Inspection on 28/11/07 for Fenland Lodge

This inspection was carried out on 28th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fenland Lodge 07/01/10

Fenland Lodge 12/08/09

Fenland Lodge 11/02/09

Fenland Lodge 11/06/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Fenland Lodge Soham Road Stuntney, Ely Cambridgeshire CB7 5TR Lead Inspector Joanne Pawson Key Unannounced Inspection 28th November 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fenland Lodge DS0000067620.V356095.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.V356095.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 668971 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.V356095.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2007 Brief Description of the Service: Fenland Lodge is registered to provide care to 49 elderly people (all of which may have dementia). European Care owns the home. The home is situated between Ely and Stuntney. There are 45 bedrooms for single occupancy and two shared rooms. All bedrooms have en-suite facilities. The weekly fees are £540. The inspection report is available in the front entrance area. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One regulation manager, one regulation inspector and one pharmacy inspector conducted the inspection on the 28th November 2007. The inspection was carried out over four hours. Methods used for the inspection included speaking to the acting manager, staff and the people living in the home, observation of care, reading documentation and a tour of the home. There were only 24 residents living in the home on the day of the inspection. What the service does well: What has improved since the last inspection? The care plans have improved so that they now include the information staff need to know so that they can meet the needs of the residents. The records relating to the receipt of medication into the home has improved. Lunchtime was observed and staff were offering the residents a choice of what they would like to eat. The recruitment checks have improved so that new staff are not commencing work until the POVA first check has been received and are then working supervised until the full Criminal records Bureau Check is received. The records of money held on behalf of residents were inspected and were now accurate and clear. Arrangements have been put in place to ensure that all staff receive supervision on a regular basis. Risk assessments are in place to ensure that risks to the residents are minimised where possible. Fenland Lodge DS0000067620.V356095.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.V356095.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.V356095.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 Quality in this outcome area is adequate. Residents are given the information they need before moving into the home. 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. The acting manager stated that no new residents have moved into the home since the previous inspection so it was not possible to assess if the pre admission requirement was met. Fenland Lodge DS0000067620.V356095.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 Quality in this outcome area is good. The care staff have 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: Care plans are now being stored in room 34 so that they are kept confidential and easily accessible to the staff. The care plans have been updated so that they know contain all of the necessary information the staff require to meet the needs of the residents. The home has had a lot of support from the local social work team in preparing the care plans. The care plans are being reviewed regularly. The wording in one care plan was inappropriate and this was discussed with the acting manager. The care plans and records show that specialist healthcare professionals are being contacted when appropriate. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 10 Staff were observed treating the residents with dignity and respect. A specialist pharmacist inspector examined the practices and procedures for the safe handling of medicines. Residents are protected by satisfactory security of medicines and the storage facilities provided are temperature controlled. Stock levels of medication have been kept to a minimum. The cupboard provided for the storage of controlled drugs, is still not fixed to the wall in the way described by the Regulations. It is expected that the home can manage this issue without the need for a statutory requirement. The accuracy of records relating to medication have been improved. Records of the receipt and disposal of medicines provide a good audit trail of medicines but the record made when medicines were given to residents showed a few problems. For example, where medication is given in a dose that is different from that printed on the form there is not always a justification in the resident’s care notes that this instruction had been approved by the resident’s GP. This could put residents at risk of not being given medication as prescribed. When residents are prescribed medication on a “when required” basis there are no guidelines in the care plans for staff to follow to ensure there is consistent use of medication and residents receive medication appropriately; and, where medication is given in a variable dose e.g. one or two tablets, the actual number of tablets given is not always recorded. This could result in residents receiving too much or too little medication. It is expected that the home can manage these issues without the need for a statutory requirement at this stage. Fenland Lodge DS0000067620.V356095.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 adequate. The residents’ are encouraged to make choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The cook stated that none of the residents needed extra calories. However there was a folder in the kitchen, which stated that some of the residents still living in the home should have fortified meals. The cook stated that this folder was still in use but he did not know why the forms had not been completed recently. The teapot being used on the day of inspection was extremely stained and did not look like you want to drink a cup of tea that had been poured from it. The activities co-ordinator stated that it was due to be being washed in the dishwasher and that the home got through lots of teapots because of this problem. Either a dishwasher safe teapot should be purchased or they should be washed by hand. The acting manager stated that the breakfast routine has changed so that more of the residents eat breakfast together in the dining room which allows more staff to assist anyone who needs help. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 12 Lunchtime was observed. Two members of staff were sitting down and assisting two residents to eat. One member of staff was standing next to a resident and assisting her to eat. The acting manager stated that all of the staff are aware that they should sit next to a resident when assisting them to eat. Residents’ were offered a choice of what food they would like to eat. One member of staff left the resident she was assisting and got up to hand out other peoples food. The acting manager stated that this should not have happened as there is enough staff on at lunchtime to ensure when staff are assisting a resident they stay there until finished. The activity co-ordinator stated that there had only been limited activities recently as she had been working on the care plans. Staff were seen sitting and talking to the residents in a warm and caring manner. Visitors spoken to on the day of the inspection stated that they could visit at any reasonable time and that they were always made to feel welcome. One visitor was having lunch with her mother on the day of the inspection. Fenland Lodge DS0000067620.V356095.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. Systems are in place to ensure the safety of the residents’. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager stated that no complaint have been received by the home since April 2007. This is unusual for a home the size of Fenland Lodge and staff must ensure that any complaints are recorded. The acting manager stated that she thought this was because if any concerns were brought to her they had always been dealt with promptly. All care staff have now attended or are booked on adult protection training. Fenland Lodge DS0000067620.V356095.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, 21,23,26 Quality in this outcome area is good. The environment has improved to meet the needs of the residents’. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the heating was only working in half of the building. (The commission had been notified of this). As there were only 24 residents where needed they had been temporary moved to a bedroom which had heating and all of the residents were sitting in their bedrooms or the lounge/dining area which had heating. There has been a large investment into the environment over the past year. These include most areas of the home have been decorated, new flooring in the lounge areas, leaking roof has been fixed, refurbishment of the kitchen and air conditioning in the medication room. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 15 The sensory garden has been completed to a very high standard and provides a relaxing and peaceful place for the residents to sit. The water feature can also be seen from inside the small dining area. The kitchen has been refurbished and was clean on the day of the inspection. There has been an industrial clean of all the toilets and sinks to remove the build up of limescale, which was caused by problems with the septic tank. The size of the septic tank has been increased and this is no longer causing a problem to the home. At present all the bedrooms have had similar curtains and duvet covers. The acting manager stated that they are now trying to introduce more choice and make sure that the residents’ wishes are taken into consideration with paint colours and soft furnishings. There are three bedrooms that still have damp areas on the walls. These rooms are not currently being used and the acting manager stated that they would not be used until the damp problem is rectified. The toilet opposite the acting managers office has a bolt on the inside of the door. If a resident was in the toilet and a member of staff needed to gain access to them in an emergency they could not open the toilet door from the outside. A lock which can be opened from the outside in case of an emergency must be fitted. Fenland Lodge DS0000067620.V356095.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): 27,28,29,20 Quality in this outcome area is good. Staff have the training they need to enable them to meet the needs of the residents’. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files for three members of staff were seen. All three of the files contained the required recruitment checks. Detailed interview notes were in the files and any gaps in employment had been discussed at the interview. When an unsatisfactory reference was received the prospective member of staff was interviewed a second time and a further two references requested and received before they commenced work. The files showed that staff had received training in the Alzheimer’s society dementia course – yesterday, today and tomorrow, first aid, moving and handling, health and safety and the protection of vulnerable adults and the administration of medication. The acting manager stated that the training plan for all the staff included annual moving and handling, food hygiene and infection control and biannual training in health and safety. There were plenty of staff on shift to meet the needs of the residents. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 17 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. Policies and procedures are in place to meet the homes desired outcomes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager stated that the home had been visited by the fire officer the week before the inspection and that they were satisfied with the measures being taken to reduce the risk of fires. The records of testing the fire alarms and emergency lighting and fire drills showed they were being carried out at the required intervals. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 18 The money and records held on behalf of three residents were checked and found to be accurate. This meets the requirement made at the last inspection. Arrangements have been put in place to ensure that all staff receive supervision. The acting manager stated that she has put all of the ‘important’ policies together and all staff have been requested to read them and sign to say that they have understood them. Two care notes for two residents showed that they had recently had a fall. However there was no accident forms available for these incidents. Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 19 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 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X 3 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 2 X 3 X 3 X X 2 Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14(1)(a) Requirement Before a service user moves into the home there must be an assessment to ensure the home can meet their needs. This was not inspected on this occasion so the timescale has been extended. 2. OP15 16(2)(i) Kitchen staff must be aware of 01/01/08 the nutritional needs of older people and when need fortified meals/supplements must be available. The toilet door opposite the 01/01/08 manager’s office must have a suitable lock fitted to it to ensure the safety of the residents. A record must be kept of all falls. 01/01/08 Timescale for action 01/01/08 3. OP21 13(4)(a) 4. OP38 17(2) Schedule 3(3)(o) Fenland Lodge DS0000067620.V356095.R01.S.doc Version 5.2 Page 21 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.V356095.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Inspection 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.V356095.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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