Inspection on 14/08/07 for Eden Lodge Care Home

This inspection was carried out on 14th August 2007.

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

Eden Lodge Care Home 15/07/08

Eden Lodge Care Home 14/02/07

Eden Lodge Care Home 26/04/06

Eden Lodge Care Home 28/09/05

Eden Lodge Care Home 09/06/05

Eden Lodge Care Home 09/02/05

Eden Lodge Care Home 06/10/04

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 Eden Lodge Care Home Park Road Bestwood Village Nottingham NG6 8TQ Lead Inspector Rob Cooper Key Unannounced Inspection 14th August 2007 10:00 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 Eden Lodge Care Home DS0000008666.V348024.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. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eden Lodge Care Home Address Park Road Bestwood Village Nottingham NG6 8TQ 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) 0115 977 0700 0115 9770786 ann-harris@hotmail.co.uk Sai Om Limited Vacant Care Home 60 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (60) of places Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. 2. Dementia, over the age of 55 years - Code DE. The maximum number of service users who can be accommodated is 60. 14th February 2007 Date of last inspection Brief Description of the Service: Eden Lodge is situated in Bestwood Village. From the village there is public transport to the wider community and the city centre. The home is registered to cater for the needs of older people, aged 65 years and over as well as people with a diagnosis of dementia who are aged 55 years and over. The accommodation is on the ground floor. There is level access throughout. All of the bedrooms are single, and some have en-suite toilets. There are four lounges. There is an activities room and two dining rooms. The grounds are expansive and mainly set to lawn. There is a large car park to the front of the home. The fees range from: £300 - £360 per week. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of the key inspection process – so that no one at Eden Lodge knew that the inspection visit was going to take place. The visit took approximately four hours through the middle of the day, with one inspector present. The method used to carry out this key inspection visit was to send out a preinspection questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. We also sent out a number of surveys to residents and relatives, and sent Eden Lodge an Annual Quality Assurance Assessment (known as an AQAA) for them to self assess their service. This was followed with a visit to Eden Lodge, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Eden Lodge, looking at the activities on offer, and talking to two residents and three members of staff about the quality of the service, and their experiences of living and working at Eden Lodge. Currently Eden Lodge does not have a registered manager in post, as the manager left two weeks before this inspection visit. The deputy manager who is acting up into the manager’s role while a new manager is recruited therefore supplied much of the information during the visit. On the day of this inspection there were fifty-four residents in residence. Prospective residents can obtain information about Eden Lodge direct from the care home, and this would include seeing previous inspection reports prepared by the Commission for Social Care Inspection. Basic information about Eden Lodge and care homes can be found at the following web site at: www.carehome.co.uk/care_homes_by_name.cfm/searchnames/E What the service does well: There are a good range of activities for residents and a partnership with a local school, has seen joint activities arranged for the benefit of the residents. Efforts have been made to involve a speech and language therapist to improve resident’s communication and choice. Eden Lodge Care Home DS0000008666.V348024.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. Eden Lodge Care Home DS0000008666.V348024.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 Eden Lodge Care Home DS0000008666.V348024.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): 123&6 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Prospective residents at Eden Lodge had sufficient information before they moved in to make an informed choice about where to live. Residents at Eden Lodge have their needs assessed before they move in. Eden Lodge does not offer intermediate care. EVIDENCE: Both the service user guide and statement of purpose were seen, and both contained all of the information that would allow prospective residents to make an informed choice about living at Eden Lodge. Both documents had been reviewed within the last six months, so that the information was reasonably up-to-date. A number of service user guides were seen in bedrooms, although they were on the top of the wardrobes, and therefore not accessible to Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 9 residents. The service user guides should be stored in a place in the bedrooms where residents can have better access to the information. Copies of the resident’s contracts were seen in individual bedrooms. However these had not been signed either by a representative of Eden Lodge or the resident or their representative. It is extremely good practice that every resident has a copy of their contract, but the documents should be signed by the appropriate people as soon as possible. As part of the case tracking process three resident’s files were seen. Each file contained a different assessment of need, one had been completed in-house, one had a Shared Nottinghamshire Assessment Profile (SNAP), which is Nottinghamshire’s preferred assessment tool for older people, and the third contained an Extended Community Care Assessment. All three assessments had been completed prior to residents moving in to Eden Lodge, which evidenced that the resident’s care needs had been based upon the assessments. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 & 11 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. The residents have their health and personal care well managed, supported and recorded by the staff at Eden Lodge. EVIDENCE: The three resident’s files that were seen all contained an individual plan of care, which had been produced from the assessment of the resident’s needs, and contained details of health, personal and social care. Evidence was seen that the care plans were being reviewed on a regular basis. All of the files that were seen contained care plans related to resident’s health care needs, and these were clear and detailed. Two residents were asked about seeing their doctor, and all said that they had a local doctor who either came to see them at the home (arranged through the staff) or they visited the surgery – depending on their particular need. Visits by Healthcare professionals are recorded in a book for the purpose. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 11 Boots (The Chemist) provide Eden Lodge with their medication. An inspection of the storage, and booking in and out procedures showed that medication is handled safely and there is a clear audit trail for medication from the point of ordering to administration and/or disposal. Administration records were inspected and found to be complete, including photographs of individual residents to help with identification. The lunchtime medication round was partially observed, and there were no concerns seen in the administration procedures. No resident at Eden Lodge currently self-medicates. A recommendation that all of the medication trolleys are immobilised by fixing to the wall when not in use, has yet to be achieved. During the course of the inspection a number of staff to resident interactions were observed. These were seen to be polite and respectful, and staff were observed knocking on resident’s doors before entering. Two residents were spoken with during the inspection visit, and one relative; the residents said that they thought the staff treated them well, while the relative said: “The staff are superb, they really do go beyond what you would expect.” Each of the resident’s files contained a sheet of paper with the resident’s wishes at the time of their death, and evidence of involvement from the resident’s families, and contact telephone numbers. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Quality in this outcome area is excellent; this judgement has been made using available evidence including a visit to this service. Residents at Eden Lodge have a lifestyle that reflects their cultural, social and religious interests, and needs. EVIDENCE: Eden Lodge employs a part time activity co-ordinator, and there was a great deal of evidence of activities being organised for residents, with photographs to support what activities have taken place. A partnership with the local junior school has been started, with both pupils coming in to Eden Lodge to help with arts and crafts, and to talk to residents, and residents going out to attend the school’s sports day. In addition contact has been restarted with local churches to get them involved with activities at Eden Lodge. Eden Lodge has an open door visiting policy for relatives, and one relative was spoken with during the inspection visit, and he said that he was always made welcome, and kept well informed about his mother’s condition. There are monthly relatives meetings held on the last Wednesday of the month, which are open to all. The minutes of the meetings since January were seen. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 13 Since the last key inspection a speech and language therapist has been involved at Eden Lodge (as recommended by the Inspector) and this has seen better signs and symbols used particularly in areas where residents have varying degrees of dementia. The better signing has increased resident’s ability to make choices, and two residents when asked said that they felt perfectly able to make choices within their lives. Menus are on display in the dining rooms, and discussions with the acting manager evidenced that there are attempts to use pictures to make these easier to understand for some residents. Two residents were asked about the food at Eden Lodge, and they said that they thought the food was “very good” and “very nice”. On the day of the inspection visit there was a choice between pork casserole and fish for lunch, served with fresh vegetables. The relative who was spoken with described the food as: “lovely and mouth watering” he said he had no problems with the food offered to the residents at all. A recommendation made at the last inspection visit about the dining room at the far end of the building, has been met, in that the dining room has been moved, so that a different room is used as the dining room, and this has been redecorated, and is a much more appealing room in which to eat meals. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Eden Lodge are safe, and their complaints are taken seriously and dealt with. EVIDENCE: Eden Lodge has not received any complaints since the last key inspection in February 2007. The complaints procedure forms part of the service user guide, which has been given to every resident, and is also on display in the foyer. Discussions with the relative visiting Eden Lodge identified that a number of small things had arisen over the years, and he had had to speak to the manager or senior staff. In every case these had been dealt with to his satisfaction. Eden Lodge do not have a compliments book, and it is recommended that one is used to ‘capture’ any positive comments from relatives and visitors. A review of staff training records showed that in March 2007 the majority of the staff underwent training in safeguarding adults’ procedures. This training is aimed at raising staff awareness of abuse, and through raising the issues, offering residents greater protection against abusive practice. Certificates for the training from Abacus Training arrived at Eden Lodge on the morning of this inspection visit. Discussions with three members of staff evidenced that they Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 15 were aware of safeguarding adults’ procedures, and had recently received safeguarding adults training. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 16 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): 19 & 26 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Eden Lodge live in a safe, clean and comfortable home, with their personal possessions around them. EVIDENCE: A partial tour of Eden Lodge showed it to be comfortable, well equipped and well maintained. Since the last key inspection a number of new carpets, and partial redecoration has been carried out, while further new armchairs have been bought. Staff were seen cleaning in various areas of Eden Lodge during the inspection, and the building was found to be clean. Two residents were asked about the cleanliness, and both said that they were quite happy, and that they thought the staff worked hard to keep the home clean and tidy. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Staff at Eden Lodge have been recruited professionally, and are competent and trained to do their jobs. EVIDENCE: A review of Eden Lodge’s staffing rota showed that there are currently enough staff working at Eden Lodge to meet the resident’s needs. A relative who was asked if he thought there were enough staff said: “There are lots of staff on Mondays, but that drops off as the week goes along.” While discussions with three staff members, who were asked the same question returned views of “Yes”, “No” and “Sometimes we could do with more.” In light of these differing views it is recommended that staffing levels are reviewed to ensure that there are sufficient numbers of staff on duty to meet the resident’s needs throughout the week. The staff training records were seen and these showed that out of a staff team of thirty care staff, there are currently ten members of staff with a National Vocational Qualification (NVQ) to level II in care, with a further six currently studying for their NVQ level II. In addition a further three members of staff have their NVQ IV qualification, and four more are currently studying for that qualification. There are currently ten staff members waiting to start their NVQ Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 18 level II studies. National Vocational Qualifications (NVQ’s) are seen as the basic qualification for care staff, and it is recommended that a minimum of 50 of the care staff have at least an NVQ qualification. Eden Lodge is very close to achieving this 50 figure. Three personal staff files were seen and each one included all of the necessary employment checks – two written references, Criminal Records Bureau checks and application forms which would demonstrate that Eden Lodge are recruiting their staff in a manner to ensure resident safety. Three staff members were asked about their recruitment, and each one said that they had been through a formal recruitment process. The staff training records were inspected and these showed that there had been an improvement in the provision of staff training since the last key inspection. Requirements set at previous inspections had been met, with the majority of the staff having received safeguarding adults training and dementia training in the past six months. A clear staff training plan exists, and discussions with three members of staff evidenced that staff were receiving regular training. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Eden Lodge is a safe, well-managed care home with good systems for ensuring it’s quality in place. EVIDENCE: The registered manager recently resigned, and left her post two weeks before this key inspection visit took place. As a result Eden Lodge are currently in the process of recruiting a new manager, and the deputy manager is acting up to fill the manager’s post until a new manager is identified and in post. Eden Lodge has a quality assurance system based on questionnaires for residents and visitors (relatives and health and social care professionals) a number of questionnaires were seen, and the relative who was spoken with Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 Page 20 said he had received a questionnaire in the past. Resident’s meetings have been introduced, although there has been some delay, and they are not yet being held every month, which would be good practice. Eden Lodge are holding monthly relatives meetings. Eden Lodge have a ‘small cash needs’ system for resident’s personal finances. The records for four residents were checked, and no errors were found. Receipts were in place to evidence expenditure and all cash totals tallied. Four staff files were seen with regard to formal staff supervision. Each member of staff had supervision records within them, which showed that staff were being properly supervised. Three staff members were asked about their supervision, and said that while they felt well supported, they had not been receiving regular one to one support sessions. A number of health & safety records were seen, and all found to be correct and up-to-date. These included the fire safety records, which showed that the system had been serviced in July, and the annual gas safety certificate, which was issued in November 2006. Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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 2 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 11 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 29 30 3 3 3 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Eden Lodge Care Home DS0000008666.V348024.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 OP1 Good Practice Recommendations The service user guide should not be stored on top of resident’s wardrobes, but be kept in a place, in their bedrooms where residents and their relatives are able to access the information easily. A representative from Eden Lodge, the resident or their representative should sign copies of the resident’s contracts. All of the drug trolleys should be able to be immobilised by fixing to the wall when not in use. A compliments book should be started to collect any positive comments from relatives and visitors. Staffing levels should be reviewed to ensure that there are sufficient numbers of staff on duty throughout the week to meet the resident’s needs. Formal staff supervision sessions should be arranged for all staff a minimum of six times a year. 2. 3. 4. 5. 6. OP2 OP9 OP16 OP27 OP36 Eden Lodge Care Home DS0000008666.V348024.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. 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