Inspection on 12/05/05 for Garden Lodge

This inspection was carried out on 12th May 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

Garden Lodge 24/07/07

Garden Lodge 20/07/06

Garden Lodge 24/10/05

Garden Lodge 13/10/04

Garden Lodge 10/06/04

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

CARE HOMES FOR OLDER PEOPLE Garden Lodge Philipson Street Walker Newcastle upon Tyne NE6 4EN Lead Inspector Allan Helmrich Unannounced 12 May 2005 10:00 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 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 B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Garden Lodge Address Philipson Street Walker Newcastle upon Tyne NE6 4EN 0191 263 6398 0191 263 6946 N/A Manor Care Home Group Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jackie Mead CRH 41 Category(ies) of DE(E) Dementia - over 65 (20) registration, with number OP Old Age (21) of places Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: No conditions are applied Date of last inspection 13th October 2004 Brief Description of the Service: Garden Lodge is a modern purpose built care home providing accomodation with personal care for up to 41 residents. The accommodation consists of 2 units, both on the ground floor with the upper floor used for storage and staff facilities. One unit consists of 20 bedrooms with ensuite toilet facilities for frail older people, the other is of 20 bedrooms with ensuite toilet facilities for older people with a dementia. The home does not provide nursing care. Garden Lodge is situated in a residential area of Walker, a suburb to the east of Newcastle upon Tyne. The home is close to local shops and public transport links. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was done in one day. The inspection lasted just over 6 hours and in that time the inspector spoke with several residents and their visitors. Management and staff were interviewed, a selection of records maintained in the home were reviewed and there was a general tour of the building. This was generally a very good inspection and my thanks go to the manager, her deputy and the staff on duty for their co-operation during the day. What the service does well: What has improved since the last inspection? The home has maintained its environmental standards and has attempted to provide a garden at the rear of the building with the provision of some seating and tables. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 6 Training is continuing and the manager is near completion of the Registered Managers Award. A quality assurance document is being used to improve the quality of care provided, this was not reviewed at this inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 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 standard(s) 1, 2, 3, 4, 5, 6. A home’s brochure and Service User Guide are available to prospective residents providing good information regarding the home. A pre-admission assessment is conducted by management prior to each admission to ensure the home is suitable. An opportunity to visit the home is provided prior to admission. Each resident benefits from a contract and a statement of terms and conditions. These elements demonstrate the home is unlikely to admit anyone for whom the appropriate standard of care cannot be provided. EVIDENCE: A pack of information to enable prospective residents to make an informed choice regarding the home is available. Visitors and residents spoken with had received information prior to making a decision to stay in the home. This information could be made more readily Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 9 available and accessible to all residents and visitors. This file could contain; the latest inspection report, details of forthcoming entertainment and with the permission of residents, some photographs of past events. Four residents files were checked, each contained a local authority contract, a copy of the home’s terms and conditions and a pre admission assessment. There are health and ‘daily living’ type assessments in place and these were evaluated periodically. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11. Good quality records are maintained regarding residents’ health and personal care needs which is important in ensuring the identified needs of residents are met. The system of administration and dispensing of medicines is adequate and is followed. A good standard of palliative care is provided supported by appropriate professional services. EVIDENCE: The four care plans reviewed, contained detailed information regarding activities of daily living. These were regularly evaluated. Two visitors and those residents able to comment were aware of recordings held in the home and of their right to see them. The manager agreed to review the recorded details for one resident’s activities that were outdated. Risk assessments are in place to ensure residents’ safety is maintained. These recordings are now due to be reviewed. The records for the administration and dispensing of medicines were generally satisfactory. The manager was requested to ensure the recording of a tablet supplied in halves was recorded appropriately and that a modern medical reference book was available for staff. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 11 The details of palliative care currently provided in the home were reviewed and found to be appropriate. Supportive policies and procedures are in place and training has been provided to the staff team. This care is supported by the community nursing service, with a community liaison nurse visiting the home weekly to discuss any issues. A guest room would be made available if possible, meals can be provided and a wake is held in the home if requested by the family. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Arrangements are in place to provide residents’ with choice and control over their lives. A good range of food is provided with the opportunity for individual choice. A range of appropriate activities are in place both within and outside of the home. Visitors are made welcome. EVIDENCE: A record of individual choice is retained in the home and whenever this choice is restricted a risk assessment is produced and discussed with the resident. Several residents visit church, a nearby day centre and visit local shops, supported by staff. In the home one staff member is responsible daily for organising appropriate activities, these include; beauty sessions, reminiscence quizzes, board games and for individual staff to sit in conversation with individuals and groups. Several of these activities were observed during the day. The minutes of a recent residents’ meeting demonstrated a range of topics with individual comments recorded. The manager confirmed that one resident not wanting either menu choice was to be provided with a substantial alternative of his choice. This was confirmed by the resident during the inspection. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 13 The kitchen was clean and hygienic. The cook provided details of the variety of food provided and of the different styles of presentation. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18. Residents and visitors are comfortable about making a complaint and are confident their concerns are taken seriously. EVIDENCE: Residents and visitors asked were confident that management take complaints seriously. A log of complaints is maintained in the home and these were investigated and well documented. One issue regarding an abusive visitor should be concluded in writing. Staff have received training in abuse awareness and those spoken to were aware of their duty. Local councillors visit the home regularly and a political advocate visited the home to support those residents wanting to use a postal vote. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 15 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The home is well maintained and provides comfortable accommodation with easy access to all internal areas. The garden area is secure with seating and tables but does not provide good access to wheelchair users and less ambulant people. EVIDENCE: The home is near to local shops and other community facilities. It is accessible and safe with all residential areas being on the ground floor. The home is well maintained with tidy grounds. A recent visit by the Environmental Health Department highlighted some issues. The manager stated these were all addressed. Seating areas are provided throughout the home and there is a separate dining area for each unit. A secure rear garden area has recently been provided. Stepping stone paving allows more ambulant residents to use the seating and tables provided. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 16 On the day of inspection the conditions outside were bright and warm, inside the lighting and ventilation in the home was satisfactory. Bedrooms meet the minimum requirements and have en-suite toilets and hand basins, furnishings are appropriate with some furniture having been brought in by the resident to provide a more homely feeling. There are handrails throughout the home and a hoist is available if required. Each unit has an assisted bath and one unused bathroom is to be converted to a shower room in the near future. A call system is available throughout the home as is emergency lighting. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30. The staff team have a good range of qualifications and experience and are employed in sufficient numbers to meet the current needs of the residents. The procedures for recruitment of staff are not robust and do not offer protection to the residents of the home. EVIDENCE: The majority of the staff team including management have worked in the home for several years, thereby providing a consistent approach to care. Visitors and residents were complimentary about the staff team. A training plan is in place for each staff member. Induction and foundation training is provided in house, staff then progress to NVQ and statutory training. Staff confirmed that a range of appropriate training is provided. The staff numbers trained to NVQ level 2 or above in care exceeds the requirement. The files of two recently employed staff contained much of the information required. One person was employed in February without a Criminal Records Bureau check having been obtained. The manager checked with head office who had just received a satisfactory check that day. The manager is reminded that no one should be employed without this check in future. It is recommended an employment audit sheet is used to demonstrate appropriate information has been received or provided. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 37, 38. The manager has many years experience in the care of older people and runs the home in the best interests of the residents. The building is well maintained with a reasonable standard of health and safety. EVIDENCE: The manager has many years experience of providing care for older people and is nearing the completion of the Registered Managers Award. Staff spoken with stated morale in the staff team is high and that management provide clear direction in the standard of service expected. There are regular meetings involving staff and residents where a good range of issues are discussed. A company quality assurance document is being used in the home to improve the standards. Development plans were not reviewed at this inspection. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 19 The fire log was up to date with regular entries in two separate logs. A separate record of fire instruction is signed by staff. It is recommended that only one fire log is used to record fire checks. Accidents are well recorded, the log is countersigned by management for quality and a separate analysis of falls is produced. The manager is requested to meet data protection requirements by storing staff accident reports in accordance with the procedures detailed in the log. A training analysis ensures all staff have accredited training in; moving and handling, first aid, fire safety, food hygiene and infection control. Cleaning materials are safely stored and regular premises checks are conducted by management to ensure the home is safe. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 3 x x x 2 3 Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 21 Are there any outstanding requirements from the last inspection? 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 OP29 Regulation 19(1) Requirement All staff should have a valid Criminal Records Bureau check in place before the commencement of their employment. To demonstrate this proces it is recommended the home use an employment audit checklist. The registered manager should obtain the Registered Managers Award by 31st December 2005. Timescale for action 30/6/05 2. OP31 9(2) 31/12/05 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. 4. Refer to Standard OP15 OP15 OP19 OP37 Good Practice Recommendations Training should be provided for catering staff concerning appropriate foods for older people with a dementia. Vegetables should be stored off the floor and frozen meats should be dated. These are considered to be good practice issues. Consideration should be given to improving access to the new garden area for less ambulent residents. This could be done by improving the pavement. One log book should be used to record fire procedures to avoid confusion. Review the storage of staff accident B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 22 Garden Lodge records as detailed in the accident log. Garden Lodge B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 B53-B03 S446 Garden Lodge V221273 120505 Stage 4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!