Inspection on 02/06/05 for Dale Lodge Residential Home

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Dale Lodge Residential Home 29/01/07

Dale Lodge Residential Home 18/10/05

Dale Lodge Residential Home 17/11/04

Dale Lodge Residential Home 23/06/04

Similar services:

Deepdene Care Centre

Ferndale Residential Care Home

David Gresham House

Elizabeth House

Elvy Court Nursing Home

Fontenay Nursing Home

Clairmont Residential Home

Cornford House

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

CARE HOMES FOR OLDER PEOPLE Dale Lodge Residential Home Dale Road Southfleet Gravesend Kent DA13 9NX Lead Inspector Harbinder Ghir Unannounced 02 June 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. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dale Lodge Residential Home Address Dale Road Southfleet Gravesend Kent DA13 9NX 01474 834877 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) Nicholas James Care Home Ltd Miss Rosalyn Ester Kelly CRH Care Home 20 Category(ies) of Dementia (20) registration, with number of places Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17 November 2004 Brief Description of the Service: Dale Lodge is one of a group of care homes managed by Nicholas James Care Homes Limited. The home offers 24-hour care to 20 people over the age of 65 years, who have a diagnosis of dementia. The accommodation is split between 2 floors in four double and twelve single bedrooms. One double room has a ensuite facility. All rooms are spacious, airy and bright. They all have hand basins, TV points and a call system. The home is close to local services and facilities within Kentish Village, South fleet. Public Transport is nearby as is the A2 providing links to Gravesend and Blue water. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 2006. The visit lasted from 10.00am to 2.30pm. The home is currently has one vacancy. On the day of the inspection 2 care staff, group manager, residents and relatives were also spoken with, some records were examined and parts of the premises were inspected. What the service does well: What has improved since the last inspection? What they could do better: Each service users care plans should be in sufficient detail to provide clear guidance to staff on the actions to be taken to meet all aspects of their health and welfare needs. Residents social needs could be better met by arranging more outdoor trips and activities. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 6 The staff composition within the home needs to be increased to meet the needs of residents and to relieve care staff of domestic duties. Staff training needs to be reviewed urgently. The home urgently needs to update staff training files and devise an up to date training matrix and provide relevant training to ensure the needs of residents are met. The home also needs to provide regular maintence checks around the home. 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. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 The homes Statement of Purpose and Service User Guide is adequate and provides sufficient information for prospective residents to be clear about the services the home provides to meet their needs. The admissions procedure needs to be improved to ensure that there is a proper assessment prior to residents moving to the home. Without this there is no assurance that care needs will be met. EVIDENCE: Although detailed and comprehensive, the statement of purpose and service user guide was not appropriately separated and easy to follow. Both documents needed to be updated to include the qualifications of new staff. The document was not readily available in the home and had to be requested for it to be seen. The last inspection was also not readily available. The current pre-admissions assessment is very brief and generalised. Not all care plans seen contained a full-completed pre-admissions assessment. The home is in the process of devising a new pre-admissions assessment format. Residents and families are offered to visit the home prior to admission and are admitted to the home on a temporary basis for 4 weeks. Intermediate care is not provided at the home. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 9 Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 The care planning system is not clear and consistent to provide staff with the information they need to meet resident’s needs. These shortfalls have a potential to place residents at risk. EVIDENCE: Individual plans of care are available but information in relation to aspects of health, personal and social care needs is generalised, brief and basic. Care plans identified risks but lacked detailed information on preventative measures. Care plans were reviewed monthly, however the review/evaluation forms were not completed on file, to reflect changing needs. Daily entries of case recording seen on one care plan were generalised, repetitive and very brief. The group manager informed that they are to introduce a new comprehensive care plan format. Records seen indicated that residents were able to have access to appropriate health care professionals as and when required. Regular visits by the optician and dentist were recorded in the care plans seen. Residents felt that staff were kind and gentle this was confirmed by observation. Staff were seen to be very considerate of the age and dignity of Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 11 residents and to treat them with courtesy. Privacy was maintained through lockable toilet and bathroom doors and residents could make telephone calls in private. Appropriate screening was provided in all shared rooms. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 The meals in this home are good offering both choice and variety and catering for special diets. Progress needs to be made in provide more daily social activities for residents. EVIDENCE: Residents were offered a choice of two meals at breakfast, lunch and teatime. Staff verbally asked residents what they would like to eat no pictures were used. Meals were well presented. One residents spoken to stated that the meals were lovely and that the portions are a good size. Another informed that they are offered plenty of choice and that the cook is always prepared to make something else if the menu on the day is not to your taste. The cook, taking into account allergies and special dietary needs, plans a 4week menu. The menu seen was very brief and did not detail what vegetables were on the menu. The menu could not be found in the main dining room. The cook informed that she is in the process of revising the menu format and for it to be readily available to residents. Resident’s likes and dislikes were recorded in the care plan seen. However, it was advised that a daily log of all individual nutritional intake is recorded for each resident. This information could not be found in individual care plans. Residents were not offered any activities at the time of inspection. The home has an activities co-ordinator who comes in twice a week for 2 hourly sessions. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 13 The home does not have a weekly programme of activities. One resident informed that they do not go out. The group manager informed that they are to increase activity hours to 14 hours per week. Relatives were welcomed to visit at any reasonable time. There is not a designated visitors room within the home. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not Inspected EVIDENCE: Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,25,26 Residents benefited from living in a warm, clean personal and communal accommodation, although their comfort would be enhanced by additional maintenance. Residents were put at some risk due to hot water temperatures and infection control issues. EVIDENCE: The premises were comfortable, airy, clean and free from offensive odours. Furnishings and fittings are of reasonable quality, domestic and unobtrusive. The home has 1 large and 1 smaller dining room and 1 lounge, which are homely and comfortably furnished. The bath on the ground floor is out of order. Current bathing facilities are inadequate for the number of residents at the home. The gardens to the rear of the home were not well maintained. The temperature of the hot water was tested at several outlets and was not at a safe temperature. The water temperature before bathing is also not checked or recorded. Regular maintenance checks are required. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 16 Service user rooms were decorated and furnished according to the wishes of the occupant. Appropriate screening was provided in all shared rooms. All rooms are lockable which staff can override in an emergency. The storage of equipment safely needs to be reviewed by the home to reduce the risks if infection. Staffs were not seen to effectively maintain infection control to promote residents’ health. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Progress needs to be made in addressing staffing shortages and as a result residents do not receive consistent care. EVIDENCE: The staff duty rota was seen; this showed that staff were working additional hours in order to cover vacancies. This was especially apparent with the day staff covering night shifts. Staff are also completing laundry duties whilst they are on shift and are expected to cover the cooks and domestic’s staff duties when there is no cover. One member of staff spoken to stated that doing too many jobs whilst on shift was becoming stressful and informed the morning is taken up completing laundry tasks. The staff member was considering leaving the home. The group manager stated that the home is aware of staff shortages and are in the process of positions being advertised. Staff were observed to respect residents and were accessible and approachable. The home has a 50 ratio of a NVQ trained staff team and benefits from permanent staff team. The staff files of two members were seen which indicated all the necessary recruitment checks had been completed to ensure the protection of residents. However, the home needs to be more robust on seeking good character references and completing POVA checks. As one file seen had a very brief reference. Staff received a comprehensive induction programme. However. staff training needs to be urgently reviewed by the home. There was no current staff-training matrix and one seen for the previous year was not Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 18 accurate. Staff files need to be better organised and collated, as information was difficult to locate and find. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, 37 The management of this home is satisfactory overall but records are not well managed. Residents’ rights and best interests and staff confidentiality would be better safeguarded by improved confidentiality in record keeping. EVIDENCE: On tour of the premises staff and residents records were not found to be kept in a safe and secure place. There was no evidence of regular staff supervision taking place. The one staff file seen with the last supervision recorded in 2003 confirmed this. One member of staff spoken to stated that she could not remember the last time she had supervision. Another spoken to was not sure what staff supervision was. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 20 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 2 x 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 2 COMPLAINTS AND PROTECTION 2 2 2 x 3 3 2 2 STAFFING Standard No Score 27 1 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 2 1 x Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 21 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 27 Regulation 18 (1) (a) Requirement The registeried, person shall, having regard to the size of care home, the statement of purpose and the number and needs of service users ensure that at all time 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. In that: appropriate numbers of staff are on duty at all times to meet the needs of service users. Domestic staff are employed to complete laundry tasks. The registered person shall ensure that persons working at care home are appropriately supervised. In that: staff are regularly supervised. The registered person shall ensure that the record referred to in sub-paragraph (a) is kept securely in the care home. In that all service user and staff records are kept in a locked and secure place at all times. The registered person shall, having regard to the size of the care home, the statement of Timescale for action 31.06.05 2. 36 18 (2) 31.06.05 3. 37 17 (1) (a) (b) 31.06.05 4. 30 18 (1) (a) (c) 31.06.05 Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 22 purpose and the number and needs of service users (a) 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;) ensure that the persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. In that an up to date training matrix is devised and staff appropriate training to meet the needs of residents. 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. 3. 4. Refer to Standard 1 1 3 7 Good Practice Recommendations It is recommended that the Statement of Purpose and Service user guide are updated and format is made easier to follow. It is recommended the Statement of Purpose and Service user guide and the last Inspection report is readily available within the home. It is recommended that Pre-assessments are more comprehensive. It is recommended Care plans are more comprehensive and daily records are recorded in detail, and daily individual records of nutrional intake are also recorded in detail. It is recommended that more hours are designated to social activities. It is recommended daily menus are readily available for H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 23 5. 6. 12 15 Dale Lodge Residential Home 7. 8. 9. 10. 11. 19 20 13 21, 25 26 12. 29 residents and relatives to view within the home. It is recommended grounds to the rear of the home are regularly checked and maintained to reduce risks to residents. It is recommended that grounds to the rear of the property are better maintained. It is recommended more outdoor trips and activities are organised. It is recommended bathing facilities within the home are increased to meet residents personal hygiene needs. It is recommended storage of healthcare equipment are adequalty stored within the home to reduce the risk of infection. Items not to be stored in the sluice room or the 1st floor office. It is recommended that POVA checks are completed for all newly recruited staff and further references are seeked where adequate references have not been provided. Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Dale Lodge Residential Home H56-H06 S23936 Dale Lodge V230680 020605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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