Inspection on 17/01/06 for Charles Lodge

This inspection was carried out on 17th January 2006.

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 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

Charles Lodge 19/06/08

Charles Lodge 10/08/06

Charles Lodge 24/08/05

Charles Lodge 16/02/05

Charles Lodge 08/09/04

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

CARE HOMES FOR OLDER PEOPLE Charles Lodge 75 New Church Road Hove East Sussex BN3 4BB Lead Inspector Kevin Whatley Announced Inspection 17th January 2006 10:00 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 Charles Lodge DS0000058240.V267134.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. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Charles Lodge Address 75 New Church Road Hove East Sussex BN3 4BB 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) 01273 777797 Nicholas James Care Homes Ltd Mrs Gloria Elizabeth Draper Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-seven (27). Service users will be older people aged sixty-five (65) years or over on admission. 24th August 2005 Date of last inspection Brief Description of the Service: Charles Lodge is a care home for older people located in Hove accessed by a quiet drive. The home is a three storey detached building with a passenger lift. The home can accommodate up to 27 residents. The home has a lounge, dining room and additional sun lounge at the front of the home. The home has a level garden around three sides of the building. The home is a short distance away from local shops and connected to other local towns by bus services that run close to the home. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Charles Lodge will be referred to as ‘residents’. The announced inspection took place on a weekday in January and lasted for approximately five hours. The inspection included a tour of the premises and it’s facilities, with a number of residents also consenting for their bedrooms to be viewed. Approximately four residents were spoken with individually. The proprietor, the manager, the deputy manager, the cook and several care staff were spoken with during the visit; whilst care staff were observed carrying out their duties. A number of records and documentation required by registration were also inspected. At the time of the inspection the home was accommodating twenty three residents. This report should be read in conjunction with the previous inspection report dated 24th August 2005. What the service does well: Charles Lodge provides prospective residents and others appropriate information regarding the home and the services it offers. The home ensures that no resident is admitted to the service without first having their care needs fully assessed, whilst relatives/carers and responsible others are involved in the admission process. The health care needs of residents are suitably assessed and subsequently met through a robust system of care planning. The wishes of residents are addressed in a sensitive manner. Residents have opportunities to engage in activities and events and are supported to lead as independent lifestyle as they can. The home responds to complaints in an adequate and timely fashion. The premises offer residents a homely and comfortable environment, whilst care staff are committed and caring. The manager is dedicated and competent and the approach taken toward running the home has created an open and supported atmosphere. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Charles Lodge DS0000058240.V267134.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 Charles Lodge DS0000058240.V267134.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): 1, 2, 3 and 4. The home provides adequate information to prospective residents and others regarding the services it offers. The home ensure that no resident is admitted to the home without having had their needs fully assessed, whilst relatives and carers are involved in the admission process. Residents have suitable terms and conditions of residence. EVIDENCE: Charles Lodge is owned by Nicholas James Home Care LTD who operate a further eight homes in the South East of England. The homes statement of purpose outlines the operational structure of the organisation and it’s aims and objectives and philosophy of care and working practices, whilst the individual aspects of Charles Lodge are described, including the proposed move toward accommodating a number of residents who have a dementia type illness. A number of files were viewed, notably those of the most recently admitted residents. These confirmed that the home have a robust admissions procedure that included a detailed needs assessments carried out by the manager or her deputy prior to admission. Where relevant copies of social services care management assessment documents had been obtained. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 9 One resident said that they had visited the home prior to admission, whilst the manager confirmed that the relatives of the most recently admitted resident visited the home on a number of occasions prior to admission. Files seen contained signed and dated written contracts of residency that detailed the terms and condition of tenancy at the home. Charles Lodge DS0000058240.V267134.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): 8, 9, 10 and 11. The health and personal needs of residents are suitably assessed and recorded into appropriate plans of care. The home have implemented suitable storage and administration systems for the use of medicines, though they must ensure that records are accurate at all times. Residents are treated with respect, dignity and care, whilst their final wishes are addressed in a sensitive manner. EVIDENCE: Several care plans were viewed these were found to contain completed assessments of the physical, medical, social and personal needs of resident’s whilst detailing the manner that such needs are to be met by care staff. Care plans had been completed sensitively in relation to how individual residents wished to be addressed and cared for and how any identified risks, such as falls, could be reduced. Residents health care needs were clearly assessed on admission with subsequent medical appointments made and kept. All residents are registered with local G.P’s and on the day of the inspection several residents were having their eye sight assessed by a visiting Optometrist. New residents and their relatives/carers are given the opportunity to complete a ‘wishes’ form. This form allows for the residents final wishes to be recorded, such as name of their preferred funeral service etc. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 11 The homes medicine storage and administration system was viewed. This confirmed that since the last inspection the home have purchased a new secure cabinet, whilst care staff undertake medicine administration training prior to being allowed to administer medicines. On viewing the medicine administration record it became clear that a majority of the recordings were up to date and accurate, however it was evident that there were several gaps in these records relating to recent days. These errors were addressed immediately by the manager and her deputy and it was clear that in general the system the home has in place is transparent and robust. Observations of staff interactions with residents clearly evidenced a high level of mutual respect and co-operation with care tasks being carried out in a caring, supportive and respectful manner. Many of the care staff at the home have been employed for a number of years and it was clear that they gain satisfaction from their roles. The atmosphere in the home was relaxed, unhurried and homely. Residents stated that care staff are ‘very caring and helpful’. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14. Residents have the opportunity to engage in interests and events, though the home should review the limited amount of trips away from the home. Residents are encouraged to maintain control over their lives. The dietary requirements of residents are met. EVIDENCE: Since the last inspection the home have implemented a more focused approach toward activities and events and have now identified a dedicated member of care staff to facilitate group activities twice a week. These include interactive games such as skittles, sticky darts and quizzes. Several residents stated that they enjoyed these events, though noted that on occasion the high number of residents participating can mean it ‘takes a long time to get a go’. Several residents are able to visit the local shops on their own and are encouraged to continue such pursuits as long as their needs are assessed as being adequate and safe; there were no risk assessments on file for residents who venture out alone. Several residents commented on the lack of opportunities to leave the home, such as trips out to events, garden centres or to sites of local interest. Several residents spend a large amount of their time in their own rooms, those spoken to stated that they were ‘very happy’ spending time alone and Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 13 commented that this was their choice and should they wish they could join other residents in the lounge areas for ‘a chat’. The homes cook was spoken with, whilst the menu was viewed. The menu confirmed that the residents benefit from a varied, balanced and nutritious diet with a majority of the meals being home cooked. The cook confirmed that he provides a flexible approach to catering for individual needs and produced records of residents choices where they had chosen alternatives to the displayed menu. Residents stated that the food was ‘very good and tasty’ with ‘lots to eat’. The meal served on the day of the inspection was found to be well presented, tasty and of a high quality. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The home ensures that the views, concerns and complaints of residents and others are addressed through appropriate polices and procedures. Residents are protected from the risk of harm, neglect or abuse. EVIDENCE: The homes complaints procedure was viewed, this was found to be clear, concise and relevant with clear information regarding the homes policy on complaints including the manner that any concerns will be investigated by the home, the timescale that they have to be investigated in, and the contact details of the Commission for Social Care Inspection (CSCI). This policy and procedure is displayed clearly in a communal area of the home. The complaints book was also viewed, this confirmed that just one complaint had been reported by a resident since the last inspection. The manner that this matter was dealt with was seen as being timely and appropriate and involved both family members and social workers. The outcome of this complaint was suitably recorded with appropriate outcomes. No complaints have been received by the CSCI since the last inspection. Charles Lodge have satisfactory policies and procedures for the protection of vulnerable adults, and new care staff undertake relevant adult protection training as part of their induction programme. Care staff spoken with displayed a good understanding of such procedures, and of the issues associated with adult protection in general. Care staff are due to undertake a course relating to the Protection Of Vulnerable Adults (POVA). Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 15 Charles Lodge DS0000058240.V267134.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, 22, 23, 24 and 26. The home is generally well maintained both inside and out and is furnished in a homely fashion. Residents benefit from adequate individual and shared space and are encouraged to personalise their rooms. The home must ensure that any risks regarding the health and safety of residents and staff are addressed at all times. The home is clean and hygienic. EVIDENCE: Charles Lodge is a large detached building set in its own grounds. Residents accommodation is situated on three floors all served by a passenger lift. There is level access into all areas of the home. A large well-tended garden area and patio offer residents opportunities to enjoy fine weather. A tour of the premises found that the home has been maintained to a good structural condition, whilst the shared areas have been appropriate furnished to a high standard. Residents bedrooms were seen to have been well maintained with personal items such as photographs, pictures and ornaments individualising each room. Residents stated they were ‘very happy’ with the standard of accommodation at the home. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 17 During the tour of the building it was evident that some work has begun to make certain areas of the home safely accessible for prospective residents who have dementia type illnesses including the separating off of a garden area, improving emergency exits and providing ‘sensory activated’ outside lighting. However the tour also found that a ‘trouser press’ had been left on the floor of the lounge, a second floor bathroom did not have a call alarm system fitted and a second floor cupboard housing a boiler had been left unlocked. The home was found to be clean and generally tidy. Records confirmed that regular fire alarm checks are carried out, whilst the homes fire equipment is regularly serviced. Records of staff training in relation to fire safety was also noted. Charles Lodge DS0000058240.V267134.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): 28, 29 and 30. The assessed needs of residents are met by the numbers and skills of care staff deployed at the home. Care staff are experienced, competent and knowledgeable. The home have a positive approach toward training. EVIDENCE: The rota showed that three care staff are on duty during the day and two staff are on waking night duty, these being supported by a full time cook and domestic worker. The manager and her deputy operate an ‘on-call’ system outside of office hours and at weekends. All new care staff undertake an induction programme which addresses relevant areas of care such as safe handling and lifting, medicine administration and first aid, though no evidence of adult protection awareness induction was identified. The newest member of care staff confirmed that she was ‘shadowed’ for the first few weeks until she became more proficient and confident in her role and the routines of the home and it’s residents. Since the last inspection the home have introduced a robust system for training with new staff enrolled on a foundation course in care that will link directly and inform the required National Vocational Qualifications (NVQ) requirements. Three members of care staff have obtained the NVQ level 3 qualification in Care. The homes statement of purpose places considerable importance on training and there is an expectation that care staff improve their knowledge and practice via training courses and NVQ qualifications. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 19 Many staff at Charles Lodge have worked at the home for a number of years and staff turnover is relatively low. Residents stated that care staff are ‘lovely’ and ‘very caring’. Care staff were seen to carryout their duties in a caring, relaxed and respectful manner, whilst their knowledge of care related issues was considerable. Charles Lodge DS0000058240.V267134.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, 33, 36, 37 and 38. Residents benefit from a home that is managed in a manner that creates a homely, open, supportive and caring environment, whilst care staff are adequately supported and supervised to carryout their tasks. The home have suitable quality assurance procedures. EVIDENCE: The registered manager of Charles Lodge has managed the home for over five years, whilst she has worked there for fourteen years and within the care profession in general for over twenty years. She has considerable experience of offering care to vulnerable adults and commands a vast knowledge in relation to meeting the assessed needs of residents within the home. The manager is currently undertaking the NVQ level 4 award in Care and Management. The manager has implemented a suitable and robust system of formal supervision for care staff. This is being carried out by the manager with care Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 21 staff on a regular basis and she displayed a sound understanding of looking to improve the current system further. Care staff stated that they felt ‘very well supported’ in their work by all of the management team and indeed noted that ‘all staff support each other’. The area manager completes monthly and informative regulation 33 reports that are subsequently forwarded to the CSCI, whilst bi-annual quality assurance questionnaires are circulated to residents and their relatives/carers. Comments contained in the most recent survey included ‘excellent meals’ and ‘extremely helpful staff’. Records maintained at the home, as required by registration, were legible, relevant and concise, confidential information concerning staff and residents is stored in the office in lockable cabinets. Charles Lodge DS0000058240.V267134.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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X 3 3 3 X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 3 Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 23 NO 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 2 3 Standard OP9 OP19 OP22 Regulation 13(2) 13(4)(a) & (c) 23(2)(a) Requirement Timescale for action 17/01/06 Records of medicine administration must be accurately maintained. That all areas of the home must 17/01/06 be free from hazards at all times. That the home have an 17/07/06 assessment of it’s premises carried out by an Occupational Therapist, notably in respect of accommodating residents who have a dementia type illness. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP11 OP12 OP12 Good Practice Recommendations That the format for gaining the wishes of residents and their relatives/carers in the event of their death be reviewed to ensure it is legally correct. That any resident who leaves the home unaccompanied needs to have a completed risk assessment. That the home considers meeting residents wishes, and complying with their own statement of purpose, to have DS0000058240.V267134.R01.S.doc Version 5.0 Page 24 Charles Lodge 4 OP28 trips out away from the home. That the homes induction programme includes adult protection awareness training. Charles Lodge DS0000058240.V267134.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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