Inspection on 28/11/05 for Forest Lodge Care Home

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

Other inspections for this house

Forest Lodge Care Home 21/05/08

Forest Lodge Care Home 12/12/07

Forest Lodge Care Home 21/05/07

Forest Lodge Care Home 02/05/06

Forest Lodge Care Home 28/07/05

Forest Lodge Care Home 10/01/05

Forest Lodge Care Home 30/07/04

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

CARE HOMES FOR OLDER PEOPLE Forest Lodge Care Home 20 Forest Road East Nottingham NG1 4HH Lead Inspector Meryl Bailey Unannounced Inspection 28th November 2005 11:30 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 Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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 Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Forest Lodge Care Home Address 20 Forest Road East Nottingham NG1 4HH 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) 0115 978 0617 0115 942 2582 Mr Riaz Khan Mr Riaz Khan Care Home 28 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (28) of places Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To admit one client aged 55 years of age with Alcohol Dependency. Staff to receive additional training to meet needs of service users with alcohol dependency To continue care of one service user aged 61 years as identified in application number 19353 dated 19/03/05 28th July 2005 Date of last inspection Brief Description of the Service: Forest Lodge provides care for a maximum of 28 older people in a large, detached house within one mile of the city centre and close to the tram route. Staff are multi-lingual and current service users are from various cultural backgrounds. Accommodation is arranged over two floors and includes four bedrooms with en-suite toilets. Other rooms are mainly single with two double rooms available. In addition to the two lounges and a dining room there is also a conservatory offering a choice of communal space. The home overlooks the Forest recreation ground and is also close to the Arboretum Park. There is an external patio area and ample car parking. A sloped entrance provides access for wheelchair users and a stair lift and a newly installed passenger lift are available to access the first floor. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector during one day and was unannounced. Some service users gave their views and the owner / manager, deputy and administrator were present during the day and contributed information. The communal areas of the home were seen, but only a sample of bedrooms was viewed on this occasion. What the service does well: What has improved since the last inspection? What they could do better: There are some activities taking place in the afternoons, but these are not clearly planned with service users. The manager should provide a clear plan of activities available each day on a notice board and in a suitable format. Generally, notices currently displayed are old and need replacing. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 6 The revised complaints procedures should be clearly displayed for service users and visitors Improvements to the environment are ongoing, but some repair work is needed: 1. A toilet seat needs replacing; 2. A tile needs replacing in a bathroom; and 3. A window in the conservatory is broken and needs replacing. Also, some records are incomplete. 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 Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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 Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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): 7 and 9 Care plans are in place and set out how needs are to be met by staff. Medication is well organised EVIDENCE: Care plans of three service users were examined and some clear instructions for staff were found. There were individual plans for identified needs, such as: hygiene, hearing impairment, emotional well-being, diet and mobility. Risk assessments were incorporated in the plans for falls, behaviour and eating. There were daily records of significant events, though for some nothing significant had been recorded for a few months. Each plan had, though, been reviewed on a monthly basis. All medication is stored in a locked cupboard. Each service user’s medication is contained within an individual box clearly labelled with name. No controlled drugs were currently held. The manager, deputy and two other staff have received training from the pharmacist and are responsible for administering medication. Records showed that procedures for recording were being followed. None of the service users are self administering their medication at present through choice and assessed risk. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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): 12, 13 and 14 There are various activities available, but these are not all planned with service users and many are not aware of what is available. Relationships are maintained with family, friends and the local communities. Service users exercise some choice within the environment. EVIDENCE: Service users had some choice about where to spend their time. Some were in the main lounge and two to three spent their time in the rear lounge. Some prefer to be in their own rooms and one had a sitting area with television outside the rear lounge. No organised activity was taking place during this inspection and there was no written plan of activities, but staff and service users reported that there were occasional outings and some activities such as dominoes and cards during the afternoons. Some service users had been assisted on shopping trips and walks, but were unaware if this would be repeated. The home took part in a community project with the Girls High School and groups of girls were supervised whilst playing cards and board games individually with service users on some Thursday afternoons. Some service users enjoyed Crocheting and reading books with large print. A clear plan of activities would help service users to know what activities were offered. There were regular visits from families and friends. Two service users attended the Asian community day centre on some days. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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): 16 and 18 There is a complaints procedure, but service users are not aware of this. Service users are protected from abuse, though clear records of financial transactions are needed. EVIDENCE: An appropriate complaints procedure was issued with the service user guide to service users and their families. However, it was not displayed within the home. Three service users spoken with were not aware of the procedure, but two said they would speak to relatives if unhappy about anything at the home. No complaints have been received since the last inspection. A copy of the Nottinghamshire Committee protection of Vulnerable Adults policy and procedures was available at the home with up to date amendments and evidence was seen that the owner / manager has registered to attend training related to these procedures in January 2006. Other staff have received some awareness training regarding adult abuse. As at previous inspections the deputy manager stated that families or other representatives deal with financial affairs, but the home pay for hairdressing and other small items, claiming them back from relatives later. Clear records of these transactions still need to be established for everyone’s protection. This is required under standard 35. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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 and 26 A clean environment is provided and maintenance is ongoing, but further attention to some maintenance is required to ensure safety and comfort. EVIDENCE: The premises are well established and suitable for use as a care home. The parking area and front gardens were still being developed. This work has been taking place for some considerable time and needs to be completed. The communal areas, bathrooms and some bedrooms were seen. They are generally well maintained and decorating was in progress, but some repair work is needed: A toilet seat needs replacing; A tile needs replacing in a bathroom; A window in the conservatory is broken and needs replacing. A new passenger lift had been recently installed, but was not ready for use. All areas were found clean and the laundry was well equipped. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 13 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): 28, 29 and 30 Most staff have received appropriate training to meet the needs of the service users, though there are some gaps. Recruitment practices have improved recently, but more work is needed to ensure procedures fully protect service users. EVIDENCE: Four of the care staff were currently undertaking a National Vocational Qualification at level 2 in care practices. Three had already obtained this qualification and two of these were pursuing level 3. There was evidence of other appropriate training in training records of some staff, but for one person records were incomplete and there was no evidence of induction training or of any contract of employment being issued. Staff records show that since the last inspection work has been done in obtaining references for new staff and completing Criminal Records Bureau checks. However, the umbrella body (Nottingham Council for Voluntary Service) has not passed on the full disclosure. Instead a letter has been received stating, “no information was disclosed”, together with the reference number and date of issue. This is not sufficient and the national policy and guidance relating to these checks states: Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 14 “Where an Umbrella Body system is used, it remains the responsibility of the provider or appropriate manager of the establishment or agency (and not the Umbrella Body) to make decisions on whether a person is or is not suitable to work in the service on the basis of the results of the CRB Disclosure information. To do this the Umbrella body will pass their copy of the Disclosure to the provider or appropriate manager.” Full guidance is available at www.csci.gov.uk. The provider/manager must request a copy of the full disclosure on each occasion. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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): 31, 33, 35, 37, 38 The home is run by an experienced provider / manager, who continues to develop management skills. Attempts are made to gain the views of service users about quality. Some records are omitted and these are required for the protection of staff and service users. EVIDENCE: The Provider is also the registered manager and he is currently undertaking training at National Vocational Qualification level 4 Registered Managers’ Award. There has been an attempt to use questionnaires to seek service users’ and relatives’ views about the quality of the service. However, this was not successful, since one service user repeatedly removed the forms. An alternative method was being planned. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 16 As at the last inspection, no cash or valuables are held on behalf of service users, but the owner / manager makes some payments for services and items and then receives money from relatives at a later date. Some receipts were seen, but written records have not been maintained in accordance with the policy. This was required at the last inspection and must now be actioned. The content of staffing records had improved greatly since the last inspection, but for one member of staff there was no contract of employment or induction training recorded. An accident recorded in the daily notes for one service user was not formally recorded on an accident record and the Commission had not been notified of this either. However there was evidence of assessing risks to service users and staff with appropriate preventative action taken. Training in safe working practices was arranged for all staff and some updating in Moving and Handling was booked for January 2006. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X 2 3 Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 18 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 OP19 Regulation 23(2)(b) Requirement Ensure all maintenance work is completed including: A toilet seat that needs replacing; A tile that needs replacing in a bathroom; And replace the broken window in the conservatory. Ensure written records are kept of all cash transactions on behalf of service users. Overdue All records relating to staff as detailed in schedules 2 and 4 of the Care Homes Regulations must be held in respect of each member of staff. (Records are incomplete for one staff member) Record all accidents in the accident record book and notify the Commission of serious incidents affecting service users aswell as all deaths Timescale for action 31/01/06 2 3 OP35 OP37 13(6) (4.9) 19(1) (2 and 4) 28/11/05 31/01/06 4 OP37 17(2) and 37 28/11/05 Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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 2 3 Refer to Standard OP12 OP16 OP29 Good Practice Recommendations Provide service users with a clear plan of suitable activities available each day. Display the complaints procedures clearly for service users and visitors. Regarding Criminal Records Bureau checks the provider should request a copy of the full disclosure from the umbrella body. Forest Lodge Care Home DS0000002198.V268840.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Care Home DS0000002198.V268840.R01.S.doc Version 5.1 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. 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