Inspection on 16/01/07 for Freda Gunton Lodge

This inspection was carried out on 16th January 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

Freda Gunton Lodge 11/01/06

Freda Gunton Lodge 01/06/05

Freda Gunton Lodge 24/02/05

Freda Gunton Lodge 19/10/04

Freda Gunton Lodge 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Freda Gunton Lodge Balkerne Gardens Colchester Essex CO1 1PR Lead Inspector Diana Green Key Unannounced Inspection 16th January 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 Freda Gunton Lodge DS0000017824.V327612.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. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Freda Gunton Lodge Address Balkerne Gardens Colchester Essex CO1 1PR 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) 01206 574786 01206 542149 admin@balkernegardens.fednet.org.uk Balkerne Gardens Trust Limited Mrs Virginia Giles Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Freda Gunton Lodge provides residential care for 40 older people. It does not offer nursing or dementia care. It is situated within the grounds of the Balkerne Garden Trust, who also have sheltered housing on the same site. The trust is a non-profit making charitable organisation that offers accommodation, predominantly, to service users who live in the Colchester area, or have family living in the area. Accommodation is provided on three levels with 36 single rooms and two double rooms, the majority of rooms having en-suite facilities. There are two passenger lifts. All rooms are well maintained, comfortably furnished and spacious. The home is situated within walking distance of the centre of Colchester and close to local amenities. These include shops, restaurants, a post office, a theatre, a library and parks. The complex has a security system in place for the protection of service users. The fees range from: En-suite single room - £480.00 per week En-suite double room- £768.00 per week (married couple). Respite room - £72.00 per night. Additional costs apply for chiropody, toiletries, hairdressing and newspapers. This information was provided to the CSCI on 16/01/07 Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 16 January 2007 beginning at 10:00 and ending at 14:00hours. The inspection process included: discussions with the registered manager, the deputy manager, three staff, four service users; observations on a number of residents’ rooms, several bathrooms, communal rooms and sluice rooms; a sample of policies and procedures and care records. Twenty-eight standards were covered, and two recommendations made. The inspection found that the outcome for all standards inspected had been met and action had been taken promptly to address the previous requirements. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well: Freda Gunton Lodge provides a good standard of personal care. Standards for assessment and care planning are robust. Staff are sensitive to meeting residents’ needs and make efforts to ensure new residents feel at home. Care staff are well trained and supervised and this is evident in their practice. There is good communication between the staff, GP’s and district nursing staff, ensuring residents’ health care needs are well monitored with appropriate action taken. Residents are supported to make choices in their daily lives and to maintain their independence where possible. A full and varied social activities programme is in place and enjoyed by residents. Those who choose not to take part have their privacy respected. Typical comments made by residents include: “they are so kind”; “all the girls are lovely”; ”they have helped me tremendously to settle in”; the staff are marvellous”; “they have made me very happy: they have helped me to get over losing my home”. Communication with residents’ representatives is good ensuring they are kept informed of changing needs. The premises are safe, clean, well maintained and provide a homely environment. Appropriate well-maintained equipment is provided to maintain residents mobility needs. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 6 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. Freda Gunton Lodge DS0000017824.V327612.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 Freda Gunton Lodge DS0000017824.V327612.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, 2 & 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives had the information they needed prior to making a decision on admission to the home. Comprehensive assessments were undertaken that included all care needs ensuring they could be met at the home. This home does not provide intermediate care EVIDENCE: The home had a statement of purpose and service user guide that met the standard and were made available to residents and their representatives. The manager or deputy manager assessed prospective residents either at home or hospital wherever possible and this was confirmed from the three files inspected. Copies of care management assessments were held on file where relevant. Following admission a full assessment was undertaken and included a risk assessment for falls. Copies of the residents’ contracts were also seen. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 9 These set out in detail what is included in the fee and the role and responsibility of the provider and the rights and obligations of the resident. The terms and conditions had been recently reviewed and offered a 42-day trial period. This home does not provide intermediate care Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 10 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. This judgement has been made using available evidence including a visit to this service. Care planning is clear and consistent and provides staff with comprehensive information to ensure residents’ needs are appropriately met. The health care needs of service users are well met through close monitoring of changing needs and referral to health professionals where relevant. The systems for administration of medicines are good with clear and comprehensive procedures in place that are generally well adhered to. Staff ensured residents’ privacy and dignity was respected. EVIDENCE: The new system of documentation introduced prior to the previous inspection is now fully in place. Arrangements were in place to ensure care staff were supported through continued development in assessment/care planning. Three care files were inspected. All three contained care plans that covered all key needs (physical and social) and provided good detail of the action required of staff to meet residents’ needs. Risk assessments were undertaken for falls, Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 11 nutrition, moving and handling and pressure areas/tissue viability. The daily records were comprehensive and demonstrated that health and social and mental health needs were well-monitored and appropriate action taken promptly as required. Health and safety assessments were also undertaken for sensory impairment where relevant. Care plans were reviewed monthly and more frequently as needed. Weights were recorded monthly and appropriate action taken where indicated. Standards of personal care were observed to be good. Individual attention was also given with make-up/manicures as residents chose. The home had a medication policy and procedures in place that included a homely list of remedies agreed with GPs. Systems for ordering and return of medicines were satisfactory. The providing pharmacist provided medicines in a monitored dosage system. Medicines were stored appropriately in lockable facilities in the treatment room and temperatures were monitored and recorded. Records of administration were well recorded but advice was given regarding the use of codes. Temazepam was stored and monitored as for controlled drugs as is recommended as good practice. A medication profile was being developed for each resident that included the potential side effects for each drug that care staff need to be aware of. This is acknowledged to be good practice. Risk assessments were undertaken for residents who chose to self medicate and lockable facilities were provided in their rooms. However during a tour of the premises eye drops that were being self administered by a resident were observed left in a tissue box. Residents spoken with said that staff were polite, respected them and upheld their privacy and dignity, especially when providing personal care. During a tour of the premises staff were observed to knock before entering a residents’ room and to address them by their preferred name as indicated in their care plan. Residents confirmed that they received their own post and could use a telephone in private. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social and therapeutic activities offered at the home met residents’ cultural needs and expectations and enhanced their daily lives. Visitors were warmly welcomed into the home. Residents were enabled to exercise choice and control over their lives. The home provided residents with a well-balanced and nutritious diet with choices acommodated. EVIDENCE: Freda Gunton had two activities coordinators who arranged a full and varied programme of activities. This included a craft club three days per week offering craft based activities, quizzes, etc. A video morning is held weekly and scrabble, whist and bridge are played between interested residents, staff and tenants from the nearby sheltered housing unit. There were also a number of volunteers who provided occasional lunch-time drinks and a fortnightly shopping trolley for residents. Another volunteer visited to provide a piano music session fortnightly. Various entertainment is arranged throughout the year and outings are made to shops, the theatre, and to coffee mornings and Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 13 tea parties at another care home in the trust. Photographs of the various events that had been organised were also on display at the home. Residents spoken with said that their visitors felt that staff were very welcoming. They also found the manager and staff friendly and supportive and communication was very good. The service users’ guide and record of activities confirmed that links were made with the local community. Regular communion and church services were held at the home and representatives of various faiths attended as needed. During this inspection residents were observed taking part in the various activities whilst others chose to stay in their own rooms or to go out of the home. Residents were able to have their own hairdresser and chiropodist or those provided by the home. Several residents spoken with said they could choose when to get up and to go to bed. However one resident said they would prefer to be assisted to get up earlier in the morning but that this had not been possible due to staff not being available at that time. Residents spoken with said they appreciated being able to bring in their own pieces of furniture into the home. Meals were served in the large dining room where tables were pleasantly laid with table cloths, condiments, cutlery and drinking glasses. The menus observed were balanced and nutritious. The lunchtime meal of roast lamb, mint sauce, roast or creamed potatoes, cauliflower and peas was observed and was followed by fresh fruit and ice-cream. A vegetarian option was also offered. Staff were seen assisting residents who required it in a senstive and dignified manner. Residents spoken with said they found the food very good. One said they could have a hot breakfast and there was always a choice available. Care plans and nutritional records inspected detailed weight monitoring and action taken as needed. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are assured their concerns will be listened to and addressed wherever possible. Appropriate policies, procedures and practices were in place to promote the protection of residents from abuse. Staff receive regular training that ensures they are competent in their practice. EVIDENCE: The home had a complaints procedure that included the timescales within which complainants can expect a response. The procedure was included in the statement of purpose and displayed in the entrance of the home. A record of all concerns and complaints is maintained and includes the investigation and the action taken. Four complaints had been received in the last year and all had been addressed appropiately in line with the home’s procedures. The home had also received a number of thank-you letters from residents and their representatives complimenting the staff and services provided. The home had a comprehensive policy and detailed procedures for the protection of vulnerable adults. The deputy manager had attended a multiagency workshop arranged by the Essex Vulnerable Adults Protection Committee to become the trainer for the Trust on abuse. A programme of regular updated group training was provided annually for staff and their competencies assessed. New staff received training as soon as possible Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 15 following appointment. The deputy manager had also undertaken updated training to maintain her skills and knowledge. The recruitment records for three recently appointed staff were inspected. All showed that appropriate prerecruitment checks were undertaken prior to appointment (see standard 29). Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 16 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, 22, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Freda Gunton Lodge is safe and well maintained with appropriate equipment to maximize residents’ mobility. The home was clean and hygienic with safe infection control practices evident. EVIDENCE: A partial inspection of the premises was made that included communal areas, several bathrooms, a number of residents’ rooms, the kitchen, the clinical room, the sluice and the laundry. The home was in a good state of decoration, maintenance and repair. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. The home had two lifts, grab rails, ramps, hoists and other mobility equipment to meet the needs of residents. Wheelchairs were provided and were well maintained. Adjustable beds and pressure relief equipment were provided as needed. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 17 The premises were observed to be clean and hygienic throughout with no odorous smells. Residents spoken with said their rooms were cleaned each day to their satisfaction. The laundry was large and well organised with appropriate, well maintained equipment in place. Linen was observed to be well laundered and sorted for residents before being returned. Residents spoken with said the laundry was excellent. The home had infection contorl policies and procedures in place for staff guidance and the training records confirmed that staff received regular updated training in infection control. The required hand washing facilities were in place and safe practices were observed. The home had one mechanical sluice and two hopper sluices. Disposable urinals were also provided for convenience and to reduce the risk of infection. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels (skill mix, number and competence) were appropriate to the needs of residents. Staff were well trained and competent to care for residents. EVIDENCE: There were thirty-five residents at the home. Staffing numbers and skill mix met the levels agreed with the CSCI; from inspection of the staff duty rota and discussion with staff and residents, there was evidence that staffing levels were well maintained, and met the needs of residents. Some staff had left employment but generally turnover of staff was low and minimal agency staff were used so that residents were in the main cared for by staff who knew them. Information provided in the pre-inspection questionnaire indicated that seventeen care staff had NVQ level 2 or 3 (51 ). One senior care assistant was also undertaking NVQ level 4. The files of three recently employed staff were inspected. These showed that all the required checks had been made prior to appointment, including evidence of identification, employment history, two satisfactory references, health check, CRB disclosure and POVA first check. All staff received a Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 19 statement of terms and conditions. The staff handbook included the General Social Care Code of Conduct and Practice. Records provided with the pre-inspection questionnaire showed that staff were up-to-date with all mandatory training including health and safety, fire safety, basic first aid and moving and handling. A regular programme of updated training was provided that included leadership for senior staff, assessment/care planning, abuse awareness, medication, NVQ level 2 & 3 training. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 20 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 good This judgement has been made using available evidence including a visit to this service. The manager is supported well by senior staff in providing clear leadership throughout the home with all staff demonstrating a good understanding of their roles and responsibilities. A comprehensive quality assurance programme is in place that ensures the needs and wishes of residents are respected and acted upon. Residents financial interests are promoted and protected through robust systems that are well adhered to. EVIDENCE: The registered manager of the home is experienced, having managed the home for a considerable number of years. A deputy manager supported the manager and was responsible for care planning and documentation. Residents Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 21 spoken with said the manager was very accessible and helpful both to them and their relatives. There was a quality assurance programme in place. A recent survey had been undertaken that comprised a service user questionnaire for residents to complete at discharge following respite care. This had demonstrated that they were well satisfied with staff and the services provided. A trust-wide Quality assurance report had been produced during 2006. Visits required under regulation 26 had been undertaken monthly and reports sent to the CSCI. The systems for managing personal allowances of residents were checked and were confirmed to be accurate with receipts held as required. All residents had a relative/advocate to manage their finances on their behalf. From discussion with the manager it was evident that action would be taken to protect any resident who was the subject of financial abuse. Records held on behalf of residents were kept up to date and stored safely in secure facilities in a locked office in accordance with the Data Protection Act 1998. Records viewed at this inspection included: care plans, medication records, statement of purpose, service user guide, maintenance records, accidents/incident records, fire safety records and service users’ monies. The home had policies and procedures for health and safety. The trust had a designated health and safety manager who provided advice, support and training and undertook regular audits of the premises. There was evidence from the records and in discussion with the manager and staff that safe working practices were in place. All accidents, injuries and incidents were wellrecorded and appropriate action taken. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 22 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 3 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 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 3 3 Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 23 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. 1 2 Refer to Standard OP9 OP14 Good Practice Recommendations Ensure the appropriate storage of medicines including eye drops. This refers to those residents who choose to selfadminister. Ensure residents’ choice of time in getting up are discussed and acted upon where possible. Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Freda Gunton Lodge DS0000017824.V327612.R01.S.doc Version 5.2 Page 25 - 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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