of the home need to be improved to make sure that the home provides a safe and pleasant environment for residents to live in. This process has started. The home must make sure that they always have enough staff on duty to care for residents. Staff should not work excessively long hours or work for many days without a break, as this could be detrimental to both themselves and residents. The home must not allow staff to work at the home until they have checked to show that they are suitable to work with older people. When staff start work at the home they must be given training so that they know the homes procedures and can care properly for residents. In order that residents are protected staff must also be given training in all relevant aspects of care such as moving and handling, adult protection and dementia. Staff at the home must also have a regular supervision meetings with senior staff, so that they the opportunity to discuss any issues and develop their practice. 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. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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.V252445.R01.S.doc Version 5.0 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 the following standard(s): 2, 3, 4, 5. Information on the home is available to prospective residents. The home could not show that resident’s needs are fully assessed before they move into the home. In addition staffing shortfalls and gaps in staffs’ induction and training mean that resident’s needs may not be fully assessed, understood or met. EVIDENCE: The registered person has produced a statement of purpose and service users guide for the home. These are available for interested parties to tell them about the home and services provided. Files viewed showed that residents are given contracts/statement of terms and conditions were in place. However these were not signed to show that the resident or their families were aware of these, or of the terms and conditions of their stay. At this inspection an admission to the home was being planned. Some elements of good practice were noted in that the resident had visited the home on two occasions, and staff were aware of their dietary needs. However the home could not show that they had undertaken a proper assessment of needs. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 9 Visits had not been used in a proactive way to ensure that the admission was appropriate, or to start the care planning process. The records of other recent admissions were looked at. Although a senior member of staff at the home gave anecdotal evidence of carrying out assessments, these were not documented. During this inspection shortfalls were noted in staffing levels. (A further explanation of this will be given later in the report). Staff records and discussion with staff did not show that staff had received a thorough induction to the home, or training in appropriate areas of care such as dementia. This raises concerns about the homes ability to understand and fully meet resident’s needs. Intermediate care is not provided at Chadwick Lodge. Chadwick Lodge Residential Home DS0000063515.V252445.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, 8, 9, 10. There is a care planning format in place at the home but this is not adequately or consistently completed. It does not properly provide staff with the information they need to fully meet resident’s care, health and social needs. The home does respond to resident’s health care needs, but this aspect needs to be better evidenced and recorded appropriately. Medication at the home is generally well managed. EVIDENCE: Individual care files are available for all residents. Several were sampled as part of this inspection. Care plans currently do little to assist staff in meeting resident’s needs, as they do not ensure that all aspects of health, personal and social care needs are identified and adequately planned for. Many of the assessment sheets were not fully completed or were blank. Where available, information from these sheets had not been transferred to the ‘Day care plan’ or ‘night care plan’ sheets as appropriate. One resident’s ‘admission form’ identified a number of care issues and medical conditions. These were not mentioned in the care plan. Another resident had specific a behavioural issue. This was only alluded to in the daily notes, it was not identified in care records. Therefore staff were not given any knowledge of this or have any guidance as to how to manage the behaviour appropriately or consistently. There was Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 11 evidence that care plans are reviewed on a regular basis. This process should pick up shortfalls and changes. There was nothing to show that residents or their families are involved in the care planning or review process as they should be. Care files are kept separately from resident’s daily records. This practice will not encourage staff to fully use or understand care plans. Daily records are referred to by staff as ‘nursing care notes.’ This is not appropriate as the home does not provide nursing care. Risk assessment processes are in place to identify potential hazards relevant to individual residents. These however need to be reviewed to ensure that they are properly completed, up to date, and cover relevant issues. For example one resident, now immobile, the assessment identifies climbing out of windows as a risk. The same resident had a bumper system in place in their bed, there were no assessments or information in place regarding this. To protect residents and staff, moving and handling risk assessments also need development, and to be kept current. Although residents spoken with felt that the care offered by the home was good, health care is poorly evidenced by the home’s records. This seems to be due to the practice of recording events in different places. The care file format has sheets (‘Health forms I and 2’) to identify health care professionals involved and any visits. Form one (professionals involved) was blank on files viewed. The inspectors were told of the professionals involved with one residents care for a specific need. On their care plan health form 2 only identified two unrelated visits. Another book is maintained, ‘Dr/DN book’ In here the same resident was identified as having a visit from a district nurse. This visit was not identified on ‘form 2’ or in the daily records. These poor recording practices have the potential to put residents at risk through information being missed by staff. Optical checks and continence assessments were evident on some files but not others. The assessment for one resident identifies that their eyesight needs assessment but there is no evidence to show if this ever happened. Although residents are now starting to be weighed regularly, resident’s nutritional screening is not undertaken on admission, and a nutrition record is not being maintained by the home. This means that an important area of their care is being compromised. Medication procedures were generally satisfactory. A member of Staff was advised on one aspect of recording that will ensure that accurate records are maintained. At the moment only two staff members at the home have undertaken training and are able to administer medication. This is not satisfactory. There should always be someone on duty able to carry out this task in order that residents have access to pain relief or other medication whenever they need it. Although the two staff report not minding, they sometimes have to come in during their off duty to give medication. The registered person said that plans are in hand to address this. During the inspection staff were noted to uphold residents privacy and dignity when carrying out personal care tasks. However other issues relating to Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 12 residents privacy and dignity were identified during the inspection. Some resident’s rooms had notices on display identifying what incontinence pads they are to use. Pads were also on display. Some recordings in the daily records, and verbally expressed descriptions of residents did not demonstrate an ethos of upholding resident’s dignity. An example from the daily records was that a resident had ‘messed themselves all over’. The institutional practice of using communal toiletries such as bath foam and shampoo has been an ongoing issue at the home. This visit, under new management, indicated that this practice was still in operation. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15. There is currently little in the way of planned or other activity in the home to provide residents with a good level of stimulation and occupation. Visitors are always made welcome at the home. The food provided by the home is nutritious and plentiful, but residents need to be offered more choice and be consulted on menu planning. 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. Activities are undertaken on an ad hoc basis. During the inspection staff did spend time interacting with residents. There were also periods when residents were left unattended for some length of time. An entertainer visits the home on a regular basis. The home is registered to provide care for residents with dementia. Some residents at the home also have significant sensory losses. There was no evidence to show that resident’s social and occupational needs are assessed in a meaningful way in order that stimulation and occupation is tailored to their needs. A visitor to the home said that they were always made welcome and was complimentary about the current atmosphere in the home, which they described as ‘much calmer’. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 14 Residents said that they generally liked the food at the home, and one said that they thought this had improved recently. Some however felt that they were not always offered a choice. The home has recently recruited a new cook. She was seen to be going round talking to each resident in the morning. It was later indicated that this was to advise what was for lunch and check if anyone would not want this. Lunch during the inspection looked appetizing and portions were of a good size. The freezers, fridges and store cupboard were well stocked. The home does not currently have any menus in place and food is planned on a day to day basis. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Development work is needed to ensure that systems are in place to record and deal with complaints appropriately. Development is also needed to ensure that residents are kept safe and cared for properly by staff receiving training, and being fully aware of adult protection issues. Staff also need to receive training and be skilled in managing difficult behaviour. EVIDENCE: The home has a general complaints policy and procedure in place. This however was not on display to residents and visitors to inform them of how to raise any concerns that they might have. There is currently no system in place for recording or dealing with complaints. A senior member of staff said that they were not sure where they would record any issues raised. Since the home was taken over by the new registered person three people have raised different issues with the CSCI. These were not formal complaints but the concerns raised were discussed with the registered person. Staff records sampled showed that many staff at the home have not received training in adult protection. One member of staff spoken with knew in principle what adult protection meant, but confirmed that she had not undertaken any training in this area. A senior member of staff confirmed that no training has been undertaken in managing challenging behaviour even though this has been an issue in the home in the case of two residents recently. Chadwick Lodge Residential Home DS0000063515.V252445.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, 20, 21, 24, 25, 26. The communal areas of the home are reasonably appointed and some improvements have been made. Resident’s private accommodation however does not provide them with a well decorated and furnished environment. The premises are not yet maintained in a safe and hygienic manner to ensure that residents are kept safe. EVIDENCE: The home is situated in a pleasant residential area. The new owner of the home is gradually undertaking a refurbishment of the premises. This will include redecoration of rooms and the purchase of new furnishings to improve the environment for residents. To ensure that residents are kept safe some items require addressing sooner rather than later. This includes worn carpets that may pose a trip hazard. The home has pleasant grounds. The homes communal areas are open plan and include a conservatory, lounge and dining areas. A separate small lounge is available for smokers. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 17 The home has two bathrooms and one assisted bath. One communal toilet on the ground floor was very small and has been converted into a store cupboard. This leaves only one communal toilet on the ground floor. This situation must be monitored to ensure that it is sufficient for residents. Five bedrooms at the home have an en suite facility. Most of the home’s bedrooms are shabby and require redecoration and bringing up to standard in order that residents have a pleasant environment to live in. The home is registered to provide dementia care therefore signage needs to be improved to assist residents in orientating themselves. Water temperatures tested at random were satisfactory. There are still some uncovered radiators in the home. This must be addressed in order that residents are kept safe. In particular the radiator in the upstairs bathroom was felt to be very hot. Adequate laundry facilities are provided at the home. Guidelines were available to inform staff about safe laundry practices. Odour control is poor in isolated areas. These areas may require new flooring to address this situation. Some infection control issues were noted at the inspection. Adequate hand washing facilities were not being provided in bathrooms, communal toilets and the laundry area. A flannel with faeces on was on the floor in an upstairs corridor. There was a communal pot of cream in the upstairs bathroom. This is poor practice and provides the potential for cross infection between residents. The assisted bath seat is in a very poor condition. The registered person said that this is to be replaced very soon. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30. The procedures for the recruitment, induction and training of staff are not robust enough. They do not provide sufficient safeguards to offer protection to people living in the home. EVIDENCE: Since the new registered provider took over the home has experienced quite a high staff turnover. Residents and a visitor to the home all spoke well of the staff at the home. Staff rotas showed that some staff are working long hours, or many days in a row without a break. This could be detrimental to residents. The rota also indicated that the home had fallen below agreed staffing levels on several occasions. The homes previously agreed minimum staffing levels for fifteen residents were for three staff one of whom is in charge to be on duty at all times during the day. This may vary upwards depending on the needs of the residents being accommodated. At night the home has one awake night staff and one parson sleeping in. The home employs a cook. Domestic cover is only provided for four on four days each week. Care staff undertake laundry tasks. The home must keep staffing levels under review to make sure that they are sufficient to meet resident’s needs. A concern at this inspection was that a member of staff recently appointed as a cook was rostered to complete an evening shift as a senior. No training had been given in this role. No moving and handling training had been completed. Resident’s care could be compromised unless the staff looking after them are fully trained and competent. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 19 To protect residents detailed checks such as employment history, obtaining references, checking identity, obtaining a POVA First/Criminal Records Bureau check (CRB) and ensuring people are physically and mentally fit for the work must be undertaken on any new staff recruited. The files of six recently recruited staff files were sampled. Each one had shortfalls in the records and information that the registered person is required to keep on staff. In some instances there was no evidence that a POVA first check had been undertaken prior to the member of staff starting work or a full CRB check being received. This indicated that staff recruitment is not being carried out on a consistent and thorough basis. To ensure that new staff are aware of how to care for residents, and maintain procedures and standards of care, they should be given a thorough induction into the home. This should be in line with skills for care standards. Five of the six files viewed showed no evidence of staff induction. A member of staff spoken with said that she had been shown round the home but had not completed any fuller induction. A situation that raised particular concerns was that a new member of staff, employed as a cook was rostered to work an evening shift as a senior without any proper training including moving and handling. This is potentially dangerous practice. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36, 38 Although there is a management structure in place at the home, this needs to be more focused to ensure that tasks, particularly those affecting resident care are prioritised. Residents are not currently protected by staff being fully trained in important health and safety areas such as moving and handling. EVIDENCE: The new registered manager/provider has now been in post for four months. This inspection highlights the need for them to take clearer control and manage and monitor all aspects of the service on a day to day basis. There are as yet no formal processes in place to regularly supervise staff and ensure that they are aware of all policies and procedures and can care properly for residents. Not all aspects of standard 38 were assessed at this inspection. It was confirmed that no staff training has taken place since the home changed Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 21 ownership. Therefore many staff are not up to date or have not received training in core areas such as moving and handling. Although a senior staff member said that moving and handling equipment such as handling belts and sliding sheets were available these were not seen to be in use. One resident was seen to be assisted from the chair into a wheelchair by staff lifting under the arms. This is not good practice and could put the resident and staff at risk. The registered person said that moving and handling training was being organised. The recently employed cook does not have a basic food hygiene qualification (although this is now being undertaken.) Advice was given regarding the correct storage and dating of foods. Currently no cleaning schedules are in place or being used at the home. This and other aspects of health and safety identified in this report need to be actioned to ensure that residents are kept safe and well cared for. Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 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 X 2 2 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 3 2 X X 1 2 2 STAFFING Standard No Score 27 1 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 1 X 1 Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP3 Regulation 14 Requirement Accommodation should not be provided for service users until their needs have been fully assessed by a person competent to do so. The service user or their supporter to be given confirmation in writing that the home can meet their assessed needs. Staff must receive training appropriate to the care they are to provide. This refers to the need for staff to receive training in dementia care. Service users plans must address how all their health, welfare and social needs will be met. As far as possible they must be compiled in consultation with the residents and/or their supporters. Proper provision must be made for the health and welfare of residents. This refers to the need for adequate risk assessments to be in place for DS0000063515.V252445.R01.S.doc Timescale for action 01/12/05 2 OP4 18 01/01/06 3 OP7 15 01/12/05 4 OP7 12, 13 14/12/05 Chadwick Lodge Residential Home Version 5.0 Page 24 appropriate areas of individual care needs. 5 OP8 12 Service users care plans or records must fully show how their heathcare needs are met and document the involvement of relevant professionals. A proper nutrition record must be maintained by the home. The home should be conducted in a manner that respects residents’ privacy and dignity. This refers to the need for the home to review some of the institutionalised practices identified in the report. The registered person must make proper provision for the health and welfare of service users. This refers to the need consult with service users and provide meaningful occupation and activity for all service users including those who suffer from dementia or other conditions. The home must have a proper system in place for recording and investigation complaints. Staff must receive training appropriate to the care they are to provide. This refers to the need for staff to receive training in adult protection and managing challenging behaviour. The provider must make proper provision for the health and welfare of service users and ensure that all parts of the home are free from hazards to their safety. This refers to the DS0000063515.V252445.R01.S.doc 14/12/05 6 7 OP7 OP10 17 Schedule 4 12 14/12/05 01/01/06 8 OP12 12, 16 14/01/06 9 OP16 22 01/01/06 10 OP18 18, 13 01/02/06 11 OP25 12, 13. 01/12/05 Chadwick Lodge Residential Home Version 5.0 Page 25 need for action to be taken to manage the temperatures of radiators in the home within a risk assessment framework. 12 OP26 13 Suitable arrangements must made to ensure adequate levels of hygiene control in the home. This refers to issues identified in the report. All areas to be kept clean, and odour free, and appropriate hand washing facilities to be provided. Sufficient numbers of competent staff must be provided to meet the health and welfare needs of the service users. This refers to the need for staffing levels to be maintained to agreed levels at all times and for them to be kept under review. Robust recruitment procedures must be followed, and records maintained in the home as per schedule 4 and 2 of the Care Homes Regulations. 01/12/05 13 OP27 16, 18. 14/10/05 14 OP29 19 14/10/05 15 OP38OP30 18 Staff must be given training 14/10/05 appropriate to the work they are to perform. This refers to the need for a robust induction process to be in place. Staff at the home must be appropriately supervised. The registered person must make suitable arrangements for the safe moving and handling of residents. This refers to the need for suitable equipment to be available and for staff to be fully trained in it’s use. 01/01/06 01/01/06 16 17 OP36 OP38 18 13 Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 26 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 OP2 Good Practice Recommendations Residents or their supporters should understand their terms and conditions of stay and sign the appropriate documentation of this. The practice of storing daily records separately from residents care plans should be reviewed. The daily records should not be referred to as ‘nursing care notes’. A qualified and competent person who is able to administer medication should always be on duty. The language used to describe the resident’s daily events should be monitored. Residents should be consulted on the homes menus. The homes complaints procedure should be on display for residents and other interested parties. The number of communal toilets on the ground floor must be monitored to ensure that it is sufficient to meet resident’s needs. Care staff should receive formal supervision at least six times a year. Cleaning schedules for the kitchen area should be available and adhered to. Food storage should be monitored and best practice adhered to. 2 3 4 5 6 7 8 OP7 OP7 OP9 OP10 OP15 OP16 OP21 9 10 11 OP36 OP38 OP38 Chadwick Lodge Residential Home DS0000063515.V252445.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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