CARE HOMES FOR OLDER PEOPLE
Eastwood Lodge Stanhope Avenue Woodhall Spa Lincs LN10 6SP Lead Inspector
Vanessa Gent Unannounced Inspection 5th December 2005 11:00 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 Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 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.V270025.R01.S.doc Version 5.0 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.V270025.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11th May 2005 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. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted in 5½ hours by one inspector. The main method of inspection used is called case-tracking which involves selecting a number of residents and tracking the care they receive through the checking of records, discussion with them and the care staff and observation of care practices. Three residents, three relatives and two staff spoke with the inspector. What the service does well: What has improved since the last inspection?
Much of the guttering has now received attention although some parts are still not cleared. The hot and cold water system has been fixed and now works satisfactorily; a new boiler and mixer taps under the residents’ bedroom sinks having been installed. New furniture and carpets have been supplied to the communal areas, making the lounges look attractive and pleasant areas to sit in. Staff training has been undertaken with enthusiasm and is now up-to-date, ensuring that staff know how to care for the residents safely. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 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. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 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.V270025.R01.S.doc Version 5.0 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 the following standard(s): 1, 2 New residents are well informed of the services available at the home to be able to make a reasonable decision of where to live. EVIDENCE: The statement of purpose and service user guide are up-to-date documents that contain all the information required to give prospective residents a good insight into the services the home offers. A terms and conditions contract that gives the number of the room to be occupied by the resident and a statement of fees payable is in place for all residents. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 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 the following standard(s): 7, 9, 11 Residents and relatives are not well informed of the care plans and their contents for them to know how care should be given although the care plans and medication practices inform staff well enough how to provide adequate care for the residents. EVIDENCE: One resident’s family was not aware of the existence of or reason for care plans. Residents and relatives are not given the opportunity to be involved in the reviews of the care plans. Care plans examined are clearly and comprehensively completed. A key work system is being introduced which is to be supervised by the deputy manager. Medication practices are sufficient to enable staff to administer drugs safely. Residents with insulin dependent diabetes self administer their insulin but are supervised and observed by the staff, who have had relevant training. The final wishes of the resident are not recorded in the care plans to afford the resident dignity at this sensitive time. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12 Activities are not provided or varied enough to cater for the needs and wishes of the residents. EVIDENCE: An activities organiser works for five hours in one day per week at the home but residents say they are not offered suitable or frequent enough activities to interest them so most prefer to stay in their rooms all day, every day, except for mealtimes. One resident said “the only thing to do all day is sleep”. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 Concerns are dealt with appropriately and speedily to ensure that residents are protected from abuse or harm. EVIDENCE: The complaints procedure is displayed in the hall and gives the details of how to make a complaint and who to approach if they do not want to go to the manager or provider of the home. No complaints have been received directly by the CSCI (Commission for Social Care Inspection) or logged in the complaints book over the past year. The manager stated and a resident confirmed that she deals with any concerns as soon as they arise. A relative said she can take any matter to the manager and it will be sorted out straight away. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19, 20, 21, 25, 26 The home provides a clean, comfortable and pleasant environment although some measures have not been put in place to minimise the risk of infection to the residents. EVIDENCE: Furniture in communal lounges and carpets have been replaced and the interior redecoration programme is almost complete. The garden provides a pleasant, tranquil area with a fishpond, and a patio for residents to sit in. The hot and cold water system has been attended to by a local plumber, mixer valves have been fitted to residents’ sinks and the water has been tested for the prevention of Legionella. Radiators for which a requirement was set at the previous inspection still have not been covered to safeguard the residents’ safety. A radiator in the upstairs lounge is within easy reach of residents needing to steady themselves and would cause burning to the hands if touched.
Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 13 Commodes are emptied into a residents’ toilet and cleaned in the hand sink as there are no specific facilities for this to be done hygienically. This means there is a risk of the spread of infection for residents using the toilet themselves. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 30 Staff are well-trained to cater for the needs of the residents safely and competently. EVIDENCE: Staff training is mostly up-to-date with a first aid course booked for the near future. Two senior staff now have NVQ (National Vocational Qualifications) level 3 in care, one staff is in the process of doing level 3 and two staff are on level 2. Two new staff, due to start in January 2006 already have level 2 in care. Staff say they feel confident in their care practices. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 37 The home is run by a competent and caring manager. The manager and staff provide a comfortable environment where the residents feel protected. However, better monitoring of the service provided would ensure a safer, more democratic situation. EVIDENCE: The manager is highly regarded by residents, relatives and staff. Since the previous inspection, she has achieved the Registered Manager’s Award. Residents say they can talk to or ask the manager about any issue and are listened to. One resident said “she is lovely; very thoughtful and chats to you”. The responsible individual does not make regular, unannounced visits to check that the home meets the needs and wishes of the residents. Staff supervision has not taken place on a regular basis although the manager says she is training senior staff to take a role in this procedure. As the
Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 16 manager does not have administrative staff, it is necessary for her to have sufficient supernumery time to complete all the administrative and managerial duties to ensure that residents are kept safe and comfortable at all times. Record-keeping is reasonably well organised but would be better maintained if the manager had more supernumery hours to complete all administrative and managerial tasks. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 17 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 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 X X X 2 2 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X X 2 3 X Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15.2.a-d Requirement Residents or their relatives must be given the opportunity to be involved in the creation and review of their care plans where possible. The final wishes of the resident must be evident in the care plans to ensure the dignity of residents at the end of life. Sufficient activities must be made available to meet the needs and wishes of residents. All radiators must be covered to keep the residents safe from harm. (Previous timescales since 11/03/03 not met.) The Provider must conduct an unannounced visit and report on the service of the home every month. All staff, including the manager must be formally supervised on a regular basis. Timescale for action 28/02/06 2. OP11 12.3, 4.a 31/01/06 3 4. OP12 OP25 16.2.n 23.2.p 31/03/06 19/12/05 5. OP33 26 31/07/05 6. OP36 18.2 31/01/06 Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 19 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 Refer to Standard OP36 Good Practice Recommendations It is recommended that staff supervision should take place six times a year for each staff. Eastwood Lodge DS0000002353.V270025.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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