Inspection on 18/05/05 for Crowborough Lodge

This inspection was carried out on 18th 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.

Other inspections for this house

Crowborough Lodge 07/06/07

Crowborough Lodge 13/07/06

Crowborough Lodge 19/12/05

Crowborough Lodge 05/10/04

Crowborough Lodge 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Crowborough Lodge 2 Crowborough Road Saltdean East Sussex BN2 8EA Lead Inspector Merle Blakeley Unannounced 18 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. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Crowborough Lodge Address 2 Crowborough Road Saltdean East Sussex BN2 8EA 01273 302614 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) Evans Care Ltd Mrs Bernadette Mary Weller Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (OP) 23 of places Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is twenty-three (23). 2. The residents will be sixty-five (65) years or over on admission. Date of last inspection 5 October 2004 Brief Description of the Service: Crowborough Lodge provides care and accommodation for up to twenty-three older people who generally do not have a high level of need. The home is a large detached residence with sea views and is situated in a quiet residential area off the A259 main south coast road in Saltdean. Local transport, shops and other amenities are located close by. Accommodation is provided on three floors and there are currently fifteen single rooms and four shared rooms. Communal areas consisist of a large and small lounge, dining area, sunroom and a small garden area to the rear of the building. There are current plans to expand the service, as Evans Care Ltd has purchased the adjoining property. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over a period of seven hours on 18th May 2005. The inspection process included speaking with eight of the residents, a brief chat with a visitor, a tour of the premises, lunch with residents, document reading and informal talks with the owner, manager and the staff team on duty. What the service does well: What has improved since the last inspection? Although this was the first inspection of this home carried out by this particular Inspector all requirements that were made at the last inspection have been carried out. Radiator covers have now been installed and the complaints procedure has been updated. The home was also required to ensure that staff supervision was carried out at least six times a year and that all new staff received a TOPPS based training induction programme. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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 Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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) 3,4 & 5 The service ensures that a pre-assessment check is carried out on all new prospective residents to ensure that the home can meet their needs. Trial visits are offered. The home does not provide emergency admissions or intermediate care. EVIDENCE: Before a new resident moves into the home the manager will normally visit the person in their own environment to gather information and to ascertain as to whether the home can meet their needs. A specific form is used for preassessment checks and this includes observing the person’s health needs, mobility, social, mental, emotional and personal needs. Both the home and the prospective resident need to be assured that these needs can be met if they move into Crowborough Lodge. After the initial assessment the prospective resident is invited to visit the home and stay for coffee, lunch or supper to chat with the current residents. They are also offered overnight and weekend stays and this provides new residents with the opportunity to see whether the home is the right place for them. Once a resident has moved into the home they are offered a four-week trial period, which means that if they wish to leave they are under no legal obligation to stay. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8, 9 & 11 In discussions with residents and reading care plans it was evident that their health care needs are being met. Medication administration and procedures appeared efficient and staff have received training. Information regarding death and dying is recorded in some residents care plans. EVIDENCE: Residents who were interviewed stated that they felt their health care needs were being met by the home. Care plans showed that doctors, chiropodists, opticians, dentists and district nurses all visit the home. One resident has a catheter in-situ and the district nurses attend to this on a regular basis. One resident is also awaiting a re-assessment. Staff will always accompany residents to medical appointments if there are no family or friends available. Medication charts and the administering of medicines were viewed during the inspection. The staff must remain extra vigilant around residents who are experiencing problems taking certain types of medications. All staff have attended medication training and they displayed a good level of knowledge and understanding of residents care and welfare needs. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 10 The last wishes of some residents have been recorded and the manager stated that she still needs to request information from the remaining residents. The home will roster on an additional staff member to remain with a resident who is very ill or dying, particularly if they have no immediate family or friends. The manager stated that the care of ill or dying residents is managed with care and sensitivity. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 The home has a quarterly activities timetable displayed although some residents stated that there was not enough to do. Residents are able to have visitors at most times of the day. Residents are offered a traditional menu and options are available. EVIDENCE: The home has a social activities programme, which includes one to one chatting (this is where a resident spends time on their own with a staff member), sing a long session, pub visit and film afternoons. A local church also carries out a monthly service in the home. A summer fete is being organised in the next couple of months. A number of residents were asked about whether they felt the home offered them enough activities during the day. Several said that they would like more ‘things to do’. This was discussed with the manager who stated that they are intending to discuss social activities at the next residents meeting. This will be looked at again during the next inspection. Residents are able to have visitors at most times of the day and many of the residents are in contact with family and friends. A visitor was asked whether they felt welcome at the home and the reply was very positive. The visitor said they found staff to be friendly and caring. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 12 A traditional four weekly menu is offered to residents with such meals as Roasts, Lancashire Hotpot etc. The inspector was able to enjoy lunch with some of the residents who stated that overall they enjoyed the meals. Other meal options are available and staff will go around to each resident on a daily basis to see which meal option they would prefer. The home employs three part-time cooks and five teatime helpers. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a complaints policy and procedure. Staff have attended in-house training on adult abuse, however it is recommended that staff attend a local authority adult protection training course, which provides more ‘hands on’ experience for staff. EVIDENCE: The home has produced a suitable complaints procedure, which includes a 28day response. The home has received one in-house complaint from a family member, which was dealt with immediately and in a very positive manner. Staff have attended in-house training in adult abuse, which involved video training. The inspector felt this training was not so effective as the manager had not been formally trained to deliver it. Staff will be required to attend formal training in adult protection as it provides a much more ‘hands on’ approach and thereby gives staff a better understanding. Video training could then be possibly used as a refresher course. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20,22,24 & 25 Residents have access to suitable communal areas. Additional adaptations have been provided. Resident’s rooms were found to be in good order and personalised with their own possessions. The home will need to review the use of free standing electrical heaters in two of the rooms. EVIDENCE: Residents have access to several communal areas, which include a large and small lounge, dining area, small rear garden and a very pleasant sunroom that has panoramic views of the sea. The home has been assessed by a suitably qualified person who has ensured that any additional equipment or adaptations for this client group have been met. Grab rails, ramps and assisted baths have been installed. A number of resident’s rooms were viewed and all appeared comfortable and well furnished. Many of the residents have brought in their own small possessions, which make the rooms much more personalised. Residents felt that their privacy was respected and staff knock before entering a person’s room. There are four double rooms in use and the owner stated that these residents had made a positive choice to share. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 15 The vast majority of radiators within the home have been covered as required. The owner did feel that there were another two radiators that also required covering. In two residents bedrooms the inspector viewed freestanding heaters, which are not suitable for this type of care home as the risk to residents is very high. Some residents have requested additional heating in their rooms as they tend to feel the cold a lot, however if the home provides additional heating it must be wall mounted so as to prevent any accidents or injuries that can occur with freestanding heaters. Hot water temperatures are recorded regularly so as to ensure that water is delivered at a safe temperature. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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 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) 28, 29 The home has a very stable and caring staff team. To date one staff member has obtained an NVQ qualification. Staffing information for newer members of staff is up to date, however files that were inherited from the previous owners of the home do need updating. EVIDENCE: The home has a stable staff team who provide a very friendly and caring environment for residents. Staff were observed to meet residents needs in a warm and friendly manner. Residents were asked about how the staff team cared for them. The responses were all very positive with comments such as ‘I am treated very well here’ and ‘staff are very cheerful, kind and friendly’. One night staff member has gained the NVQ Level 3 qualification and two staff are due to complete NVQ Level 2 very soon. Two more staff will be due to commence their NVQ Level 2 training this year and another two are due to start NVQ Level 3. The home will be hoping to encourage more staff to complete NVQ training in the future, so that 50 of the staff will eventually be trained to NVQ Level 2 and above. The home currently employs a total of fifteen carers. Staffing recruitment files were viewed and all recent appointments include the information as set out in Schedule 2 of the National Minimum Standards. When the home was bought by Evans Care Ltd a lot of the staff stayed on and remained working in the home. Consequently some of their files do not contain adequate information regarding references, proof of identity etc. This was discussed with the owner who stated that he would apply to the previous owners for references. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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 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) 31, 32, 36 & 38 The home is well managed by a very approachable and experienced manager. The management approach of the home is open, friendly and caring. The home ensures that the health and safety of both residents and staff is protected. EVIDENCE: The current registered manager of the home has twenty-five years experience of working with older people and she has commenced the NVQ Level 4 training in Care and Management. It is hoped that this qualification will be completed by October 2006. Residents and staff were asked about how the home was managed and they replied that they felt it was managed in a very friendly, helpful and approachable manner. The views of both residents and relatives are sought during the regular meetings that are held in the home. Resident’s finances were checked and were found to be in order. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 18 The home carries out regular fire drills and staff have attended courses on manual handling, food hygiene, first aid, medication, fire safety and infection control. An Environmental Health Check was carried out in February 2005. As mentioned previously on page 15, the home needs to replace the freestanding heaters in two of the bedrooms. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x 3 x 3 2 x STAFFING Standard No Score 27 x 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 x x 3 Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 20 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. 2. 3. Standard OP18 OP25 OP29 Regulation 13(6) 13(4)c Schedule 2 Requirement That all staff attend formal Adult Protection Training. That the two freestanding heaters are replaced with wall mounted heaters. That all staff recruiment files contain the required information as set out in Schedule 2 of the National Minimum Standards. Timescale for action 30/9/05 30/9/05 30/9/05 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. 2. Refer to Standard OP12 OP28 Good Practice Recommendations That staff record a list of additional activities that residents would like to participate in. That more staff are encouraged to commence NVQ Level 2 training. Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Crowborough Lodge H59-H10 s37605 Crowborough Lodge v222982 180505 Stage 4.doc Version 1.20 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!