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Inspection on 10/10/05 for Garden Lodge

Also see our care home review for Garden Lodge for more information

This inspection was carried out on 10th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a small and friendly staff group who know the residents well, and continue to give a high standard of care. Residents spoken to during the inspection said they were very happy and felt that staff were helpful and kind. All residents are asked their preference for lunch at the start of the day.

What has improved since the last inspection?

The home has a new patio and residents and staff said this had made a huge improvement to their ability to get outside during the good weather. Four residents have pressure mats in their rooms, which alert staff when the person gets or falls out of bed during the night. This means that assistance can be provided as soon as an incident occurs keeping the residents safe. Residents commented that there is a better choice of food since the last inspection.

What the care home could do better:

There were three rooms that had unpleasant odours. Risk assessments and care plans should be updated when a resident returns to the home after a hospital admission to ensure the staff provide appropriate care. Senior staff should receive training relevant to their post. All food stored in the fridge should be dated.

CARE HOMES FOR OLDER PEOPLE Garden Lodge 37a Lincoln Road Glinton, Peterborough PE6 7JS Lead Inspector Mrs Alison Hilton Unannounced Inspection 10th October 2005 07:39 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 Garden Lodge DS0000015117.V253409.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. Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Garden Lodge Address 37a Lincoln Road Glinton, Peterborough PE6 7JS 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) 01733 252980 01733 252980 Mrs Touran Watts Mrs Touran Watts Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: Garden Lodge is a residential home in the village of Glinton close to the city of Peterborough. The home is registered for 10 older people. Garden Lodge is a chalet bungalow providing residential accommodation on the ground floor, with office accommodation on the first floor. The residential accommodation consists of eight single and one double bedroom. Two bedrooms have en-suite facilities. There is one large communal room set out with separate seating and dining area, and a smaller seating area in an annex. There is a patio outside and a very large garden.The home is close to village amenities, which include a shop, post office and public houses. Peterborough city centre is approximately six miles from the home. Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Monday 10th October 2005 between 07:39 and 10:00 hours. The homes deputy care manager arrived just after the start of the inspection. Night staff, day staff and residents were spoken to during the inspection. A tour of the building was undertaken and various records were seen. What the service does well: What has improved since the last inspection? What they could do better: There were three rooms that had unpleasant odours. Risk assessments and care plans should be updated when a resident returns to the home after a hospital admission to ensure the staff provide appropriate care. Senior staff should receive training relevant to their post. All food stored in the fridge should be dated. Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 6 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. Garden Lodge DS0000015117.V253409.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 Garden Lodge DS0000015117.V253409.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): EVIDENCE: None of the standards were inspected on this occasion. There have been no new admissions to the home to ensure the requirement (1) from the last inspection has been fulfilled. This was in relation to the home having comprehensive pre-admission assessments. Garden Lodge DS0000015117.V253409.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): 7,8,10 Care plans and all risk assessments had not been reviewed after hospital discharge and therefore the home could not ensure any changes to the health and care needs of the resident could be met. EVIDENCE: The one file inspected did not have all risk assessments or the care plan updated after the resident had been discharged after a hospital admission. This was especially significant in relation to weight loss during the time in hospital. There should have been a nutritional screening tool completed and more regular weight details taken after the discharge to ensure any further weight loss was noticed and dealt with. There was also an entry about bruising noted by night staff, which, according to the deputy care manager, had occurred in hospital (after a fall) but there was no evidence of this on file. Residents said that staff were always pleasant and caring. Staff were seen and heard to treat residents with respect. Garden Lodge DS0000015117.V253409.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): 13,15 The home now provides a more varied selection of food that residents find appealing. EVIDENCE: Most residents had breakfast in the dining room during the inspection. One resident had breakfast in his room as this was his choice. Residents said that there is now a much better selection of food and they are very pleased with this change. Food kept in the fridge after opening should be labelled with the date. Residents spoke about their friends and family visiting as well as going out with them. Garden Lodge DS0000015117.V253409.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): EVIDENCE: None of the standards were inspected on this occasion. Garden Lodge DS0000015117.V253409.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): 20,26 The provision of a new patio area has enhanced the independence of residents. In general the home is well maintained and clean. The exceptions were three bedrooms that do not provide pleasant and hygienic surroundings in which to live. This was a requirement made at the last two inspections. The last date for action was 10th June 2005. Failure to comply with this requirement by 1/12/05 may lead to legal action being taken by the Commission. EVIDENCE: The home has a new patio outside the dining room and staff and residents said how nice it was to be able to go outside safely. The residents said that they appreciated that they could get outside without having staff present, as it was now much easier. There were three bedrooms that had unpleasant odours. It was discussed with the deputy care manager that alternative flooring may assist with providing a Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 13 more hygienic and pleasant bedroom. This should be done in consultation with the resident and their families to ensure that choice and dignity are maintained. Garden Lodge DS0000015117.V253409.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): 27,30 Staff are not receiving appropriate training for their role within the home to ensure their competence. EVIDENCE: The staff at the home are all female, but this does not appear to be a problem for the residents or staff in relation to the support given to male residents. There are no residents who require the assistance of two carers. The manager is aware that if there is a change in the physical or mental health needs of any resident then the staffing levels would need to be reviewed. There continues to be one member of staff on duty from 08:00 to 15:00 hrs, one from 15:00 to 22:00 hrs and one waking night from 22:00 to 08:00hrs. During the week there is also a cook/carer from 09:30 to 13:30 hrs. There is always a member of staff (who lives close by) on call and the manager is often in the home completing paperwork and providing extra care time. This level of staffing appears adequate to meet the current needs of the residents. Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 15 The deputy care manager said that all staff had completed the statutory training and she was ensuring staff courses are updated when necessary. She has not received any training in relation to her role as deputy care manager, does not have a job description and was not able to describe all her responsibilities. It is therefore unclear how she is fulfilling her role as deputy care manager. She has NVQ Level 2 and would like to go on to complete NVQ Level 3 although there is currently no funding. Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NONE EVIDENCE: None of the standards were inspected on this occasion. Garden Lodge DS0000015117.V253409.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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 3 X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 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 OP7 Regulation 15 Requirement The care plan must be reviewed and updated to reflect changing needs and current objectives for health and personal care. The registered person shall keep the care home free from offensive odours. This was a requirement made at the last two inspections. The last date for action was 10th June 2005. Failure to comply with this requirement by 1/12/05 may lead to legal action being taken by the Commission. The registered person shall ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. Timescale for action 01/12/05 2 OP26 16 01/12/05 3 OP30 18 01/12/05 Garden Lodge DS0000015117.V253409.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 OP9 Good Practice Recommendations The registered person should provide an easier surface on the driveway for those service users with walking difficulties or in wheelchairs. This was a recommendation from the last inspection. The home has until 2005 to achieve a minimum ratio of 50 staff trained to NVQ 2 or equivalent. The manager is aware. This was a recommendation from the last inspection. The registered manager should establish a system for reviewing and improving the quality of care. This includes providing the Commission with a report in respect of the review. This was expected by September 2005. This was a recommendation from the last inspection but was not inspected, as the manager was not in the home. 2 OP28 3 OP33 Garden Lodge DS0000015117.V253409.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Garden Lodge DS0000015117.V253409.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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