Inspection on 15/05/08 for Harbledown Lodge Nursing Home

This inspection was carried out on 15th May 2008.

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

Harbledown Lodge Nursing Home 16/05/07

Harbledown Lodge Nursing Home 31/08/06

Harbledown Lodge Nursing Home 13/12/05

Harbledown Lodge Nursing Home 22/06/05

Harbledown Lodge Nursing Home 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Harbledown Lodge Nursing Home Upper Harbledown Canterbury Kent CT2 9AP Lead Inspector Sandra Crosby Unannounced Inspection 10:00 15th May 2008 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 Harbledown Lodge Nursing Home DS0000026096.V363158.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. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harbledown Lodge Nursing Home Address Upper Harbledown Canterbury Kent CT2 9AP 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) 01227 458116 01227 784816 manager.harbledown@njch.co.uk Unique Help Group Manager post vacant Care Home 56 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (56) of places Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. OP is 56 of which 30 beds can be DE(E) Date of last inspection 16th May 2007 Brief Description of the Service: Harbledown Lodge is an elegant Georgian country house, which is set within 50 acres of grounds and is accessed via a private drive. There is a separate Day Centre within the grounds, which is not included in this inspection report. There are adequate parking facilities at the front of the house. Harbledown Lodge is part of a group of care homes called the Nicholas James Care Homes Ltd. There are four other nursing homes owned by this company within the vicinity, and some activities for residents include more than one home at a time. The home can be easily accessed via the M2 motorway, and is close to the historic city of Canterbury, with all its accompanying facilities. Most bedrooms are for single use, and most have their own en-suite toilet facilities. Each room is fitted with a call bell, telephone point, and TV. The company added an additional category to the Home’s registration during 2006, so that older service users with dementia (and nursing needs) can be admitted to the home, as well as older people with nursing needs. There is no segregation between these categories, but the Provider has stipulated that service users who may be disruptive to others will not be considered suitable for admission. There is an enclosed garden area for the safety of residents with dementia, and outside doors are fitted with keypad locks for security. The fees range from £400 - £1000 per week, depending on the type of room, and the care needs required. The manger provided this information at the time of the inspection visit. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good, quality outcomes. This report contains the findings of the home’s key inspection and takes account of information obtained from various sources since the last inspection of 16 May 2007, including a visit to the home. An unannounced visit took place firstly on the 15 May 2008 between 10:00 hours and 15.00 hours, and then on the 16 May 2008 between 10.00 and 15.00. The visit included talking to the group manager, the manager, deputy manager, staff on duty, and residents. An accompanied tour of some areas of the home was made, and various records were seen. The person in day to day management is not registered with the Commission but for the purposes of this report is identified as the manager. The manager has worked at the home since August last year, and this was the first inspection at the home since she took up post. Following the inspection dated 16 May 2008 when the quality rating for the service was judged as adequate, the management and staff team at the home have worked very hard to improve the quality outcomes for residents. It was found that the requirements and recommendations made at the last inspection visit have now been met. The completed Annual Quality Assurance Assessment (AQAA) documentation was comprehensive and has been used to inform this report. Five out of fifteen resident’s surveys have been returned to the Commission, and indicated some negative comments about the home. However from discussion with staff and residents at the time of the visit all but one person gave positive comments about the home. The inspection was also shown a very complimentary article printed in one of the local papers in January 2008 praising the care provided at the home for their relative including comments ‘staff could not do enough’. ‘always somebody to hold a hand or give a hug’. On the day of the visit, the Inspector found the staff to be helpful and supportive to residents and to each other, and to be knowledgeable about the care needs of individual residents. The findings of this inspection indicate that standards have improved at the home. Good progress was noted in a number of areas, including good record keeping, opportunities for activities, and refurbishment of many areas in the building. The manager is actively creating an open and positive atmosphere in the home. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Staff training is ongoing A staff-training matrix has been completed Monthly reviews of service user plans have been maintained Regular supervision of staff on a one-to-one basis has been started A thorough quality assurance system is being implemented Many areas of the building have been improved, and include refurbishment to the entrance hall, communal rooms, many bedrooms, shared bathrooms and some en-suite facilities A ‘wet-room’ facility has been completed in one of the first floor bathrooms The kitchen has been upgraded including new tiling to the walls and new floor covering Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 7 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. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 8 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 Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 9 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): Standards 1,3 and 6 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The company provides suitable information to enable residents to make an informed choice about coming into the home. Detailed pre-admission assessments are carried out. EVIDENCE: The Statement of Purpose and Resident’s Guide are readily available to view and are in the same format. The Statement of Purpose seen was dated October 2007, and provided all information as required by regulation. The complaints procedure is included and is up to date. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 10 The Service Users’ (Residents’) Guide is produced in large, bold print, and includes the terms and conditions of residency, as well as the complaints procedure, a précis of the Statement of Purpose, a sample contract and a service user survey form. This document was seen at the last inspection visit. The manager confirmed that she usually carries out pre-admission assessments. Two completed pre-assessments were viewed and these had been well completed, with lots of details recorded about all aspects of residents’ health needs, emotional needs, and social needs. Residents are admitted for a trial period of 4 weeks, and all have a contract in place. Fees are charged according to the type of room, and the fee is specified in each contract. Joint assessments are also obtained – from hospitals/care management. Part of the pre-admission assessment is to determine if the resident needs any specialist equipment prior to moving in to the home – e.g. pressure-relieving mattress, nursing bed, hoisting facilities. Residents with dementia care as well as nursing needs, have additional assessments, to ensure that they do not have disruptive or challenging behaviour that could upset other residents. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 11 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): Standards 7,8,9,10 and 11 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans that show that person centred care is promoted, and that health needs are being met. EVIDENCE: Four service user plans were seen. They contained detailed assessments and care plans. The personal hygiene records are kept for each day and these records are stored in residents’ rooms, but kept in a drawer (with their agreement) to preserve confidentiality when visitors are present. Weight charts are also maintained as part of the care planning process, however these were not currently up to date, as the weighing machine had been sent for repair. Risk assessments and daily records were also seen at components of Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 12 the service user plan. The documentation is reviewed monthly or sooner if needed and showed discussion with other family members as appropriate. Residents were seen to be clean and mostly well groomed. The hairdresser was visiting on the day of the inspection. Residents were appropriately dressed for the time of year. Relatives are requested to check clothing items are clearly labelled, to avoid confusion over clothes. Care staff and the laundry lady assist with this process. Male residents had been shaved. Care staff stated that foot care is checked daily at each wash/bath/shower or bed bath, and this is included on the tick charts; and that oral hygiene is attended to twice daily. One care plan seen indicated in the daily records that the chiropodist was required and there was no further mention of the action taken. The manager followed this issue up and reported that it had been attended to. There are good records for multi-disciplinary involvement, showing appropriate referrals to other health professionals. These include GPs, speech and language therapist, physiotherapist, dentist, optician, and specialist support nurses. The service user plans seen showed good attention to detail in regards to wound care. Wounds are recorded separately, and records include graphs for the size of the wound, body mapping, and details of the wound at each dressing change. Photographs are included, and written consent was seen for the photographs to be taken. Since room is no date. used. the last inspection visit a new clinical room has been provided. The was well organised and an improvement on the previous facility. There overstocking of medication sent and no items were found to be out of It was reported at the last inspection visit that homely remedies are not Two systems are used for administration, with different Medication Administration Records (MAR charts). One system is supplied by Boots, and the other is supplied by a local GP surgery. The MARS sheets were seen, and discussion took place in relation to a couple of issues that the manager agreed to address. There were correct procedures in place for the management of controlled drugs, and for the disposal of unused medication. Nursing staff have received training for the administration of medicines. The home has good input from this GP, who visits 2-3 times per week as a routine, and will always visit promptly if the call is urgent. It was reported at the last inspection visit that care plans show some records in regard to any special wishes if residents are dying. Care staff will stay with residents who are dying, if relatives are not available. The home tries to ensure that residents are not inappropriately admitted to hospital if they wish to stay in the home, and their needs can be met. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 13 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): Standards 12,13,14 and 15 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident they will have satisfactory opportunities regarding lifestyle choices. Food is generally satisfactory, but could be improved at times. EVIDENCE: The home has an activities organiser, who oversees day-to-day activities for groups, one to one activities, and outings. Each resident has a life history taken, and the organiser finds out their preferred hobbies, likes and dislikes. The main lounge on the ground floor has a table at one end where many shared activities are carried out. This enables the organiser to spend time with five to six residents at a time, carrying out activities such as board games. Some residents like to actively take part, while others are happy to sit and observe. The lounge is also used for larger activities such as singing entertainment. The activities organiser talked about time spent on one to one Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 14 sessions, as there are many residents who do not particularly wish to join in with others. The activities organiser keeps a record for each individual person, so that she can see the things which they most enjoy taking part in. It was discussed with the manager that there are limited opportunities for one activities organiser to interact with such a large and diverse group of residents, especially at times when there is an increased number of residents with dementia. The manager said that the company is considering how best to address this issue. It was reported at the last inspection visit that residents have the opportunity to go over to the Day Centre in the grounds if they wish to do so, and mix with other people there. This enables them to broaden their circle of friends. Outings are arranged with the Day Centre driver, usually 2- 3 times per week, enabling residents to go out for a drive, or to a local town. Although the Day Centre is not included in the inspection, the inspector visited it briefly at the last inspection visit, in order to see this additional venue where residents can go if they wish to. Visitors are welcome at any time, and are invited to join in with activities with residents. There are also occasional residents/relatives meetings, when there is the opportunity to share ideas and suggest any changes. Residents said that the food is usually good, and that there is always a choice. The menus showed a varied and nutritious diet was provided. The daily record of the food provided was not comprehensively maintained and one of the chefs spoken with said they were in the process of setting up a suitable format for the recording of the daily records. Discussion took place on the first day of the inspection visit in relation to the main meal of the day being cooked and in the heated trolley at 11.15am. The chef said that this was done in order to allow sufficient time for him to plate all the meals. The manager said that the company were looking at employing a person to start at about 11.00am in order to assist with this process. Two of the heated trolleys seen in dining areas of the home were very dirty, and the manager agreed to address this issue. Some comments from completed resident surveys indicated that the food provided is not always consistently good. Main meals prepared for lunch looked well cooked and presented on the second day of the inspection visit. People feel their rights as citizens are recognised and promoted, including fairness, equality, dignity, respect, and autonomy over their chosen way of life. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and visitors know their complaints will be listened to and acted upon. Staff have good knowledge and understanding of adult protection issues, which protects the residents from abuse. EVIDENCE: The complaints procedure was on display in the entrance hall of the home, and is clearly set out with all the relevant details. The Inspector viewed the complaints log, and this showed that complaints are acted on. It was indicated that fewer complaints are being received since the manager has worked at the home. Evidence was seen that complaints made are recorded together with written information recorded about the action taken, and the outcome. The Adult Protection Team is currently investigating one complaint. The manager said that a follow up review is due, following which it is anticipated the adult protection alert will be closed. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 16 The home has a training programme in place for all aspects of staff training, including the recognition and prevention of adult abuse. (Safeguarding Adults programme). The Inspector was informed that the basics of this training are included in the induction programme. Training in relation to the Protection of Vulnerable Adults was taking place at the home on the first day of the inspection visit. Staff spoken with during the inspection was able to comprehensively answer questions in relation to the Thematic Probe on Safeguarding that was also undertaken as part of the inspection process. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 17 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): Standards 19,21 and 26 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and comfortable home that has been much improved by a continuing programme of refurbishment and redecoration. EVIDENCE: An accompanied tour of some areas of the home was undertaken. It was reported at the last inspection visit that communal areas, the entrance hall and corridors have all been redecorated and carpeted since the last inspection, and look much improved. Many of the bedrooms have been redecorated and refurbished, and new bedroom furniture, nursing beds and soft furnishings are evident. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 18 Since the last inspection the shared bathroom on the first floor has been refitted and now provides an additional ‘wet room’ facility. There is a “Parker” bath on the ground floor, an electric shower room on the ground floor, and a bathroom with a hoist facility on the first floor. A bathroom on the top floor has been refurbished. Some of the bedrooms have usable en-suite shower facilities. The kitchen has been refurbished with the walls being re-tiled and the flooring replaced. The kitchen meets the requirements of the environmental health officer. The laundry is in the basement, and has been fitted with two commercial washing machines and a commercial sized dryer. A red alginate bag system is used for soiled items. On discussion with the manager she confirmed that the sluice areas seen were in need of upgrading, and said that she would be talking to the company about this. The home has a passenger lift to all floors. Radiators are fitted with guards, and window restrictors are fitted throughout the building. There is a keypad system at the front door, for the safety of service users with dementia. There is a call bell in each room, and a system for checking residents at regular intervals if they are unable to use a call bell. The premises have extensive grounds, and these would enhance the property if the immediate flowerbeds were kept in better condition. Lawns are kept at a reasonable level. The inspector was told that the company are in the process of arranging for contractors to undertake this work. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 19 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): Standards 27,28,29 and 30 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective staff team, in sufficient numbers to meet their needs, are available to support residents. Staff training needs to be further developed to ensure that all care staff have the skills and knowledge to meet the needs of the residents. EVIDENCE: The staffing rota was seen, and indicates that currently there are sufficient staff on duty at all times to meet the needs of the current group of residents. The home currently had 35 residents. In addition to the nursing and ancillary staff there are six care staff on duty in the mornings, and four in the afternoons. It is the provider’s responsibility to ensure that, should additional residents be admitted that staffing levels should be reflective of the increased needs. Other senior staff, including a deputy manager, assists nursing and care staff. Residents said that they are usually attended to fairly quickly, but there are times when they have to wait for the necessary attention. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 20 Nursing and care staff are supported by ancillary staff that includes two cooks, kitchen assistants, laundry assistants, maintenance men and cleaning staff. Bedrooms are cleaned each day, and care staff highlights rooms where there is the need for more in-depth cleaning in any areas. The home currently has 50 care staff who have completed NVQ 2 or 3. Recruitment practices are satisfactory. Staff files have been re-organised and are now easier to access information. Five staff files were viewed and these contained all components as required by regulation for example application form, two references, CRB and POVA checks. The inspector was told that the company is currently reviewing the application form. The manager confirmed that one to one supervision of staff is now being undertaken on a regular basis. Evidence was seen of these records in one of the staff files. A staff training matrix has now been implemented, and indicates that training is ongoing at the home. It was seen that some staff had not completed mandatory training for example in moving and handling, fire and infection control. The manager confirmed that action is being taken to ensure that all staff undertake all required mandatory training. Dementia training for all staff has not been provided for staff despite the needs of residents. The group manager stated that this would be included in the future training programme. It is the provider’s responsibility to ensure that staff have the skills to match the needs of the residents admitted to the home. The manager stated that new staff have an induction using the “Skills for Care” induction programme, and evidence of the skills for care documentation was seen. People are well supported by a staff team that recognises and responds appropriately to their diverse needs and human rights. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 21 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): Standards 31,33,35,36 and 38 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their home is well run. Health and safety issues are attended to and ensure the residents and staff live and work in a safe environment. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 22 EVIDENCE: The current manager has been in post since August 2007, and is in the process of completing forms to apply to become the registered manager of the home. She is a level 1 nurse, has many years experience and has previously been a registered manager of a home. The inspector talked with a number of different staff, who spoke highly of the manager and said that if they have any concerns about residents or their care, they go to the manager. They were confident that she would address their concerns. Staff on duty on the day of the visit was aware of their differing roles, and the importance of working together. Some nurses have been designated with specific tasks – e.g. oversight of medication. Residents are assigned named nurses and key workers, to enable them to know who is most familiar with the details of their care. The manager has an open door policy to be available to staff and relatives. Staff said that staff meetings are held on a regular basis, and they are able to voice their opinions. Senior management carry out monthly audit checks in the home. Residents are encouraged to manage their own finances if possible, or relatives/advocates are appointed. The home does not manage any residents’ money except for “pocket money”. This is stored in individual wallets in a safe place, and all transactions are recorded and signed for by two people including the resident if possible. All receipts are retained. These records were viewed at this visit and indicated that they were appropriately recorded and up to date. Other records confidentiality. viewed were up to date and stored with regards to Care staff said that they can access the care plans at any time, and do so as needed. Policies and procedures are all in place and were reviewed at the end of 2007. The completed AQAA documentation indicates that equipment maintenance is managed satisfactorily. This includes lift and hoist servicing, fire equipment, emergency call bells, PAT testing, and gas and electrical checks. COSHH assessments are in place. Water testing for temperatures and chlorination is satisfactory. A thorough Quality Assurance system is being introduced that includes regular auditing of for example fire, human resources, medication, laundry, general environment together with the monthly Regulation 26 reports, meetings and surveys for residents and relatives. Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 23 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 X 3 X X 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 Standard No Score 16 3 17 X 18 3 2 X 3 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 3 X 3 3 3 3 Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 24 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. 3. Refer to Standard OP15 OP19 OP26 Good Practice Recommendations Maintain comprehensive records of the food provided The gardens to be maintained in good order Upgrade the sluicing facilities in the home Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Harbledown Lodge Nursing Home DS0000026096.V363158.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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