Inspection on 13/09/07 for Eastwood Lodge

This inspection was carried out on 13th September 2007.

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 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

Eastwood Lodge 05/03/08

Eastwood Lodge 06/06/06

Eastwood Lodge 05/12/05

Eastwood Lodge 11/05/05

Eastwood Lodge 10/12/04

Eastwood Lodge 18/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Eastwood Lodge Stanhope Avenue Woodhall Spa Lincs LN10 6SP Lead Inspector Ken Hague Key Unannounced Inspection 08:00 13 September 2007 th 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 Eastwood Lodge DS0000002353.V341892.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. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastwood Lodge Address Stanhope Avenue Woodhall Spa Lincs LN10 6SP 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) 01526 352188 Mr S J Cobb Mr J A Hill Ms Yvonne Margaret Lovely Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2006 Brief Description of the Service: Eastwood Lodge Care Home is an Edwardian property, which has been upgraded and extended by its owners, Mr J Cobb and Mr S Hill. The home is situated in a suburban, tree-lined avenue in Woodall Spa, 300 yards from the shops and local facilities. The home is registered to provide personal care for up to nineteen people of both sexes over the age of 65 years. Accommodation is provided on two floors, with seven bedrooms on the ground floor and twelve on the upper floor, three of which are ensuite. Rooms on the upper floor are served by a chair/stair lift. There are car parking spaces to the front of the building. The garden has an attractive patio area for residents to sit in. The building and garden are on level ground and accessible for wheelchair users. The owners of the home visit regularly and work closely with the manager and the staff working in the home. Charges made by the home range from: £345.00 - £355.00 pw. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available to all new potential residents and explain the resources and services offered, by the care home. A dedicated intermediate care service is not provided by the home. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours. The registered manager was on leave on the day of the site visit. A senior member of staff assisted the Inspector during the site visit. Feedback was given to the senior carer at the conclusion of the site visit. The Registered manager was provided with feedback after her return from annual leave. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of four residents were sought. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document asks the residents to answer 12 questions, which seek their opinions about the services offered by the care home. At this key inspection only one document was returned. The opinions of the residents were sought however during discussions held at the site visit. Their views are reflected within this report. What the service does well: Residents are cared for in a safe, well-maintained, homely environment by staff who are aware of their needs. Residents said that they enjoyed living at the home. Staff are well trained and supported by the management team and have a good knowledge of residents needs. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Eastwood Lodge DS0000002353.V341892.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 Eastwood Lodge DS0000002353.V341892.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): Standard 3 & 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Initial assessments for all residents have not been carried out and therefore it is likely that residents needs cannot be met. EVIDENCE: The care records for three residents were examined as part of the case tracking process. Two residents care records contained an assessment completed prior to their admission. The third resident was admitted in August 2007. There was no assessment within his care records. The care home could not demonstrate that any assessment had been carried out or show any record to evidence that his needs had been identified. No risk assessment had been carried out carried out. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 &10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information is not recorded in sufficient detail in the care plans to ensure that residents needs are met. The failure to provide lockable facilities in bedrooms for residents who self medicate places other residents at risk. Staff provide care and services in a sensitive respect manner which reassures residents that their privacy and dignity is being respected. EVIDENCE: The care records for three residents were studied as part of the case tracking process. One resident’s care records contained no care plan. The care records for the other two residents contained a care plan. The choices and wishes of the residents in respect of their personal care and social life were not recorded. A new care plan had not been written after a review when changes had been identified. When care plans had been reviewed the only entry on care records was “no change in care plan”. In some cases care plans have been on files for over two years changes in for Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 10 example mobility have been noted on old care plans and yet the review record states “no change”. Information was missing regarding the choice and wishes of residents. No details of activities or dietary needs were found on the care plans. Care plans do not instruct staff how care needs should be met. Example the need identified prostrate cancer, management obtain injection from district nurse. There was no attempt to personalise care plans for the individual resident. There is no description of the resident. There is no detail of his or her past life social interest or extended family. Health care needs are recorded on individual resident’s files. There was evidence of visits by general practitioners and district nurses. Chiropody and dental care is being provided. Staff stated that in their opinion and knowledge health care needs were being addressed and services made available to residents. Four residents confirmed that their health care needs are being met by the care home. Care plans contained details of individual residents medication. Staff confirmed that they have been trained in the administration and storage of medication. Medication records seen on the day the site visit were being completed correctly. Care records do not demonstrate that residents had been offered the opportunity to self - medicate. The senior carer in charge stated that this opportunity was offered to all residents and produced information and records which showed some residents were self-medicating. However she stated 50 of residents self medicate. A second member of staff stated that only four of the 19 resident self-medicated. It was found that no lockable container has been provided to residents who self-medicated This problem was corrected before the Inspector left the home. One resident was found to have painkillers loose in a draw in their bedroom. A resident stated “staff here treat us well”. “We could not criticise the care they give us”. A second resident said “staff respect our privacy when providing personal care and always treat us in a courteous manner”. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are insufficient activities provided to meet individual needs of residents. The home encourages family and friends to visit maintaining relationships and links into the local community. There is insufficient catering to ensure that residents have a choice, have their preferences are met and fully understand what is being provided. EVIDENCE: Activities were not organised on the day of the site visit as the activity organiser was on maternity leave. This information was obtained from residents and the staff member in charge at the time of the site visit. Staff stated that due to the care needs of residents there was insufficient time to allow them to organise any activities. One member of staff stated “even when our organiser is at work residents are reluctant to take part in activities”. There is no evidence that residents been consulted regarding choices of activities. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 12 Residents stated family members are made welcome when they visit the home. The home’s visiting policy is displayed in the care home and given to residents in the service users guide. Residents stated members of the family are often offered meals with the residents when they visit. They stated they are encouraged to maintain links with their friends and family. Four residents spoken to as part of the site visit said residents choose how they use their social time. The care home supplied a copy of the menu, which demonstrates choice. However discussions with the residents suggested that the menu is not always maintained. A member of staff in charge on the day the site visit stated residents are consulted and asked their choice of food on a daily basis. Residents stated this did not always happen. One resident stated we do get a lot of sandwiches and I wish they gave me choice it tends to be one type of sandwiches only. Two residents stated “ the food is very nice” Another resident stated “the food is always very good”. The personal likes and choices of residents were not recorded on care records. The home cannot therefore demonstrate that resident’s dietary needs are being met. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from updated comprehensive complaints and adult protection procedures EVIDENCE: Residents confirmed that they had a copy of the complaints procedure and are therefore able to raise concerns using the procedure or the residents meetings. A copy of the complaints procedure is in the service users guide. The complaints procedure is also displayed within the care home. Staff demonstrated a knowledge of the complaints procedure and stated that in their opinion residents are able to raise concerns particularly through the residents meetings. There have been no adult protection inquiries held or formal complaints received by the home since the last inspection. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with a comfortable and safe accommodation. EVIDENCE: Since the last inspection the manager has increase the number of hours allowed for domestic staff. Improvements have been made to the call bell system. Ongoing maintenance has been carried out. The downstairs and upstairs landing areas have been decorated. New lighting systems have been added to some areas of the care home. The home was clean and tidy and free from any odour. Staff confirmed that a new cleaner has been employed. Residents stated their satisfaction with their individual rooms and the general cleanliness of the home. One resident stated “My room is very nice” Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 15 No safety or infection control problems were identified during this visit. Staff confirmed that they followed the infection control policy of the care home. Staff stated they found the home a safe environment in which to work. Residents said that it is a pleasant, clean and safe home. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27.28.28 &30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who have been recruited safely using the up-to-date recruitment policy of the care home. EVIDENCE: Staff confirmed that in their opinion there is sufficient numbers of staff on duty to meet the needs of the residents. Four residents confirmed that call bells are answered promptly. Residents stated the quality of care is good. Staff stated they felt service users were safe at all times Recruitment records for a new member of staff confirmed that the care homes recruitment policy is being followed. The file contained two written references a criminal record bureau check and proof of identity. An induction record was on the new member of staff’s file. Staff gave details of training courses they have taken since the last key inspection, which included some specialised training. They confirmed that training in the prevention of abuse had taken place. Essential core training has been provided to all staff. The member of staff in charge on the day the site visit confirmed a training programme is in place. . Staffs individual records contain details of the training course they had undertaken and copies of training certificate were on individual files. NVQ training is encouraged. Staff stated that they felt they had received Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 17 appropriate training to be able to answer the needs of all residents. The individual staff members interviewed confirmed that NVQ training had taken place. One member staff had recently been awarded an NVQ three in care. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 18 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): Standards 31.33.35 7 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is positive leadership, guidance and direction to staff to ensure residents receive consistent quality care. Working practices promotes the health and safety of residents. EVIDENCE: The care home has a registered manager in post who staff described as being supportive and committed to providing quality care. Residents stated she is approachable and very helpful. Residents are satisfied with the quality of care and services provided by the care home. They stated that the manager runs the home well. If they are unhappy with any aspect of the service she would deal with concerns immediately. Residents spoken to stated that the home is run in their best interests. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 19 The care home has a policy and procedure in place for the protection of the residents finances. The care home holds some resident’s personal allowances, which are given out on the signatures of two members of staff. The staff member in charge stated that most residents ask family or advocates to handle their finances. No health and safety issues or infection control issues were identified during the site visit. Staff stated that the home is a safe place in which to live and work. Residents stated they felt safe living within the care home. Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 X X 3 Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 21 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. 1 Standard OP3 Regulation Reg 14-1 Requirement An assessment must be undertaken of every resident prior to being admitted to the care home, to identify their needs and ensure they can be met. A full written care plan must be completed for all residents to ensure their needs are met, and choices catered for. A lockable facility must be provided for residents who selfmedicate, to ensure the safety of all residents. Action was taken immediately to correct this on the day of the site visit 4 OP12 Reg 16-2 (n) Activities must be provided to ensure that individual and collective needs of residents are met, for a fuller and independent life. 28/10/07 Timescale for action 28/10/07 2 OP7 Reg 15-1 28/10/07 3 OP9 Reg 12-2 14/09/07 Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 22 5 OP15 Reg 16-2 (I) A varied diet must be offered to ensure residents have choice, personal preferences met and a satisfactory diet. 28/10/07 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 Eastwood Lodge DS0000002353.V341892.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Eastwood Lodge DS0000002353.V341892.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. 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