Inspection on 12/12/05 for Forest Lodge

This inspection was carried out on 12th December 2005.

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

Forest Lodge 13/07/07

Forest Lodge 22/05/06

Forest Lodge 19/08/05

Forest Lodge 11/02/05

Forest Lodge 09/06/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Deepdene Care Centre

Aldwick House

49 Glendale

Ferndale Residential Care Home

David Gresham House

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

CARE HOMES FOR OLDER PEOPLE Forest Lodge Horney Common Nutley Uckfield East Sussex TN22 3EA Lead Inspector Paul Taylor Unannounced Inspection 10:00 12 December 2005. th 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 Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Forest Lodge Address Horney Common Nutley Uckfield East Sussex TN22 3EA 01825-712514 01825-713653 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) Sussex Health Care Ambowatee Seeruthun Care Home 68 Category(ies) of Dementia - over 65 years of age (68), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (68) Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That service users must be sixty five (65) years or over on admission. That service users with a dementia type illness only be accommodated. That service users with a mental disorder only be accommodated. That the maximum number of service users to be accommodated is sixty eight (68). 19th August 2005 Date of last inspection Brief Description of the Service: Forest Lodge is registered for 68 people aged over 65 years on admission who have dementia or a mental disorder. Nursing care is provided in the home. The home is owned by Sussex Health Care and is located one mile north of Nutley, East Sussex. Due to it’s rural location there are no local amenities within easy distance of the home. The home is divided into three units spread over two floors. Each unit has a Registered Nurse and Unit Leader. There is a lift and there are ramps in the home to ensure that service users have access to all parts of the home. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place at Forest Lodge on 12/12/05. The inspection started at 10 a.m. and finished at 3.30 p.m. A Regulation Manager and a Regulation Inspector carried out the inspection. During the inspection the Inspectors met with the manager of the home, a senior nurse, care staff and nursing staff, service users and visitors to the home. A number of records were examined and a tour of the premises was undertaken. There were 57 service users living in the home at the time of the inspection. What the service does well: What has improved since the last inspection? Staff files examined contained all the information required by the National Minimum Standards. The care plans had been regularly reviewed and there are plans to improve their format. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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 Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Assessments were thorough and of a good standard and outlined the needs of potential admissions to the home. EVIDENCE: Copies were seen of pre admission assessments which are carried out by the manager of the home although there are plans to delegate this task to other members of staff when they have been assessed as competent to undertake this role. The assessments were detailed and contained a lot of information and formed the basis upon which care plans were developed. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 9. Health needs are thoroughly assessed and monitored and the care plans regularly reviewed. Medication is appropriately stored and administered. EVIDENCE: A sample of service users care plans was examined. The health needs of the service users were outlined in the care plans that had been regularly reviewed and this process had been signed and dated by the member of staff responsible. Corroborative notes had been made to ensure that issues had been monitored and addressed and there were records of doctors’ visits, the recommendations made as a result of these visits and how the recommendations had been implemented. The Inspectors were informed that the format for the care plans was due to be changed. An example of the new format was seen and it appeared to be a well thought out and thorough document. The administration of medication was observed. A nurse on duty was giving the medication during lunch. Records were completed appropriately and the home’s procedure was followed. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14. Visitors are made to feel welcome. Service users choices are respected and they have a range of activities offered to them by the activity assistants. EVIDENCE: The Inspectors met with three different relatives and friends who were visiting the home. All described the staff as friendly and welcoming. One relative was very complimentary about the care her relative receives and said ‘I can’t find a fault.’ A minister of religion provides a service at the home once a month. The home has three members of staff who act as activity organisers. They meet on a weekly basis to discuss the activity programme. At the time of the inspection manicures were being given to those service users who wanted them. The home had a series of activities planned for the Christmas period; these included carol singing, a play and a dinner to which relatives had been invited. Service users were observed to make choices on what they wanted to eat and if they wished to partake in activities occupational therapist or remain in their rooms. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. The members of staff are aware of their obligations with regards to the issue of adult protection. The manager had responded promptly to a concern raised by a member of staff. EVIDENCE: The Inspectors examined training records and these showed that training had been made available to members of staff on adult protection. The members of staff who met with the Inspectors were aware of what to do in the event that they had concerns over service users’ welfare. The Inspectors were also told about an incident where a member of staff had reported a practice issue to the manager and this had been promptly addressed. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25 and 26. The home was generally clean and there had been substantial refurbishment in some areas. The Inspectors found some areas which needed to be made safe such as the fire exit, mentioned below, the unrestricted window in the bathroom opposite room 35 and the fuse cupboard needed locking. One bathroom needed a deep clean and two service users rooms needed cleaning and /or redecoration. EVIDENCE: The Inspectors undertook a tour of the premises. On the whole the home was tidy and well maintained. Numerous rooms had been refurbished and the carpets had been replaced in both service users rooms and in the corridors and stairways. All service users seen were clean and appropriately dressed. The Inspectors found three storage rooms which had signs on the doors which said they should remain locked, these rooms were unlocked. The manager informed the Inspectors that the signs were inaccurate and that the store rooms could be left unlocked. Inside one of the rooms was a cupboard Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 13 containing fuse boxes and this cupboard was also unlocked. This cupboard needs to be kept locked. The Inspector found a fire exit leading to the front drive unlocked and the alarm was not working to alert staff of its use. A member of staff rectified this immediately when this was pointed out, however, this exit needs to be monitored and the alarm system kept active on it. One bathroom on the first floor was found to have an unrestricted window, the bath was in the process of being dismantled so that a shower could be installed but the room had been left unlocked and unattended. Faeces were found on a bath hoist in one bathroom and there were black bags containing clothes on the floor beside the bath. The floor in this bathroom was in need of a deep clean. Two of the service users’ rooms were found to have carpets in need of cleaning and one of these rooms had paint peeling off the wall at ground level under the bed. Some of the call bed extensions were grubby and needed cleaning. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30. Staff have access to a variety of training. Staff numbers and skills are adequate to meet the current needs of the service users. EVIDENCE: The Inspector examined a number of staff files. These were found to contain all the information required by the National Minimum Standards. An extensive record of training was examined. The staff team at Forest Lodge comprises approximately sixty members of staff. Therefore, due to the size of the staff team and shift patterns, some training is offered on a repetitive basis. Examples of training offered on this basis include fire training and training in dementia. The training record seen did not make it clear which staff had not attended all the key training. The Inspectors recommend that this system is made clearer. One member of staff who met with the Inspectors had not yet completed her induction after working at the home for three months. The manager reported that some members of staff had attended English lessons. Two visitors had reported that they struggled to understand some members of staff as they had strong accents. Members of staff who met with the Inspectors reported that there are enough staff on duty to meet the needs of service users. There is a clear chain of responsibility in the home. The manager provides a weekly briefing to the staff team to ensure that they are kept up to date with any issues or developments in the home. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 38. The manager has worked hard to ensure that the home meets standards required by legislation and had introduced systems to monitor the performance of the home. The plans for the new build on site need to be clarified and the Commission for Social Care Inspection informed what the use will be. The maintenance manager has a thorough system which monitors health and safety issues. EVIDENCE: Feedback from members of staff who had worked at the home prior to the current manager beginning her role was that systems had been improved under her leadership and that the home was more organised. The manager showed awareness of the challenges that her role entails and praised the teamwork shown by the staff group. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 16 The home sends out questionnaires on a monthly basis to relatives in an effort to gain feedback on how the home is functioning. Written evidence was seen on responses made to comments from the questionnaires. In addition to these questionnaires the manager holds meetings with relatives every three months and there are staff meetings every two to three months. There was major building work being undertaken in the grounds at the time of the inspection. The long-term use of the new build has not yet been made clear to the Commission for Social Care Inspection. The Inspectors asked the manager to let the Commission for Social Care Inspection know in writing what the intended purpose of the new build is when she has that information. The Inspectors met with the maintenance manager and examined the records for monitoring various safety issues such as electrical and gas checks, fire safety checks and emergency lighting checks. The system had ensured that these checks had been kept up to date. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 17 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 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 2 2 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X X X 3 Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 18 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 2 3 4 Standard OP25 OP25 OP25 OP26 Regulation 13 (4) (c) 13 (4) (c) 13 (4) (c) 23 (2) (d) Requirement That the fire exit leading to the front of the building is monitored and the alarm is working. That the fuse cupboard in the storage room is kept locked. That the window in the bathroom opposite room 35 is restricted. That the bathroom and bath hoist therein situated opposite room 55 is thoroughly cleaned and the clothes removed from beside the bath. That the rooms identified during the inspection as needing cleaning and /or redecoration have this done. Timescale for action 12/12/05 12/12/05 12/12/05 19/12/05 5 OP26 23 (2) (d) 31/01/06 Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations That the record of staff training shows who has not undertaken training identified as needing to be done. Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 Forest Lodge DS0000013987.V264818.R01.S.doc Version 5.0 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. 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