Inspection on 07/11/05 for Coniston Lodge

This inspection was carried out on 7th November 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

Coniston Lodge 07/10/09

Coniston Lodge 10/12/07

Coniston Lodge 14/07/06

Coniston Lodge 29/06/05

Coniston Lodge 11/01/05

Coniston Lodge 14/06/04

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 Coniston Lodge 43 Beaufort Road Southbourne Bournemouth Dorset BH6 5AS Lead Inspector Debra Jones Unannounced Inspection 7th November 2005 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 Coniston Lodge DS0000003932.V264561.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. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Coniston Lodge Address 43 Beaufort Road Southbourne Bournemouth Dorset BH6 5AS 01202 421492 NO FAX kevin@coniston43.fsnet.co.uk 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) Mrs Daphne Margaret Bailey Mrs Katrina Marlene Stephanie Bailey Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Coniston Lodge is registered to provide accommodation for eleven older people in what were two attractive converted houses now linked together at the ground floor. It is set on a corner plot in the residential area of Southbourne. Local bus services provide easy access to Bournemouth and Christchurch. There is plenty of on road car parking in neighbouring side streets. There is a large well-maintained garden to the side and rear of the home. The accommodation for residents in the home is over the ground and 1st floors with a passenger lift between. There are a variety of aids and adaptations around the building to allow residents to move about more independently. There are 11 single rooms, 4 of which have en suite facilities. There are additional communal toilets and bathrooms around the home. Situated on the ground floor are the residents lounge and dining room, both of which overlook the garden. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 1 hour and was one of the two anticipated inspections of the year. The 4 requirements and 4 recommendations made at the last inspection were followed up to see the progress made towards meeting them. In addition the requirements and recommendations made by the Commission’s Pharmacy Inspector were discussed and progress towards meeting these noted. During the inspection some records were looked at. The Inspector walked around the building and met and chatted with the few residents who were at home. All spoke positively about the home ‘It’s lovely here, they treat you very nicely.’ Mrs Bailey (Registered Person), Mrs Bailey (Registered Manager) and Mr Bailey helped the Inspector in her work. Prior to the inspection the Commission asked the home to send out a number of comment cards to get people’s views of the home. 6 were returned. 1 was from a resident, 1 was from a Health and Social Care Professional and 4 were from relatives. All comment cards returned were very positive about the staff and service provided at the home. ‘I feel very happy here and well looked after, and well fed. I have a lovely garden to sit in with animals and birds, and I have just had my room redecorated and refurnished.’ A resident. ‘My grandmother is very well cared for at Coniston Lodge. I am very pleased with the care she receives there and know she is very happy and settled.’ A relative. ‘I am very happy with my mother’s home – Coniston Lodge, for it feels like a home and that’s wonderful. I can’t praise Mrs Bailey and her staff highly enough.’ A relative. ‘I am very pleased with the way Mrs Bailey and her staff care for my mother, she always seems happy and well cared for. There is always someone I can talk to if needed whenever I am visiting my mother.’ A relative. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home needs to update their medicines policy. They also need to progress their plans for changing their system of storage and administration of medication to ensure that the health and well being of residents is protected and that the system is as free from risk as possible. It would be good if a qualified person carried out an assessment of the premises, looking at the suitability of the home for the type of older people that the home caters for and making suggestions for improvement should any be identified. It will be good when the programme of covering radiators and pipe work, that pose some risk to residents, is completed. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 7 The home must extend their quality assurance surveys to all parties who might have views on the home and how it might be made better for the people living there. Such people might include relatives and friends of residents, health professionals and care managers. It would be good if more details about fire evacuations at the home were written down. 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. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 8 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 Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 9 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): Standards 3 and 5 were met at the last inspection. 6 is not applicable. These standards were not assessed on this occasion. EVIDENCE: Coniston Lodge DS0000003932.V264561.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): 9 (Standards 7,8 and 10 were met at the last inspection). The home is making progress towards managing medication, according to good practice guidelines, in order to promote the good health and well being of residents. EVIDENCE: In July 2005 the Commission’s Pharmacy Inspector visited the home. 4 requirements and 1 recommendation were made. These were followed up at this general inspection. The home had been required to update their medicines policy to include the recommended additions supplied by the Pharmacy Inspector. This has not yet been done. The home is aware of the need for them to obtain a lockable plastic box should they have to store any medication in the fridge. The expired medicines found at the Pharmacy Inspector’s visit have been returned to the pharmacy for disposal. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 11 The home was required to record the quantities of medicines received when a new resident moves into the home. No new residents have moved in to the home since July and so the home has not been able to put this requirement into practice yet, but intends to do so when the situation arises. The home is also aware that should they have any medicines in the home that are not in the cassettes supplied by the pharmacist e.g. in packets, that these should be dated as to when a new container is started or a carry forward balance be written on the Medication Administration Record. Concerns were raised with the home about the way that they were administering medication. The home was not administering the medicines from the labelled containers in which the pharmacy supplied them and the home was told that medicines should not be re-dispensed by one member of staff for others to administer. Concerns were also raised about where the medicines were stored i.e. in an area not suitable due to temperature and humidity. The home told the Inspector that they have been talking with their supplying pharmacist and are arranging to have medicines supplied in blister packs and for a storage system to be supplied with these. This introduction of such a system should address the concerns raised. As this is not yet in place the recommendation is repeated. Coniston Lodge DS0000003932.V264561.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): Standards 12,13,14 and 15 were met at the last inspection. These standards were not assessed on this occasion. EVIDENCE: Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 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 the following standard(s): 18 (Standard 16 was met at the last inspection). The home’s ongoing development of their adult protection policy and commitment to staff understanding in this area demonstrates the importance the home places on protecting their residents. EVIDENCE: The home has an adult protection policy, which Mr Bailey has recently updated and expanded. Abuse is covered in the National Vocational Qualification training that staff undergo. Adult protection is also discussed informally with staff and will be included in induction programmes. The home has also found a suitable training video to purchase to further raise awareness of this topic with staff. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 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 the following standard(s): 22 and 25 (Standards 19,20,21,23,24 and 26 were met at the last inspection). The home is well–maintained and a comfortable environment is provided for the residents living there and anyone visiting. Residents will benefit from the minimisation of risk afforded by the covering of radiators and pipe work. EVIDENCE: Coniston Lodge is a family run home with a warm and friendly atmosphere. The home is well maintained and communal and private areas are comfortably furnished. The garden is also well looked after, attractive and accessible. The lounge is currently being redecorated along with one of the bedrooms. Whilst there is nothing to suggest that the home is not suitable for the current residents’ needs and that there is no specialist equipment needed by residents to maximise their independence the premises have not been assessed by a qualified person(s). Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 15 Since the last inspection radiators identified as posing the greatest risk to residents have been covered. Plans are in place for other radiators to be covered that pose less of a risk. The same is true of the pipe work in the home. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 (Standards 28 and 29 were met at the last inspection). Sufficient, well trained and qualified care staff are employed and deployed to ensure that the care needs of residents can be met. EVIDENCE: Staffing rosters are in place that show who is on duty and when. Rosters now show all staff on duty, their full names and their designations i.e. what job they do. Training is taken seriously at the home. Staff mostly either have or are studying for National Vocational Qualifications. In addition staff have access to other training courses relevant to their work e.g. food hygiene, infection control, handling of medication. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 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 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): 31,33,37 and 38 (Standards 35 and 36 were met at the last inspection). The home is well managed and organised by people who have the skills, knowledge and experience to run the home. Whilst there is nothing to demonstrate that the home is not run in the best interests of residents a full quality assurance system has not been fully implemented yet. EVIDENCE: Mrs Daphne Bailey is an experienced proprietor and is at the home daily. Mrs Katrina Bailey is the registered manager and also has a daily presence in the home. Mr Kevin Bailey deals with maintenance issues and management / administrative tasks. Mrs Katrina Bailey has a National Vocational Qualification (NVQ) at level 4 in management. One of their senior carers has an NVQ level 4 in care. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 18 At the last inspection the following was noted. ‘The home carries out quality assurance surveys to find out what people think about the home. In previous years they have depended on feedback from Commission surveys to find out what stakeholders outside the home think of Coniston Lodge. It would be good if this year they approached them themselves e.g. health professionals, relatives and care managers. When the survey is done later this year a report should be written based on the analysis of the results of the survey. This report can then be circulated or be available to any interested parties’. A requirement was made to this effect with a date for compliance of 1/04/ 06. This date has not been reached yet and the requirement is repeated in this report. An up to date insurance certificate was on display along with Coniston Lodge’s registration certificate. Both pages of the registration certificate were displayed. The Dorset Fire and Rescue Service visited July 2005 at which time the existing fire precautions were being satisfactorily maintained. Their next inspection will be in July 2007. At the last inspection it was recommended that when the next fire evacuation took place that the record be more detailed e.g. showing when they took place, how long the evacuation took, what happened and who took part. The annual evacuation has not yet taken place and so this recommendation is repeated as a reminder. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x x 2 x x 2 x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x 2 Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 (2) Requirement Timescale for action 01/12/05 2. OP25 13 3. OP33 24 The medicines policy must be updated to include the recommended additions supplied by the Commission’s Pharmacy Inspector. Where risk has been identified 01/12/06 radiators must be guarded or have guaranteed low temperature surfaces. Pipe work must be risk assessed and any risk identified eliminated / minimised. (Previous timescale 1/09/05) The views of other stakeholders 01/04/06 should be sought by the home as part of their quality assurance system. A report of the review conducted must be made and be available to interested parties. Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 21 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 OP9 Good Practice Recommendations The home should follow guidance from the Royal Pharmaceutical society in “The Administration of medicines in Care Homes and Children’s Services”: • Staff should administer medicines from the labelled container in which the pharmacy supplied them. They should not be re-dispensed by one member of staff for others to administer. • Storage for medicines should be reviewed so that they are stored at the correct temperature. It is recommended that the home be assessed by suitably qualified persons including an Occupational Therapist. It is recommended that a more detailed record be made of fire evacuations. 2. 3. OP22 OP38 Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Coniston Lodge DS0000003932.V264561.R01.S.doc Version 5.0 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!