Inspection on 05/07/05 for Earlfield Lodge

This inspection was carried out on 5th July 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

Earlfield Lodge 02/06/08

Earlfield Lodge 09/07/07

Earlfield Lodge 29/08/06

Earlfield Lodge 21/12/05

Earlfield Lodge 08/11/04

Earlfield Lodge 10/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Earlfield Lodge 29 Trewartha Park Weston Super Mare North Somerset BS23 2RR Lead Inspector Alison Murray Announced 5 July, 2005 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. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Earlfield Lodge Address 29 Trewartha Park, Weston Super Mare, North Somerset, BS23 2RR 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) 01934 417934 01934 622491 Mr Gerald William Butcher Mr Gerald William Butcher Personal Care home 65 Category(ies) of Old age registration, with number of places Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 65 persons aged 65 years and over requiring personal care only. 2. May accommodate two named older person aged 53 years or above. Date of last inspection 8 November, 2004 Brief Description of the Service: Earlfield Lodge offers personal care to older people over the age of 65. The home has been owned by Mr Butcher for many years. He is the registered manager, and Mrs Bowers is the head of care. The home is situated in a quiet residential area on the hillside of Weston Super Mare. Over the years the accommodation has been revised and refurbished. It now offers 57 single rooms, and 4 which may be shared. The majority of these rooms have en suite facilities. Residents have access to a number of lounge and dining rooms, as well as a small cinema and private chapel. The gardens are attractively laid out, and offer a range of quiet places to sit. Mr Butcher takes residents on regular trips out in the home minibus. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive announced inspection. Two inspectors spent a total of 13 hours in the home. During this time, they visited all areas of the home, and consulted a large number of the residents, both individually and in groups. Informal interviews were held with staff, contractors and visitors; time was spent in discussion with Mr Butcher and Mrs Bowers. Care and staff documentation was reviewed. What the service does well: What has improved since the last inspection? Residents and staff were keen to praise Mr Butcher’s ongoing programme of refurbishment and redecoration. One person commented ‘He never stays still. He is always looking for ways to improve things’. Staff records have improved significantly since the last inspection. Although a requirement was made, this related to one young worker. There was evidence of a thorough and robust recruitment procedure. At the last inspection, requirements were made regarding infection control procedures. These have been addressed. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 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 Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 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 and 2 Prospective residents and their relatives are given good information about the services offered at Earlfield Lodge. EVIDENCE: The statement of purpose and service user guide are clearly written, and provide good information to residents and their relatives. Both documents still contain the old address for the local CSCI office. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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) 7, 8, 9 and 10 Residents’ health and personal care needs are well met. They are treated with respect, and actively encouraged to maintain their independence. EVIDENCE: The care records of 6 residents were reviewed. These all contained evidence of a comprehensive assessment of need at the time of admission. A care plan had been written for each area of identified need. These care plans were focussed on the needs and wishes of the resident. They had been regularly reviewed. Accident records and regulation 37 notifications suggested residents in the home have a high incidence of falls. This was explored in detail at the inspection. Staff had assessed the mobility of each resident. A specific assessment had been carried out in relation to those identified at risk of falling. Individual risks were assessed and negotiated with residents. Risk management strategies reflected a commendable willingness to promote and encourage independence. Staff said that they encourage residents to use walking aids, rather than a wheelchair. A relative commented that staff had ‘worked miracles’ to get her mother back on her feet, after a stay in hospital. The home has a good range of manual handling equipment. Staff were observed to use this appropriately. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 10 Care records indicated that a resident was at risk of wandering from the home. It was clear that this risk had been discussed with the resident and her family. The agreed management procedures included a daily record of the lady’s clothing, so staff could give an up to date description of her. In another case, a resident chose to self medicate. A comprehensive risk assessment had been carried out, and negotiated with the resident. Conversations with relatives confirmed that the staff actively promote the health of residents. One person commented that staff had acted very prompted when she raised concerns about her father. They have forged good links with the local GP and district nurses. All the residents and their relatives stated that the staff were consistently polite and helpful. One lady said ‘Staff tell you things nicely. They never shout or are unpleasant’. Another said that the staff respected her dignity at all times, commenting ‘They’re very nice when it comes to bathing me’. There was a friendly, informal atmosphere in the home, with lots of light hearted exchanges between staff and residents. All the medication records and storage facilities were inspected. These were well completed and tidy. Observation of staff giving the lunchtime medications to residents confirmed good practice. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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, 14 and 15 Residents are offered the opportunity to participate in a commendable range of activities. Staff work hard to ensure that these meet their needs and expectations. The standard of food provided is good. Residents’ dietary needs are well met. EVIDENCE: All the residents and relatives consulted commended the range of activities and outings offered at Earlfield Lodge. Mr Butcher uses the home minibus to take residents shopping every Tuesday. He organises a weekly bus trip. One lady said that she had particularly enjoyed a drive around the local villages. She said that Mr Butcher had taken them all out for tea afterwards. Many residents gave examples of Mr Butcher and his staff going out of their way to arrange activities to suit them. One of the lounges has been fitted with a cinema screen to allow ‘in house movies’. The home has its own private chapel, and strong links with the local church. Residents may choose to attend one of the regular services, or use the room for quiet contemplation. One lady said ‘it’s there if you want it; but you are not forced to join in’. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 12 There was evidence that residents are able to choose how to arrange their day. Some preferred to remain in their room, whilst others socialised in one of the communal lounges. It was clear that close friendships had developed between residents. A number of residents go out for walks together. Others have continued to attend local clubs and meetings. All those consulted said that family and friends were always made welcome. All the residents praised the quality of the meals served at Earlfield Lodge. Lunch on the day of inspection looked and smelt appetising. Tables were laid with attractive crockery and table linen. Staff were on hand to provide discrete assistance if required. Residents gave examples of Mr Butcher, and the chef going out of their way to meet dietary needs and preferences. One lady said that she needs a low fat diet. Mr Butcher ensured that she had her own jar of peanut butter, for snacks. Those consulted particularly enjoyed the supper served with late evening drinks. They said that in the hot weather, staff gave them ice creams before they went to bed. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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 and 18 The complaint procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: All those consulted said that they would have no hesitation raising concerns with Mr Butcher, or Mrs Bowers. The home has a book, in which to record complaints made. There were no recent entries in this. Staff demonstrated a good awareness of adult protection issues. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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) 19, 20, 21, 22, 23, 24, 25 and 26 The standard of accommodation provided at Earlfield Lodge is good, and meets the needs and expectations of the residents. EVIDENCE: Although Earlfield Lodge is a big home, staff have worked hard to reduce the impact this has on residents. Rooms are informally arranged in wings, each with its own communal lounge. Residents are able to choose whether to remain in their wing, or join other residents. A passenger lift offers easy access to all areas of the home. There was evidence of an ongoing programme of refurbishment and redecoration. Staff said that Mr Butcher was always making improvements. Work was underway, to create a new patio area, with raised flower beds and a water feature. The maintenance person said that he was gradually fitting mixer valves to the hot water taps. The standard of the furniture and decoration is good. The communal rooms are attractively decorated. Residents with high needs are transferred to the ‘care wing’ (after consultation with them and their relatives). The fixtures and Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 15 fittings in the ‘care wing’ are perhaps less homely than the rest of the building. Nevertheless, it was clear from conversations with residents and their relatives that they were comfortable and happy. This wing has a good range of mobility aids, and patient hoists. All the residents consulted expressed satisfaction with their own room. Most had chosen to bring their own belongings into the home. The furniture provided is of a good standard, and meets the needs of the residents. One lady said that Mr Butcher had offered her the choice of three different armchairs, to see which she felt was most comfortable. The standard of housekeeping is good. Staff consulted took an obvious pride in their work. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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) 27, 28, 29 and 30. Staffing levels meet the needs of the current residents. Staff are encouraged to develop their skills and knowledge. EVIDENCE: All the residents and relatives consulted said that the staffing levels are appropriate. Staff said that they were kept busy, but that they were actively encouraged to spend time chatting with the residents. Staff records confirmed a generally sound recruitment procedure. The records kept in relation to 4 members of staff were reviewed. All of these contained two written references. CRB and PoVA First checks had been obtained as required. The records relating to one young worker did not contain proof of identity. Training records contained evidence of recent and relevant training. Mrs Bowers said that she often uses shift handover as an informal training session. She was advised to keep a record of this, and also to note the duration of any training courses attended. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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, 33, 35, 36, 37 and 38 The home is effectively and efficiently managed. Systems are in place to enable staff, residents and visitors to comment on the way the home is run. EVIDENCE: Mr Butcher has been the manager of Earlfield Lodge for many years. Everyone consulted said that they found him to be very approachable and open to new ideas. One staff member said ‘He never stays still. He is always looking for ways to improve things.’ The management structure of the home works well. Staff and residents were clear about who to approach and when. Staff said they had regular meetings. Some residents said that they would welcome the opportunity for formal resident meetings. Others felt this was not necessary, as Mr Butcher was readily available at any time. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 18 Residents said that they had recently completed a questionnaire, asking their opinion of the home. These demonstrated a high level of satisfaction with the service offered at Earlfield Lodge. All the records reviewed were well maintained. Procedures in place to safeguard residents’ personal monies were robust. Health and safety procedures were generally sound. One resident uses oxygen in his room. A warning sign must be obtained for his bedroom door. Fire records confirmed that the appropriate checks and tests had been carried out. Conversations with staff indicated that fire drills are held regularly. These should be documented in the training records. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 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 3 x 3 3 2 3 x 3 3 3 2 Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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. Standard OP29 OP38 Regulation 19.1 Schedule 2 23.4 Requirement Proof of staff identity must be kept in the home. Oxygen storage sign must be obtained for the identified room. Timescale for action 05/08/05 05/08/05 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. 3. 4. Refer to Standard OP1 OP25 OP30 OP32 Good Practice Recommendations The statement of purpose and service user guide should be amended to include the new address for the CSCI office. Mixer valves should be fitted to all hot water taps. The duration of training courses attended should be recorded in staff records Mr Butcher should consider holding formal meetings with residents. Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Earlfield Lodge D53 - D02 S8040 Earlfield Lodge V224883 050705 Stage 4.doc Version 1.30 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. 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