Inspection on 11/06/08 for Fenland Lodge

This inspection was carried out on 11th June 2008.

CSCI found this care home to be providing an Adequate 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

Fenland Lodge 07/01/10

Fenland Lodge 12/08/09

Fenland Lodge 11/02/09

Fenland Lodge 28/11/07

Fenland Lodge 28/06/07

Fenland Lodge 02/02/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Fenland Lodge Soham Road Stuntney, Ely Cambridgeshire CB7 5TR Lead Inspector Joanne Pawson Unannounced Inspection 11th June 2008 09:15 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 Fenland Lodge DS0000067620.V367161.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. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fenland Lodge Address Soham Road Stuntney, Ely Cambridgeshire CB7 5TR 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) 01353 668971 01353 772734 fleuropeancare@aol.com European Care (Central) Limited Vacant Care Home 49 Category(ies) of Dementia - over 65 years of age (49), Old age, registration, with number not falling within any other category (49) of places Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2007 Brief Description of the Service: Fenland Lodge is owned by European Care and is situated between Ely and Stuntney. The home is registered to provide care to 49 elderly people, all of whom may have dementia. There are 45 single occupancy bedrooms and two shared rooms. All have en-suite facilities. The weekly fees range from £347 to £600. The inspection report is available in the front entrance area of the home. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection of Fenland Lodge on 11th June 2008 from 09:15 am until 17:15 pm using the Commission’s methodology described below. This report makes judgements about the service based on the evidence we have gathered. We spent time talking to the residents, the family liaison officer, and head of care and looking at care plans, health and safety documents, staff recruitment, supervision and training documents, and talking to the members of staff on shift. On the day of the inspection there were 29 residents living in the home. What the service does well: What has improved since the last inspection? The staff induction training has improved and includes information on writing and using care plans. Two relatives and residents meetings have been held and were well attended by about 20 families. A minibus has been purchased so that the residents can go on trips out of the home. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fenland Lodge DS0000067620.V367161.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 Fenland Lodge DS0000067620.V367161.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): 1,3,4,5 Quality in this outcome area is good. People thinking about moving into the home have enough information to make an informed decision about if their needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prospective residents are invited to look around the home and meet some of the staff before they decide if they would like to move in. Pre admission assessments had been completed for residents that had recently moved into the home. One resident told us that she had been to look around the home before moving in. One resident had moved into the home the day before the inspection. The head of care was seen to make a call to the resident’s daughter to reassure that she had settled in well. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. The care staff do not have all the information they require to meet the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for four residents were looked at. One resident who had moved into the home 6 days before the inspection did not have a care plan. The head of care stated that this had been an oversight and would be written as soon as possible. The resident was spoken to and was quite distressed and said that she was in a lot of pain and wanted some painkillers. Staff were aware that a prescription had been written by the GP for paracetamol but said they had been waiting since the previous day for the tablets to arrive. These painkillers could have been provided immediately if a member of staff had gone to Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 10 purchase them from a local shop and the resident may have had some relief from her pain. Because there was no care plan it was not possible to look at her health information and there was no information for staff about pain relief. The daily notes for the resident stated on one day that she had washed herself and on another day that staff had helped her with this. Again because there was no care plan staff may not be aware of what she could do for herself and how they could encourage her to be as independent as possible. The end of life care plan was seen for one resident and it included information very personal to the resident such as ‘open the window when warm enough so that the resident can hear the wind chimes as she finds this soothing’ and ‘a member of staff to sit with the resident to give her comfort and so that her relatives know she is not alone’. The third residents care plan contained the majority of the information that staff needed to know, and a dependency assessment had been reviewed monthly. The falls risk assessment had also been reviewed monthly but it did not include the information that the resident was registered blind. The resident, although able to, had not signed the care plan to say that he agreed with what was written about him. The mobility care plan had not been updated when the reviews showed that he had gone from using a wheelchair for all his mobility to walking with a frame. Although the bathing care plan was detailed it did not state what the resident could do for himself. When we spoke to him he told us he could wash his body apart form his back. The care plan for the fourth resident contained important information about how the staff should work with the resident when she became agitated. During the inspection the resident was seen to be itching her back a lot. The daily notes showed that this has been recorded on at least another three occasions however there was no care plan to explain what treatment could be given or if she had seen a GP about the itching. The residents spoken to during the inspection confirmed that they are treated with dignity and respect and that they can make decisions that affect them such as when they want to go to bed and get up. One resident said ‘the staff are polite’. The administration of medication was observed and the correct procedures were followed and the medication administration records were inspected and found to be accurate. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 11 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 good. Residents are involved in the planning of activities such as trips out so that they can do activities that interest them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Lunchtime was observed. There were no tablecloths on the tables. Condiments were available on the table. Residents were offered a choice of what food and drink they would like. Residents can choose to eat in their bedroom if they wish to. Some residents were shown the puddings so that they could choose. One member of staff although working in a caring way did refer to the resident as a ‘good girl’ three times. One resident stated that he had been living in the home for about twelve weeks and the home was a ‘really good grade with three meals a day and staff around day and night’ and that staff were always polite. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 12 One resident stated that his choice has been respected when he was asked if a new member of staff could observe him having assistance with a bath and he had refused and she had left the room. One member of staff stated that she would like more training about how she can get the residents involved in different activities. The home now has it’s own minibus which has been used for residents to go out on trips to garden centres and places of interest. Some of the male residents were going to look at some shire horses on the day of the inspection. One resident regularly gets dropped in Ely so that she can go shopping and is picked up again later. There have been two relatives and residents meetings this year with 20 families attending. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 13 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. Residents are confident that if they complain any issues will be dealt with appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the residents spoken to confirmed that they would know who to complain to if they needed to. All of the staff spoken to were aware of the procedure if they suspected a resident had been abused in anyway. The staff files showed that they had attended training on safeguarding vulnerable adults. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 14 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): 19,20,21,23,24,26 Quality in this outcome area is adequate. The home is comfortable and had a programme to improve the decoration, fixtures and fittings so that the residents have a pleasant environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: When talking to one resident in his bedroom, which is next to the kitchen, the kitchen door slammed three times in ten minutes. This sounded very loud in the residents bedroom. This was discussed with the head of care who stated that he would look into getting a door opener fitted to prevent the slamming. The basin and bath taps in the resident’s bedroom did not provide any hot water. There was no water pressure in the hot tap in the bath. This is an Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 15 ongoing issue. The family liaison officer and the head of care stated that the hot water boiler is not big enough to meet the needs of the size of the building. Residents who were spending time in their bedrooms had the calls bells nearby them so that they could request the staff if needed. New tables and chairs have been ordered for throughout the home. The home was clean throughout on the day of the inspection. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 16 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 adequate. Low staff levels could lead to the service users needs not being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three staff files were inspected. They contained the necessary recruitment, training and supervision records. New staff complete a detailed induction, which is recorded in the European Care Induction booklet. The induction includes information on the homes aims, understanding the principles of care, the organisation and role of the worker, access to policies and procedures and the involvement of families and carers. A newly appointed member of staff confirmed that she had completed a two week induction working 9 to 5 to get to know the residents, read their care plans and completed the induction booklet. The pre inspection information shows that out of 18 care staff 14 have an National Vocational Qualification at level 2 and one member of staff is working towards the qualification. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 17 One resident stated that when the home was short staffed (which he felt was normally at weekends) and he had to wait up to half an hour to have his call bell answered. Staff also expressed their concerns that staffing levels went as low as two or three members of staff on some shifts to care for 25 residents some of which have dementia and high needs. One member of staff felt that on one occasion the low staffing numbers could have led to a resident falling over as there were no staff in the communal areas as they were both busy with a resident. Whilst lunchtime was observed two members of staff were seen to put a moving and handling belt on one resident and help her stand up without explaining to her what they were doing. She became agitated so another member of staff went over and explained to her what was happening and she calmed down. One member of staff was seen giving constant reassurance and encouragement to a resident who was walking to the dinner table. One resident became slightly distressed with the staff whilst eating her meal and raised her voice at them several times and kept repeating herself. Although at first staff seemed to try and comfort her when it happened again two members of staff laughed at her behind her back instead of understanding that it was due to her dementia. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 18 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 adequate. Regular health and safety checks are being completed to provide a safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager has left the home. The family liaison officer and head of care are currently completing some of the management tasks until a new manager is appointed. The family liaison officer stated that her line manager Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 19 had completed supervision with her although he had not supplied a written record of it. The records of the monthly visits by the provider (Regulation 26 visits) were inspected and several of the comments were repeated monthly. Although all the forms looked at showed that the residents had made comments regarding care or other issues and that these should be recorded; there was no comments made by the residents. The fire records were inspected and found to be satisfactory. The financial records and cash held on behalf of three residents were inspected and found to be accurate. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 20 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 X 3 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 01/08/08 2. OP27 18(1)(a) 3. OP21 23(2 )(j) Care plans must detail all the needs of residents and state how staff should meet these needs to ensure there is a consistent approach. Care plans must be written as soon as the information is available to ensure that staff are aware of the needs of new residents. Staff must always be available in 01/08/08 sufficient numbers to ensure the safety of those living there, and that their needs can be met There must be an adequate 01/08/08 supply of hot water to the residents ensuite bathrooms. This will ensure that residents can wash their hands or have a bath in their ensuite if they choose to. Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Fenland Lodge DS0000067620.V367161.R01.S.doc Version 5.2 Page 24 - 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!