Inspection on 05/07/05 for Heath Lodge

This inspection was carried out on 5th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 11/07/06

Heath Lodge 31/10/05

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 St Georges Avenue Weybridge Surrey KT13 0DA Lead Inspector Mrs C Campbell-Ace Unannounced Inspection 05 July 2005 10.30 am 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 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 H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heath Lodge Address St Georges Avenue Weybridge Surrey KT13 0DA 01932 853282 Telephone number Fax number Email 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 Dr Ajit Prasad CRH (PC) 26 Category(ies) of Old age, not falling within any other category registration, with number (OP) 16. of places Dementia - over 65 years of age (DE(E)) 10. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 65 years and over. Date of last inspection 26 January 2005 Brief Description of the Service: Heath Lodge is a registered care home caring for up to 26 older people. The home is a large detached house with a purpose built extension set in a large garden in a residential road close to the town of Weybridge. The accommodation is on two floors; there is no lift access to the first floor, instead there is a chair lift, which falls short of the last few steps on 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. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted five and a half hours. It was carried out due to a number of serious concerns and complaints, and followed on from a complaint investigation by the Commission For Social Care Inspection on the 1st July 2005. The inspectors were Mrs Catherine Campbell-Ace and Mrs Cathy Clarke. The inspectors would like to thank the general manager, manager and staff for assisting them in the inspection. The inspectors examined care plans, supervision files, training files, the Statement of Purpose, accident books and complaints records. Please refer to the standards examined during this inspection. What the service does well: What has improved since the last inspection? The home has an ongoing programme of decoration. The manager stated that when a resident is newly admitted to the home a new carpet is fitted. New crockery and new tablecloths had been purchased. The dining room chairs were also new. An air purification system had been purchased since the last inspection. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 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 standard(s) 1,3,5 Prospective service users and relatives have an opportunity to visit and assess the quality, facilities and suitability of the home. The Statement of Purpose was out of date and assessments viewed were incomplete and misleading. EVIDENCE: The home’s Statement of Purpose was viewed and found to contain information about the services Heath Lodge provides. Parts of it were out of date. A copy of the Statement of Purpose was evidenced to be available for viewing in service users bedrooms. Staff stated that service users could visit the home beforehand and were invited to visit the home on a trial basis. They were assessed either in their homes or in hospital. Five service users care plans showed that they had been assessed in Ashford Hospital. One service users assessment was of home based care and not a pre admission assessment carried out by Heath Lodge, another care plan dated 10/06/05 referred to respite care and domiciliary care. No local authority care assessment had been made. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, Care plans were found to be incomplete, therefore not providing staff with the information they needed to meet the service user’s needs in an informed and safe manner. There was evidence that the home was not following safe practices regarding the administration of medication. EVIDENCE: Care plans were evidenced and found to be incomplete. They were deficient in risk assessments, including falls, hazards in the environment, nutrition and manual handling. Social activities were not recorded, and some care plans did not include photographs of service users. Mental health assessments were viewed and found to be deficient, as they had not been completed. The medication profile stated: ‘refer to MAR sheets.’ The paper on which the care plans were written stated Oak House and not Heath Lodge. Care plan contact sheets were signed by the first name of the staff member writing the report and records were completed using inappropriate language; for example, one service user had been incontinent of faeces and the staff member had written: ‘ made a mess in the lounge, everything cleaned.’ Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 10 One service user had experienced a serious accident in May 2005. No record of this accident was recorded in the contact sheets. Another service user had bruises to the bridge of her nose. This was not recorded in the contact sheet and no notification had been received by the Commission For Social Care Inspection. Medication was being administered by a senior carer when the inspectors arrived. The staff member had dispensed the medication by placing the medication for service users in plastic medicine pots with their name written on a piece of paper inside the pot. The senior carer was advised that this practice must cease immediately, as this practice puts service users at risk. No service users administered their own medication.Medication was observed to be stored properly. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 There were inappropriate activities held in this home for service users. Service users choice was limited. Family and friends were able to visit EVIDENCE: When the inspectors arrived at the home Christmas Carols were being played to the service users. One service user was given a jigsaw puzzle, which had very small pieces and no guide to the picture being constructed. The inspector asked the staff member if she had any jigsaws with larger pieces and she said yes, she would find one. The service user was still trying to use the same puzzle at the end of the inspection. One staff member said that service users did not go out on social excursions even though they had their own transport. Relatives were observed to visit service users. Service users stated that the food was good, and they had enough food. Fresh fruit was on offer during the day and service users had plenty of drinks within easy reach. The monthly menu was evidenced and showed that service users had no choice of main meal. They could choose an omelette or salad if the main meal was not to their liking. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 12 Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 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 standard(s) 16,18 There was no evidence of a complaints policy and procedure in place. The home had not provided staff with the opportunity to attend training in the Protection of Vulnerable Adults. EVIDENCE: The complaints book was viewed and found to be unsatisfactory, as the complaints documented were requests from service users, for example, to have a new carpet in their bedroom. No other complaints were evidenced. Staff knew to whom they could complain but stated that they did not know of any policy. One service user said that a complaint that he had made was not followed up. Training records were viewed and no training had taken place in the Protection of Vulnerable Adults, although staff spoken to said that they knew what abuse was and knew to whom they would report if they saw any abuse occurring. Staff stated that they had no knowledge of a whistleblowing policy. Staff stated that they knew they could contact the Commission For Social Care Inspection and knew where they could find the number. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 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 standard(s) 19,20,23,24,25,26 The cleanliness of the home was inconsistent and some areas inside and outside the home were found to be in need of repair. Safety issues were identified as requiring action and had not been risk assessed. EVIDENCE: The main lounge was dark because the light source was not sufficient. An odour of urine was noticed in the main lounge and the upstairs corridor. Several areas in service users bedrooms and bathrooms were observed to be in need of repair. The downstairs lavatory door was open and it was observed that the ventaxia air extractor unit was in need of cleaning. The home employs one domestic staff part time from Monday to Friday and another for weekends. This person also works in the laundry. Please refer to the actions which must be taken to comply with the requirements made. The home has two domestic washing machines which do not have a sluicing facility for soiled linen. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 15 A service user had sustained severe injuries recently when she fell over the stair lift. There were no safety notices regarding the correct storage of this piece of equipment to prevent further accidents occurring. The grounds were inspected and the inspectors found the door to the shed containing COSHH products open. Fire Safety Training had not been carried out regularly. Accidents occurred in the home had not been recorded correctly; staff members had written their first name only on these forms. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,30 Staff training had not taken place; therefore staff were not able to competently meet the needs of service users. EVIDENCE: Mandatory training had not taken place for staff. Training records viewed showed that some staff had received training in the Safe Administration of Medication and in Dementia Care in February 2005. First Aid training was reported to be planned for the 22nd July 2005. No staff had received the NVQ level 2 or 3 awards in care. Several staff qualified as Nurses in Eastern Europe. The provider stated that this was equivalent of NVQ level 3 award in care. The manager must provide evidence to this to the CSCI Surrey Local Office No regular Fire Safety Training had been arranged for the staff. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36,37,38 The management of this home is inadequate and records are not well managed. Staff are not formally supervised or trained. This is putting service users and staff at risk. EVIDENCE: Please refer to standards 7 and 8 of this report regarding the health of service users and standard 28 and 30 regarding staff training. Service user’s records were viewed and no evidence was found of consistant care planning in risk management. Standard 19 refers to a service user who sustained severe injuries due to a hazard within the home. No action had been taken to limit the risk to other service users and the accident was not recorded in care plans. The Commission For Social Care Inspection and The Health and Safety Executive had not been informed. Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 18 Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 x 1 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 1 14 2 15 1 COMPLAINTS AND PROTECTION 1 1 x x 1 1 1 1 STAFFING Standard No Score 27 x 28 1 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 x x x x x 1 1 1 Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 20 no 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. 2. 3. 4. Standard 1 3 3 7 Regulation 6 14 14 15 Requirement The Statement of Purpose must be updated Accurate information must be included in the pre admission assessment. A needs assessment must be carried out on all prospective service users. All service users must have a comprehensive care plan drawn up with each service user involved to ensure that all aspects of the health, personal and social care needs are met. The service users plan must meet relevant clinical guidelines, which includes a risk assessment including a falls risk assessment. Care plans must be written in appropriate language and signed in full by the author. Current photographs must be attached to service user files. Care plans received from care management services must relate to Heath Lodge admission. The practice of secondary dispensing of service users medication must cease. Service users must be offered appropriate social activities. H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Timescale for action 5/08/05 5/08/05 5/08/05 5/09/05 5. 7 15 5/09/05 6. 7. 8. 9. 10. 7 7 7 9 12 15 15 15 13 16 5/09/05 5/09/05 5/09/05 Immediate 5/07/05 5/08/05 Page 21 Heath Lodge Version 1.40 11. 12. 12 12 15 16 13. 14. 15 16 16 21 15. 16 22 16. 17. 18 18 18 21 18. 19. 20. 21. 19 19 19 19 13 23 13 23 22. 23. 24. 25. 26. 19 19 19 19 19 23 23 23 23 23 Social activities interests must be recorded in the care plans. Up to date information regarding activities must be circulated to service users in formats suited to their capacities. A choice of two main meals must be given to service users. A clear and accurate complaints procedure must be written to include stages and timescales and that complaints are dealt with promptly and effectively A record must be kept of all complaints and include details of any investigation and action taken Staff training must take place in The Protection of Vulnerable Adults. A whistleblowing policy must be written and all staff must sign that they have read and understood it. A risk assessment of the hazards in the home must be carried out. A Fire Risk Assessment of the home must be carried out. Communal soap must be removed from bathrooms Wires on the ceiling of the accommodation in the garden must be secured and maintained. Shower next to room 5 must be maintained and the commode stored elsewhere. The worktop next to the sink in room 6A must be replaced and the dripping tap maintained. The handle must be affixed to the top drawers in room 7. Room 14 sliding door to the bathroom must be repaired and headboard fixed to the bed The ventaxia must be cleaned in the downstairs lavatory. H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc 5/09/05 5/09/05 5/08/05 5/09/05 5/09/05 5/09/05 5/09/05 5/09/05 5/09/05 Immediate 5/07/05 5/08/05 5/08/05 5/08/05 5/08/05 5/08/05 5/08/05 Page 22 Heath Lodge Version 1.40 27. 28. 19 20 16 23 29. 30. 31. 32. 33. 26 26 26 26 27 23 13 13 13 18 34. 28 18 35. 30 18 36. 37. 36 37 18 17 38. 39. 40. 38 38 38 23 13 37 The odour of urine must be eliminated from the main lounge and upstairs corridor. The lighting in the main lounge must be sufficiently bright and positioned to facilitate reading and other activities. The washing machine must have a sluicing facility. Soiled linen must not be washed with service users clothes. Linen must be placed in a trolley and transported to the laundry. Clothes and linen must be given to the correct individual. Domestic staff must be employed in sufficient numbers to ensure that standards relating to food, meals, nutrition are fully met and that the home is maintained in a clean and hygienic state, free from unpleasant odours. A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) must be achieved by 2005. Mandatory training for staff must be organised, to include The Protection of Vulnerable Adults, Care plan report writing, accident and incident reporting and training specific to the service user group. Staff Supervision must take place at least six times a year Individual records must be up to date and in good order;and are constructed, maintained and used in accordance with the Data Protection Act 1998 Fire Safety training must be carried out regularly The door to the shed containing hazardous substances must be kept shut and locked All accidents, injuries and H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc 5/08/05 5/09/05 5/09/05 5/08/05 5/08/05 Immediate 5/07/05 5/09/05 12/05 5/09/05 5/09/05 5/09/05 5/09/05 Immediate 5/07/05 5/08/05 Page 23 Heath Lodge Version 1.40 41. 38 13 incidents of illness or communicable diseases must be recorded and reported. Safety procedures are posted, and explained, in formats that are easily understood and take into account service users special communication needs. 5/09/05 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 Good Practice Recommendations Heath Lodge H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 24 Commission for Social Care Inspection 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 H58 H09 s13668 Heath Lodge v237320 050705 Stage 4 unn.doc Version 1.40 Page 25 - 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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