Inspection on 21/05/07 for Haslingden Hall and Lodge

This inspection was carried out on 21st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Haslingden Hall and Lodge 17/07/08

Haslingden Hall and Lodge 25/09/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Haslingden Lodge Lancaster Avenue Haslingden Lancashire BB4 4HP Lead Inspector Mrs Janet Proctor Unannounced Inspection 21st May 2007 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 Haslingden Lodge DS0000067729.V332674.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. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haslingden Lodge Address Lancaster Avenue Haslingden Lancashire BB4 4HP 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) 0845 6032566 0170 6219755 haslingdenlodge@orchardcarehomes.com www.orchardcarehomes.com Orchard Care Homes.Com Limited Catherine Elaine Connor Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 36 service users to include:*Up to 36 service users in the category of DE (E) (Dementia over 65 years of age) 15th January 2007 Date of last inspection Brief Description of the Service: The home is a purpose built 36 bedded property in a residential area of Haslingden that was registered in November 2006. There are local shops nearby and there is access to Haslingden town centre, which is about one and a half miles away. The registered persons are Orchard Care H The company have a number of other homes throughout the country, which are registered with the Commission for Social Care Inspection. All bedrooms are single with an en-suite toilet with shower. There is a lounge and dining area with a kitchen on each floor. There is access to a garden from the conservatory on the ground floor and a first floor terrace can be accessed from french doors on the landing. Information about the home is given to propsective residents and a copy also provided in their bedroom when they come in to the home to live. In April 2007 the fees were £320-00 oer week if funded by a Local Authroity. Residents who paid privately were charged £450-00 per week. The fee did not include hairdressing or private chiropody treatment. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Haslingden Hall on the 21st and 22nd May 2007. The Pharmacy inspector attended on the first day of the inspection. At the time of the inspection there were 29 residents at the home. The home is newly built and has only been registered since November 2006. This was the first key inspection of the premises and all of the National Minimum Standards for Older people were assessed on this visit. Since registration one visit had been made to the home in January 2007 in order to monitor the control of medications at the home. At that time it was found that medications were not always being given as prescribed. Prior to the visit the Registered Manager had submitted information in a preinspection questionnaire. This gave information that was used in the planning of the inspection. Surveys were sent out and were returned by two relatives. On the day of the inspection information was obtained from staff records, care records, and policies and procedures. Information was also got from talking to residents, the Manager, staff members and visitors. A tour of the building took place. Wherever possible the views of residents were obtained about their life at the home and their comments are included in the report. What the service does well: All residents receive a contract that made it very clear what they could expect for the fee paid and what was not covered by this. This prevented misunderstandings. All residents received a thorough assessment before they came to live at the home. This meant that their needs were known and arrangements could be made to meet these. Prospective residents could visit and see if they liked the home before making a decision to come and stay. Visitors were made welcome at the home and could see their relative in private. Visitors spoken to said, “We’re always welcome to visit and we can stay and have a meal with them if we want. It’s Dad’s birthday on Sunday so we’ll stay and have a bit of a party” and “ The staff are very kind and make me very welcome.” Routines were flexible and this meant that residents could choose what they wanted to do and when. A resident said, “I can choose myself when I get up and go to bed.” Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 6 Residents spoken to said that they enjoyed the meals served at the home. They said, “The meals are good. There’s a choice of a starter, a soup, a main meal and a pudding. They give you a list today and you pick what you want for tomorrow. It’s always very nice “ and “They bring us our meals to our room. They’re very good “. This meant that they were provided with a balanced diet that was to their liking. Residents were happy with the environment of the home and found it a pleasant place to live. A resident said, “My room’s very nice, you couldn’t ask for more. It’s OK, if you want a bit of peace and quiet you can come and sit in your room and watch the TV. I’ve got a key for my door and I keep it locked when I’m not in it. I’ve brought some of my own things in with me and it’s nice to have them around me. They keep the room clean, they come in every day and do it.” Recruitment practices were through and proper background checks were carried out. This protected residents as they ensured that staff were suitable before they started work. All staff received training when they started work and throughout their employment. This meant that they had the skills and knowledge to do their work and knew how to meet residents’ needs. The management systems made sure that the views of residents, relatives and staff were obtained and used to identify any problems. There were systems to look at and improve the quality of care and services at the home. This meant the Manager could identify areas that needed attention and take action to resolve these. What has improved since the last inspection? What they could do better: The plans of care must include all the health, personal and social care needs of the residents. This is so that staff know what they have to do to meet these needs and to ensure consistency of care. There should be more details of how and when the hygiene of residents have been met. This is because, due to memory loss, most of the residents are unable to tell anyone whether this is being done frequently enough. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 7 The details about the pressure area care needed should be more precise. This is so that staff know exactly what to do to prevent pressure sores. The charts used to record pressure area care should state what position the resident has been placed in so that it can be seen that this has been changed. Medicines must be given at the correct time in relation to food intake, this is important to ensure they work correctly and to reduce the chances of side effects. The existing systems for marking and identifying laundry should be revised so that residents are assured of having their own clothes returned to them. The development plan should contain more information so that it can be seen what resources and monitoring will be provided. A record should be kept of any furniture brought in by the resident so that there are no misunderstandings at a later date about who this belongs to. 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. Haslingden Lodge DS0000067729.V332674.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 Haslingden Lodge DS0000067729.V332674.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): 1, 2, 3, 4, 5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents were given information about the home, an opportunity for a trial visit, and a contract so they knew what to expect. An assessment was done before they moved in to ensure their needs were known and arrangements could be made to meet them. EVIDENCE: The Statement of Purpose and Service User’s Guide was on display in the foyer. A copy was also seen in some residents bedrooms. The Statement of Purpose and Service User’s Guide contained all the information required for prospective residents to make a chocie about whther to live at Haslingden Lodge or not. Residents spoken to said, “We‘re very happy here. We’ve got everything we need” and “It’s very nice here. I like it. Everyone’s very kind”. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 10 All residents were issued with a contract on admission. The contract stated what was included in the fees and what was not and said what period of notice was required. A pre-admission assessment was always done. Pre-admission assessments were seen on file for those residents who were case tracked. Letters were sent to prospective residents telling them whether their needs could be met at the home or not. This gave them confidence that they would receive the right care. The home was registered to meet the needs of residents who were older people with dementia. No nursing care was done by the staff at the home, this was the duty of the District Nurse. All staff did training for health and safety and received dementia care training. A high number of staff had the National Vocational Qualification in care so that they had an understanding of how to meet residents’ needs. Trial visits could be done. The Manager said that some propsective residents came for the day and stayed for meals and activities so that they can see if the home was suitable for them. Intermediate care was not done at Haslingden Lodge. Haslingden Lodge DS0000067729.V332674.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): 7, 8, 9,10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans did not include all the health, personal and social care needs of residents to assist staff in caring for them. Records and checks showed that medicines were usually given as prescribed to ensure the health and well being of residents. Privacy and dignity were maintained and residents were treated with respect. EVIDENCE: Each resident had an individual care plan folder. The care plans examined showed that the information gathered during the assessment had been included in the plan of care. A resident had had a fall that resulted in a fractured wrist. This problem and the care required had not been added to the plan of care. As the resident had some problems with the plaster cast there was the potential for these problems not to be managed correctly by staff, as they had no directions on what to do. The daily notes for two of these residents indicated that they could be aggressive at times but this was not Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 12 properly identified as a problem in the care plan. This meant that staff might approach them incorrectly or inconsistently when this occurred. The daily notes did not give enough details about whether the hygiene needs of the resident had been met. This is important as, due to memory loss, most of the residents were unable to tell anyone whether this had been done or how frequently. The care plans were signed by the resident or relative to show that they had been consulted about what was to happen. The plans were reviewed each month so that the details in them were kept up to date. Relatives spoken to said that they were kept informed of any change to the resident’s condition. There were forms for assessing the health of the resident. This meant that potential risks to health were identified before a problem occurred. It also meant that there was a base line against which any improvement or deterioration could be measured. Pressure relieving equipment was obtained as needed. A plan of care stated that the resident needed 2 hourly pressure care but was not precise in what this care was. The charts used to record fluid input, output and pressure care did not correctly state whether the resident had been on their right side, the left side or their back. This meant it could not be shown that positional changes had been made. There were records to show involvement of GPs and other professionals. These included District Nurses, chiropodists and opticians. A pharmacist inspector for the commission carried out a detailed inspection of medicines handling in the home. It was found that appropriate arrangements were in place to ensure medicines were securely stored. This is important to help prevent mishandling and misuse. Record keeping was found to be clear, detailed and generally accurate. Occasional mistakes were found but these were due to individual staff making isolated errors. Ordering, checking and record keeping procedures were good and managers carried out regular checks on the medicines to ensure care staff were following the correct recording and administration procedures. Records, stock checks and observations showed that medicines were usually given to residents as prescribed. However some medicines were not given at the correct time in relation to food intake. This is important to ensure medicines work effectively and in some cases to minimize the chances of side effects. Medicines prescribed as “when required” and as a “variable dose” had written criteria to help staff take a consistent approach to ensure they were given correctly to residents. These had recently been developed and still required some more detail to help staff give these medicines correctly. Detailed advice was given to the managers on how to improve this further. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 13 Care staff had received medicines handling training and managers said, “Staff competence is assessed by managers on a regular basis to ensure the homes’ own policies and procedures are being followed”. Recent improvements in record keeping showed that the training and supervision provided by the home had had a positive impact on the competence of staff when handling medicines. Staff were told how to promote privacy and dignity when they received their Induction training. A telephone was available for residents to use and they could do this in the privacy of their own room. Two different visitors and a comment card said that on occassion other residents items had been found in the wardrobes. There were some details in the care plans about residents’ wishes when death occurred. These included who to contact and the funeral directors of choice. There was no resident who was terminally ill at the time of the insepction so whether end of life care wishes were identified and followed could not be assessed. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ social and recreational needs were met by activities being available and contact with visitors. The daily routines for residents matched their preferences and choices. Residents received a balanced diet and enjoyed their meals. EVIDENCE: A programme of social activities was on display in the foyer and the days activities on the notice board. The interests and hobbies of the resident were noted in the plan of care. There was a social activity record in the care plans that said what had been done with the resident and also whether they had been asked if they wanted to do this and refused. A visitor spoken to said, “They get him to do some activities. He opens the windows and waters the flowers for them. It makes him feel useful.” Holy Communion was advertised and an invitation extended to all residents to attend this. Wishes about religious services were also noted in the care plan. The Service User’s Guide stated that regular contact through visits, letters or phone was encouraged and staff would assist residents with this. Visitors could Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 15 attend at all reasonable times and that the resident has right to refuse to see any visitor and this will be respected. There were no set routines for residents apart from meal times. Residents were observed to get up at different times of the day and could use their rooms as they wished. There was a purpose built kitchen on the second floor that prepared food for both the Hall and the Lodge. In addition to this each floor had a kitchen area in the dining room where drinks and snacks could be prepared for residents. The Cook said that the seniors on night duty also had access to her store so that there was no need for anyone to go hungry during the night. Staff were seen to prepare drinks for residents at regular intervals and also on request. Biscuits were also offered. The dining tables were nicely set out and staff gave discrete assistance to residents at lunchtime. Some residents were seen to have trays with their lunch on delivered to their rooms. There was a four-week cycle of menus with a choice of meals for lunch and tea. This menu was on display in the foyer and the days menu was also advertised on the notice board. Alternatives to the menu were also available. Staff asked residents what they would like after lunch for the next days meals and a record was made of this and kept so that it could be seen whether residents were ordering a balanced diet. There was sufficient food in stock and this included fresh fruit, vegetables and salad. Appropriate records were kept of storage and cooking temperatures. Two visitors spoken to said that their relatives had put on weight since coming to live at Haslingden Lodge. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 16 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): 16, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were confident that any concerns or complaints would be listened to and acted upon. The procedures for staff, and training given to them, ensured that residents were protected. EVIDENCE: The complaints procedure was on display in the foyer and also in the Service User’s Guide. There was a complaint recording file. This was a loose leaf system with a master index of what had been received and when, so it could be seen if any of the records had been lost or mislaid. One complaint had been made direct to the home. There was a record of the investigation and the result of this. A resident said, “It’s very nice living her. I’ve been here a bit and I’ve no complaints. “ A visitor said, “I’ve discussed one issue with staff and this was sorted out. I think the staff are approachable and I would go to them if I had a problem.” There was a policy on rights that said that these would be respected. It stated a committment to respect residents diverse needs and their right to these being upheld. The manager was in the process of ensuring that the residents would be registered to vote. There was a policy and procedure on advocacy. Residents could have access to their records. There were procedures for Safeguarding Adults. These told staff what to do should they see, hear, or suspect that something was not right. There were Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 17 telehone numbers of the people to contact so that staff had this information immediately to hand should anything happen when they were in charge of the home. All staff had Safeguarding Adults training as part of their Inducion to the home and there were training records to confirm this. Staff spoken to said that they had received the training and knew what to do if anything should happen. They said that they felt the management of the home and the Company would be open to receiving the information and would act properly about this. A resident said, “I feel very safe here which is important to me.” There were appropriate policies and procedures for dealing with aggression and safeguarding residents’ financial safeguards. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 18 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): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was furnished and decorated to a high standard and provided a very pleasant and safe place for residents to live. EVIDENCE: The home was a purpose built 36 bedded home in a residential area of Haslingden that was registered six months ago. It had an appropriate layout for the care of elderly people. The home was in an excellent state of repair and minor repairs could be done immediately as a Handyman worked 10 hours each week. There were local shops nearby. There was access to a garden from the conservatory on the ground floor and a first floor terrace could be accessed from french doors on the landing. There was a lounge and dining room with a kitchen area on both floors. The home was extremely well decorated and furnished. The furniture was arranged in a homely manner. It was very clean throughout. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 19 All bedrooms were en-suite with a shower, wash basin and toilet. There were disabled toilets near to each lounge. There were two bathrooms and one shower room on each floor. Bath hoists were fitted for assisted bathing. There was a separate sluice room on each floor that was kept locked. There were bedrooms on both floors and the first floor could be accessed by a passenger lift or the stairs. All bedrooms were of an ample size with sufficient quality furnishings. These included a flat screen TV and DVD player. There was an integral fridge in the wardrobe so that residents could safely store food and drink items in their room. There was a call system to each bedroom and wander leads seen for those who could not easily reach the wall point. There was some evidence of personalisation in bedrooms, for example, small items of furniture and pictures. One married couple were using one room as a bedroom and the other room as a sitting room. Privacy and dignity was maintained as all bedroom doors had an appropriate lock and there was lockable storage space in each bedroom. Health and safety was maintained through the fact that radiator surfaces did not get too hot and thus reduced the risk of scalding. The windows were safeguarded by the use of restrictors. The windows were placed low down in the room so that residents were able to sit in a chair nearby and look out at surroundings. Liquid soap and paper towels were provided in each en-suite area to promote good infection control. All laundry was done on site. There was a separate laundry on the second floor that was suitably equipped. Liquid soap and paper towels and plastic gloves were seen in the laundry area, which meant staff were protected from infection. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty met the needs of the residents. Recruitment practices safeguarded residents. Staff were given training to give them the skills and knowledge to meet residents’ needs. EVIDENCE: At the time of the inspection there were 29 residents accommodated at the home. There was a duty rota that showed the name of the staff, their grade and the hours worked. There were sufficient care and ancillary staff on duty to meet the needs of the residents. The Manager or the Deputy were in addition to the care staff. Staff spoken to said, “Weve had a lot of people leave and thats left us short staffed at times and thats led to low staff morale. Anyway its fine now, the staffing levels are now OK. And were gelling together as a team which is good.” The records of three staff were examined. These showed that a thorough recruitment procedure was followed and all the required documents were in place. Staff spoken to confirmed that they had completed an application form and had an interview. They said they had supplied the name of two referees and had a Criminal Records Bureau check before starting employment. There were equal opportunities procedures and an equal opportunities monitoring form was completed on application for employment. All staff were given a copy of General Social Care Council’s code of conduct and a contract. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 21 All new care staff came in for basic Induction training before starting employment. This inlcuded: fire safety; Health & Safety; COSHH and infection control; and Safeguarding Adults training. Moving & Handling training was also completed. Once employment began then the Skills for Care 12 week Induction training was started so that staff had the basic skills and knowledge to care for residents. Staff kept care of their own booklets, which were completed as tasks were done and competancy achieved. Completed booklets were seen in staff files. Staff spoken to said that they had done this training when they started work and felt they had enough knowledge to do their work well. There was a training matrix available to show that staff had completed mandatory training. The Acting Manager said that all staff do dementia care training. There were 20 carers employed, 8 of which had NVQ level 2. Other staff were enrolled on the course. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 22 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): 31, 32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed. There were systems to monitor quality and ensure that the home was run in the best interests of the residents. Health and safety of staff and residents was protected. EVIDENCE: A Registered Manager took responsibility for the day-to-day running of the home. She was doing the National Vocational Qualification in care at level 4 and the Registered Manager’s Award and hoped to have this finished in 6 months time. She had a job description and was aware of her role and responsibilities and lines of accountability. The Manager said that she felt well supported by the Company and her Area manager, who visited frequently. A proposal for a new management system was in place and being trialed. The Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 23 result of this is to be forwarded to the Commission and a decision made of future arrangements. Staff spoken to said that the Managers and seniors were approachable. Any issues brought up were listened to and dealt with. Ethos of the home was open and friendly. Staff and residents were seen to approach the office and be responded to well by the management team. There were Quality assurance systems in place. These included daily, weekly and monthly audits. An action plan was prepared for any deficiencies identified. The Area Manager visited each month and completed a report of what she found at that time. The views of residents and relatives were identified and acted upon. Meetings were held for residents so they could talk about the home and what they wanted from it. Anonymous surveys were sent out to residents and returned to Head Office. The results of these were then sent back to the home for action on any points raised that showed residents were unhappy with anything. A meeting for relatives was held twice a year so that they could discuss their opinions of the home and how it was working. The views of staff were also taken into account. This was done through staff meetings and through staff surveys from the Head Office. There was a development plan for the home. This needed more information on the resources needed to meet the stated aims. Appropriate insurance was in place. Finances were made available from the company for any items needed. Any receipts were forwarded to Head Office and paid from there. The Acting Manager had some petty cash held at the home so she could purchase small items as and when needed. She said there was no difficulty or problems in obtaining things for the home as she needed them. All fees were managed by relatives and they provided the personal allowance or items for residents. Some residents had money kept at the home. There was an individual wallet kept in the safe and a recording sheet of the tranactions. These were checked and found to be correct. Receipting system were available for any items of value of money left at the home. Supervision was given to staff and appraisals also done. These were done by the Acting Manager and the Care Manager. A written record was kept and included any issues to be carried over to the next session. Staff spoken to said they received supervision every 6 weeks. All the required records, except for a record of furniture belonging to residents, were kept and seen in place at the time of the inspection. This was a newly built building with all new equipment in place. Servicing contracts had been set up with appropriate Companies. The fire alarm system was tested each Friday and the result recorded. The emergency lights were tested monthly. Risk assesments were in place, including a work based fiire Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 24 risk assesment, and there were health and safety policies and procedures. The Acting Managers, Care Manager and Senior Carers all had first aid training so there was always someone on duty with this knowledge. Training in safe working practices was done for all staff. All accidents were recorded. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 25 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 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 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 3 18 3 4 4 4 4 4 4 4 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 2 3 3 2 3 Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement The plan of care for each resident must include all their personal, health and social care needs so that staff know how to meet these. The registered person must ensure medicines are administered at the correct time in relation to food intake to ensure residents’ health is maintained. Timescale for action 31/07/07 2. OP9 13(2) 21/06/07 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 OP7 OP8 OP8 Good Practice Recommendations The plan of care should give precise details to staff on the care needed by the resident so that the care will be given in a consistent manner. The daily notes should include full details of how the hygiene needs of residents have been met so that there is a record of this. The records of pressure care should include details of the DS0000067729.V332674.R01.S.doc Version 5.2 Page 27 Haslingden Lodge 4. OP9 5. 6. 7. OP10 OP34 OP37 positional changes made to the resident. Medicines prescribed as when required or as a variable dose should have more detail in their written criteria for their use to ensure a consistent approach is taken by care staff. The existing systems for marking and identifying laundry should be revised so that residents are assured of having their own clothes returned to them. The development plan should contain more information so that it can be seen what resources and monitoring will be provided. A record should be kept of any furniture brought in by the resident so that there are no misunderstandings at a later date about who this belongs to. Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Haslingden Lodge DS0000067729.V332674.R01.S.doc Version 5.2 Page 29 - 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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