Inspection on 11/07/06 for Heath Lodge

This inspection was carried out on 11th July 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

Heath Lodge 02/03/10

Heath Lodge 29/01/09

Heath Lodge 22/01/08

Heath Lodge 31/10/05

Heath Lodge 05/07/05

Heath Lodge 29/09/04

Heath Lodge 13/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heath Lodge Heath Lodge St Georges Avenue Weybridge Surrey KT13 0DA Lead Inspector Mary Williamson Key Unannounced Inspection 11th July 2006 10:15 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 Heath Lodge DS0000013668.V303861.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. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heath Lodge Address Heath Lodge St Georges Avenue Weybridge Surrey KT13 0DA 01932 853282 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) Dr Ajit Prasad Mrs Nishi Prasad Dr Ajit Prasad Care Home 26 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (16) of places Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 65 years and over 6th May 2003 Date of last inspection Brief Description of the Service: Heath Lodge is a registered care home for up to 26 older people. It is one of three homes owned by Surrey Rest Homes Ltd. The home is a large detached house with a purpose built extension, set in a large garden in a residential road close to Weybridge railway station and town. The accommodation is on two floors with a chair lift that falls short of the last few steps to the ground floor. The home has single and double rooms, some with en-suite facilities. There is a garden to the rear of the premises and parking to the front of the building. The fees range from £540 for a shared room to £570 for a single room. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken by Mary Williamson who is the Lead inspector for the home. Caroline Walker newly appointed manager was present for the duration of the inspection, which took place over six hours. Several service users were spoken to some in more detail than others. One service user comment card and one relative comment card were returned to the inspector with favourable comments regarding the home. Two relatives spoken to during this visit provided the inspector with good feedback regarding the home. The manager provided The Commission for Social Care Inspection with a completed pre inspection questionnaire. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. The home was functioning well and a new carpet was been fitted in the hall, which was a continuation of the new lounge carpet the previous day. Service users were looking forward to a summer Barbeque at the weekend and were watching the maintenance man erecting two gazebos and bunting. It was extremely hot weather during the inspection and it was pleasing to observe staff providing plenty of cold drinks for service users. There was good interaction between service users and staff who were polite and respectful to service users. The inspector would like to thank the manager, staff, and service users for their positive contribution to this inspection process. What the service does well: The home provides good quality care to service users, which was reflected in service user comments throughout the visit. Individual care plans are well maintained and are regularly updated. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 6 The catering arrangements provided service users with a wholesome and varied diet. There is the opportunity for drinks and snacks to be served between meals. Health care arrangements, adult protection procedures and health and safety procedures promote safety. What has improved since the last inspection? What they could do better: The recruitment practices must be improved to include all essential documentation when employing new staff. The unoccupied bedroom must be refurbished before another service user is admitted to this. The downstairs bathroom, which, is out of use is currently being used as a storeroom. This must be re -commissioned as part of the required bathroom allocation on the ground floor and alternative storage space found. The manager would benefit from some deputy support in order her to undertake administration duties as part of her management role at least one day a week. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 7 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. Heath Lodge DS0000013668.V303861.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 Heath Lodge DS0000013668.V303861.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5, and 6. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. Prospective service users have the appropriate information available to help them make a choice about living in the home. Pre admission needs assessments are undertaken and signed contracts of occupancy are in place. EVIDENCE: The home has a statement of purpose and service users guide in place and all prospective service users and their relatives have a copy of this in order to enable them to make an informed choice about living in the home. A copy of the service user guide is also available in service users bedrooms. The manager stated that all prospective service users have a needs assessment undertaken by her prior to admission. Needs assessments were seen for JB, HR, and ML. These were informative and also included a health needs assessment. Contracts of occupancy are in place and outline the room to be occupied, care to be provided, and fees to be paid, and any extra charges. The service user Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 10 or their designated representative sign these contracts and a copy retained on file. Trial visits are offered whenever possible but there are occasions when the relatives make the choice on behalf of the service user. Intermediate care is not offered by this service. Heath Lodge DS0000013668.V303861.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. Arrangements are in place to meet health and personal needs of service users are outlined in individual care plans. Service users are protected by the home’s medication policy. EVIDENCE: Individual care plans were sampled for ML, HR, and JB. These were well maintained and included risk assessments for the management of falls, nutrition, use of hoists and manual handling, skin care, chair lift, and the use of bed rails. Following the risk analysis for falls the manager has employed a carer for a twilight shift (8pm to 11pm) to observe specific service users and reduce the risk of falls. This was seen as good practice. The care plans are well written based on the initial pre admission needs assessment, the health needs assessment, input from the service user whenever possible and information from relatives. These plans are reviewed on a regular basis and updated accordingly. All the service users are registered with a local GP who visits the home every Wednesday or when required. She will also review the medication at regular Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 12 intervals. The district nurse from the practice will also visit the home to undertake dressings, take blood for testing, and administer flu vaccines. The community psychiatric nurse also visits the home for reviews or in an advisory role. Arrangements are in place for regular chiropody, dental and optician visits. The home has a medication policy in place and all staff who administer medication are familiar with policy. Medication is supplied by Boots the chemist, who also undertake regular audits and training. There is an audit trail of all medicine entering and leaving the home. The medication recording charts were seen and are well maintained. Facilities are available for the storage of controlled drugs. Currently there are no service users in the home that self medicate. There is a small fridge available for the storage of medication, which is kept locked and the temperature is checked and recorded. Privacy and dignity is respected. Staff were observed to knock on service users bedroom doors prior to entering and address service users in a polite and respectful manner. Both double bedrooms have screens available and there is also a curtain surrounding the wash hand basin. Heath Lodge DS0000013668.V303861.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, and 15. Quality in this outcome area is good. Judgement has been made using information available including a visit to the service. Activities available in the home meet the individual and collective needs of service users. Catering arrangements within the home are satisfactory. EVIDENCE: All service users have a social history and activities profile in their care plan. One member of care staff has attended training in leisure activities and another staff member coordinated the activities for the home, which includes board games, card games, music and movement, quiz sessions, walks in the garden, and trips to the local shops. One service user stated that she was looking forward to the summer bar-be-q the following Saturday as her family will be attending. Special events are also celebrated to include birthdays. Two service users attend a local day centre returned to the home for lunch. Family links are maintained and visitors are welcome in the home at any reasonable time. They are also encouraged to attend care reviews whenever possible and to be part of the care planning process. The catering arrangements in place are satisfactory. Regular service user meetings take place where menus are discussed and planned with the chef. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 14 The food wholesalers 3663 also provide sample menus for new ideas with nutritional value for older people. The menus are displayed in the lounge daily. Lunch was observed during the inspection, which consisted of beef stew and dumplings, potatoes and a selection of vegetables, followed by sponge and custard, or a selection of fruit or ice cream. Several service users commented on the food. One stated “the food is very good here” and another said, “I really enjoy my food”. All service users eat in the dining room and help and support is offered by staff in a sensitive manner to service users who require help at meal times. The kitchen was clean and orderly. Records are kept for fridge and freezer temperatures, which are recorded daily. However the last entry was for 09/07/06. Heath Lodge DS0000013668.V303861.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 18. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. The complaints procedure in place is satisfactory and procedures are in place to safeguard service users from abuse. EVIDENCE: The home has a complaints procedure in place, which, is displayed in the front hall and a copy is also available in the service user guide. There has been one complaint since the last inspection. This is well documented and has now been resolved. The home has an abuse awareness procedure and a whistle blowing policy in place and all staff have undertaken training in these policies and procedures. This is also displayed on the notice board in the staff room. There is also a copy of Surrey County Councils Multi Agency Procedures on Safeguarding Vulnerable Adults in place and the manager has been booked to attend the next training session in these procedures. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 16 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, 21, 24, and 26. Quality in this outcome area is adequate. Judgement has been made using available evidence including a visit to the home. The home is suitable for its intended purpose. The home is generally clean and hygienic with mal odour evident three bedrooms. The home would benefit from a routine programme of maintenance. EVIDENCE: The home was generally clean and tidy with the exception of mal odour in three bedrooms. During the inspection the carpets were being replaced in the hallway as a continuation from the lounge. The service users were very please with this. The carpet outside the staff room, laundry room and the front stairs are badly worn and stained and also need replacing. The two lounge areas and dining room are well furnished and decorated and provide comfortable communal accommodation to meet service users needs. Bedrooms are personalised and service users are encouraged to bring their own furniture and possessions with them if required. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 17 The bedroom, which is currently unoccupied needs to be refurbished and the vanity unit surrounding the sink to be replaced before it is reoccupied. One of two bathrooms on the ground floor is currently not in use and is used for storing mops and buckets and other cleaning equipment. It is recommended that this arrangement be reviewed to provide a useable bath or shower in place of the present bath, and adequate storage facilities provided for the cleaning equipment. The home has an infection control policy in place and all staff undertake training in this during induction. The laundry is equipped to wash infected laundry. Arrangements are in place for the collection of clinical waste. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. Quality in this outcome area is poor. Judgement has been made using available evidence including a visit to the service. The number and skill mix of staff meet the current needs of the service users. The recruitment policy does not protect the service users. EVIDENCE: The staff daily shift plan was seen and indicated five staff allocated to work the am shift, four the work the pm shift, one to work a twilight shift, and two night staff one of which sleeps in. There are also two chefs, one cleaner one housekeeper, and a maintenance man working in the home. This allocation of staff is adequate to meet the assessed needs of the service users. Staff employment files were sampled for AM, MB, and RC. One file was not available in the home, another was incomplete with one reference and CRB (Criminal Records Bureau) not in place, and the third was satisfactory. Two staff confirmed that they had undertaken induction training, and evidence of this was seen in personal files. The manager stated that all staff undertake induction and this is followed by foundation training. Regular updates in manual handling, food hygiene, first aid, basic first aid, fire safety, and infection control take place. 47 of staff have an NVQ level 2 award in care. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 19 Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 20 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, 36, and 38. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. The home is managed efficiently and promotes the health and welfare of service users. EVIDENCE: The home manager Caroline Walker has been in post since 16/06/2006, having been in the acting managers post for the previous six months. She has several years experience in a senior team leader role and has enrolled at Brooklands College to undertake her RMA (registered managers award). The home is run efficiently in the best interests of the service users. Caroline is currently working fifty hours a week and it is recommended that the registered provider considers deputy support to enable her to undertake her administration duties at least one day a week as part of her managerial role. The manager undertakes formal staff supervision, and this is recorded. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 21 Quality assurance is monitored in service user meetings, monthly care plan reviews, and key worker monitoring. The manager demonstrated a Resident/family questionnaire, and a client satisfaction questionnaire, which have not yet become a working document. This needs to be implemented, and formally monitored. There is a wide range of health and safety policies and procedures in place and these were sampled during the inspection. All staff have training in COSHH procedures and this was evident when staff were asked about certain procedures. Risk assessments are in place for safe working practice. Fire safety policies and procedures are in place. The maintenance man undertakes weekly fire alarm checks. These are well documented together with the frequency of fire drills. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. A new fire display panel has been fitted since the last inspection. The accident records are well maintained and following analysis of the frequency of falls in individual service users action was taken in the form of a twilight carer being employed in the home. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 22 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 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 X X 2 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 23(1)(a) Requirement The registered person shall ensure that the premises are suitable for the purpose of achieving the aims and objectives as set out in the statement of purpose. The registered person shall ensure that suitable numbers of useable bathrooms are provided in the care home. The registered person must ensure that suitable storage facilities are provided in the care home. The registered person must ensure that the unoccupied bedroom is refurbished and the vanity unit replaced before it is reoccupied. The registered person must ensure that all parts of the care home are kept free from offensive odour. The registered person shall not employ anyone to work at the care home unless all the required documentation in Schedule 2 is in place to include written references and a CRB disclosure. DS0000013668.V303861.R01.S.doc Timescale for action 24/08/06 2 OP21 23(2)(j) 24/08/06 3 OP21 23(2)(l) 24/08/06 4 OP24 23(2)(d) 24/08/06 5 OP26 16(2)(k) 24/08/06 6 OP29 19(1)(b) 24/08/06 Heath Lodge Version 5.2 Page 24 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 OP31 Good Practice Recommendations It is recommended that the home manager is given senior support in the form of a deputy or senior team leader in order that she may undertake her administration duties required of her role at least one day a week. Heath Lodge DS0000013668.V303861.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Heath Lodge DS0000013668.V303861.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. 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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