Inspection on 08/09/05 for Charlton Lodge

This inspection was carried out on 8th September 2005.

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

Charlton Lodge 01/08/08

Charlton Lodge 31/08/07

Charlton Lodge 13/09/06

Charlton Lodge 06/02/06

Charlton Lodge 21/12/04

Charlton Lodge 21/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Charlton Lodge Orchard Way Tiverton Devon EX16 5HB Lead Inspector Stephen Spratling Annual Inspection 8 September 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Charlton Lodge Address Orchard Way Tiverton EX16 5HB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01884 253319 01884 253319 info@devon.gov.uk Devon County Council Lorna Priest CRH PC Care Home providing Personal Care 30 Category(ies) of OP Old Age [30] registration, with number of places Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st December 2005 Brief Description of the Service: Charlton Lodge is a care home providing personal care and accommodation for 30 people over the age of 65 years of age. Some residents at the home stay long term but the home does offer a respite service and an intermediate care service. Up to ten people can be accomodated for intermediate care at any one time with the aim of helping them to regain their indepndance so that they can return to their own homes. The home is a detached purpose built property owned by the local authority, Devon County Council. It was refurbished in 2004 when many rooms were made bigger and fascilities improved. The building is set over two floors, with access to the top floor by shaft lift, it has all single bedrooms with shared bathrooms and toilets. The home has three lounge areas and pleasant grounds. It is situated centrally in Tiverton, close to local shops and amenities. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 11am and finished at 4pm and was conducted by one inspector, Stephen Spratling. During the inspection Stephen met with eight residents, two visitors, seven staff members and the home manager. He also looked at the care records of three residents and some other records held in the home. What the service does well: What has improved since the last inspection? What they could do better: All radiators should be properly covered to prevent residents getting burnt. Recommendations made by an occupational therapist regarding a safety barrier next to a staircase should be acted upon. The home should have some height adjustable beds to ensure that residents needing nursing in bed can be cared for properly. Evidence that all the required pre-employment checks are being done for staff should be available for inspection. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 6 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. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 6 Good assessment practice of the home helps to ensure that residents needs can be met. The intermediate care service is successful in helping many people regain their skills and confidence to move from the home and to live more independently. EVIDENCE: The three resident records seen contained detailed information about the needs of residents and included information provided by social workers/care managers, nurses and physiotherapists. The home has a flat equipped with kitchen, large bed/sitting rooms and a bathroom where residents can develop their independent living skills. Staff specifically involved with doing rehabilitative work said are experienced carers, showed an understanding of their role and described being well supported by an Occupational Therapist who is employed at the home part time and a Physiotherapist. Two residents who spoke with the inspector said that they felt they would be more able to cope when they go home thanks to the staff. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 10 Good care planning practice helps to ensure that resident’s needs are met in a consistent way and as the residents want. Residents benefit from being treated with respect and made to feel valued. EVIDENCE: All three residents records seen contained detailed care plans, which reflected the needs identified in assessments and risk assessments. They all showed evidence of review. Residents asked said that staff consult them about how they want to be helped. Residents spoken with confirmed that all staff are polite and patient, that they knock on bedroom doors before entering and respect residents choices about where and with whom they spend their time. One resident said that they had “never had such good care”. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 Residents benefit from the contact with family and friends, which is encouraged by the home. EVIDENCE: Visitors to the home said that they are always made to feel welcome and visit without appointment. One visitor said, “ If the staff see me coming they have a chair and a cup of tea waiting for me” on arrival. Residents spoken with said that they know they can have visitors when they want and meet them in the shared lounges or in private if they wish. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents can be confident that their complaints will be listened to and acted upon. EVIDENCE: The inspector saw the home complaints log; though it showed that there had been a number of complaints in recent months none were of a serious nature and it was clear that remedial action had been taken promptly in each case. Residents said that staff and managers listen to their concerns and always take action; residents indicated they have full confidence that staff act in their best interests. All staff and visitors spoken with indicated that managers are approachable and responsive to concerns. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 24, 25 & 26 Resident’s benefit from the clean, homely environment, but are not adequately protected from risks presented by hot surfaces. Lack of adjustable beds may mean some residents do not get care delivered in the safest way possible. EVIDENCE: The inspector visited all of the shared areas of the home and some of the private bedrooms, all areas seen were, properly maintained, clean and fresh smelling. Residents said that the home is always kept clean, though one resident said they felt that shared toilets sometimes need to be cleaned more often particularly where raised seats are used. The inspector did look at two of these and found one was not as clean as it should be; the manager agreed to ask cleaning staff to pay closer attention to this. One member of cleaning staff who spoke with the inspector and said that with hard work, she and colleagues feel they have the time and equipment to keep the home clean. Hand washing facilities with soap and hand towels are available through out the home. An Occupational Therapist has assessed the building and produced a report (1st June 2004) making various recommendations, which would make the building Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 13 more accessible for people with disabilities and in some instances safer (see standard 38); some of the recommendations have been implemented. Most radiators and hot pipes are guarded to prevent residents getting burnt though the tops of radiators are still not covered (as previously recommended) meaning there remains a risk that residents could burn themselves (see standard 38). Most of the beds in the home are at a fixed height; three staff said that this can make providing care to immobile residents difficult, suggesting that they need height adjustable beds. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Trained and well supported staff are employed in sufficient numbers to meet the needs of residents. Residents cannot be assured that they are protected properly by the homes recruitment procedures. EVIDENCE: All the residents spoken with said that they get help when they need it without having to wait unreasonable periods of time. They confirmed that staff do not rush them, though several said they feel staff are often busy and commented on how hard staff work. Several residents said that the staff “know what their doing”. One resident described the staff as “all excellent” a visitor said that “staff are wonderful”. The manager said that sickness among the staff team was recently a problem but that agency staff are brought in to cover. Carers spoken with said that they do at times feel pressured particularly when colleagues are sick and that they do not always feel able to give the time to residents they would like to. Several of the staff said that they feel well supported by colleagues and that the home currently has a good team atmosphere. All the staff spoken to said they like working at the home. All staff spoken with had done mandatory training such as moving and handling and fire safety recently, some had also done other courses with the past year such as recognition and reporting of abuse and NVQ courses. The manager reported that 22 care have NVQ2 or above. Training records are kept. The recruitment records for three care staff were requested; all contained evidence that staff had been checked with the criminal records bureau before Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 15 starting in post, one had all other pre-employment information in it, the other two did not, the manager said that all checks would have been done but some records are still with Devon Council Human Resources department. The home uses two care agencies to supply staff to cover sickness etc, the inspector was shown a letter from one saying that all staff undergo proper checks and training before being supplied, this did not provide enough detail. Confirmation of proper checks was not available from the other agency. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home is managed and maintained so as to protect the health and safety of residents and staff in the vast majority of areas however failure to minimise all identified risks within the building means they are not as safe as they should be. EVIDENCE: The inspector was shown an environmental health report (07/09/05), which indicated only one area for improvement, and which the manager said was being addressed. Records were seen indicating that the fire alarms are tested weekly and that fire training is done as recommended by Devon Fire and Rescue. An invoice was seen dated 05/07/05 confirming the homes hoists had been professionally serviced. All staff confirmed that they had received updated moving and handling training, which took into account lessons learnt from an incident last year. Moving and handling risk assessments seen were comprehensive and up to date. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 17 A recommendation, made by an occupational therapist over one year ago, about a safety barrier at the top of a flight of stairs have not yet been acted upon. Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 3 x 2 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 2 Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19 Requirement Where a person is employed by someone other than the registered person (e.g. an agency care worker) The registered person must not allow that carer to work in the home unless they have obtained from the employer of that care worker (the agency) written confirmation that all information specified in paragraphs 1 to 7 of Schedule 2; has been obtained and that they are satisfied that it is satisfactory. The registered person must maintain in the care home all the records spcified in Schecule 4 (6).. and they must be avaiable for inspection in the care home by a person authorised by the Commission to enter and inspect the care home. Timescale for action Previous requierment timescale exceeded New timescale to be acheived by 08/11/05 2. 29 17 (2) (3) 08/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 20 Charlton Lodge 1. 2. 3. Standard 24.3 25.5 38 Adjustable beds should be provided for service users receiving nursing care. Pipe work and radiators should be guarded or have guarenteed low surface temperatures. (Ref tops of radiators need to be covered) The registered manger should ensure so far is reasonabley practicable the health and safety of service users.. (ref recomdations made by the OT regarding a barier for the stairs should be acted upon) Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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. Extracts may not be used or reproduced without the express permission of CSCI Charlton Lodge D54 D06 S39224 Charlton Lodge V241810 080905 stage4.doc Version 1.40 Page 22 - 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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