Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 10/05/05 for Country Lodge Nursing Home

Also see our care home review for Country Lodge Nursing Home for more information

This inspection was carried out on 10th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This is a care home where older people are well looked after. It has a competent staff team who understand the needs of the elderly people living there. The residents who were spoken to said they liked living in the care home. Staff is very caring and considerate and the atmosphere was very homely. One resident said staff is very friendly and helpful. A range of activities is provided for residents to take part in. The inspector watched a group of five residents taking part in a gentle exercise session. Resident said that they enjoyed the activities, which have been provided.

What has improved since the last inspection?

Records of staff training and induction training have been improved so that it was clear that all new staff have been given time to learn about what is expected of them. This means that residents are cared for by staff that has the necessary skills to provide the care required.Country Lodge Nursing HomeH60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 0.docVersion 1.30Page 6

What the care home could do better:

Whilst care plans have been drawn up for the majority of residents, such a plan had not been put in place for one resident who had been recently admitted. There was, therefore, no information for staff to follow to ensure they were caring for the resident in an appropriate way. Care plans were being reviewed monthly to ensure they are updated to reflect any changes to the care required by residents. However, in one instance the care plan had not been reviewed since the end of March 2005. The resident is now very poorly and is being nursed in bed. The information provided to staff did not reflect the care the resident now needs. It was agreed that care plans need to be looked at more closely to make sure they are place when a resident is admitted and reviewed as often as needed to make sure the information is up to date to ensure staff provide the appropriate care to each resident.

CARE HOMES FOR OLDER PEOPLE Country Lodge Nursing Home Cote Street Worthing West Sussex BN13 3EX Lead Inspector David Bannier Unannounced 10 May 2005, 10.00 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. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Country Lodge Nursing Home Address Cote Street, Worthing, West Sussex, BN13 3EX 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) 01903 830600 01903 693696 enquiries@countrylodgenursing.co.uk Mr John Patrick Wright; Mrs Mary Claire Wright Mrs Deborah Susan Spokes Care Home (CRH) 25 Category(ies) of Old age, not falling within any other category registration, with number (OP), (25) of places Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This care home may admit service users requiring nursing care. Date of last inspection 6 January 2005 Brief Description of the Service: Country Lodge is a care home which is registered to accommodate up to twenty five residents in the category (OP) old age, not falling within any other category. It provides personal and nursing care. Country Lodge is a detached two storey property which provides accommodation in three double and nineteen single bedrooms located on the ground and first floors. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. There is also a small sitting area on the first floor. The property is located on the outskirts of Worthing. The service is privately owned by Mr and Mrs John Wright, whilst the registered manager, who is responsible for the day to day running of the care home, is Mrs Debbie Spokes. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10am. It took place over five hours. The inspector spoke separately to four residents who had been admitted since the last inspection, and to seven staff who were on duty. The deputy manager showed the inspector around the care home. Some records were also examined. The inspector returned the following day to tell Mr Wright what the inspector had discovered about the way residents were being cared for and how well the home was being run. Mr Wright had told the inspector that he had to leave at midday at the time the inspection took place. What the service does well: What has improved since the last inspection? Records of staff training and induction training have been improved so that it was clear that all new staff have been given time to learn about what is expected of them. This means that residents are cared for by staff that has the necessary skills to provide the care required. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 0.doc Version 1.30 Page 6 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. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 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 Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 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 and 6. Before moving into the home, people are assessed, by a trained member of staff to make sure Country Lodge is able to provide the care they need. Residents are also invited for a trial period to see if they like what the care home can offer them. The provider told the inspector that County Lodge does not provide intermediate care. EVIDENCE: Records seen showed that the manager had assessed the needs of each resident user before they arrived at Country Lodge. Where possible the resident had signed the assessment record to confirm they had been asked about their requirements. The inspector spoke to the staff on duty. They were able to demonstrate they understood what the residents needed to have done for them and what they should do to ensure each resident is well cared for. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 9 Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 and 11 Where possible residents are involved with the drawing up of their care plans. Otherwise their family or close friends have become involved in this process. Apart from two instances, care plans have been developed out of assessments. These care plans provided information to staff to ensure residents’ health care needs have been met. From the comments made by residents it would appear that the staff members respect the privacy and dignity of the people living at Country Lodge. The inspector saw that, when helping residents, staff is mindful of being respectful. EVIDENCE: The inspector read a selection of care plans. In general care plans were informative and included appropriate information for staff to follow. Care plans also included information with regard to the wishes of residents at the time of their death. Whilst an assessment had been carried out, there was no care plan for one resident, who had recently been admitted. The staff had no written information about the care they were expected to provide for this person. It was not possible know if the care that was provided was as agreed with the resident Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 11 before they were admitted. The manager was advised to ensure that a care plan, which has been agreed with the resident, is made available. One resident was very poorly on the day of the inspection and was being nursed in bed. The resident’s care plan had been last reviewed on 30th March 2005. The care being given was not the same as the care plan agreed with the resident. The manager was advised to make sure that, when necessary, care plans are reviewed as often as need be, especially when residents are unwell and their requirements are different to what staff usually does for them. Staff would then know what they must do to ensure the resident is well cared for. Residents said that they felt well cared for. One person told the inspector that when they get a migraine the staff knows what to do. Another resident said that staff “is very friendly and helpful”. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and 15 Residents at Country Lodge are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate. Residents are encouraged to maintain contact with all their old friends and family wherever possible. The food is of a good standard, and offers a choice of menu. People are able to eat together or in their own room should they prefer. Sufficient staff is available to assist those residents who need help and supervision with eating and drinking. EVIDENCE: At the time of the inspection a gentle exercise session was taking place in the lounge. Five residents were taking part. Afterwards one resident commented that the session was enjoyable and was good for keeping joints and muscles healthy. One resident was busy working on a jigsaw puzzle in their room. Another told the inspector that they liked to read and had a full bookshelf in their room. Knitting was another pastime, which they enjoyed, especially knitting baby clothes for friends and family. Information about a range of activities was displayed on a notice board just outside the lounge. Everyone said they enjoyed the activities, which have been put on for them. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 13 One resident told the inspector that going to church and taking communion was important to them. They also told the inspector that ”someone visits regularly to give them Communion” and that “sometimes they will go the local church nearby”. They also enjoyed taking part in the activities, whatever they are. All the residents who were spoken to said that they keep in touch with family and friends. They enjoy regular visits from sons and daughters, grand children and, sometimes, great grand children! One resident keeps in touch with family members who do not live nearby by telephone. The inspector watched whilst the main meal of the day was served. The meal consisted of a choice of chicken casserole or macaroni cheese, mashed potatoes, broccoli and cauliflower followed by a choice of apple sponge and custard or cream, semolina or jelly with pineapple. The meal, including those which needed to be liquidised, was attractively presented on hot plates. Tables in the dining room were attractively laid with matching table clothes and napkins. Small sprays of fresh flowers had been put on tables in small vases. Some residents, who did not wish to go to the dining room, were able to have their meal in the comfort of their own room. Those residents who required help with eating were attended to by staff that sat with the resident and provided appropriate assistance. All residents who were spoken were very complimentary about the food. One resident said, “The food is very good”. Another said that the cook would go out of her way to find something especially as the resident needs to have a special diet for diabetes. Yet another resident said, “The food is particularly good, I have no complaints. The cook is very pleasant.” Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None The standards in this section were not looked at during this inspection. EVIDENCE: Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 15 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) 19,23, 25 and 26 On the day of the inspection Country Lodge was clean, appropriately furnished, decorated in a homely manner and well maintained. This made it very pleasant for residents who live in the home. The location of the home is suitable for the residents who live there. Overall the care home was clean and hygienic. EVIDENCE: During the course of the inspection the majority of the bedrooms, the lounge and dining room were visited. The environment was attractively presented and was homely, safe and comfortable for people who live there. Many residents had brought personal possessions into the home, including small items of furniture, ornaments and photographs. Residents have been able to use these items to make their own rooms comfortable and reflect their own personality. One resident told the inspector that it was the homely atmosphere, which encouraged them to choose to live at Country Lodge. The resident told the inspector “this is the best home I have seen.” Another resident said, “this is home from home”. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 16 Country Lodge employs a person who is responsible for the day to day maintenance of the care home. A maintenance book is used to inform this person of any jobs that need to be done to ensure the home is safe for residents and staff. At the time of the inspection work was being carried out on an external fire escape. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 17 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 30 Country Lodge is adequately staffed with employees who are skilled and experienced in caring for older people. Induction training is provided for all new staff. All staff is provided with opportunities to undergo training leading to National Vocational Qualification awards at Levels 2 and 3 in caring for elderly people. Other training to improve the knowledge and skills of the staff in the care of the elderly is also provided. All training is recorded on staff member’s files. EVIDENCE: Rotas were seen which showed that staffing levels, including trained nurses, catering and domestic staff were sufficient to ensure residents are well cared for. Residents said that staff is very friendly and helpful. One resident told the inspector that staff is “marvellous”. Inspector spoke to the staff on duty in a group over their meal break. They said that many of them had left this home but had chosen to return. When they were asked about why this is, they informed the inspector that they feel well supported by the manager and the owner. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 18 Staff informed the inspector that they have been provided with a range of training, which helps them understand how they should provide care to older people. They were able to tell the inspector about what the manager and owner expects of them. They meet regularly with the manager and the owner to discuss any problems they have and to talk about how they can improve the way the home is being run. All staff knew about the individual care requirements, which had been agreed with each resident. Records seen showed that each member of staff had been provided with appropriate training, including induction training. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 19 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) 33 and 38 Mrs Spokes, the registered manager and Mr Wright, the registered provider are running in the home in the best interests of the residents. As mentioned in an earlier section, some work is needed to ensure residents care plans are kept up to date. The manner in which the laundry is handled would benefit from a review. This would ensure frail and elderly residents continue to be protected from the risk of infection. EVIDENCE: All the residents spoken appreciated the “hands on” approach of the provider, “he is very approachable and will do anything to help you”. The manager is also very well thought of by the residents. The staff members that the Inspector spoke to echoed these comments. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 20 Residents told the Inspector that they liked the way Country Lodge was run. It is “like home from home” and “it is the best home I have seen. The deputy manager showed the inspector round the care home during the course of the morning shift. This is a busy time when people are being helped to get up, dress, wash and have baths. The laundry room was also very busy dealing with personal laundry and bed linen. A member of the care staff had been asked to cover in the laundry, as the person normally working here was unavailable. The deputy manager told the inspector that she had spent some time with the member of staff helping her to organise her work to ensure there is no risk of cross infection, particularly from soiled linen. This is particularly important as the several of the residents were very poorly and being nursed in bed. They would be, therefore at greater risk of infection than usual. It was recommended that systems in use to prevent the risk of infection are reviewed to ensure the safety and wellbeing of residents. The manager should also ensure all staff who work in the home are kept informed of what is required of them should they be expected to work in the laundry. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 21 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 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x 2 Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation Requirement Timescale for action 20th June 2005 2. OP7 Regulation Unless it is impractical to carry 15(1) out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (the service users plan) as to how the service users needs in respect of his health and welfare are to be met. Regulation The registered person shall keep 15(2)(b) the service users plan under and (c) review; and where appropriate, and unless it is impractical to carry out such consultation, after consultation with the service user or a representative of his, revise the service users plan. 20th JUne 2005 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 OP38 Good Practice Recommendations The registered person should review laundry practices to ensure systems are in place to control the spread of infection in accordance with relevant legislation and H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 23 Country Lodge Nursing Home published professional guidance. Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Susex BN11 1RY 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 Country Lodge Nursing Home H60-H11 S24171 Country Lodge Nursing Home V224560 100505 Stage 4.doc Version 1.30 Page 25 - 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!