Inspection on 27/09/06 for Garden Lodge

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Garden Lodge 10/07/07

Garden Lodge 10/10/05

Garden Lodge 09/05/05

Garden Lodge 01/11/04

Garden Lodge 26/04/04

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

CARE HOMES FOR OLDER PEOPLE Garden Lodge 37a Lincoln Road Glinton, Peterborough PE6 7JS Lead Inspector Dragan Cvejic Unannounced Inspection 10:00 27 September 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Garden Lodge DS0000015117.V291855.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. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 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 F/P 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.V291855.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th October 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 well-stocked 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.V291855.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, and was spread over two days, lasting around four hours in total. The proprietor was not available on the day of the first inspection, hence a second visit, and on the first day, one of the care staff assisted the inspector with the information required. It was also possible to talk to three of the service users living in the home. The home is registered for up to 10 older people, and charges between £360 and £370 per week. What the service does well: What has improved since the last inspection? Requirements made at the last inspection have been met, with one remaining outstanding, and since the last inspection some redecoration of the home has taken place, and the Patio area re-laid, enabling more use by service users. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Garden Lodge DS0000015117.V291855.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 Garden Lodge DS0000015117.V291855.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): 3 and 6 Quality in this outcome area is Good. This judgement has been made using available evidence and a visit to the premises. Detailed assessments are carried out and service users and families encouraged to visit the home to ensure their needs will be met. EVIDENCE: The home has a policy and procedure in place to ensure that the needs of service users are fully assessed prior to admission to the home. During the inspection, the pre admission assessment of a service user admitted in July this year was examined and discussed with the member of care staff working on the day. The assessment included information on care and health needs, social history, religion, and included details of friends or relatives who may visit. There was also evidence of the involvement in the service users family in the assessment. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 9 Similar information was available on two other service user files, and included the signature of the service users, and it was clear that the service user had been involved in the assessment. The home does not offer intermediate care. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is Poor. This judgement has been made using available evidence and a visit to the premises. The home must ensure their registration categories are accurate and health needs identified and met EVIDENCE: The individual service user files included details of care and health needs, together with risk assessments, both generic and individual, also including daily records, nighttime assessments, medication procedures, falls and continence assessments. Basic care plans were also included within the file, but further work is required on the care plans, ensuring that they are outcome focussed, and clearly involve service users. It is also important that the care plans are reviewed at least monthly, and evidence of the review available. It is also important that all health needs are suitably recorded, for example, where weight loss or gain is suspected, a record of regular monitoring of weight must be maintained, and where the needs of service users have changed, this must be addressed. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 11 There are currently more than one service users living in the home with a diagnosis either formal or informal of dementia. The home is not registered for dementia care, and if the service users are to remain living in the home, this must be addressed. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is Good. This judgement has been made using available evidence and a visit to the premises. Service users are able to take part in a variety of activities and served with a good range of appetising food. EVIDENCE: During the inspection, it was noted that a range of activities was displayed on the lounge wall, including reminiscence, chair exercise, a quiz, bingo and card games and service users indicated that these activities take place on a regular basis. Two service users spoken with said how happy they were in the home, it was relaxed and informal. They both felt the food was excellent, one having put on 2 stone in the five years she had lived there! The home is in a quiet residential area, and there are good links with the local community. Visitors are welcome at any time, and on both of the inspection days, relatives were visiting service users. Both service users spoken with felt that they were in control of their lives, and offered choices in all areas, and staff were seen offering mid morning drinks and biscuits. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 13 Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Quality in this outcome area is Good. This judgement has been made using available evidence and a visit to the premises. Concerns are quickly dealt with and policies in place to ensure service users are safe from abuse. EVIDENCE: The home has an appropriate complaints policy, and would deal with any complaint received in accordance with this policy, although over the last twelve months has not received any complaints. The home follows the local authority policy on adult protection, and ensures that staff all receive training in POVA procedures. There have been no incidents at the home requiring these procedures to be used. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 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 the following standard(s): 19, 20 and 26 Quality in this outcome area is Good. This judgement has been made using available evidence and a visit to the premises. The home offers a pleasant and safe environment for the service users living there. EVIDENCE: Garden Lodge offers the service users a pleasant and domestic style of living, and on the day of the inspection was clean and free from any offensive odours. Within the home are two lounge areas, offering service users the choice of where to sit, and the home has large gardens, which are used during the better weather and since the last inspection, the Patio area has been re-laid. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 16 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, 28, 29 and 30 Quality in this outcome area is Adequate. This judgement has been made using available evidence and a visit to the premises. Staffing levels must be adequate to meet service users needs. Staff are well trained and recruitment policies good. EVIDENCE: The home employs a small number of care staff, and in view of the increasing needs of some of the service users in the home may need to review this. The homes recruitment policy was discussed with the manager, and evidence seen on three staff files examined of all the required checks being made for new employees. Training is of a good standard and both mandatory and service users specific training provided, although the manager noted on the pre inspection information that additional training in the care of people with dementia is needed. The home’s deputy manager has recently left, and they are currently trying to recruit a new deputy manager. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 17 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, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence and a visit to the premises. Management arrangements must ensure staff are appropriately supervised. EVIDENCE: The home is managed by the owner, and appears to be well run, although the recent loss of the deputy manager has increased her workload, and she needs to ensure that robust management arrangements are in place when she is not available. This has also affected supervision arrangements, and at the present time, staff are not receiving supervision in accordance with the standards. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 18 Health and safety policies and procedures and staff training ensure that service users and staff are not placed at risk, and all the required maintenance is carried out. Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X 3 Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 20 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 OP1 Regulation 4, 5 Requirement The statement of purpose and service user guide must be updated to include the care of service users with dementia The care plan must be reviewed and updated to reflect changing needs and current objectives for health and personal care. This was a requirement made at the last inspection and must be addressed, as failure to comply will lead to legal action being considered. A variation request must be submitted to include care of service users with dementia Timescale for action 30/11/06 2. OP7 15 31/12/06 3. OP8 4. OP8 Care Standards Act (2000), Section 15 16 The registered person must ensure that the health needs of all service users are recorded and regularly monitored. 18 (1) 30/11/06 31/12/06 5. OP27 The registered person must ensure that the staffing numbers and skills of staff meet the increasing needs of service users 30/11/06 Garden Lodge DS0000015117.V291855.R01.S.doc Version 5.1 Page 21 6 OP36 18(2) The registered person must ensure that appropriate supervision arrangements are in place 30/11/06 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.V291855.R01.S.doc Version 5.1 Page 22 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.V291855.R01.S.doc Version 5.1 Page 23 - 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!