Inspection on 19/05/05 for Chester Lodge General Nursing Home

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Chester Lodge General Nursing... 18/09/08

Chester Lodge General Nursing... 05/09/07

Chester Lodge General Nursing... 14/09/06

Chester Lodge General Nursing... 20/09/05

Chester Lodge General Nursing... 21/10/04

Chester Lodge General Nursing... 13/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Chester Lodge Nursing Home Brook Street Cheshire CH1 3BX Lead Inspector Wendy Smith Unannounced inspection 19th May 2005 11:00 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. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chester Lodge Nursing Home Address Brook Street Chester CH1 3BX 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) 01244 342259 Heathbrook Limited Sheila Percival Care Home 40 Category(ies) of OP (old age) 40 registration, with number PD (physical disability) 1 of places Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 40 service users to include: * Up to 40 service users in the category of OP (old age not falling within any other category). * 1 named service user in the category PD (physical disability under the age of 65). 2. The registered person must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 21st October 2005 Brief Description of the Service: Chester Lodge nursing home is a modern three-storey building situated close to Chester city centre and convenient for all local amenities and public transport.There are bedrooms and bathrooms on all three floors. A passenger lift and two staircases provide access to all levels. Communal space consists of a large lounge, dining room and conservatory on the ground floor, with smaller lounges on the first and second floors. Outside there is a small garden with sitting space, and a small car park at the rear of the property.The home provides personal care and nursing care to older people who are physically frail. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over a period of five and a half hours. As he home manager was on holiday, information was provided by the registered person and the nurses on duty. The inspection was carried out using a process of cross referencing the documentation of identified residents following discussion with them, and following the delivery of care and support to them. Staff records were inspected. A tour of the building, including all communal areas and bedrooms, was completed. On the day of the inspection 29 residents were living at the home. Of these, 15 were receiving nursing care, 13 were receiving personal care and one had been admitted under transitional care arrangements. Three residents were currently in hospital. Six residents spoke about their experience of living in the home and five of the staff on duty were spoken with. What the service does well: What has improved since the last inspection? More social activities have been provided, including some arts and crafts sessions. The home now has a stable team of registered nurses and care assistants and the reliance on agency staff has been considerably reduced. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 6 Staff training has increased and the manager collates the relevant sessions and dates attended in a training file. Some areas of the home have been decorated and a number of bedrooms have been refurbished. Some new equipment, including washing machines and a hoist, have been purchased. 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. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 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 Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The residents at Chester Lodge had their needs assessed prior to moving into the home to ensure that their needs could be met there. EVIDENCE: The registered person said that the manager visits and assesses all prospective residents prior to their admission. The care plans examined contained evidence of these visits. The care plans also contained assessment documents from social workers and health professionals. The home has admitted a number of people through ‘Transitional Care’ arrangements with the Local Authority. Assessment information was always received before these admissions were agreed. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Each resident has a plan of care that sets out their needs and details how these needs are met. The health care needs of residents were met in full. Observation of staff practices showed that residents’ privacy and dignity were upheld. EVIDENCE: Sample care plans were examined. Care plans are stored in the manager’s office and updated by the nurses on duty at the end of each shift. The care plans examined provided details of the residents needs and contained evidence that the residents, their relatives/representatives were consulted about their care. The care plans examined were up to date and relevant. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 10 Residents expressed their satisfaction with the care they received. Pressure sore risk assessment is carried out and reviewed monthly. Residents identified as being at risk of developing pressure sores had appropriate pressure relieving equipment in place. One resident had a pressure sore and this was adequately documented in her care plan. On the day of the inspection one resident was very frail and was nursed in bed. This person was clean and comfortable and equipment for the prevention of pressure sores was seen to be in use. Charts were in place to record nutrition, hygiene and re-positioning. Frail residents are reviewed fortnightly by the visiting GP. There was evidence of the involvement of a range of healthcare professionals including district nurses, chiropodist, optician and dentist. Staff have recently received training in oral and ophthalmic care. There was evidence that residents have access to hearing and sight tests. A choice of GP’s is available. Residents receiving nursing care receive their financial entitlement. At the time of the inspection, all bedrooms were either singly occupied or were occupied by a married couple who had chosen to share a large room. 17 bedrooms have en-suite facilities. Personal care is carried out in the privacy of the bedroom. During the inspection, residents were treated with patience, dignity and respect by the staff. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 While residents are supported to exercise choice in their lifestyle and to meet their social needs, a more structured approach to the provision of social activities would enable more residents to participate. Families and friends are welcomed into the home at any reasonable time. Residents have a good choice of meals and individual requests are catered for. EVIDENCE: Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 12 The residents were generally satisfied with daily living routines in the home. Some residents choose to spend most of their time in their own room, however almost all had their lunch in the dining room. A number of residents go out on a regular basis either alone or with family members. Care staff provide social stimulation for residents in the afternoons. Some residents had recently enjoyed art and craft sessions and had made items to decorate their bedrooms. A professional entertainer provides a singalong in the afternoon once a month. The home receives visits from religious groups, from children at a local nursery school and from a mobile library. The registered person and staff said that they would like to see residents go out more often. At present there is no member of staff with responsibility for planning social activities so they tend to occur on an ad hoc basis. See Recommendation. Residents said that they are able to receive visitors at any time and can see visitors in private. Residents vary greatly in their ability to exercise choice and autonomy. The great majority of residents have family members to look after their financial affairs. The other residents are encouraged to use the advocacy service provided by Age Concern. Evidence was seen that all publicly funded service users have an annual review with their allocated social worker. Residents receive three full meals a day, including a cooked breakfast if they wish. The main meal is served at 5pm and a choice of dishes is available. At lunch time there is soup and a light meal of the day. Residents may also choose a baked potato with filling, or snack meals e.g. eggs/cheese/beans etc on toast. The menu for the day was displayed on a notice board in the dining room. Residents and staff were very satisfied with the service provided by the chef. There remains a vacancy for a part-time chef. Residents, including those who need assistance, are encouraged to take their meals in the dining room. Residents were observed to receive assistance with their meals in a sensitive manner. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this visit. EVIDENCE: Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22 and 26 EVIDENCE: The home is very conveniently situated close to Chester city centre and public transport is easily accessible. The exterior of the building is well maintained and the upper part of the building was painted last year. There is a small, but pleasant, garden area which is accessible to residents. The home does not use CCTV, but security lighting is in place. The registered person has a maintenance plan which evidenced upgrading work that had been carried out. Several bedrooms had been refurbished and new laundry equipment had been installed. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 15 A large communal area on the ground floor comprises a dining area, lounge and conservatory. Smaller lounges are situated on the first and second floors. A number of the armchairs in the lounges are worn and shabby and do not provide suitable seating for frail or disabled residents. The registered person said that she had ordered 18 new armchairs but did not yet have a delivery date for these. See Requirement 1. The home provides an adequate number of bathrooms and toilets to meet the needs of residents, including some assisted baths. All areas of the home are accessible for the residents. Aids and adaptations meet the needs of residents and a number of profiling beds were available. A new hoist had been purchased. A call system is installed in all areas. At the time of the inspection, all areas were clean and were comfortably heated. All bedrooms have a window and natural ventilation. Lighting in the corridors is poor. The registered person said that a new lighting system was planned but there was no definite date for this. See Requirement 2. All baths are fitted with thermostatic controls and thermometers are available in bathrooms. A sample check showed that water temperatures in two bathrooms were within safe limits. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Chester Lodge provides an appropriate number and skill mix of staff to meet the needs of residents. Recruitment procedures were followed to ensure that new staff were suitable to work with vulnerable adults. EVIDENCE: At the time of the inspection the home was fully staffed for nurses and care assistants. A total of eight registered nurses are employed. There are four senior care assistants on days and two on nights. The home has part-time vacancies for a cook and a kitchen assistant. On the day of the inspection there were two registered nurses working in the morning and one in the afternoon. Staff files relating to three recently recruited staff were inspected. These showed that appropriate recruitment procedures had been carried out for the protection of residents. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 38. The home is managed by a suitably qualified person who runs the home in the best interests of the residents. The registered person and the manager promote an open and inclusive ethos in the home. Health and safety policies and procedures are in place, however staff training in Fire Safety and Moving and Handling was not always up to date, and the home’s water systems must be tested for Legionella. EVIDENCE: Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 18 The manager is a Registered Nurse and is registered as manager with the Commission for Social Care Inspection. She has been in post for two years and works closely with the registered person, who provides administrative services for the home. The manager has almost completed a management qualification. There is an informal and homely atmosphere in the home and both the manager and the registered person work alongside the staff. Maintenance records inspected provided evidence that plant and equipment are serviced and maintained to a safe standard. Fire records were maintained up to date and showed that equipment is regularly tested and fire drills are carried out. Staff training in Fire Safety and Moving and Handling was due to be updated. See Requirement 3. The home’s water system has not been tested for Legionella. See Requirement 4. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 2 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x 2 Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP20 OP25 OP38 Regulation 16(2) 23(2) 13(5) 23(4) 23(2) Requirement Timescale for action 31/7/05 4. OP38 Armchairs that are in poor condition must be replaced. Suitable lighting must be 30/9/05 provided in all areas used by service users. Staff must receive induction 30/6/05 training and periodic training updates regarding fire safety and moving and handling. The homes water systems must 31/7/05 be tested for Legionella 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 OP12 Good Practice Recommendations A programme of regular planned social activity should be made available for service users. Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit D off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 Chester Lodge Nursing Home F51-F01 S18715 Chester Lodge V222142 190505 Stage 4.doc Version 1.30 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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