Inspection on 23/02/06 for Harrowby Lodge Nursing Home Ltd

This inspection was carried out on 23rd February 2006.

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 15/11/05

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 23rd February 2006 2:00 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.V284817.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. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 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.V284817.R01.S.doc Version 5.1 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 15th November 2005 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.V284817.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a week day afternoon and early evening with the inspector spending 4 hours in the home. The deputy manager who had operation responsibility for the home as the manager and administrator were on leave assisted the inspector. 10 residents, 1 visitor and 2 staff were spoken with. The main method of inspection used was called “case tracking” which involved selecting residents 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? What they could do better: Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 6 Evidence needs to be available to demonstrate that residents receive written confirmation that their assessed needs can be met following their initial admission assessment. Medication administration records must be maintained accurately to demonstrate when medication has been given. 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.V284817.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 Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.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): 4,5 The homes admission procedure enables residents to be confident that their needs will be known to the home prior to their admission. Written confirmation must be given to residents that the home can meet these needs. EVIDENCE: The deputy manager confirmed that all residents were assessed prior to admission to the home. Residents have access to the homes service user guide and statement of purpose. A resident’s relative confirmed that one of their relatives had been able to visit the home prior to the residents admission to the home. It was confirmed at the last inspection that residents received written confirmation that their assessed needs could be met. It was recommended that this document be placed onto the file to evidence this. On inspection of 4 files this letter could not be located. It is required that evidence must be available to demonstrate that written confirmation has been given to resident. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 9 One resident spoken with did not recall seeing a letter confirming their needs could be met, but did say that they thought their relative may have the letter. The resident stated that their admission to the home has been undertaken in a calm manner and felt that staff were aware of their care needs when they had arrived at the home. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.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): 7,9,10 Care is delivered in a respectful manner. Residents care needs are being identified and met. Reviews have resident/ relative involvement where possible. Medication records need to be completed accurately to reflect administration arrangements . EVIDENCE: All residents have a service users plan profile which contains assessments, care plans, risk assessments and other relevant records which evidence the care delivered and required. The information is divided into 2 files, one retained in the office and containing confidential information and information for nursing staff. The other file is in the resident’s bedroom and provides clear instructions to enable care staff to deliver care safely and correctly. During the inspection 2 residents service user plans were inspected. Both of these demonstrated that staff had undertaken a through assessment with clear outcomes identified. Evidence was in place that residents have been involved Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 11 in the production of the plan. One relative had signed plans on behalf of the resident and this was clearly documented. As part of the care plan process care staff sign daily documents to evidence the care they have delivered., since the last inspection these have been completed more thoroughly to evidence the actual care given and by whom. Medication administration records were inspected for half of the residents. Some of these records did not have signatures even though staff spoken to confirmed that they had given medication. Discussion took place regarding how medication is administered. It is advised that the procedure is reviewed to ensure medication is signed for at the time medication is dispensed. As per the homes medication policy. Observation by the inspector found that staff knocked on resident’s doors before entering and care was being delivered in a kind and dignified manner. On speaking with residents it was clear that they felt that staff understood the importance of maintaining residents dignity when delivering care and that this was taking place. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.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): 15 Resident’s dietary preferences are catered for, including specialised diets. EVIDENCE: A record is maintained of the food provided for residents. The record does not always identify in sufficient detail the quantity of the food provided. All of the residents spoken to made very positive comments regarding the food , which they viewed as “always lots of it” and “Its always home made and what we like”. one resident said that the cook “will always check we like what is being cooked” Records in care plans identify that dietary needs such as diabetic meals and soft meals are provided. During the inspection the teatime was observed. Those residents who require help taking their meals are assisted in a dignified manner. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 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): 16,18 Service users have systems in place to raise concerns and are satisfied these will be listened to. The homes training and procedures in respect of safeguarding Adults provide residents with assurance they will be safe living at the home. EVIDENCE: The home has a complaints procedure in place, which was not on display but forms part of the homes service user guide. Those residents spoken with stated they were aware of whom to speak to if they had any comments or concerns, and that they believed these would be addressed. The complaints procedure does not contain any timescales for acknowledging concerns when they are first raised. It is suggested that this is included to reassure residents that their concerns have been taken seriously and that they can be confident an investigation will take place. Records demonstrate that staff receive training in safeguarding adults. Policies are in place and available for staff to refer to. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 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): 19,26 Residents live in clean and comfortable surroundings that are suited to the residents accommodated. EVIDENCE: A tour of the premises evidenced a clean and tidy home with no adverse odours noted. Pathways outside the home and corridors inside were clear of potential hazards and there was room for residents to move freely. Equipment such as hoists and wheelchairs were stored in a safe manner. Fire safety equipment was in place. Residents who gave permission for their rooms to be viewed were satisfied with the décor and cleanliness. Domestic staff are employed to maintain the cleanliness of the home. Bathrooms were clean and tidy with specialised baths in the bathrooms viewed. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 15 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 Residents are cared for a by a trained enthusiastic and motivated care team. EVIDENCE: Since the last inspection no staff have left the homes employment. This has enabled residents to receive continuity of their care, delivered by a static care team. Residents made very positive comments regarding staff such as, “they are lovely and so kind”, “I couldn’t ask for anything better they are always cheerful”. Residents stated that there were enough staff to meet their care needs. The staffing level is operated above the minimum staffing level. Staff said that they believed there were enough staff on duty, and that there was time to sit and talk with residents. Trained staff confirmed that they had time set aside from direct care to update care plans and other necessary paperwork. Supernummary hours are provided for the deputy manager. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35, Robust procedures and policies protect resident finances. The homes quality assurance programme promotes an ever improving service with residents involvement and views directing this. EVIDENCE: The home has robust procedures in place for the safe keeping of resident monies. All records maintained were an accurate refection of the finances stored at the home. Resident spoken with confirmed that they felt their valuables including money were safe at the home. The home has a quality assurance system in place with relatives, residents and other stakeholders such as GPs and community nurses being involved in completing questionnaires regarding the service the home provides. Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x 3 x x 3 3 3 STAFFING Standard No Score 27 4 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 18 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. 1 Standard OP4 Regulation 14(d) Requirement The registered person must ensure that a copy of the letter identifying that assessed needs can be met is retained on the residents file The registered person must ensure that Medication administration records are accurate and reflect the medication arrangements for the resident. Timescale for action 31/05/06 2 OP9 13(2) 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harrowby Lodge Nursing Home Ltd DS0000065654.V284817.R01.S.doc Version 5.1 Page 19 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.V284817.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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