Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Courtfield Lodge Nursing & Residential Home 81a Marians Drive Ormskirk Lancashire L39 1LG The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Vivienne Morris Date: 3 0 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Courtfield Lodge Nursing & Residential Home 81a Marians Drive Ormskirk Lancashire L39 1LG 01695570581 01695570885 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Flightcare Limited care home 70 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 23 0 Over 65 0 47 Conditions of registration: The registered person may provide the following category of service only: Care home with nursing - Code N To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 47) Dementia - Code DE (maximum number of places is: 23) The maximum number of people who can be accommodated is: 70 Date of last inspection Brief description of the care home Courtfield Lodge is a purpose built home situated in a quiet residential area close to the town centre of Ormskirk. The home provides both nursing and personal care for up to 70 older people. The accommodation is on two floors, the upper floor being reached by both stairs and a passenger lift. There is a lounge and dining room on each floor. The rooms are predominantly single but facilities are available if people choose to Care Homes for Older People Page 2 of 9 share accommodation. The bedrooms all benefit from the provision of en-suites. Those living at the home are encouraged to personalise their bedrooms with their own belongings. The menu provides a variety of food choices, although alternatives are available if desired. Specialised diets are catered for if required and people can eat their meals within the privacy of their own rooms, should they so wish. The service users guide, which contains relevant information about the home, including the most recent inspection report, is given to people who are thinking about living at Courtfield Lodge, so that they are able to make an informed choice about where to live. The scale of charges as at 20th September 2007 ranged from £386 to £504 per week. Additional charges were being incurred for hairdressing, newspapers/magazines, toiletries, private transport and private chiropody. Care Homes for Older People Page 3 of 9 What we found:
When we toured the dementia care unit we found that people living there looked clean and well presented. We found that only one senior care assistant was trained to administer medications on the dementia care unit at night time. Therefore when this person was not on duty the nurse from the ground floor administered the medications throughout the home, resulting in some people on the dementia care unit receiving their 10pm medications quite late. Records showed that some members of staff had received training in the safe handling of medications, but this training only covered one senior care assistant from night duty, who had also achieved a recognised qualification in care at level 3. The Medication Administration Records on the dementia care unit were appropriately signed when medications had been administered. We found only one bedroom door to be locked at the time of our visit to the dementia care unit and this had been reportedly requested by the relatives of the person living in this room in order to reduce the possibility of his belongings being disturbed by fellow residents. However, there was no written information available to confirm this statement. Records showed that there were two members of staff on duty on the dementia care unit at night time with 22 residents, some of whom were very wandersome, spending long periods of time out of their bedrooms during the night and who needed a lot of observation and care intervention. We also found that there was a high turnover of staff and that an excessive amount of agency staff were being used, therefore, although the agency staff were, in general, the same ones, this situation was not ideal for the people living at the home. Records showed that, where necessary, the observation of individuals living on the dementia care unit was increased at night time, in accordance with identified risks. However, due to only two staff members being deployed on this unit we were not certain that increased observation could be effectively implemented. We found that at the time of our visit to the dementia care unit there were no unpleasant smells evident and that the standard of cleanliness was good, providing people living there with a comfortable environment in which to live. We noted that the beds were made by mid morning with good quality bedding and that dinner plates were collected shortly after lunch time so that the unit looked tidy and clutter free. We found that although the environment was clean and hygienic, the hours of domestic input was not enough for the size and layout of the home and that due to some sickness care staff had been responsible for domestic duties at weekends, which was not an ideal situation as this was taking them away from their caring duties and the risk of cross infection was increased. What the care home does well:
Care Homes for Older People
Page 4 of 9 People living on the dementia care unit looked well presented and cared for. Some members of staff had received medication training and had achieved a recognised qualification in care at level 3. The Medication Administration records on the dementia care unit had been appropriately completed to ensure safe handling of medicines. We found the home to be clean, tidy and free from any unpleasant smells, providing people with a comfortable environment in which to live. Positive comments were received from an agency care worker and other people spoken to during our visit to this service. A duty rota was in place showing which staff were working at any time of the day or night and in what capacity they were employed so that the skill mix of staff could be easily identified. What they could do better: 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 15(1) The registered person must 31/10/2007 give all residents or their representatives the opportunity to be involved in the planning of their care to ensure that the care provided is in accordance with their wishes. The registered person shall 30/11/2007 having regard to the size of the care home and the number and needs of service users: Make arrangements to enable service users to engage in local, social and community activities, and consult service users about the programme of activities arranged by or on behalf of the care home. (Timescale of 31/08/06 not met). 2 12 16(2)(m)(n) Care Homes for Older People Page 6 of 9 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 1 27 18 Staffing levels at night time 15/02/2009 on the dementia care unit must be reviewed to ensure that enough staff are on duty to supervise the people in their care. To ensure that the health and safety of people living on the dementia care unit are always protected. 2 38 13 Risk assessments must be conducted for people who have or their relatives have requested their room doors to be locked when they are not in their bedroom. To reduce the possibility of people being mistakenly locked in their bedrooms. 15/02/2009 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 9 Additional care staff should be trained to administer medications on the dementia care unit at night time to allow those living there to have an earlier night if they
Page 7 of 9 Care Homes for Older People choose to do so. 2 26 Domestic hours should be reviewed so that these staff are deployed evenly throughout the week and some forward planning should be conducted so that known absences are covered in advance. It is recommended that due to the size and layout of the home there is one domestic working on each floor every day to ensure that the standard of cleanliness is maintained. It is recommended that enough permanent staff are recruited so that the use of agency staff is reduced in order to enhance the continuity of care. It is recommended that the home implements strategies of forward planning to cover known absences in advance so that staffing levels are more appropriate to meet the needs of those living at the home. It is recommended that written agreement is sought from residents or their relatives, who have requested that their room doors are locked when their bedroom is vacant. 3 27 4 27 5 38 Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 9 of 9 - 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!
