CARE HOMES FOR OLDER PEOPLE
Eaton Lodge Nursing Home 62 Westgate Bay Avenue Westgate-on-sea Kent CT8 8SN Lead Inspector
Sandra Crosby Unannounced Inspection 27th January 2006 14:00 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 Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 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. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Eaton Lodge Nursing Home Address 62 Westgate Bay Avenue Westgate-on-sea Kent CT8 8SN 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) 01843 832184 01843 832184 Mr Mukesh Raojibhai Patel Ms Maria Kallis Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. The registered manager: has at least 2 years` experience in a senior management capacity in the managing of a relevant care setting within the past five years; and [by 2005], has a qualification, at level 4 NVQ, in management and care or equivlent; or where nursing care is provided by the home (ie nursing home),is a first level registered nurse and has a relevant management qualification [by 2005]. One (1) Service User, whose date of birth is 25.08.15, to be admitted to the home for residential care. 13th June 2005 2. Date of last inspection Brief Description of the Service: Eaton Lodge is an older style two storey detached premises situated near the town centre and sea front. The home is registered for 24 older people requiring nursing care and provides both single and shared room accommodation. There is a pleasant garden at the rear of the building with seating arrangements, and some parking space is available at the forecourt. The Registered Person Mr M Patel visits the home on a regular basis, and the Registered Manager has been in post for several years and is an experienced first level nurse. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and carried out on Friday between 14.00 and 17.00 hours. During the inspection the Inspector spoke with several Service Users, the Registered Manager, a nurse and care staff on duty. Records were seen and an accompanied tour of the premises was made. The atmosphere of the home was welcoming, calm and relaxed, and the home was clean and orderly at the time of the inspection visit. The Inspector spent time talking with Service Users, who commented that they liked the staff of whom it was said that they were friendly and helpful. They said they enjoyed the food provided at the home. The home shows commitment towards meeting the National Minimum Standards. What the service does well: What has improved since the last inspection?
Bedrooms are re-decorated when a room becomes vacant, and a large number of bedrooms have recently had new carpets fitted. A new hoist has been purchased. Fire Training has been undertaken.
Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 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. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 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 Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 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): 1,3,6 The homes Statement of Purpose and Service User Guide provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. Service Users move into the home knowing that their needs can be met and that their independence will be maximised and promoted. Standard 6 was judged as not applicable at this inspection visit. EVIDENCE: Standards 1, and 3 were judged as standard met and Standard 6 was judged as not applicable at the announced inspection visit dated 13 June 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The Statement of Purpose and Service User Guide were seen, and contained information as required by Standard 1 and Regulation 4 and 5.
Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 9 A comprehensive completed pre-assessment documentation was seen for the most recently admitted Service User. It is not the general policy of the home to admit Service Users on a short-term basis, and the Registered Manager confirmed that short-term care was only provided occasionally. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The care planning system meets the requirements of the minimum standards and regulations and the assessed needs of the Service Users. The health needs of Service Users are mainly well met with evidence of good multi-disciplinary working taking place on a regular basis, however good practice in relation pressure area care needs to be improved. The systems for medication administration are good with clear and comprehensive arrangements being in place to ensure Service Users medication needs are met. Personal care is offered in a way to protect Service Users privacy and dignity. Staff are supportive and sensitive to the needs of Service Users at the time of their death, and they and their family are treated with all due respect. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 11 EVIDENCE: Standards 7,9,10 and 11 were judged as standard met and Standard 8 was judged as nearly met at the announced inspection visit dated 13 June 2005. Four service user plans were seen. Comprehensive records including care plan, daily records, reviews, and risk assessments were contained within the service user plans. In relation to the information on skin integrity records, these were now being accurately recorded and showed that in some cases an improvement in skin condition was being achieved. The staff must however ensure that they seek the advice of professionals when written records of pressure area care indicate necrosis. Medication records were seen and indicated that they were mainly appropriately signed and up to date. The medication supplies had just arrived and a member of staff was at the time of the visit booking these in. For this reason the storage of medication was not seen at this visit. Service Users confirmed that they are treated with respect and their dignity is upheld. The Inspector evidenced a good rapport between staff and service users. From discussion at the announced inspection visit it was evidenced that the staff are supportive and sensitive to the needs of a Service User who is dying, family may stay at the home overnight if they wish to, and every effort is made to ensure the Service Users comfort, and close contact is maintained with family and professional services. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service Users spoken with confirmed they were happy with the lifestyle they had living at the home, maintain contact with family and friends, and are able to exercise choice and control as far as is possible over their lives. The meals in the home are good offering both choice and variety and catering for special diets. EVIDENCE: Standards 12,13,14 and 15 were judged as standard met at the announced inspection visit dated 13 June 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. All Service Users that the Inspector spoke with at the announced inspection visit dated 13 June 2005, and at this visit spoke highly of the home, and about their different lifestyles within the home. Flexibility in routines was seen to suit individual needs. Activities are undertaken that suit the needs of the Service Users, and one staff member told the inspection that massage and aromatherapy are carried out, and gently exercises are undertaken, and that Service Users are taken out, to the beach or nearby local café or to the shops.
Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 13 Visitors were seen arriving at the home during the course of the inspection visit. The home endeavours to maintain a close knit family community with relatives able to stay and have a meal if they wish to do so. All Service Users spoken with commented on how they enjoyed the food at the home. Food records were seen, and the meals seen provided on the two inspection days, were well presented and look appetising. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Service Users know their complaints will be listened to and acted on. Arrangements for protecting Service Users are satisfactory, and staff have knowledge and understanding of Adult Protection issues. EVIDENCE: Standards 16, and 18 were judged as standard met at the announced inspection visit dated 13 June 2005. The Registered Manager confirmed that there had been one complaint since the last inspection visit, and that appropriate action has been taken to address the issues raised. It was evidenced from talking with staff at the announced inspection visit that they were aware of the policies and procedures in place in relation to Adult Protection, and were able to talk through what action they would take should an issue of concern be raised. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Other than bedrooms being decorated when vacant, there has been no change in the décor to the main communal areas, and although this does not pose a risk to Service Users, the areas could do with updating. The home was clean, pleasant and hygienic at this inspection visit. EVIDENCE: Standards 19, and 26 were judged as standard met at the announced inspection visit dated 13 June 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 16 It was seen during the accompanied tour of some areas of the premises that the main communal area, together with hallway and stairs were in need of the décor updating. The Registered manager reported that a number of bedrooms had been re-decorated, and the Inspector was shown that a large number of bedrooms had had new carpet fitted. The Registered manager said that the main Lounge and the hallways were the next projects to be undertaken in relation to re-decoration. It was seen that many of the bedrooms are personalised, and bedrooms are re-decorated when vacant. The home was clean, hygienic and warm at the time of the inspection visit. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staff morale is good resulting in a workforce that works positively with Service Users to improve their whole quality of life. Staff are multi-skilled ensuring good quality care and support. Service Users are protected by the homes thorough recruitment procedures. The arrangements for induction of staff are good with the staff demonstrating a clear understanding of their roles. EVIDENCE: Standards 27,29 and 30 were judged as standard met at the announced inspection visit dated 13 June 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The home is fully staffed, and it was seen at this visit that there were sufficient staff on duty at the time of the inspection visit to meet the needs of the current group of Service Users. Three staff files were seen at the announced inspection visit, and these mainly contained all documentation that would support that a thorough recruitment system was in place, including application form, references, CRB checks, copy proof of identity etc. Completed induction paperwork was seen in staff files.
Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 18 The Registered Manager reported at the announced inspection visit that currently approximately 70 of the care staff has achieved NVQ Level 2, one member of staff is about to start NVQ Level 2, and one member of staff is about to start NVQ Level 3. Staff training is ongoing at the home. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 The Registered Manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. Staff are appropriately supervised and the Service Users benefit from a well run home. Service Users financial interests are safeguarded, and the systems for Service User consultation are good with a variety of evidence that indicates that Service Users views are sought. The health, safety and welfare of Service Users and staff are promoted and protected. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 20 EVIDENCE: Standards 32,35,36 and 38 were judged as standard met at the announced inspection visit dated 13 June 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. Discussions with Service Users and staff indicated that management provides a positive open and inclusive atmosphere. The Registered Manager reported at the announced inspection visit that currently the home does not hold any personal allowance monies for Service Users, therefore no written records are kept. There is a system in place at the home for the regular supervision of all staff with written records kept. The Fire Log Book was seen, and all regular weekly and monthly monitoring checks are recorded together with regular fire drills being undertaken. The accident book records were viewed at the announced inspection visit, and at this inspection visit. The training matrix for the home was seen at the announced inspection visit and shows that training is ongoing. Maintenance certification information was taken from the Pre Inspection Questionnaire and would indicate that the home currently has all relevant certification. At this inspection visit the Registered Manager reported that staff had undertaken Fire Safety Training. In relation to Moving and Handling it was reported that a new hoist has been purchased. Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 3 X 3 3 X 3 Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 & 13 Requirement To promote and make proper provision for the health and welfare of service users Improve practice in relation to pressure area care Timescale for action 27/01/06 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 OP19 Good Practice Recommendations To update the decor in the communal areas of the home Eaton Lodge Nursing Home DS0000026091.V274532.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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