Inspection on 17/03/09 for Clare Lodge Residential Care Home

This inspection was carried out on 17th March 2009.

CSCI found this care home to be providing an Good service.

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

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clare Lodge Residential Care Home 8 Battlefield Road St. Albans Hertfordshire AL1 4DD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yoke-Lan Jackson     Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Clare Lodge Residential Care Home 8 Battlefield Road St. Albans Hertfordshire AL1 4DD TBC TBC Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): B & M Investments Ltd t/a B & M Care care home 24 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 24 The Registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose Primary care needs on admission to the home fall within the following Categories: Old Age not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Clare Lodge is a residential care home provided by B & M Care. It was registered on 08/09/2008. The home is located in a residential area in St Albans. The historic town centre with its many shops and amenities are a short distance away. It is close to the countryside and the M1 and M25 motorways, and there are public transport links with Care Homes for Older People Page 4 of 24 Over 65 0 24 24 0 Brief description of the care home a main line rail route and bus services. There are parking spaces to the front of the building and on the road. This purpose-built care home provides accommodation on three floors. The administrative office, communal lounges and dining room are all on the ground floor. There are 24 en suite bedrooms, 20 with showers, and all of the bedrooms may be personalised with occupants own personal items and belongings to help create more familiar surroundings for the residents. The back garden is attractively designed with a patio and seating areas for residents. The home charges £421 - £695 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service Users Guide. A copy of these and the most recent CSCI inspection report are available in the home Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Clare Lodge was inspected on 17/03/2009 for the first time since its registration on 08/09/2009. The inspection was unannounced. The registered home manager and the deputy manager were present. There are currently 10 people in residence. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents. Staff, residents and visitors were spoken to and key documents were examined. The inspection ended with a thorough discussion with the home manager Information received by us included the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us with statistical data. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: During the site visit it was noted that staff have not had any training on Parkinsons Disease. As the home has a number of residents with this condition, an understanding of the condition would enhance the care provided The home manager said that she will arrange the training session as soon as possible. Care Homes for Older People Page 7 of 24 The management has taken on board the following comments made by residents and relatives during the site visit. She ensures that appropriate action will be taken to improve the service. The food provided is fair to moderate. There is room for improvement. The selection during high tea is not so good. I personally have not seen many group activities during my visit but my (resident) has only been here (very recently). Some of the staff are very good to me. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective clients have the information they need to help them make an informed decision about where to live and they can be assured that a pre-admission assessment will be completed before they are admitted to ensure that the home can meet all their care needs. Evidence: The service has a Statement of Purpose which provides detailed information including the aims and objectives and the philosophy of care and the facilities provided. Each resident is given a Service User Guide, which gives a summary of the service provided and other relevant information. The pre-admission documents of two recent admissions were examined and they were found to be satisfactory. The management team had carried out a thorough preadmission assessment before they were admitted to ensure that the home can meet their personal, healthcare and social needs. The home manager confirmed that each Care Homes for Older People Page 10 of 24 Evidence: resident is given a four week trial period. A recent admission was relocated following a trial period as the home was not able to meet all their care needs. A respite client said that they were very happy with the service and had decided to stay on in the home. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can expect to be treated with respect and can rest assured that their personal and healthcare needs can be met. They are protected by the homes medication policy and procedures. Evidence: Each resident has a written care plan which is drawn up with the resident and provides the basis for the care to be delivered. The written care plan document used is called the Bethel System, used by all B & M homes. The care planning process is personcentred. However the written care plans examined did not reflect the care provided for residents who have Parkinsons disease. Since the inspection, the home manager has updated the care planning records to include this specific medical condition and the specific care that is to be provided. Appropriate risk assessment documents were seen in the care plan folder. Each resident has a regular review of their care needs that involves all parties including the next of kin and the relevant social worker. The home manager said that Care Homes for Older People Page 12 of 24 Evidence: she will be meeting a recent admission and their relatives in the coming week to ensure that the home is able to meet all the residents care needs before the final contract is agreed. The manager said that there have been no incidents of falls and none of the residents have pressure sores. All residents have access to healthcare if required. Each of the residents is registered with a general practitioner of their choice. One of the residents is waiting for surgery and the management ensure that the pain relieve is adequate for this resident. On the day of the site visit, both the resident and their relative were waiting to see the doctor to discuss pain relief and the date of surgery with support from the home manager. Although the home is registered for people with dementia, there are no dementia clients at the present time. The home uses the Monitored Dosage System for individual residents. All medicines are stored in a drug trolley that is kept in a locked storage room when not in use. There is a Controlled Drug cupboard and the drugs in use were recorded correctly and administered appropriately. The district nurse administers Fentanyl patches to a resident. The storage room temperature is monitored regularly to ensure that it is below 25 degrees centigrade. The Medication Administration Record (MAR) charts examined were correctly filled in. All containers of medicines have the opening date written on them. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be given the opportunity to make everyday choices, including their recreational activities and menu and that their preferences and requests will be respected. They will be encouraged to maintain links with their friends and families and they will be encouraged to have a healthy diet. Evidence: On the day of the inspection, members of staff were observed to interact well with the residents. Residents are consulted on all aspects of life in the home and are encouraged to make their own decisions and to get involved in the daily routine in the home. Visitors are welcome at all reasonable times. A couple of residents were busy conversing with their visitors on the day of the inspection. Although group activity was not observed during the site visit, members of staff were constantly chatting with individual residents in the lounge and bedrooms. The residents seemed cheerful and contented. The manager said that there were group activities organised but the current group of residents do not always participate. She is planning to hold a street party and other events in the summer months. The current organised group exercise to music is carried out every fortnight by an outside entertainer whilst members of staff organise bingo sessions and other spontaneous one-to-one recreational and therapeutic activities on a daily basis. These include a game of cards, scrabble and Care Homes for Older People Page 14 of 24 Evidence: walking exercises in the garden. A resident said that they love knitting and making soft toys and they were recently given a teddy bear to make and they are very pleased with this gesture by a member of staff. Another resident said that the home has arranged for them to have a regular Holy Communion service and that they are very grateful for this arrangement. Lunchtime was observed to be unhurried. The majority of the residents have their meals in the dining room. They all seemed happy with the three course lunchtime menu. Members of staff were readily available to assist those residents who needed some help. A member of staff attended to a resident who was feeling unwell and had lunch in their bedroom. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be safeguarded from abuse, they will be listened to and any complaints made will be handled promptly and effectively. Evidence: Residents meetings are held regularly and the management deals with issues raised at the meetings promptly. Residents and their relatives are aware of the homes Complaints Procedure. The home is not involved with the residents finances or personal allowances. Members of staff have training on the protection of the vulnerable and are aware of the joint agency Safeguarding Adults procedures of Hertfordshire County Council Adult Care Services. Staff interviewed said that they are aware of the Whistle-Blowing Policy. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they live in a clean and comfortable environment and that they will have access to all communal areas. Evidence: This is a brand new building that was purpose-built to accommodate people in a residential home environment. The premises have attractive internal decor and furnishing, including a flat screen television in the lounge and state of the art lighting installed. The corridors appeared well lit. Residents have access to all the communal facilities, including the attractive dining room and back garden. The overall appearance is fresh and attractive and several residents described the place as a brand new hotel. The residents spoken to were happy to show us their bedrooms which have en suite shower and toilet facilities. The furniture were arranged to suit the residents individual lifestyle and personal preferences and there were personal items on display, including flat screen television and personal telephone installed as of choice. The bedrooms, community areas and toilet facilities are cleansed daily by the domestic staff. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them. They can be confident that they are safeguarded by the homes robust recruitment policy and procedures. Evidence: Residents are well supported by an effective staff team with a skill mix that benefits residents. The manager said that as the number of residents increases, the staffing level will be increased to include an activity co-ordinator, assistant chef and additional care workers and domestic staff. In the meantime all members of staff assist in the daily routine. On the day of the inspection, the deputy manager was the cook for the day as the chef had a day off. The domestic cleaner, who commenced working two weeks ago, was busy cleaning the bedrooms and communal areas. There were two care workers assisting the ten residents who were mobile and the majority of them were in the communal areas. Since the inspection the home has recruited a laundry assistant. Staff recruitment records were examined and they were found to be thorough and kept up to date. Criminal Record Bureau (CRB) checks and the protection of Vulnerable Adult (POVA) checks were made and new members of staff only commence working after CRB and POVA clearance. The home manager has carried out supervision of individual staff members since the new service began in September. The management ensure that staff show respect Care Homes for Older People Page 18 of 24 Evidence: when conversing with residents and any bad practice is addressed immediately at supervision. Staff supervision takes place every six weeks. The home follows the guidelines from the organisation, Skills for Care. Staff records examined indicated that all new staff received a thorough induction training programme. The management is attending further training on Dementia and the knowledge gained will be cascaded down to all staff in due course. During the site visit it was noted that staff have not had any training on Parkinsons Disease. As the home has a number of residents with this condition, an understanding of the condition would enhance the care provided. The manager said that she will arrange this as soon as possible. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the service and care provided will continue to improve. They can be assured that their health, safety and welfare are promoted and protected. Evidence: This is a new service that was registered with us in September 2008. Currently there are 10 people in residence and they seemed settled in their new home. The day to day management and administration of the service are well maintained. The registered home manager is a trained nurse. Both the home manager and the deputy manager have attained the Registered Managers Award. Staff handled confidential information in accordance with the Data Protection Act 1998. On the day of the site visit it was noted that all the documents and care plans were kept in locked cabinets in the administrative office. All servicing records are well maintained. Care Homes for Older People Page 20 of 24 Evidence: The home manager confirmed that the home is not involved with the financial affairs or the personal allowances of residents. As this is a new service the annual quality assurance and monitoring system has not yet been established. However, the management is in the process of sending out survey questionnaires to residents, relatives, staff and others. Information received will be collated and analysed and an annual report will be produced. The Registration Certificate was on display in the entrance hall. The Annual Quality and Assurance Assessment (AQAA) forms issued by us were returned on time for this inspection. The information provided was satisfactory for a new service. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 30 It is recommended that all staff receive training in Parkinsons Disease as their understanding of the condition would enhance the care provided. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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