Inspection on 21/01/09 for Etherley Lodge

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Good service.

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

Etherley Lodge 10/01/07

Etherley Lodge 27/02/06

Etherley Lodge 23/11/05

Etherley Lodge 21/02/05

Etherley Lodge 12/11/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Etherley Lodge Etherley Lodge Low Etherley Bishop Auckland Durham DL14 0HD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Etherley Lodge Etherley Lodge Low Etherley Bishop Auckland Durham DL14 0HD 01388832879 P/F etherleyoffice@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Timothy Charles Irving care home 38 Number of places (if applicable): Under 65 Over 65 1 17 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 0 20 Etherley Lodge Residential Care Home is located in the small village of Low Etherley near to Bishop Auckland and is on a regular bus route. Set in its own grounds Etherley Lodge is a large converted two- storied former residential house without the benefit of a passenger lift. There are 2 double bedrooms; 31 single bedrooms of which 21 have en suite facilities. Throughout the building there are a number of different communal lounges, dining areas, a conservatory, communal toilets and bathrooms. The home has a large well-maintained garden of approximately 2.5 acres, along with a patio and other hard surfaced areas for residents use. Car parking spaces are located to the front of the home for use by relatives and visitors. Etherley Lodge is registered to provide residential care for up to 35 people with a Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home mental disorder (excluding learning disability or dementia). Etherley Lodge does not offer intermediate residential care facilities. Mr Timothy Charles Irving and Mrs Julie Brown are the Registered Provider and Registered Manager respectively. The weekly fee to stay at Etherley Lodge Residential Care Home is currently 407.50 pounds. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The Visit: Care Homes for Adults (18-65 years) Page 6 of 28 The inspection was unannounced and was undertaken by the link inspector for the service. The inspection started at 10:30am and lasted 5.5hrs. During the visit we: Talked with people who use the service. Talked with the home owner, manager and staff on duty. Looked at information about the people who use the service and how well their needs are met, Looked at case records for three residents and other records that must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since the last visit. Also surveys were sent to residents and visiting professional people. Responses were received from thirteen residents and six professional people. Information from these sources is used in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sufficient information on the needs of the people who live there and access to appropriate services to enable their needs to be met. However insufficient information about the home is provided to new referrals. Evidence: Before accepting an admission, information is obtained from pre admission assessments and from informed professional supporters to ensure the individuals needs can be met. Part of the admission process can involve trial visits. These are followed up by meetings with the professional supporters, when a care package is agreed. Each person has a plan of care developed to meet their needs and this is recorded in a computer system accessed by the staff team. Professional visitors commented in a survey; Care staff and community staff liaise regularly to manage individual care packages. The service will contact me in relation to individual care needs. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Everyone spoken to had good things to say about the home, although not everyone was happy to be there, they said that the home meets there needs and the support from care staff is good. The home has a Service User Guide to describe the service provided and other useful information. However seven of the twelve people surveyed felt they did not receive good information before moving in and one person commented, I wasnt happy because I never received enough information. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are involved in their own care planning and are consulted on their lives in the home. Evidence: We met three of the people who live in the home and each said the support they receive is good. One person said she hated it here but then said she wouldnt go anywhere else. Another person said they choose what to do and where to go. Each person has an individual plan of care detailing the areas where they require a degree of support. The home has worked with one recent admission to accomodate her pet dog. It was not deemed suitable for it to be in the home so a new dog house was provided by the owner in the car park. Each of the plans are reveiwed monthly and there was evidense in the files that people in the home are included in the development of their support package and that social Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: care and health teams are also involved. Risks in daily living are identified together with any actions used to reduce the risk and continue to promote independense. An assessment of risk was in place for one person who smokes in their bedroom putting themself and other people in danger. The majority of survey responses were positive about the care and support provided by the staff team. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are encouraged to make choices for their activities, and the staff support them to develop their skills for independence. Evidence: People living at Etherley Lodge have individually planned programs of weekly activities. These have been developed to take account of each persons own likes and dislikes. Activities offered ranged from a meal or drink at local public houses, quiz sessions, shopping, gardening, watching TV, and listening to music. The home are currently trying to replace the activities organiser and care staff are currently providing the necessary support that people in the home need. Four people spoken to about life in the home all stated they choose what to do and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: where to go. One person who has lived in the home for many years has here daily routines of choice and is content with the support she receives from care staff. Another person said he enjoys playing his mouth organ and that staff support him to visit his family twice each week. Another resident said she likes some time in a small quiet lounge in the home, she likes word searches and reading. She also goes each week for a meal at a local pub and gets taxis to the shops. One person said the home is very good and care staff support her well but she would rather be in her own home. She does however understand that she needs the support provided to her. People were seen freely moving around the home throughout the day and taxis were seen coming and going taking people to places of their choice. Staff regularly engage people in conversation and in ad hoc activities. There are regular residents meetings enabling residents to influence decisions being made in the home like choice of menus and choice of activities. Records are kept of these meetings. The homes menus take account of the likes and dislikes of the residents. The cook promotes a healthy eating menu but also respects people individual choice wherever possible. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff support people to maintain their health needs and to consult other medical professionals. However the medication system could be improved to promote good health care. Evidence: The care plans contain good details of each persons care needs. The health care records seen included references to hospital visits and contact with GPs and other health professionals. These include the psychiatrist and community nurses. One person assessed as at risk of pressure ulcers has been provided with a special mattress to limit this possibility. Professional people surveyed commented; Care needs are fully met to promote wellness and recovery. Care staff have helped people to recover and move back into the community. Medications are managed appropriately. Staff possess the the appropriate skills to support people in the home. The home has systems in place to manage peoples medication safely. All staff who dispense medication have obtained a safe handling of medicines certificate. We Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: checked the medication records for three people. The records were free of errors with no signature gaps found on the MAR (medication administration record) charts. The security of storage was good and the temperature is recorded to ensure medicines are appropriately stored. One medication seen was out of date and a medication reference book was not available should anyone need to check a detail. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a trained staff team to live safely in the home and have their concerns appropriately addressed. Evidence: The home has a complaints procedure and a log to record matters of this nature. Everyone who responded to a survey confirmed they are aware of how to complain and who to complain to. The home has received one anonymous complaint that was investigated and recorded in detail. All staff have now received training related to the protection of vulnerable people known as safeguarding. Staff spoken to were aware of their responsibilities in this area and supporting information is available to them in the home. Everyone spoken to in the home felt safe there and said that staff are caring and supportive. Management understand the principles of safeguarding and have been involved in one related to pressure area care since the last inspection. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and well maintained environment for the people who live there, and the staff maintain a good standard of cleanliness and hygiene that protects people from the risks of the spread of infection. Evidence: Etherley Lodge was originally the home of the owner before being converted to its present use. It is located in a small village with limited community facilities, however there is a regular bus service to the nearby town of Bishop Auckland. The home has large well maintained grounds and internally there are smoking and non smoking lounges and a conservatory. Recently a lounge for non smokers was redecorated and provided with new furniture. Peoples bedrooms have been improved with new curtains and bedding. Everyone spoken to was proud of their home and their private space. Those bedrooms seen were each different in character and contained many personal possessions. The home was clean and reasonably well maintained. The laundry was well fitted out with suitable equipment, including a washing machine with a sluice programme. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff in sufficient numbers and with the appropriate training to meet their needs. Evidence: From the rota provided and from observation during the inspection the staffing levels are sufficient to meet the needs of people who live in the home. The owner is committed to training staff to ensure good standards of care and support are provided. Three staff hold the Registered Managers Award. Three staff have achieved a National Vocational Qualification (NVQ) level 4 in care, five staff have NVQ level 3 and thirteen have NVQ level 2. Also five staff are working towards NVQ levels 2 or 3. Other training is provided as required to maintain a balanced workforce. People living in the home were complimentary about the support provided by the staff team and good interactions were observed between them throughout the day. Professional visitors commented; Care staff encourage individuals to function at their optimum level. Care staff have helped people to recover and move back into the community. Care staff are well trained. Staff are skilled in supporting people to meet Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: their needs. A good system is in place to ensure only appropriate people are employed in the home. Two files reviewed contained references, Criminal Record Bureau checks, a record of induction to ensure the person is aware of their duties and responsibilities and copies of regular supervision meetings to monitor progress. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed for the benefit of the people who live there. Evidence: The owner and his wife are in the home each day and together with the registered manager, direct the care provided. A programme of works required to ensure the home is well maintained is produced by the owner. Meetings are held with staff and residents to ensure everyone has a voice in the home. Surveys are also used to give people in the home the opportunity to comment on the care provided. Staff spoken to stated the home is well managed and that they feel supported in their work. Professional visitors commented; There is a safe yet homely atmosphere where people are treat as individuals. A safe secure homely atmosphere is provided. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Periodic fire checks are recorded and staff fire instruction takes place to promote the safety of people who live and work in the home. A fire risk assessment of the building has not been produced to identify any areas of potential danger. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The manager should ensure that people considering moving into Etherley Lodge are provided with enough information about the service provided. Consideration should be given to producing a welcome pack with information that would be useful in the early days of settlement. Audit the medications held to ensure outdated medicines are removed. Provide staff with a current medical reference book like a BNF. 2 20 3 42 Ensure a fire risk assessment of the building is carried out and is available in the home for inspection. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!