Inspection on 22/06/05 for Courtfield Lodge Nursing & Residential Home

This inspection was carried out on 22nd June 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

Courtfield Lodge Nursing &... 30/12/08

Courtfield Lodge Nursing &... 20/09/07

Courtfield Lodge Nursing &... 19/06/06

Courtfield Lodge Nursing &... 15/11/05

Courtfield Lodge Nursing &... 10/03/05

Courtfield Lodge Nursing &... 10/08/04

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 Courtfield Lodge Nursing & Residential Home 81a Marians Drive Ormskirk Lancashire L39 1LG Lead Inspector Vivienne Morris Unannounced 22 June 2005 09:30 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. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Courtfield Lodge Nursing & Residential Home Address 81a Marians Drive Ormskirk Lancashire L39 1LG 01695 570581 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) Flightcare Ltd Care Home 70 Category(ies) of LD - Learning Disability registration, with number OP - Old Age of places Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 70 Service Users in the category OP (Old Age) who need nursing care. 2. Up to 40 service users in the category OP (Old Age) who need personal care only. 3. 1 named service user in the category of LD (Learning Disability). 4. The service should at all times, employ a suitably qualified and experienced manager who is registered with the NCSC Date of last inspection 10.03.05 Brief Description of the Service: Courtfield Lodge is a purpose built home situated in a residential area close to the town centre of Ormskirk. It provides nursing and personal care for up to 70 older people. The accommodation is on two floors. The upstairs floor is accessed by both stairs and a passenger lift. There are lounges and dining areas on both floors. The rooms are predominantly single but facilities are available if service users choose to share, either at the time of admission or following admission. The rooms all benefit from the provision of en-suite facilities. The menu provides a variety of food, although alternatives are available if desired. Specialised diets are catered for if required. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two regulatory inspectors conducted this unannounced inspection over one day during June 2005. The inspection process focused on the outcomes for people living at the home. During the course of the inspection 7 service users and 3 staff were spoken to, relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas and service areas were seen. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. What the service does well: What has improved since the last inspection? The hot water system had been upgraded, which meant that those living at the home were not limited as to the amount of hot baths they could take, which made residents spoken to very happy. Previously the hot water supply was limited due to a problem with the system, which resulted in hot water not always being freely available for those living at Courtfield Lodge. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 6 One resident said ‘ I cant complain, I get a bath ever other day now, it’s improved since the new hot water system was fitted’. The recording of social activities provided demonstrated that residents were offered some leisure activities, including excursions out of the home. Systems for monitoring the quality of service had been introduced to determine how the home was achieving its goals. The management of service users’ monies had improved since the last inspection. 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. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The residents’ needs had been well assessed before admission to ensure that staff were able to give appropriate care and support. EVIDENCE: The care of three people living at the home was ‘tracked’ during the course of the inspection, so that the inspector could determine if service users needs had been assessed prior to admission and if appropriate care was being delivered to meet these needs. The information obtained by the home prior to admission involved the resident and was detailed, providing staff with a clear picture of individual assessed needs so that the resident could be assured that the home was able to appropriately meet their needs. Copies of the assessments conducted by the social worker had also been obtained, therefore the needs of these people had been established prior to the home conducting their own assessment. Plans of care were in place and were based on the combined information obtained from the two assessments prior to admission. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 9 For those receiving nursing care an NHS registered nurse had conducted an assessment to determine the level of funding required. Qualified nurses were always on duty at Courtfield Lodge, allowing care staff to seek professional advice, as required. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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 and 8 Clear guidance was provided for staff to ensure that the health, personal and social care needs of those living at Courtfield Lodge was fully met. The residents were not protected by the medication procedures in place at the home. EVIDENCE: Residents spoken to said that the staff were very helpful, offering assistance to people, as needed. One stated, when asked about staff response to the nurse call system, ‘ I have no grumbles, they come pretty quickly’. Staff were seen to be communicating well with those living at the home, making sure that people understood what was being said to them. Personal care was offered in private, and service users felt that staff were respectful. The plans of care for all three residents were very informative, providing staff with a clear picture of the individual health, personal and social care needs of those living at the home and how these assessed needs were to be met, including supporting independence where possible. The plans of care had not always been regularly reviewed to establish if the needs of residents remained the same or had changed, so that their needs could be appropriately met. The Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 11 resident or their representative had not been consistently involved in the care planning process, therefore they had not always been offered the opportunity to have some input into the care they were receiving. At the time of the inspection wound care was found to be well managed, and appropriate equipment had been provided in accordance with the plan of care in order to promote pressure relief and reduce the risk of pressure sore development. The registered manager had sought advice from a variety of external professionals and a wide range of risk assessments had been conducted in order to improve the quality of care for those living at the home and to ensure their continued health and safety. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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) 12and 13. Some activities were being provided. In general, the residents were given choices in relation to activities of daily living which suited their preferences. Those living at the home were encouraged and supported to maintain contact with relatives, friends and the local community. EVIDENCE: The care records examined provided detailed information in relation to the preferences of those living at the home, including their preferred leisure and social activities. The policies of the home and the service users’ guide demonstrated that visitors were welcome to the home and residents were encouraged to maintain contact with family, friends and the local community. When asked about being able to make choices in the home service users said they could make lots of choices including when to get up, and where to spend time in the home. The provision of hot water throughout the home had been improved since the previous inspection. However, one bathing facility was still faulty, which reduced the choice of bathrooms for service users on the ground floor. One person stated ‘the staff give us a knock to see if we are ok, it depends how I feel, but if I feel like it I go down to the lounge for a chat’ Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 13 Service users were asked about what sort of social activities were available in the home. Some said that there were activities in the downstairs lounge that they were invited to, and bingo and card games were played some days. Others felt that there was not much going on, and that they would like activities such as arts and crafts to do. It was noted however that one service user had made a greeting card with the staff, so some arts and craft activities were in place. Some staff had received training in the provision of activities for those with a dementia related illness, so that appropriate activities could be provided for these people. Service users were very positive about the standards of meals served, and felt that they were offered a reasonable choice of menu, but also felt the kitchen staff would get them something else if they did not like the meal being served. Service users’ comments included ‘we don’t do too bad with meals here, they come round in the morning and ask me what I want’, ‘we often have choices, and I like the salads, especially in this weather’ and ‘we cant grumble, and I’ve never sent anything back, so it cant be bad!’ One service user did suggest that a smaller portion option could be offered, as they felt a little embarrassed when they left food due to the large size helpings. The cook was due to review the menu, and planned to speak to the service users about which meals they preferred and which ones they were not so keen on. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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) 18 The policies, procedures and practices of the home protect those living there from potential abusive situations. EVIDENCE: A written policy was in place at the home in relation to the protection of vulnerable adults, which provided clear guidance on the procedure to be followed in the event of any allegations of abuse being received. A copy of the guidance ‘No Secrets’, produced by the Department of Health was readily available for staff reference to ensure that correct procedures were followed. A whistle blowing policy was also in place so that staff were aware of their responsibilities in relation to the reporting of any concerns which may affect those living at Courtfield Lodge. Policies also demonstrated that service users had access to their own records. Monies retained on service users’ behalf were securely stored and receipts were given for any money or valuables received, which service users wished to the home to retain on their behalf for safekeeping. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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 Service users lived in a well maintained environment. The safety of those living at the home was compromised due to the unsafe hot water temperature being provided to one of the bathrooms. EVIDENCE: A programme of routine maintenance was in place for a 12month period and records showed when work was due to be done and when it had been completed, so that the home was being maintained to an acceptable standard. The hot water being supplied to one bath was well above the recommended temperature of 43C, and could present a risk to service users. The acting manager of the home was informed during the inspection and the maintenance person was asked to look at the temperature regulator. The building work to the bridge at the entrance of the grounds of the home had been completed and the grounds were maintained to a satisfactory standard, ensuring those that lived at the home were accommodated in safe surroundings. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 16 A fire procedure and risk assessment was in place. Fire training for staff had been provided. Fire records demonstrated that appropriate checks had been conducted on the fire systems and fire equipment within the home. The Fire Officer and Environmental Health Officer had not visited the home since the last inspection. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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 29. Inadequate numbers of qualified nurses were on duty at the time of the inspection. The cleanliness of the home was being compromised due to staff sickness. A robust recruitment process was in place to ensure staff employed were suitable to work with vulnerable adults, which ensured that service users were safeguarded by the employment practices of the agency. EVIDENCE: A staff rota was in place demonstrating which staff were on duty at any time of the day and night and in what capacity they were employed showing the qualifications of staff working at the home. The staffing levels were calculated in accordance with the minimum requirements of the previous regulating authorities. On the day of the inspection there was a deficit of one qualified nurse from 8am and 8pm. All other days checked showed that the staffing levels were adequate. The home must be sufficiently staffed at all times to ensure that the health and safety of service users is adequately protected and to ensure that their assessed needs are appropriately met. The registered person should consider calculating the ratio of service users to staff in accordance with their assessed needs, in order to ensure sufficient staff are deployed to meet individual needs in accordance with the plan of care. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 18 The home had a robust recruitment procedure, which ensured that their staff were suitable to work with vulnerable people. All of the personnel files examined revealed that thorough pre-employment checks were carried out, and an induction to the home was also completed and a copy kept on staff personal files. A number of service users commented that due to the home being short staffed, cleaning in bedrooms was not being done as well as usual. One was concerned that the en-suite had not been cleaned for a few days, and another said ‘they are not getting things done, my room isn’t cleaned, as staff are on holiday’. The acting manager informed the inspectors that the home was currently short of domestic staff due to sickness. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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 35 Feedback from service users, relatives and staff was sought so that the home could monitor the quality of service provided. Service users’ financial interests were safe guarded. EVIDENCE: There was no annual development plan available for inspection to demonstrate that the home has a systemic cycle of planning in place, which reflects the aims and outcomes for service users. A system had been implemented at the home to monitor the quality of care provided, which involved feedback from those living at the home and their representatives. This process should now be extended to any external professionals who have input into the care of service users. Internal audits should now be commenced as part of this process. The results of service users’ surveys had been produced in a graph format, which should now be published so that prospective and current service users are able to see how the home is achieving it’s goals. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 20 The registered person must provide the Commission for Social Care Inspection with a monthly written report in relation to the conduct of the care home to ensure that an internal audit has been conducted in relation to the quality of the service. The plans of care seen were very well written and incorporated short term and long term goals for service users, which demonstrated a commitment to the development for each service user and promoted their independence. Any discussions with relatives of service users were documented so that a record was retained of any concerns or compliments. Staff meetings had been held every three months, with minutes kept, demonstrating that the home had a system in place to obtain feedback from those working at the home. Some of the policies and procedures of the home had been reviewed and updated in light of changing legislation and good practice advice. However, some were still in need of updating. Action should be progressed within agreed timescales to implement requirements identified in CSCI inspection reports. Any service users’ monies kept by the home for safekeeping was retained securely. Any accumulation of money was transferred to a service users’ bank account. Any transactions were appropriately recorded and receipts were given when money or valuables were handed over to the home for safekeeping. Policies and procedures in relation to service users’ monies had been developed to ensure that there was a system in place to safeguard service users’ monies. Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 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 3 x x 2 x 3 x x x Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Timescale for action 15(1) Unless it is impracticable to carry 31.10.05 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. 15(2)(b)(c The registered person shall keep 31.10.05 )(d) the service users plan under review and shall revise the plan in consultation with the service user or their representative, notifying them of any such revision. 23(2)(j) The registered provider must 31.10.05 ensure that sufficient numbers of baths fitted with a hot and cold water supply are available. (Timescale of 12.03.05 not met) 13(4)(a)(c The registered person shall 15.07.05 ) ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety and any unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. 13(4)(a)(c The registered person must 31.08.05 F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 23 Regulation Requirement 2. 7 3. 12, 21, 22 38 4. 19 5. 22 Courtfield Lodge Nursing & Residential Home 6. 27 7. 27 8. 33 ) ensure that the premises to be 23(2)(b)(c used as the care home are of ) sound construction and kept in a good state of repair externally and internally. The registered person must ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. Any unnecessary risks to the health and safety of service users must be identified and so far as possible eliminated, including making the ramp to the external patio safe. (Timescale of 30.04.05 not met) The registered person must ensure that equipment provided at the care home for use by service users or persons who work at the home is maintained in good working order, including the nurse call system, in order to reduce the length of time service users have to wait for a response to their nurse calls. (Timescale of 31.05.05 not met) 23(2)(d) The registered person shall 31.07.05 having regard to the number and needs of service users ensure that all parts of the care home are kept clean. 18(1)(a) The registered person shall 15.07.05 having regard to the size of the care home, the vstatement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. (Timescale of 15.07.05 not met) 26(4) The registered person must 31.08.05 provide the Commission for F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 24 Courtfield Lodge Nursing & Residential Home Social Care Inspection with a monthly written report in relation to the conduct of the care home. 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 11 Good Practice Recommendations The registered provider should review the homes policies and procedures in relation to care of the dying to ensure that all the information as listed within standard 11 of the National Minimum Standards for Care Homes for Older People is incorporated, including that a service user who is dying is able to spend their final days in their own room, surrounded by their personal belongings, unless there are strong medical reasons to prevent this. The policy should also include information on how the other service users and staff at the home are supported and enabled to offer comfort to a dying service user, if they wish to do so. The inspectors recommend that it is established with service users what type of activities would be suitable to individual preferences and needs. The inspectors recommend that those living at the home are given the opportunity to be served a smaller portion at meal times if they so wish. The registered person should consider calculating the ratio of service users to staff in accordance with their assessed needs, in order to ensure sufficient staff are deployed to meet individual needs in accordance with the plan of care. It is recommended that the home continue to work towards achieving 50 of care staff being trained to a National Vocational Qualification at Level 2 or above. The inspectors recommend that an annual development plan be implemented, based on a systemic cycle of planning, action and review, reflecting the aims and outcomes for service users. The quality assurance monitoring system should include feedback from stakeholders in the community to determine their views on how the home is achieving goals for service users. Internal audits should be commenced as part of this process. The results of service users’ should be published so that prospective and current service users are able to see how the home is achieving it’s goals. F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 25 2. 3. 4. 12 12 27 5. 6. 28 33 7. 33 Courtfield Lodge Nursing & Residential Home 8. 9. 33 33 The policies and procedures of the home should be reviewed on a regular basis to reflect changes in legislayion and good practice guidelines. Action should be progressed within agreed timescales to implement requirements identified in CSCI inspection reports. The registered person should make suitable arrangements for the provision of a qualified first aider at all times. 10. 38 Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Courtfield Lodge Nursing & Residential Home F57 F08 S25553 Courtfield Lodge V235120 220605 stage 4.doc Version 1.40 Page 27 - 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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