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Inspection on 21/08/07 for Eighton Lodge Residential Care Home

Also see our care home review for Eighton Lodge Residential Care Home for more information

This inspection was carried out on 21st 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Eighton Lodge Residential Care Home Low Eighton Gateshead Tyne & Wear NE9 7UB Lead Inspector Miss Nic Shaw Key Unannounced Inspection 9:30 21 &29th August 2007 st 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 Eighton Lodge Residential Care Home DS0000007380.V340374.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. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eighton Lodge Residential Care Home Address Low Eighton Gateshead Tyne & Wear NE9 7UB 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) 0191 410 3665 0191 492 1006 Wellburn Care Homes Limited Kelly Sarah Watt Care Home 47 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (47), of places Physical disability over 65 years of age (5), Sensory Impairment over 65 years of age (2) Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2006 Brief Description of the Service: Eighton Lodge is a large home in Low Eighton set back from the road in its own extensive grounds. It is a listed building of historical interest and is directly opposite the Angel of the North, which can be seen from many of the bedrooms. The home currently provides personal care for up to 47 older people, some of whom have dementia care needs and a smaller number who have physical needs. The home does not provide nursing care. There are bedrooms on both floors of the home, which are served by a central passenger lift. There is level access into the home from the driveway, and around the ground floor where the communal lounges and bathrooms are located. The home is situated on a main bus route, and it is a couple of miles to the nearest local facilities. The weekly fees range from £364-£500. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two days in August 2007 and was a key unannounced inspection. The inspection included information which had been provided by the manager in the Annual Quality Assurance Assessment. Four completed relatives/visitors questionnaires were also received as part of the inspection process. Time was spent talking to the manager, deputy manager, residents, staff and visitors and looking around the building. A sample of staff records were also looked at. The inspection particularly focussed on four residents with very different needs, known as “casetracking”, and looked at what it was like, from their point of view, living at Eighton Lodge. This involved talking with those residents, observing staff’s care practices with them and checking that information obtained from discussion and observation was accurately recorded in the care records. What the service does well: The manager makes sure that Eighton Lodge is able to meet the needs of prospective residents by getting a copy of their social work assessment and also completing her own assessment before they move in. The staff make sure that residents are treated with dignity and respect. The activities available are excellent and everyday there is something for residents to do. There is good contact maintained with family and friends and relatives are able to visit anytime. Mealtimes are a very pleasant occasion in Eighton Lodge. Dining tables are beautifully presented and there is always a choice of main meal and pudding. Everyone said that if they had any concerns or complaints they would have no hesitation in talking to the manager or staff about them. The building is immaculately clean and well maintained and everyone benefits from being able to use the spacious garden area which is enhanced with a range of colourful plants. There is also a beautiful fountain by the entrance of the home. The environment offers everyone, particularly those people with dementia, a therapeutic, calm place to live. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 6 There is little turnover in staff. This means that staff have time to get to know the needs of the residents and therefore are able to provide continuity of care. Staff training is good and as well as being paid to attend every training course arranged for them the manager regularly provides in-house training on topics such as the home’s policies and procedures The home is well managed, and there are frequent checks by the manager and area manager to make sure the good standard is kept up. Residents and relatives are asked for comments and suggestions about the service they receive. Their comments are used to continually make improvements to the service. Residents said: • • • “its lovely here” “its champion here” “the food is 100 ” Relatives said: • • • • • “my family member is catered for well” “they keep a very clean environment, employ very helpful staff and provide a variety of entertainment, functions and trips for residents” “the atmosphere in Eighton Lodge has always been very homely and welcoming. The staff are very caring and dedicated” “the standard of care is very good. The home is clean and tidy and of a high standard” “the home attracted my family to it for the lovely setting, gardens and friendly staff, including senior staff who are only too willing to make my relatives stay as homely as possible”. What has improved since the last inspection? The manager and staff continue to work hard to improve the service. Residents who have a visual disability have been provided with information about the home on CD. One resident has also been provided with talking books. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 7 The manager now makes sure that when residents go out on day trips they never miss their lunchtime medication. This is because the home has purchased a special container to take with them, when they go out, in which to safely store medication. Daily reports are now completed and proper advice is sought should a resident be at risk of falling. Relatives and residents are involved in the care plans through the six monthly review meetings. The manager now makes sure she gets proof of identity for all staff working in the home. She also asks staff to sign a form to say that they are physically and mentally fit. Care staff assist the cook with serving the food so that people with dementia do not have to wait a long time for their meals. Extra shelves have been fitted in the laundry and a laundry assistant has been employed to work weekends. There have been many improvements to the environment, for example, • • • • Easy slide chairs have been purchased for the dining rooms The hairdressing room has been improved A number of bedrooms have been up-graded with new curtains, chairs, carpets and bedroom furniture All en-suites now have privacy locks fitted. An additional member of staff has been provided on the late shift and more than 50 of care staff now have the NVQ level 2 qualification in care. What they could do better: Care plans need more information in them and assessments need to be kept up-to-date so that staff can make sure the residents health and personal care needs are fully met. Medication needs looking at as sometimes the information on the medication bottle does not match with the medication record. Warfarin, which is a medication used to thin the blood and therefore must be given in the correct amount, especially needs looking. This is because there is no record on the medication sheet of the dose to be given. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 8 The shower temperatures need to be kept at as near to 41 degrees centigrade as possible so that residents are not in danger of being scalded. There should be an annual development plan for the home so that residents know where improvements have been made. The manager needs to record more information on the resident’s personal allowance records to fully protect them from financial abuse. Relatives said: • • “when visitors come in and the small lounge is full it is difficult to find a seat” “perhaps another lounge would be nice with a bit of space for visitors to sit with residents” 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. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 9 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 Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 10 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): 1,3,4&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with the information they need to make an informed choice about where to live. The admissions process ensures that residents are adequately assessed prior to care being offered. This means that residents know that their needs will be met at Eighton Lodge. Intermediate care is not provided. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 11 EVIDENCE: There is a Statement of Purpose, which is on display in the office. There is also a brochure, (Service User Guide), and both these documents are available on CD. Residents with a visual disability have been provided with a CD player so that they can listen to this information. The manager has sought specialist advise from the sensory impairment team about orientation and support for people with a visual disability. As a result of this one resident has been provided with talking books. Admissions are not made to the home until a full needs assessment has been undertaken. For people who are self funding and without a care management assessment the manager always visits the prospective resident in order to complete her own assessment documentation. The assessment involves the individual and their family or representative. Prospective residents are always invited to spend the day at the home so that they can “test” the service. The manager writes to residents confirming to them that Eighton Lodge is able to meet their needs. A copy of this letter is not kept on the resident’s file, which would be good practise. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The resident’s health and social care needs are not fully reflected in the care plans and therefore guidance is not always available to ensure that the staff provide continuity of care. Medication administration procedures do not protect the residents. Staff care practices preserve the residents’ dignity and privacy. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 13 EVIDENCE: A variety of assessment tools are used to identify the residents care needs. These cover a range of health care issues such as mobility, nutritional needs as well as the support people need with their personal care. An assessment tool called the “Clifton Behaviour Rating Scale” is used to measure the extent of a residents care needs and whether or not they require nursing care. For one person they were given a score of 23. According to the guidelines provided with the assessment this means that they now require nursing care. However, the manager was confident that Eighton Lodge could continue to meet their care needs. The relevance of continuing to use this assessment tool was discussed with the manager. The assessments are not routinely reviewed. This means that for some people they do not provide staff with accurate information. For example, on admission one resident’s nutritional and falls risk assessment indicated that they were at low risk. However, as the resident’s dementia has progressed this is no longer the situation. From the assessments care plans are developed. Some care plans are very detailed and provide guidance to staff on how to support a resident with their specific needs. Staff regularly carry out evaluations, however, this information is not used to up-date the care plans. It was good to note that since moving to the care home one resident’s level of independence has improved, however, their care plan had not been up-dated to reflect this. For one resident, who has recently lost a significant amount of weight, there were no food and fluid charts to monitor their nutritional intake. The manager arranges a six monthly review meeting with the residents and their relatives. The residents weight is monitored each week. Staff now write a daily report, however, some of the entries made, for example, “no problem at all”, “good diet” do not adequately describe the care being given. Residents said that they felt their health care needs were met in the home and most relatives said the staff always kept them informed of any changes in this area. A record of GP, district nurse, chiropody and optical appointments is Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 14 maintained in the resident’s case file. During the inspection staff supported one resident to visit their own dentist for their regular check-up. Residents also benefit from the new community matron whose role it is visit people living in care homes. The manager can also make direct referrals to the Community Resource Team for Older People (known as the C.R.O.P. team) should a resident require the input of an occupational therapist or a physiotherapist. A referral is made through the GP for the input of a falls assessor should this be identified as a need. Medication is dispensed by the pharmacist in a “blister” pack. Staff do not see the original prescriptions, rather the pharmacist collects these on behalf of the home, and therefore staff cannot be assured that the medication they are administering has been prescribed by the GP. In most instances there were photographs of residents on the medication administration record. Some residents have been prescribed Warfarin, which is an anti-coagulant. However, when there have been changes to the prescribed dose of this medication the home does not always receive written confirmation of this. This is because they are contacted by telephone by the Hospital’s pharmacy department. This is not best practise as the margin for medication administration errors occurring is increased. The home must develop a policy in relation to the administration of Warfarin to reflect best practise and to fully safeguard the residents. The medication administration instruction on the medication container did not always reflect what was happening in practise. For example, on the instruction of the GP one resident was being given one Temazepam, (which is a controlled drug), at night yet the medication administration record stated that 1 or 2 should be given at night “when required”. The instruction on the container of one pain relieving medication stated to be given “as and when required”, however, this was being administered four times a day. A pharmaceutical label had not always been provided on prescribed eye gels. The date of opening of these had not always been recorded on the container, which is important as many only have a shelf life of 28 days. A record is maintained of prescribed creams, which are administered by staff. Senior staff are responsible for the administration of medication. They are provided with training in the safe handling of medicines. A small number of controlled medication is held in the home in a separate controlled drugs cabinet. A controlled drugs register is maintained and a brief audit of the medication held in stock corresponded to the records. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 15 There is a separate medication fridge and records are maintained of the temperature of this to ensure that medication is stored appropriately. However, the temperature of the medication room is not monitored. Residents said that the staff always treated them with dignity and respect. In the staff toilet a sign had been mounted on the wall, “privacy and rights”. This is the “topic of the month” and is placed there to remind staff of the aims and objectives of the service. Relatives said staff “ respect the dignity of the residents “regardless of their difficulties”. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 16 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. Arrangements to provide activities, stimulation and community contact are excellent with lots of opportunities being provided for residents to maintain contact with their family and friends and to exercise choice and control over their lives. This ensures that residents lead fulfilling lifestyles. Residents are provided with a good, varied and well presented, choice based, menu which helps to promote their general health and wellbeing. EVIDENCE: There is an excellent activities programme, available to residents in their bedrooms, which is up-dated every month. Forthcoming activities and outings are also advertised in the entrance foyer. There are two activity co-ordinators and regular activities include aromatherapy, pilates, exercise and manicure sessions, sing-a-longs, bingo, Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 17 cards and Karaoke. There are also regular outings, for example, for coffee at a local garden centre, trips to Chester-le-Street park and the Laing art gallery. Residents said they loved the trips out. A Priest visits the home every week to give Holy Communion to Catholic residents. On the morning of the inspection some of the residents were sitting in the entrance foyer reading the daily newspaper. The local newspaper is also provided on tape, every 2-3 days, for those people who have a visual disability. There is a magnificent spacious garden which residents can independently use when the weather is nice. Residents are able to continue their own preferred daily routines and to make their own choices about how they spend their day. Residents said they can choose when to get up in the morning and when to go to bed. During the day some residents chose to spend time in the communal lounges whilst others preferred to spend time sitting in the entrance foyer watching the busy comings and goings of the home. Residents are encouraged to take part in activities around the home such as folding the washing, helping the gardener and making their own beds. Relatives are able to visit them at any time in the home and this was observed on the day of the inspection. Good contact is maintained with relatives and with the local facilities, such as the Allerdene social club, so that residents still feel that they are part of the local community. Generally residents said that the food was very good. A cooked breakfast is always provided and a choice of main meal and pudding is always offered. The dining tables were immaculately presented with linen tableclothes, napkins and condiments so that residents could help thesmselves. A lunchtime meal was shared with three residents. Staff were observed to be courteous, encouraging the residents independence throughout. A choice of juice or water was offered with the meal followed by tea or coffee. The menu is regularly reviewed, in consultation with the residents. As a result of this fresh kippers, home made ginger bread, and jam rolly polly have been provided. It was excellent to note that the manager has been told by the company to “buy the residents’ whatever they want regardless of the cost”. Staff have undergone role play, by being assisted to eat with a blind fold on, so that they know what it feels like to have a visual disability and be provided with support in this way. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 18 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. The home has a satisfactory complaints system. Complaints are handled appropriately and the outcomes used to improve the service. Policies, procedures and staff training ensure that the residents are protected from abuse and potential harm. EVIDENCE: The home has a complaints procedure, a copy of which is available to residents in their bedroom, in the information pack. Residents and relatives said that they would have no hesitation in approaching the manager or staff if they had any concerns or complaints. There has been one complaint made to the manager since the last inspection. Records showed that this had been fully investigated and the outcome and action taken as a result clearly documented. The home has its own policy and procedure documents relating to safeguarding adults, which are available to staff to guide them if they have any concerns in this area. The manager has also obtained a copy of Gateshead local authority’s safeguarding adult procedure. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 19 The majority of staff working in the home are trained in safeguarding adults. Arrangements are in place for new staff to receive this training. There has been one safeguarding adult referral made since the last inspection. The outcome from this has been dealt with appropriately by the home. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 20 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 excellent. This judgement has been made using available evidence including a visit to this service. Eighton Lodge offers residents a clean, homely, well maintained place to live with fixtures and fittings throughout of an excellent standard. EVIDENCE: The building was found to be immaculately clean and fresh smelling throughout. Relatives commented that there were never any odours in the home and that it was always “pristine clean”. There are two communal lounges located on the ground floor. These areas are bright, airy comfortable places in which to sit and chat with friends and relatives. Some relatives commented that additional seats for visitors would be beneficial. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 21 Carpets and other flooring were clean and decoration throughout is of an excellent standard. A number of bedrooms have been upgraded to include new curtains, carpets, bedroom furniture and new vanity units. One bathroom, which was previously out of use, has been upgraded. The spacious grounds are immaculate with beautiful well maintained hanging baskets and potted plans. People with dementia are not accommodated in a separate “unit” or “wing” of the home, sharing the same communal facilities as those people who do not have dementia. This works really well in this home with a quiet therapeutic relaxed environment being provided. Signs have been placed on doors to help people with dementia find their way around the home. Those bedrooms viewed were found to be clean and well personalised reflecting each individual’s likes and tastes. Staff are provided with training in relation to infection control as part of their induction and all staff are soon to attend a distance learning course in this subject. Throughout the inspection staff demonstrated an awareness of good care practise in relation to this issue with the appropriate use of protective gloves and aprons. There is a separate laundry facility which was found to be well organised. It is evident from the high quality of furniture, fixtures and fittings that the company spend money on the environment in the best possible way so that outcomes are improved as much as possible for the people living in the home. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 22 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. Staffing levels are good and staff training is excellent which ensures that resident’s needs are effectively met. The resident’s welfare is protected by the staff recruitment procedures. EVIDENCE: Residents spoke positively about the staff and it was clear that positive respectful relationships had developed between staff, the residents and their relatives. There has been a low turnover of staff, which is excellent in terms of promoting continuity of care. Staff said that they felt valued by the company. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 23 Staffing levels are maintained at six staff during the day and evening and three night staff. These figures include an additional member of staff who has been provided since the last inspection to work each evening. This is excellent evidence of how the company keep staffing levels under review to reflect the needs of the residents. The manager completes a training audit that shows training completed and training that is required for all staff. Certificates for all training completed by staff are kept in their personal file. Nineteen of the twenty-five care staff have completed either the NVQ level 2 or NVQ level 3 qualification in care. Other than those recently recruited all staff have completed a twelve week training course about dementia. All staff are soon to attend a refresher training course on this subject. All new staff receive suitable Induction training in line with Skills for Care standards. Staff said that they have good opportunities for training, and training records confirmed this. Records show that all staff have training in statutory health and safety matters. An excellent aspect of the training is the on-going in house training provided by management. This includes discussing a selection of the home’s policies and procedures as well as role play as a way of raising staff awareness of those everyday difficulties older people with disabilities encounter. Staff files examined were easy to follow and well organised. All contained application forms, an interview record and references. Two references are always sought, one from the last employer. Criminal Record Bureau clearance and Protection of Vulnerable Adults (POVA) first checks are also obtained for all staff. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 24 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&38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents welfare is promoted by a well managed home. Recording procedures generally safeguard the residents finances, however, further improvements need to be made to fully protect people. The quality assurance system is being implemented to ensure that the home is run in the best interests of the residents. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Registered Manager has many years experience at a senior level within the home. She has attained a number of care and management qualifications, including the NVQ 4 level 4 in Management and in Care. There was a positive atmosphere in the home and much of this is attributed to the manager and deputy manager who not only “muck in” but clearly value their staff, which is very important in any care environment. The manager and deputy have also recently undertaken dementia care training alongside the staff. It was evident that good mechanisms are in place to support the staff with their personal development. An example of this is the regular role playing exercises carried out every month. Relatives said “management are very approachable” and that the deputy manager “is excellent”. Effective relationships have developed between residents, staff and the manager. Residents and staff were observed interacting with the manager with confidence and respect. The manager is supported and supervised by an area manager, and there are clear lines of accountability within the organisation. The area manager regularly visits the home. She makes herself known to residents and visitors and asks for their views about the service. She also completes a thorough monthly audit of the service. The organisation has a comprehensive quality assurance system that includes a number of audits of the homes practices, and also includes the views of residents. There are regular residents meetings where residents are able to voice their ideas, comments and suggestions. Satisfaction questionnaires are also used to gain the views of residents and relatives. There is no annual development plan available, which would be good practise as this would show relatives, residents and other stakeholders whether or not the service is meeting its stated aims and objections. The personal allowance records showed that receipts and double signatures are maintained for all transactions. The manager checks these each week and a sample checked every month by the area manager. However, some entries made did not include information about what the money was being used for, Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 26 which would be good practise. Different receipt books are used for money being deposited and for hairdressing and chiropody. The receipt number is recorded on the transaction sheet, however, the different receipt books are not numbered and this may cause confusion when carrying out an audit. Appropriate records are held in relation to accidents. There has been a recent fire officer visit and recommendations as a result of this have been addressed. Staff carry out regular health and safety checks, including checks of hot water temperatures, and records are maintained of this. Records showed that the shower temperature was sometimes as high as 49 degrees centigrade. This needs to be addressed. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 27 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 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 4 X 3 X 2 X X 2 Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Residents care plans must be in sufficient detail to guide staff on the action they must take to meet the residents care needs. This is to ensure residents receive continuity of care. Timescale for action 31/07/08 2. OP9 13(2) Systems must be in place, where this has been assessed as a need, to monitor the resident’s food and fluid intake. This is to ensure the resident’s care needs are fully addressed. The home must develop a policy 31/10/07 in relation to the safe administration of Warfarin, which reflects best practise. The instruction on the pharmaceutical container and medication administration record must reflect what is happening in practise. The date of opening on eye gels and drops must be recorded on the pharmaceutical container. This is to fully safeguard the residents. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 29 3. OP38 23(2)j Hot water temperatures of 31/10/07 showers must be maintained at a safe maximum temperature of 41 degrees centigrade. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP4 OP7 OP9 OP33 OP35 Good Practice Recommendations A copy of the letter sent to residents, confirming with them that the home can meet their health and personal care needs, should be maintained in the home. The daily reports should describe the care being delivered so that this information can be effectively used to evaluate the care plans. The manager should see the original prescription issued by the GP. The home should produce an annual development plan. This so that information is available as to whether or not the service has met its stated aims and objectives. Details of expenditure should be maintained and receipt books should be numbered. This is to fully safeguard the resident’s finances. Eighton Lodge Residential Care Home DS0000007380.V340374.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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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