Inspection on 20/11/07 for Doddington Lodge

This inspection was carried out on 20th November 2007.

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

Doddington Lodge 25/09/06

Doddington Lodge 07/02/06

Doddington Lodge 02/08/05

Doddington Lodge 24/02/05

Doddington Lodge 03/08/04

Doddington Lodge 09/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Doddington Lodge Doddington Hopton Wafers Cleobury Mortimer Worcestershire DY14 0HJ Lead Inspector Martin George Draft - Unannounced Inspection 20th November 2007 10:00 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 Doddington Lodge DS0000055436.V354657.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. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Doddington Lodge Address Doddington Hopton Wafers Cleobury Mortimer Worcestershire DY14 0HJ 01584 890864 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) Chelcare Ltd Suzan Mary Reeves Mrs Suzan Mary Reeves Care Home 41 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (41) of places Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: care home only (PC); to service users of the following gender: either; whose care needs on admission to the home are within the following categories: old age, not falling within any other category (OP) 41, dementia (DE) 30. The maximum number of service users who can be accommodated is 41. 25th September 2006 2. Date of last inspection Brief Description of the Service: Doddington Lodge is a residential care home, located on Clee Hill in South Shropshire. It is registered to provide care and accommodation for up to 41 older people, many of whom have dementia. Accommodation is provided in a large, adapted main house and a purpose built extension. The majority of rooms have en-suite facilities and in the main house the three floors are accessed by a lift. Communal rooms are spacious and the home is set in pleasant gardens and grounds. The home is owned by Ms V Cronk, who has over 25 years experience in the residential care home business. On a day to day basis Doddington Lodge is managed by Suzan Reeves, who is suitably qualified and has had many years relevant experience. The home makes their services known to prospective service users in the Statement of Purpose and Service User Guide. The inspection report is mentioned in these documents and is given out on request. Fees are reviewed annually and range from £400 - £600. Any additional charges are clearly laid out in the terms and conditions. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out by two inspectors between 10:00 and 15:00. As part of the inspection all National Minimum Standards defined by the Commission for Social Care Inspection (CSCI) as ‘key’ were inspected. Information about the performance of the home was sought and collated in a number of ways. Prior to inspection we were provided with written information and data about the home through their annual quality assurance assessment (AQAA). The views of a number of people living at the home and staff working there were also acquired, both through pre visit surveys and during the inspection. Visiting relatives who were present on the day also provided useful information about satisfaction levels of the service provided. Information was analysed prior to inspection and helped to formulate a plan for the visit and helped in determining a judgement about the quality of care the home provides. On the day of the inspection we spoke to staff and service users and observed practice and this provided evidence in support of the records that were also checked on the day. What the service does well: What has improved since the last inspection? The two requirements identified at the last inspection have been met. A bathroom in the Elderly Mental Infirm (EMI) unit has been converted into a wet room. A dedicated activities co-ordinator has been appointed to ensure service users are provided with creative and stimulating recreational opportunities. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 6 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. Doddington Lodge DS0000055436.V354657.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 Doddington Lodge DS0000055436.V354657.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): 1 and 3 Quality in this outcome area is excellent. Service users and their families are provided with information that helps them to make informed decisions about the home before moving in. Pre placement assessments ensure service user needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Service User Guide contains detailed information about what the home provides within the standard fees and details any extra costs. All new residents receive a comprehensive needs assessment before admission. For those being funded the home ensures it acquires assessments completed through care management arrangements and for those who are self-funding a suitably qualified member of staff completes the assessment. Evidence of these were seen by us on residents files. Individuals are supported Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 9 and encouraged to be involved in the assessment process. Information is gathered from a range of sources, including other relevant professionals and family members. Opportunities for prospective residents to visit the home are made available to allow them to familiarise themselves with the surroundings and current residents, helping them feel more comfortable upon admission. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. There is a high level of vigilance given to medication procedures to ensure effective safeguarding of service users. Overall practice within the home is respectful and sensitive to service user needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The quality and organisation of care plans is very good, giving staff comprehensive information about service user needs. Specific risk assessments are carried out where there has been acknowledgment that this is necessary. These are reviewed on a regular basis and were seen on residents care files. Residents who use the service know that they can access their records. This is explained in the service user guide. Past histories are contained within the service user’s personal profiles. There is evidence that assessed needs are incorporated in the plans and that these are regularly reviewed to ensure service user needs continue to be met. We found evidence of regular Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 11 involvement from external professionals, such as Community Psychiatric Nurse (CPN) and General Practitioners (GP’s), to assist the home in providing the best possible level of care. The Medicines Management Officer for Care Homes in Shropshire has helped the home devise a self medication protocol, and minutes of a meeting indicate that she is very pleased with how the home stores and administers medication. It is a service user’s own choice whether to self medicate and they are assessed for competency. All relevant staff have undertaken medication training and an updated policy to cover changes to the law in relation to medication in residential care homes has been shared with staff. This ensures all possible safeguards are in place to prevent harm coming to service users from poor medication practices. Some service users are given their medication crushed, for which there is a specific policy, risk assessment, authorisation from the GP and evidence of consultation with the pharmacist. Medication Administration Records (MAR) are completed satisfactorily and the controlled drugs (CD) cupboard and storage meet requirements. The stock cupboard is well organised, separated into service user compartments, with a photo. We spoke to several service users during the visit and satisfaction with both the home and staff was high. Service users feel their views are listened to and respected and there were no concerns expressed about their right and access to privacy. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. Service users are engaged and stimulated through an imaginative range of activities organised by a creative activities co-ordinator. Meals are varied and responsive to service user preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a part time activities co-ordinator who has developed a very varied choice of stimulating physical, mental and creative activities. We observed an activity on the day of the visit and service users were engaging enthusiastically. Amongst the activities on offer are creative skills and reminiscence, painting for pleasure, bingo, aromatherapy, darts and puzzles. Outings are also organised. There was a recent trip to Bodenham Arboretum and a trip to Burford House is being planned. Families and members of the local community are involved where practical and possible and activities are organised in line with the assessed needs of service users. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 13 Although the home does not use a great deal of home grown food they purchase good quality provisions and all meals are home cooked and regarded highly by service users. The menus provide evidence of a good choice of meals and responsiveness to service user needs and preferences. There is a book in the kitchen detailing exactly what each service user has actually eaten, allowing checks on the nutritional value of each service user’s intake. The cook is proud of her work environment and minutes of meetings evidenced her high level of awareness of how the kitchen area should be maintained to meet the necessary food hygiene standards. The home encourages service users to maintain as much control over their own lives as possible, in areas such as opening their own mail and deciding who they wish to have visiting them. Service users can have their own personal computers (PC’s) in their room and the manager explained how one service user uses his to order online from Tesco. The activities programme is successful in engaging service users in both physical and mental exercises, which helps individuals maintain the maximum level of independence consistent with their physical and cognitive abilities. We spoke to a service user who explained that she chose the furniture in her room and brought in personal possessions too. Several service users confirmed that they can come and go as they please and can rise and retire as they wish. There are little touches that evidence how the home recognises the need to provide a homely environment for service users, such as a fruit bowl in the lounge. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is excellent. The well-being and protection of service users is well managed and staff are trained to a good standard in this area of practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We checked the complaints book, which details all complaints made and how they were addressed and resolved. The culture of the home encourages as much involvement from service users and their families as they are prepared to commit to, and they have a committee that reviews current practice and makes suggestions for improvement. This openness allows service users and their families to feel safe about raising any concerns they may have, knowing their concerns will be taken seriously and acted on where possible. The manager described how she views complaints as part of a process of learning and development. The level of training provided to staff enhances their knowledge and awareness of how best to protect service users from harm and abuse and the manager ensures that refresher training happens too, so keeping the safeguarding of service users as a high priority. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. Service users benefit from the commitment of the home to maintain and improve their living environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment is maintained to a high standard throughout. The home employs a part time gardener to ensure the grounds are kept as a pleasant area for service users. The house is kept to a high standard of cleanliness by a housekeeper and team of domestics. We checked records that showed the home has all necessary health and safety checks carried out, including fire, environmental health, electrics and boilers. There is evidence of an understanding of how important good health and safety standards are in creating an environment that safeguards service users. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 16 A diahorrea and vomiting outbreak in July 2007 was managed effectively; required notifications completed, necessary external professionals involved and clear actions detailed to ensure staff and service users were properly safeguarded. Health and safety related training is comprehensive and a discussion with the manager identified that they are currently putting their staff on more health and safety courses than requirements necessitate and includes manual handling, infection control, fire safety and food hygiene. Service users we spoke to on the day of the visit were very complimentary about the standard of cleaning and the choice and quality of food, a good reflection of the overall standards provided by the staff team. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. Service user needs are being met by a well trained and supported staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA identifies how the home is developing the management skills and qualifications through the Institute of Leadership and Management (ILM) awards and this will impact positively on the overall effectiveness of the staff team and will subsequently benefit service users. The range of skills, knowledge and experience in the staff team ensures the needs of the service user group are well met. Skills and knowledge are regularly developed and updated through a comprehensive training programme. Dedicated rotas have been drawn up for care staff, non-care staff and managers. These make it easy to see how the physical, emotional and practical/administrative needs of service users are met by the home. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 18 We checked staff records and found these to be in good order with all necessary recruitment related documentation kept in well structured files. All necessary checks were evidenced and the files contained evidence of a good induction process, ensuring staff are provided with a level of competence necessary to provide safe care for service users. The manager explained her commitment to getting the whole staff team trained in the Protection of Vulnerable Adults (POVA) but courses are limited in number. The manager has all staff who have so far not attended this training on a waiting list. The training plan is very clear, showing when the required training was undertaken and who attended. It also projects forward, showing dates for refresher training and evidencing the homes’ commitment to ongoing development. Every member of staff has a Continuing Professional Development (CPD) file showing the skills and knowledge they have acquired to better equip them to meet the diverse needs of service users. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. There are good systems in place that provide effective audit trails, evidencing good health and safety and safeguarding practices that are of benefit to service users and staff alike. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management systems that are in place provide a good audit trail of how things have been done, who was involved as well as dates and times being consistently entered on records. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 20 Service user finances are managed or self managed as discussed and assessed with service users and their families. Records we checked showed who dealt with each individual’s finances. The Health and Safety file provided evidence of regular internal and external checks of fire and electrical systems, environmental health issues, Care of Substances Hazardous to Health (COSHH) records, water temperatures, food storage/preparation and infection control practices. The level of vigilance given to this area of practice ensures the everyday safety and well being of service users and the staff team. The Hazard Analysis and Critical Control Point (HACCP) file kept in the kitchen was used consistently and effectively to provide evidence of how the home protected service users from potential risks to their health and well being. The fridge and freezer meet food storage requirements in terms of temperature and labelling. There was slight disruption on the day of the visit due to a new dishwasher being fitted. Areas of responsibility for managers and staff are allocated to ensure a culture of “ownership” is encouraged. Lines of accountability are made clear and supervision of staff is given the appropriate priority. The manager attends all the Shropshire Partners in Care (SPIC) meetings, which encourages providers to share best practice to improve outcomes for service users. A minor shortfall was identified with the manager regarding the absence of risk assessments for room keys for service users with dementia. It was agreed that this would be addressed without delay. Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 4 Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Doddington Lodge DS0000055436.V354657.R01.S.doc Version 5.2 Page 24 - 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!