Inspection on 15/11/05 for Harrowby Lodge Nursing Home Ltd

This inspection was carried out on 15th November 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

Harrowby Lodge Nursing Home Ltd 26/01/07

Harrowby Lodge Nursing Home Ltd 23/02/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Harrowby Lodge Nursing Home Ltd 4 Harrowby Lane Grantham Lincs NG31 9HX Lead Inspector Kathryn Emmons Unannounced Inspection 15th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.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. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harrowby Lodge Nursing Home Ltd Address 4 Harrowby Lane Grantham Lincs NG31 9HX 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) 01476 568505 01476 575872 Harrowby Lodge Nursing Home Ltd Miss Susan Margaret Smith Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal and nursing care for service users of both sexes whose primary needs fall within the following categories:OP - Older Persons 32 Not applicable Date of last inspection Brief Description of the Service: Harrowby lodge is a care home providing personal and nursing care and accommodation for 32 older people. A registration application has been processed whereby the home is now a Limited company and trade as Harrowby Lodge Limited. The responsible individual and manager remain as Miss Sue smith. The home is located in a quiet residential area of Grantham close to the town centre and local amenities. Miss Smith has been the owner and manager of Harrowby Lodge since 1987. The home consists of a turn of the century building with a single story extension to the back of the home. The home is set in landscaped gardens. A passenger lift is in place and the home offers a mixture of single and twin bedrooms. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The homes manager and the administrator assisted the inspector during the unannounced inspection. One inspector undertook the inspection spending 4 and a half hours in the home .The inspector toured the ground floor of the building and spoke with the homes manager and administrator. 5 residents, 2 visitors and 2 staff were spoken with. The main method of inspection used was called “case tracking” which involved selecting clients and tracking the care they receive through checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? This is the first inspection of the home. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 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. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.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 Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.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): 1, 2, 3, 4, 6 Residents are provided with information to assist them in making an informed choice about living at the home. Residents are given information, which informs them of their rights and the service they can expect. Pre assessment of residents gives them confidence the home can meet their needs. A copy of the letter confirming needs can be met should be placed on the resident file. EVIDENCE: All prospective residents are assessed prior to admission to the home. Residents were given a copy of the service users guide and statement of purpose. These documents are regularly reviewed and updated by the Miss Smith and the homes administrator. 2 Residents spoken with and 2 visitors confirmed that contracts and terms and conditions of residence had been provided. Copies of these are retained on the residents file for reference. The home does not provide intermediate care facilities. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.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 Residents care needs are being identified and met. Access to health care professionals is satisfactory which ensures residents’ health needs are met. Residents live in a home with an ethos that demonstrates their rights to dignity, privacy and respect. EVIDENCE: Through case tracking 1 resident’s care plan files was inspected. It was evidenced that the relatives had been involved in the compilation of the care plan as the resident was not able to participate. The deputy manager confirmed that care plans were being reviewed and when this happened residents or their relatives were being involved. The care plans were clear to follow and contained sufficient information for care to be delivered correctly and safely. Reviews were taking place within agreed time scales. The new care plan assessment tool the home had produced enabled a more detailed assessment to be recorded. Care records evidenced that the residents had access to health care professionals such as district nurse, GPs and specialists such as Tissue Viability Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 10 nurses. 2 residents spoken with confirmed that they were satisfied with the health care arrangements. Interactions were observed between staff and several residents. These interactions were appropriate and residents were addressed in their chosen form. Bedroom and toilet doors were knocked on before entering. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 11 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, 15 Residents have opportunities to make decisions regarding how they spend their time and hoe the home operates. The catering arrangements provide residents with their preferred dietary requirements. EVIDENCE: Residents spoken to said that they were given freedom to spend their day how they chose to. The home hold residents meetings and visitors confirmed that Miss Smith and trained staff were always available for them to speak to regarding their relative’s care. The home offers activities and these are decided upon with consultation from the residents and the activities coordinator. Residents gave examples of how their views were requested on issues such as menus and what the residents’ comfort fund was spent on. It was evidenced that residents were supported to continue to follow their religious beliefs and the home were in contact with the local community and a communion service was held monthly. Contact with the local school was in place and one resident said they were looking forward to the school children attending the home nearer Christmas. Residents made very positive comments regarding the food. Menus demonstrated that a nutritionally balanced and variety of meals was provided. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 12 Specialized dietary requirements such as high fibre and diabetic diets are provided for. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 13 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): 18 Residents are protected by the homes policy and training in the prevention of adult abuse. EVIDENCE: A policy is in place for the management of allegations of abuse. All staff attend training on this subject and refresher sessions form part of the in-house training programme. Residents spoken to said they felt safe living at the home and if they had any concerns they would speak to Miss Smith or any of the trained staff. One resident said that staff treated them in a “very kind and sensitive manner”. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 14 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, 22, 23 Residents live in a safe environment. The standards of decoration and furnishing are good, providing residents with a comfortable and homely place to live. There are aids and adaptations to ensure the needs of residents with a physical disability can be met EVIDENCE: An inspection of the external premises and the ground floor of the home were undertaken. The gardens are landscaped and residents have views either over the garden or the courtyard. Some residents have window boxes on their windowsills. The home employs a Gardener on a part time basis. All pathways were clear and no hazards were noted. Some bedrooms had patio doors, which led, onto the courtyards. Externally the building in a good state of repair with no hazards noted. Plans are in place to replace 3 windows in one of the lounges. Internally the home is in a good state of décor. Part of the planned refurbishment is to redecorate and refurnish the dining room and redecorate Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 15 one of the lounges. New easy chairs have been purchased for this room already. Residents who gave permission for their rooms to be inspected said they were satisfied with their room and that the housekeepers and care staff always kept the rooms clean and tidy. The bedrooms were bright and airy and a couple of rooms seen had specialist nursing mattress in place. A Call bell was tested in 1 bedroom and this was responded to quickly. The resident in this room said that the response time to call bells was “always quick”. Another resident said that when they called for assistance their bell was also answered quickly and that if the care staff could not attend straight away after having answered the bell they would return as soon as they could. No adverse odours were noted and the home has odour control systems in place. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 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, 30 Residents are cared for a by a trained and competent care team. Residents are protected by the homes robust recruitment procedures. EVIDENCE: Recruitment records were inspected for the 2 newest members of staff to be recruited. These were complete and included references, completed application form, interview notes and a job description. It was evidenced that the staff members had not started work in the home until a Criminal Records Bureau check and Protection of Vulnerable Adults Check had been undertaken. An induction programme is in place and all staff work an induction period with a trained nurse who is responsible for all the in house training. Contracts were in place, which identifies the accepted codes of behaviour and expected job performance. Residents spoken to made very positive comments regarding the staff including comments such as “Its like being in my own home” “they (staff) treat me like one of their own”. Interactions observered and heard demonstrated that staff had an understanding of resident communication abilities and needs. The duty rota for the past 2 months was inspected. It was identified that during day time hours the minimum staffing levels was exceeded with there Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 17 often being 3 trained nurses on duty during the morning shift. Residents felt that there were enough staff on duty to meet their needs. The 2 visitors spoken with stated that when they visited the home is was normally easy to locate a member of staff. Fifty Percent of the care staff are currently undertaking National Vocational Qualifications at either level 2 or 3. A designated nurse supports care staff with the practical work of the course for 3 shifts a week. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 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 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, 32, 37, 38 The home benefit from a manager with good leadership skills Record keeping is robust and evidences resident safety is promoted. EVIDENCE: The registered manager and owner director is Miss Sue Smith. Miss smith is a trained nurse with many years experience of working with in the Older Person sector. Miss Smith has been the manager of the home since 1987. Residents and visitors made very positive comments regarding Miss Smith, such as “She knows what is happening all of the time”, If you ask to see her she will see you nearly straight away if she is here”, “I didn’t want to come into a home but Sue and her staff are so kind to me”. Miss Smith attends regular relevant study days to keep her knowledge of current care practices updated. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 19 Maintenance and servicing records were well organised and it was evidenced that risk assessments for the environment including fire safety arrangements were regularly reviewed. Polices and procedure are on display and staff were able to confirm where these were located. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 4 3 x 3 3 x x x STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 x x x x 3 3 Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 Refer to Standard OP4 Good Practice Recommendations It is recommended that a copy of the letter identifying that assessed needs can be met is retained on the residents file. Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Harrowby Lodge Nursing Home Ltd DS0000065654.V267388.R01.S.doc Version 5.0 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. 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