Inspection on 26/09/08 for Down Lodge

This inspection was carried out on 26th September 2008.

CSCI found this care home to be providing an Good service.

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

Down Lodge 06/09/06

Down Lodge 15/12/05

Down Lodge 28/06/05

Down Lodge 18/01/05

Down Lodge 22/09/04

Down Lodge 16/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Down Lodge 11 Sturges Road Wokingham Berkshire RG40 2HG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Amanda Longman     Date: 2 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Down Lodge 11 Sturges Road Wokingham Berkshire RG40 2HG )1189786484 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Mr Graham Richard Casselden The registered provider is responsible for running the service Name of registered manager (if applicable) Mr Graham Richard Casselden Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 16. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age- not falling within any other category - (OP) Date of last inspection 0 Over 65 16 Care Homes for Older People Page 4 of 25 Brief description of the care home Down Lodge is a care home for 16 older people. It is situated in a residential road, close to Wokingham town centre. The home is situated over 2 floors with a stair lift providing access to the first floor. Fourteen rooms are single occupancy, with one room currently being shared. There is a communal lounge/dining room, which provides access to an enclosed lawned garden. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was an unannounced key inspection. It was a thorough look at how well the service is doing. We (the commission) received detailed information from Down Lodges owner in the form of an Annual Quality Assurance Assessment (AQAA). This provided details of current care provider, as well as plans for the future, details of staff and resident numbers, qualifications and training of staff and information about the health and safety of the home. We also received information from three residents who replied to a questionnaire we sent asking about standards within the home. A site visit was undertaken by Amanda Longman, Regulation Inspector, on 26 September 2008. During this site visit we observed care practices, toured the home and spoke with many of the people who live their, staff and visitors. We also examined a sample of care records, staff records and other records such as minutes of meetings and policies. Care Homes for Older People Page 6 of 25 As part of this inspection process we also reviewed all the information we have received about Down Lodge since the previous inspection. The current fees for the home are between 460 pounds per week and 550 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their needs fully assessed and are assured these can be met before they are offerred a place in the home. Evidence: The information we received from the manager of Down Lodge prior to our site visit stated that all prospective service users are provided with information about Down Lodge, including the Statement of Purpose and Service User Guide. It also stated that pre-admission assessments are always undertaken to ascertain whether or not Down Lodge is able to meet an individuals needs. During our site visit we examined a sample of service user files. These confirmed that pre-admission assessments are undertaken before a place is offerred at Down Lodge. They also confirmed that contracts were in place for privately funded service users. Service users and relatives spoken with on the day of the site visit confirmed they had received enough information to enable them to make an informed choice about moving in to Down Care Homes for Older People Page 10 of 25 Evidence: Lodge. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care needs are detailed in individual plans which are drawn up with their input. They include needs relating to diversity as well as social and health care. Medication procedures are appropriate and people are treated with dignity and respect. Evidence: The information we received from the manager prior to the site visit stated that all the people who live at Down Lodge have a care plan which is discussed with the resident or their representative and regularly reviewed. Care plans were generally signed by the resident or their representative. They have a diversity and equal opportunities policy which was reviewed in July 2008. Diversity is respected including religious needs, race, disabiliaty and sexual orientation and resulting needs are identified in their care plan. During our site visit we examined a sample of four care plans. The home uses the Standex system for recording the needs of people who live their and how these needs will be met. All the records we examined contained detailed information about how their phsical needs, such as bathing and dressing, would be met. Care Homes for Older People Page 12 of 25 Evidence: Care plans also identified other needs relating to, for example, emotional, psychological and personal needs (including cultural, spritual and sexuality). There was not such detailed information as to how these needs would be met. We discussed this with the manager who was confident that because the home is relatively small and does not ever use agency staff they are able to meet these individual needs. This was confirmed in conversation with the manager and his staff who all demonstrated detailed knowledge of the people living there and their cultural and religious needs. Three completed questionnaires were received from residents prior to our site visit which confirmed that the home usually (33 ) or always (66 ) met their care needs. The care plans examined all recorded specific medical needs, medical interventions and contact with other helathcare professionals. Conversations with residents and relatives confirmed that residents can choose their own GP and that consultations happen in private. People spoken with on the day of the site visit also confirmed that their individual needs were met and that Mr. Casseldene and his staff were extremely approachable. Risk assessments were seen to be up to date and regularly reviewed. The previous inspection highlighted a need to review medication practices. This had been done and medication administration records and storage were all seen to be appropriate and accurate. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users enjoy the lifestyle of the home, although they would benefit from a wider choice of activities. Their personal lives are respected and they are supported to maintain contacts as they wish. Evidence: Regular activities are organised within the home which include physical movement activities, religious services and games. There is no specific member of staff responsible for organising activities. The home is close to Wokingham Town Centre and at least one resident walks most days in to town. We observed a religious service on the site visit which was conducted in a manner which was sensitive to other religious persuassions. It was a Church of England service but the clergyman and the staff knew who, for example, was Roman Catholic and catered appropraitely for this. Records showed this service happens monthly. It was obvious on our site visit that relatives and friends are very much welcomed in to the home. One family group visiting on the day of the site visit commented they can turn up any time and are always welcomed. The new conservatory provides space for quiet meetings with family and friends if desired. Care Homes for Older People Page 14 of 25 Evidence: We looked at the records for activities attended on individual care plans. Activities are recorded in residents care plans. However whilst these do include specific activities they also include past times such as watching TV. Feedback from people who live at Down Lodge indicated that they enjoy the activities offerred but would like more activities. Menus are planned in advance. Residents and visitors informed us that the food is usually good. The homes cook has attended training on Safer Food, Better Business and the home received 4 stars in its most recent inspection from the Environmental Health Department. We ate with the people who live in the home on the day of the site visit. The food was of a good standard, choices were offerred, last minute changes in mind were catered for with no problem and satff were seen to appropriately assist and encourage residents with their meals. Drinks and refreshments were avaiable throughout the day. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse and know how to complain should they wish to. Evidence: Information received from the manager indicated there had been no complaints or safeguarding issues since the previous inspection. Up to date policies are in place to deal with these matters and procedures are in place to ensure all staff reveive training in the safeguarding of vulnerable adults. This was confirmed with the manager on the day of the site visit. Questionnaires received from residents prior to our site visit all confirmed that they knew how to complain. We spoke with people who live at Down Lodge and visitors on the day of the site visit. This confirmed that they were all were very clear about who they needed to speak to if they were not happy about something. We discussed with the manager the benefit of recording small complaints or gripes as a way to improve quality assurance and he will look in to doing this. Down Lodge has an up to date copy of the local protocol for dealing with allegations of abuse. Staff are trained in safeguarding procedures and staff spoken with were familiar with these procedures. Everyone who lives at Down Lodge is registered to vote. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a safe and well maintained environment which is homely, comfortable and clean throughout. Evidence: The information we received from the manager prior to our site visit confirmed that all electrical. gas and other appliances have had the necessary safety checks carried out and a random check on the day of our site visit confirmed this. The home has undergone extensive refurbishment during the last two years. Five ensuite facilities have been provided. Our tour of the home on the day of the site visit confirmed that Down Lodge is bright, clean, homely and comfortable. Residents and relatives confirmed the new ensuites are a welcome addition and we saw that all rooms were well furnished and homely. We saw evidence that people who live at Down Lodge are welcome to bring their own furniture should they so wish. A new conservatory has been added which is bright and cheerful. It provides a seperate quiet sitting area and a new station for the hairdressing point. One of the bedrooms does open on to the new conservatory but privacy curtains have been provided, and the person whose room it is is very happy with the arrangement. We discussed with the manager that if this room was let in the future he would have to ensure the new occupant was happy with this arrangement. The manager assured us that a new window could be provided on to the Care Homes for Older People Page 17 of 25 Evidence: garden, from this room. Down stairs, in the home, a new wet room has been provided in a previously little used bathroom and upstairs the two bathrooms have been refurbished with accessible baths. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Down Lodge benefit from being supported by well trained, qualified staff who have been appropriately recruited. Evidence: The home employs 15 care staff, 14 of home are qualified to NVQ level 2 or above. This means the home has a very high proportion of qualified staff. The fifteenth member of staff is currently working towards their NVQ level 2. The owner is in day to day control of the running of Down Lodge and has completed his Registered Managers award. The home does not use agency staff but covers for annual leave or sickness through its own staff. The home operates a shift system of working in the day time when their are usually between two and four members of the care staff on duty. In addition the home has a chef and the manager likes to work hands on to stay in touch with the staff and residents. There is usually only one member of staff on duty at night with the manager or another experienced member of staff on call to assist in any emergemcies. The home currently does not have any residents who require assistance by two care workers at night. We discussed with the manager the importance of undertaking a regular risk assessment to review night time cover. Feedback from residents both before and during the site visit stated that they always received the medical support they needed and that staff were always available when they needed them. Some feedback sated that some residents would like to go out more. Staff Care Homes for Older People Page 19 of 25 Evidence: spoken with stated that they were sometimes able to take a resident out but that most of the residents had families and friends who visited or took them out. Following the previous inspection a requirement was made to ensure appropriate recruitment procedures are always followed. The home has since reviewed it recruitment procedures to ensure all pre-employment checks are always undertaken prior to a member of staff starting work. The manager has also reviewed how training is provided to staff since the previous inspection. All training is now supplied by one provider and a full training programm covering all mandatory subjects was put in place from October 2007.We spoke in detail to one member of staff who confirmed they had received all mandatory training and residents and visitors we spoke with during the course of the day confirmed that staff were well trained and competent. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents at Down Lodge benefit from living in a home which is well managed and where the home is run in their best interests. Their finances are safeguarded and health and safety standards are met. Evidence: The owner of the home is also in day to day charge of the home. He is a business man of many years experience and has undertaken his registered managers award. Residents, visitors and staff all speak highly of his dedication to provide a good quality of care to people living at Down Lodge. One example of this is the very extensive refurbishment of the home which he has undertaken in the last few years. A second example of his approach was that on the day of the site visit the homes chef was absent and the owner was cooking the meals for the day. Evidence also showed that he attends all updates of training with his staff. The home has various procedures in place to ensure quality assurance. These include staff meetings, service user meetings, Care Homes for Older People Page 21 of 25 Evidence: an annual review of policies and procedures and an annual quality assurance survey. Residents and visitors spoken with on the day of the site visit confirmed that the owner is approachable and that any issues they have raised have always been dealt with. The most recent annual quality assurance survey showed a high level of satisfaction. We discussed with the owner the benefit of formally bringing together all the elements of his quality assurance process to formally review the annual performance of the home against its statement of purpose as a helpful way of informing the subsequent years development plan. This could include a mechanism for monitoring minor complaints or requests and suggestions. The manager will look in to this. We saw evidence that residents meetings and staff meetings occur approximately every six months. Down lodges policy regarding residents meetings states they will be held quarterly and we discussed with the manager the benefits of more frequent meetings. The manager informed us that residents and their families manage their own finances but the home will hold small amounts of pocket money on behalf of residents. We checked the financial records for three residents, all were accurate and the money was held securely. We discussed with the owner the benefit of regularly auditing these accounts which the owner agreed to look in to. Down Lodge has in place policies and procedures relating to health and safety. These include, infection control, food safety, manual handling, Control of Substances Hazardous to Health and Accident Reporting. All policies were reviewed in June or July 2008 and staff sign to say they have read and understood them. Water and other temperatures are regularly monitored and equipment is maintained in line with manufacturers recommendations. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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!