Inspection on 31/07/07 for Filsham Lodge Residential Care Home

This inspection was carried out on 31st July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Filsham Lodge Residential Care... 15/08/06

Filsham Lodge Residential Care... 13/12/05

Filsham Lodge Residential Care... 28/06/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Filsham Lodge Residential Care Home 137 South Road Hailsham East Sussex BN27 3NN Lead Inspector Christine Lawrence Key Unannounced Inspection 31 July 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 Filsham Lodge Residential Care Home DS0000062001.V345745.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. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Filsham Lodge Residential Care Home Address 137 South Road Hailsham East Sussex BN27 3NN 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) 01323 844008 01323 844008 filshamlodge@tiscali.co.uk Mr and Mrs Ravichandran Mr and Mrs Suganthakumaran Mrs Olive Dunford Care Home 53 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE). 2. The maximum number of service users to be accommodated is 53. Date of last inspection 15 August 2006 Brief Description of the Service: Filsham Lodge is registered to provide personal care and support to people with dementia. It is not far from the centre of Hailsham. The building is on two floors with a passenger lift and one stair lift providing access to all parts of the home. There is a car parking area at the front of the building. There is level access to the front of the building with a garden to the rear. The rooms are all single and some have en suite facilities. Information about the service including the latest report from the Commission for Social Inspection (CSCI) is made available to prospective residents and/or their relatives, on request. The range of weekly fees, as of 31 July 2007, is £410.00 - £650.00. Some rooms are more expensive. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit to Filsham Lodge was unannounced and I was there form 10.00 till 17.00. I spoke to the manager and to two of the owners who visited that day. I made observations of staff supporting and caring for residents and I had lunch with residents in one of the dining areas. Thirteen surveys were completed by relatives and information from them is used in this report. The manager, Mrs Dunford provided further information by completing the Annual Quality Assurance Assessment (AQAA) form. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 6 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 Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 7 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): 2 (Standard 6 does not apply to Filsham House) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs. EVIDENCE: There is clear evidence that a detailed assessment is carried out by the manager before a decision is made that the home will be able to meet the needs of the resident. This includes gathering information about the individual including expressing sexuality, particular physical needs and any special equipment and any ‘idiosyncrasies’. The manager was clear about seeing people as individuals. One visiting relative made the point that staff…” treat people as individuals…” and this is underpinned by the initial assessment. This information is used to compile a care plan (see standard 7) which gives clear guidance to staff. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 8 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: The care plans seen contained all the relevant information relating to the identification of individuals’ social and health care needs and how they should be met. The care plans are considered working tools and are kept up to date. They are clearly written and contain assessments of any risk. There is information about the kind of dementia an individual might have. The records showed that health care professionals are involved as and when required. I observed medications being given out during lunchtime. This was appropriately managed. The records seen were all properly completed and the Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 9 storage was satisfactory. Only senior staff give out medication and they have received training. One member of staff said that medication was very important and you had to take it seriously. The manager and other staff confirmed that dignity and privacy are an important part of the care provided at Filsham Lodge. Staff spoken to also confirmed that the ‘shadowing’ of an experienced member of staff during induction allows for these attitudes to be reinforced. Medical examinations would take place in the residents’ own room and personal care would be in own rooms or bathroom areas. I observed respectful and polite interactions between staff and residents. Dignity was particularly upheld in the administration of medications that I observed. The care plans reflect residents’ preferred name, sometimes provided by the relative. The following comments were included in surveys completed by relatives:“…kindness…” “…care and kindness…” “…staff very aware of any distress…” (when talking about how a resident can’t communicate) Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 10 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to and that they will be enabled to maintain contact with friends and family. Wherever possible, within the limitations of an individual’s dementia, residents are given opportunities to make choices, therefore allowing for some level of control over their lives. The meals in this home offer both choice and variety and catering for special needs. EVIDENCE: An activities co-ordinator is employed for 40 hours per week and the records showed that there are group activities and individual activities. I observed some of this during my visit to the home. People’s religion is noted and there is a monthly interdenominational church service in the home. The Salvation Army visit regularly and a local religious group visit monthly to sing hymns and other songs with and for residents. There are no real restrictions on visiting although relatives are asked to avoid mealtimes unless they are joining residents for a meal. From the surveys Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 11 completed it is clear that relatives are made to feel welcome when they visit. Residents who wished were able to move freely around the building. Staff explained that residents would be encouraged to make choices about which clothes to wear if this was something that they were able to do and they also said that they try to make sure residents have opportunities to make choices and decisions throughout the day. There are different lounge areas within the home and staff try to ensure that residents are in the most appropriate atmosphere. There are different areas for residents to eat according to their needs and wishes. Staff were observed to help residents, either by encouragement or actually assisting them to eat. I joined one group to have lunch and observed another group being supported with theirs. The food being served was satisfactory and residents were seen to eat well. Residents were encouraged to drink fluids and there were frequent offers of tea and coffee. There are small kitchenette style facilities available in different areas of the home to facilitate this. Residents’ likes and dislikes, as well as special needs are noted. Staff were seen to try and respond to residents own wishes with regard to moving about after lunch, returning to own rooms or the lounge areas or sitting and relaxing at the table. One relatives survey had the following comment:- “…I am always welcome there and they have many entertainment afternoons where relatives and friends are welcome…”. Another relative said during the visit that staff go at the resident’s own pace and people can stay in bed for a lie in if they want. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 12 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: The home’s procedure for complaints is clearly written and included within the ‘welcome pack’. There is information about how to contact the Commission for Social Care Inspection. Mrs Dunford said the ethos within the home was very much about trying to deal with any small issues before they become of concern to anyone. Staff spoken to were very clear about their responsibilities relating to protecting residents. There are policies and procedures in place which include whistle blowing and systems relating to protecting residents’ finances. External trainers are used for adult protection and this is reinforced in house on a day-to-day basis. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 13 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well-maintained and clean environment. EVIDENCE: The building and grounds are well maintained and the décor within the home is kept looking fresh. The new extension is particularly well appointed and the owners have plans to continue with the redecoration of the parts of the building that need it. The furniture and fittings are good quality and domestic in style. There are no outstanding requirements from the local environmental health department or the fire safety officer. Two relatives made comments about the need for improved facilities in the garden but the home has already made plans for this to happen. One relative included in a survey the fact that when visiting the home they were “…impressed by how clean everywhere was…”. This reflects the Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 14 inspectors’ experience on the day of the inspection that the home was clean and had no unwanted odours. Clothes washing machinery (ozone system) provides appropriate washing cycles for foul or infected items. There is an appropriately secured cupboard for storage in keeping with the Control of Substances Hazardous to Health Regulations and there are hand-washing facilities. There are appropriate policies and procedures in place. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 15 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: The rota indicated that there are sufficient staff on duty. There is a management structure of manager, head of care and seniors. Each member of staff has a senior who provides a mentoring role. There are domestic staff members and a maintenance man. Staff are encouraged to gain their national vocational qualifications and this is ongoing. Staff records seen during this inspection were well maintained and provided information which showed that the recruitment procedures include two written references, Criminal Records Bureau checks, and terms and conditions of employment. The home does not currently provide of copies of Codes of Conduct published by the General Social Care Council but the manager and owners agreed to rectify that immediately. There is a training programme in place and the induction training is in keeping with Skills for Care guidance. Some training is provided by external trainers and some in house. Mrs Dunford has ‘standards of care’ meetings where a particular topic is discussed. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 16 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: Mrs Dunford is experienced and has a nursing qualification. She is undertaking further work to secure her registered manager’s award. She is very experienced and has worked in residential care settings for many years. Questionnaires are used to get feedback from relatives and there is a summary of the findings available. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 17 The owners carry out visits to home and provide reports under Regulation 26 of The Care Homes Regulations. The owners visit more often and both they and the manager confirm that they work together well to agree on any necessary improvements. Mrs Dunford confirmed that where the home has any involvement with any residents’ money, there are clear records maintained. The training programme covers a range of aspects of health and safety such as first aid, food hygiene, manual handling and fire safety. The fire safety checks are appropriately carried out. The home has relevant and appropriate policies and procedures and a spot check on maintenance and service contracts showed that these were satisfactory and up to date. Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 18 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 X X 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 3 X 3 X 3 X X 3 Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Filsham Lodge Residential Care Home DS0000062001.V345745.R01.S.doc Version 5.2 Page 21 - 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!