Inspection on 10/12/07 for Courtland Lodge

This inspection was carried out on 10th December 2007.

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.

Other inspections for this house

Courtland Lodge 20/12/06

Courtland Lodge 26/01/06

Courtland Lodge 14/06/05

Courtland Lodge 28/02/05

Courtland Lodge 27/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Courtland Lodge Courtlands Drive Watford Hertfordshire WD1 3HR Lead Inspector Mrs Alison Butler Key Unannounced Inspection 10:50 10th December 2007 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 Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Courtland Lodge Address Courtlands Drive Watford Hertfordshire WD1 3HR 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) 01923 681231 01923 689867 www.quantumcare.co.uk Quantum Care Limited Amanda Liles Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2006 Brief Description of the Service: Courtland Lodge is a purpose built two-storey building providing sixty residential places in four self contained units. Four of the bedrooms are used to provide respite care. All bedrooms are for single occupancy and each has an en-suite toilet and wash hand basin. Each of the units has a dining room, kitchenette and lounge. A day centre, the main kitchen, laundry, reception area, communal sun lounge and the administrator’s office are located centrally on the ground floor. The home has a landscaped garden and ample off road parking. It is located close to a parade of shops that offers a variety of retail outlets and a Post Office. There is a local bus service that provides easy access to the town centre. Information regarding the service is available in the Statement of Purpose and Service User Guide. For these, a copy of the most recent CSCI inspection report or up to date fee information contact the home manager. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written following an unannounced visit to the service where an expert by experience (ex by ex) accompanied the inspector. An expert by experience is someone who has some previous insight into residential care provision. Their views have been incorporated into this report. The report includes information already known to the Commission. Time was spent talking to and observing the staff at work. Talking with residents and visitors to the home. Discussions also took place with the manager. Care records were also examined. Where information remains the same this has been brought forward into this report. What the service does well: What has improved since the last inspection? The medication procedures have improved since the last inspection as a regular audit is carried out and any errors are followed up promptly. The activity hours have increased and this in turn has promoted more choice for the residents and allows for some one to one support for those who do not which to join in with certain activities. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 6 Capital Grant funding has been gained and this has allowed for the home to provide a shower facility and improve the other bathrooms. There is also some funding that it to be used in landscaping the garden, which will happen in the spring. 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. The summary of this inspection report can be made available in other formats on request. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that a full assessment is carried out prior to admission to ensure their needs can be met at Courtlands Lodge. EVIDENCE: Examination of a newly admitted residents care plan showed that a full assessment had been carried out prior to admission. This formed the basis of a more detailed care plan to meet people’s individual needs. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Courtlands Lodge can expect that their health and personal care needs will be set out in care plans for staff to follow which ensures that they receive the care they require and are treated with dignity and respect. People living here can also be assured that they will be safeguarded by the medication policies and procedures in place. EVIDENCE: Four care plans were examined. Two were very detailed and provide the action required by staff to meet individual needs. Whilst the other two did not provide very detailed information on meeting individual needs, or promoting what they are able to do themselves. One individual has some behavioural issues but there is no plan in place to support them and the staff in managing this. The area relating to communication states “struggles with words” but there was no information on how staff can support this persons communication needs. Additionally information was not consistent throughout the plans as the health Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 10 form for one individual states they have no type of dementia, where as the risk assessments summary states “suffers from dementia”. Daily notes are very brief and do not give you an overall feel as to how needs are met and the well being of individuals. Individuals names and date of birth are not noted on each sheet and this could lead to misfiling and confusion in providing an individuals care. Risk assessments contain a lot of information that is not relevant to the individual and makes it difficult for staff to absorb what the control measures are in place. Health needs and visits by the doctor are recorded within the care plan and followed up as required. A check on medication was carried out and an auditing process is in place and errors are picked up quickly and action taken, although it is not always recorded within the folder. The manager stated that she would ensure that this is done in the future for all errors that have been noted. One person’s medication had not been given as they were still sleeping, this information had not been transferred to the daily record sheet so staff are able to monitor any effects this may or may not have had on them. Residents were complimentary about the care they received and stated “the staff are lovely” “ they are always busy”. They feel they are treated with dignity and respect and that staff always knock on their doors before entering. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Courtlands Lodge can expect to be offered a range of social activities, which meets their needs, preferences and expectations. EVIDENCE: There are three activity co-coordinators employed who consult with the people who use the service and find out what they like to do. When activities take place they encourage individuals to join in. They also provide one to one activities for those who prefer this. There are a number of photos around the home capturing various activities and showing that a good time was being had. One resident assist in walking a dog in the garden and they very much enjoys this. Observations made by the ex by ex were “It appears that the operation was “task lead” with staff so busy with various tasks that they have very little time to have a conversation or socialise with their charges. Having said that, I did observe one lady having a hand massage and another having her nails done”. The activity co-ordinators arrange and stimulated residents with a variety of activities from a cooking club to general sing song; visits to the local Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 12 pantomime or concert parties at the home. It is they who have one to one conversations with the residents and help out at meal times. Residents were complimentary about the food on offer and there is a choice although if they do not like the choice on offer the chef is able to offer them alternatives. Likes and dislikes are recorded within their care plans and the chef will visit individuals on the units to ensure they are happy with what is on offer. The Ex By Ex observed how lunch was delivered and her observation was noted as follows. The trolleys were taken to each of the dining rooms from a central kitchen. Unfortunately, they could not tell if the trolley had been plugged in on arrival on the unit. There were five staff helping the residents, two of whom were the activity staff. Several residents did not wish to have their lunch in the dining room, so tables were set up in the lounge area. One very disabled person was handfed in the lounge and one was handfed in her room. Lunch was delayed as the “lifting belt” was mislaid and there was a shortage of a wheel chair. Once the lifting belt & wheelchair had been located, the residents were moved into the dining area. Those that need to be moved were done carefully and with dignity. There was a choice of main course, which looked appetising, & plenty of it. One very disruptive resident was treated with great patience. If she didn’t get what she wanted, she screamed. She wanted her meal NOW & was banging a fork on the china plate. She was gently persuaded to relinquish the fork. When the meal arrived, she decided that this was not what she wanted after all so the alternate meal was provided immediately. Help was provided to any who wished it, to cut up the meal and, as it was fish on the menu, look for bones. None of the residents that I observed at lunch were left unattended or ignored. The ex by ex spoke to a number of residents and this is what was noted. One person of 92 was very homesick and wanted to go home as soon as possible. They thought they had been there a fortnight but had been there nine months. This was also true of another person that she (the ex by ex) met and chatted with. One sprightly gentleman upstairs had been there 2½ years. His family lived near by. He said, “He was very happy there and the staff could not be kinder.” Relatives are able to visit the home at any reasonable time and are offered hospitality. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Courtlands Lodge and their family’s can be confident that their views, concerns and complaints will be listened to and acted on. EVIDENCE: Staff confirmed they have received training in safeguarding and are clear on how to respond to any allegations made known to them. A complaints procedure is in place and available to all who enter Courtlands Lodge. The complaints that have been received by the home have been dealt with and recorded appropriately and provides an audit trail. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Courtlands Lodge benefit from a well maintained environment that is kept clean and fresh. EVIDENCE: A tour of the building showed that it remains well maintained. No odours were detected and the home was cleaned to a good standard. The seating in Sherwood and Hazelwood is looking tired and consideration should be given to replacing it. Hazelwood needs additional seating to accommodate all the residents, as they appear to only have ten and they are able to accommodate fifteen residents. Whilst observing the serving of the morning drink, there were not enough small tables available for residents to put there drink on and some people were having difficulty holding their drink for a period of time. Staff were assisting Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 15 them but would then put it on a table in the middle of the lounge, which was out of their reach, and then they would return to offer it to them later as they were assisting a number of residents. The ex by ex was given a tour of the home by a care team manager and noted the following: The rooms look in good order & there is a very pleasant 1940’s style quiet room which is popular with some residents. However, some of the furniture in the upstairs lounge looks well used &“tired”. The home have received some capital funding grant which is allowing them to have a walk in shower fitted into one of the bathrooms, a further two bathrooms are being replaced this allows for more choice as a shower has not previously been available. They are also going to landscape the garden in time for the spring. The lighting is being replaced in the dementia units to make it brighter. The laundry has had some additional shelves fitted to give more space when sorting out the washing. Residents appeared well dressed and were happy with the laundry service. The home have had a recent outbreak of diarrhoea and vomiting which involved input from the infection control nurses and appropriate measures were put in place to protect all who live and work at Courtlands Lodge. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Courtlands Lodge can expect to have their needs met by appropriate numbers of staff who have been appropriately recruited and are adequately trained to ensure that all are safeguarded. EVIDENCE: Previous inspections have shown that robust procedures are in place when recruiting staff and all appropriate documents are received prior to a position being offered. Staff spoken to were happy in their job and there was good teamwork observed. The company have an on going training programme and records are kept to ensure staff are kept updated with their skills. There are four internal NVQ assessors and five in house trainers who provided support and training for staff at Courtlands Lodge. Adequate numbers of staff are available to meet the needs of the residents. Additional staff have been brought in to cover individuals when required. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Courtlands Lodge can be confidant that the home is well managed and is run in their best interests and that their health, safety and welfare will be promoted. EVIDENCE: The manager has been in post for two has holds an NVQ level 4 and her Registered Mangers Award. There is an effective system in place for managing monies for those people who are unable or choose not too. The company employ an auditor who carries out a yearly audit of monies within the home. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 18 Good recording systems are in place for the auditing of accidents and incident that affect the well being of the residents. An annual forum is arranged and this gives families and friends the opportunity to come along to the home and find out the results of the annual questionnaires and they are given the opportunity to ask questions about the service and hear any plans for the future. Health and safety systems are in place with regular checks being carried out on fire equipment, moving and handling equipment, any maintenance issues are recorded and dealt with appropriately this is to ensure that all who enter Courtlands Lodge have their health, safety and welfare promoted at all times. Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations The care plans and daily should be more detailed and consistent throughout to ensure that staff are clear on how to meet individuals needs and areas of need are identified and changes made as necessary. Furniture should be replaced as required when it becomes worn and there should be enough furniture made available in each unit to meet peoples needs e.g. seating & small side tables. 2 OP19 Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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 Courtland Lodge DS0000019325.V352583.R01.S.doc Version 5.2 Page 22 - 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!