Inspection on 15/01/09 for Herrick Lodge

This inspection was carried out on 15th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Herrick Lodge 18/01/07

Herrick Lodge 01/11/05

Herrick Lodge 07/10/04

Herrick Lodge 23/06/04

Herrick Lodge 11/11/03

Similar services:

Applegarth

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Herrick Lodge 28 Orchardson Avenue Leicester Leicestershire LE4 6DP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Clarke     Date: 1 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Herrick Lodge 28 Orchardson Avenue Leicester Leicestershire LE4 6DP 01162531304 01162629169 socis217@leicester.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Ramesh Bhawsar Type of registration: Number of places registered: Leicester City Council care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: No one falling within category DE(E) or MD(E) may be admitted into Herrick Lodge when 20 persons who fall within categories/combined categories DE(E) or MD(E) are already accommodated within the home No one falling within the category PD(E) may be admitted into Herrick Lodge where there are 10 persons of category PD(E) already accommodated within the home. No one falling within the category SI(E) may be admitted into Herrick Lodge where there are 10 persons of category SI(E) already accommodated within the home To be able to admit the named person of category DE named in variation application dated 28th November 2002. Care Homes for Older People Page 4 of 31 0 0 0 0 0 Over 65 20 20 40 10 10 Date of last inspection Brief description of the care home Herrick Lodge is a residential care home run and owned by the Adult and Housing Department of Leicester City Council, and is located close to the centre of Leicester. Accommodation is on the ground and first floor and accessible by the stairs or the passenger lift. The home consists of several small and large lounges on the ground and first floor, dining room, designated smoking lounge, prayer room and temple room. Bedrooms are located on both floors with sufficient numbers of bathrooms/shower and toilets facilities. There is parking to the front of the home, and the home has a central garden. A copy of the lastest Commission For Social Care Inspection (CSCI) Inspection Report is located in the foyer of the home, and information regarding fees is available by contacting the Manager of Herrick Lodge. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We as it appears throughout the Inspection Report refers to The Commission for Social Care Inspection. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self-assessment tool completed by a representative of the service, reviewing previous Inspection Reports, and any information we have received. The unannounced site visit commenced on the 15th January 2009, and took place between 10:00 and 16:30. The focus of the inspection is based upon the outcomes of people who use the service. The method of inspection was case tracking. This involved identifying people with Care Homes for Older People Page 6 of 31 varying levels of care needs and looking at how these are being met by the staff at Herrick Lodge. Four people accessing services were chosen, and discussions were held with two of the people chosen, along with two other people living at the home, visiting relatives, a District Nurse and staff including the Assistant Manager. We also sent surveys to some people living at the home, and their relatives. Surveys were also sent to health and social care professionals, and a selection of staff who work at the home. What the care home does well: What has improved since the last inspection? What they could do better: The environment in which people live and have access to, could be improved through decoration, with consideration being given as to how the decor of the home could be improved to support people who become disorientated and are confused. The garden could be improved by making it accessible to people, and by it being maintained and planted to provide a pleasant area for people to sit and relax. People who live at the home should be encouraged to influence the care and support they receive by being consulted as to their views, and by improvements to their daily Care Homes for Older People Page 8 of 31 lives, by reviewing the range and frequency of activities and recreational pursuits made available to them. The home needs to be managed by a stable management and senior staff team, who are able to plan the future development of the home, and ensure that staff are supported and receive training that enables them to continually improve the care and support people receive. The surveys sent to health and social care professionals, relatives and staff asks how could the care service improve? The which they commented:Asian TV programmes. Adopt different practises/approaches to care, listen to carers who know people best for most effective approaches. Improve staffing levels so that carers can spend more time on a one to one basis communicating with them. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Herrick Lodge enables people who require residential care to make an informed decision as to whether the home is appropriate to their needs by providing information about the services it provides and through its assessment process. Evidence: We wanted to look at the information provided to people who use the service to find out whether it was detailed and answered all their questions, and to find out how the service passed on the information. We spoke with the Assistant Manager who told us that information about the services the home has to offer along with a copy of the complaints procedure is kept within each bedroom, in addition there is a copy on the notice board of the entrance foyer. The Assistant Manager told us that people have a copy when they move into the home, or when they or their representative visit the home, before moving in. The information provided is available in English and in three Asian languages, which is representative of the people that live or stay at Herrick Care Homes for Older People Page 11 of 31 Evidence: Lodge. We spoke with one lady who told us that she had lived at Herrick Lodge for two years, and that she was very happy at the home, and that she thought of the staff as friends. We also spoke with a relative of someone living at the home, who told us that it was a comfort to them that their relative had settled well, and that they lived close by and could visit frequently, they also said that they were satisfied that the care their relative received was of a good standard. We looked at the records of four people living at Herrick Lodge, and found that individuals had had their needs assessed by a Social Worker before moving into the home, this enables the Manager to look at the information provided and decide whether their needs can be met by the staff and facilities of the home. We sent surveys to people living at the home, along with their relative and health and social care professionals, surveys that were returned to us expressed satisfaction with the support provided to people who live at Herrick Lodge whilst Social Workers expressed confidence that the home could meet the needs of people living at the home. A majority of people living at Herrick Lodge are Asian and are supported by Asian staff, who are able to converse with people in their first language, and provide the care and support reflective of their cultural needs, including dress style, dietary and religious needs. Our observations were that staff were also able to communicate verbally in English to people living at the home who are European. Information provided within the self assessment tool completed by the Manager stated that peoples needs are assessed prior to moving into the home by a Social Worker, and that upon moving into the home a care plan is developed with the involvement of the person or a family representative, in order to enable them to express individual views and preferences and so maintain control of their own care. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs, choices and expectations of care, and the principles of respect, dignity and privacy are put into practise. Evidence: We wanted to find out how the health and personal care needs of people living at the home were met. We spoke with people living at the home along with visiting relatives, and observed the care and support provided by staff. We also looked at the care plans and records of four people. We spoke with the Team Manager to establish whether people moving into the home are supported to manage their own medication, they told us that where people have the capacity a risk assessment is undertaken. We spoke with one lady who said, I think of the staff as my friend, they are always cheerful. We spoke with another lady who said I like living here, they look after me, and they let me make decisions about what I do. We also spoke with a relative, who told us that he was satisfied with the care and support his relative received, and that Care Homes for Older People Page 13 of 31 Evidence: he was kept informed about her health. We sent surveys to people who live at the home, their relatives, staff who work at the home and health and social care professionals who are involved in the care of people living at Herrick Lodge. Surveys told us that people believe that the privacy and dignity of people living at the home is promoted, and that the diverse needs of individuals are met. Staff recorded that they are given up to date information about people living at the home, which enables them to provide the care and support they need. Care plans contain good information about the care and support individuals need, and the role of staff in providing support, including information about the persons cultural and religious needs, individual preferences were also included such as to the gender of staff they would prefer to provide personal care, and where they prefer to spend their day. Information in care plans provides information about a persons life before moving into the home, such as information about their work and family life, hobbies and interests, and cultural needs. Other records we looked at evidenced that people living at the home have access to health care professionals, and that daily information about a persons day to day lives is recorded. Herrick Lodge supports people in conjunction with health care professionals to remain at home if they so wish in the final stages of their life, enabling them to die with dignity in the home, and not go into hospital. We saw evidence that people living at the home had specified their wishes with regards to their future health, and action or inaction they wished the home and health care professionals to undertake on their behalf. We spoke with a visiting District Nurse, who told us that they were confident in the staffs ability to care for people living at the home, and that she had found staff to be polite and courteous towards people living at the home. The District Nurse also told us that staff contact her with any concerns, and that advice she gives is followed, due to the care staff provide the District Nurse team has little involvement with the home. We looked at the medication and medication records for some people, and found them to be in good order, however their were minor errors with regards to recording medication upon arrival into the home. We spoke with the Team Manager about this, who said it would be rectified the following day, recent changes to legislation mean that the registered person for Herrick Lodge needs to ensure that the way in which Controlled Drugs are stored and managed is satisfactory. Care Homes for Older People Page 14 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are available for people to engage in activities, but these are not far ranging and are dependent upon the availability of staff to provide them. Herrick Lodge provides a wholesome and varied diet reflective of the cultural needs of people at the home. Evidence: We wanted to find out about how people spend their day, and how staff working at the home support people to make decisions and stay in contact with relatives and friends, we did this by observing people throughout the day, talking with people living at the home and by looking at the care plans and the records of four people. Herrick Lodge has a relaxed atmosphere, with people getting up and spending time where they choose too, for some this meant staying in their bedroom, whilst others sat in one of the lounges in the home. We spent our time in the Summer Lounge, which is where a majority of people living at the home choose to sit during the day, there is a fire place in the room, with a large flat screen television above, our observations were that during the day the television was on, but we saw no evidence that staff discussed with people, at intervals during the day what channel or programme they Care Homes for Older People Page 15 of 31 Evidence: wished to watch, to the extent that childrens television programmes came on. We noted that a majority of people didnt appear to watch the television, one lady however did watch the news programme at lunchtime, and we spent time talking to her about current affairs. A majority of people living at the home are Asian, and we asked whether the television had channels reflective of this group, we were told that the home previously had, but no longer did, but this was again being explored, we were told that the home has a wide selection of Asian films on video/dvd for people to watch. Our observations were that whilst staff spoke with people living at the home throughout the day, this was when they provided care and support, and that there was insufficient time for staff to come and sit with people to talk with them, or engage them in an activity, and therefore their was a reliance on the use of the television to provide stimulation. There is a programme of weekly activities in the afternoon, on the day of our site visit, bingo was scheduled, however we saw no evidence of this activity taking place. We spoke with one of the Chefs, who as part of our discussion, told us that they were making cakes, and that tomorrow afternoon people living at the home would decorate them, we noted when we looked at the activities board, that cake decorating was scheduled for the following afternoon. We observed visitors arriving throughout the day spending time with their relatives and friends, one relative told us that it was a comfort to her that a majority of the people living at the home were of an Asian background, as this meant that she was confident that her relatives cultural needs would be met. One lady told us that she had visited the Temple to celebrate Diwali, and their were photographs in the home, that showed a range of celebrations taking place, including Diwali, Christmas and Eid. The Assistant Manager told us that relatives and friends visit the home during the festivals, which was supported by the contents of the photographs on display. We spoke with one lady who told us that consistent with her Roman Catholic religion she takes part in Holy Communion on a weekly basis. Herrick Lodge has a Prayer Room and Temple Lounge and the Assistant Manager told us that staff who are Muslim will support and help people living at the home of the Muslim faith, to take part in prayer as their religion requires. Herrick Lodge has two separate kitchens, one providing a European diet and the other a vegetarian Asian diet. We sat and joined in the lunchtime meal with a group of people in the dining room, earlier in the day we had observed a member of staff Care Homes for Older People Page 16 of 31 Evidence: asking people what they wanted for their lunchtime meal. We noted that everyone sat at small dining tables, and that meals were served in accordance with individual cultural customs, and that people were encouraged to serve themselves, with staff asking people if they wanted additional helpings. The Assistant Manager told us that some people living at the home reflective of their cultural needs ate an Halal diet, which was provided by an external provider, however a majority of people preferred the Asian vegetarian diet provided by the Chef at the home. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Herrick Lodge are able to express their concerns, and have access to a complaints procedure, improvements need to take place in the training of staff, to ensure that people are protected from abuse. Evidence: We wanted to find out how the staff of Herrick Lodge promote the safety and welfare of people who use the service. Newly appointed staff undertake a period of induction which takes place over three months, and includes training as to their roles and responsibilities in ensuring people in their care live a life free of abuse. Staff who have worked at the home for some time, in many instances have not received training on how to safeguard people from abuse, discussion with staff showed that staff were not knowledgeable as to all forms of abuse however they did say that if they had any concerns they would report these concerns to a member of the Management Team. Information supplied by the Manager within the self assessment tool, told us that the home has received eleven complaints in the last twelve months, we looked at the records regarding complaints, and noted that all complaints had been recorded along with discussions with the complainant as to the outcome, in many instances complaints were expressed by relatives of people living at the home, and meetings were held with them to discuss the issues. Care Homes for Older People Page 18 of 31 Evidence: Surveys completed by staff told us that staff are aware of their responsibilities in reporting concerns and complaints, and surveys received from other interested parties told us that they have confidence in the management of complaints. The complaints procedure is displayed in the entrance foyer of the home and bedrooms. The complaints procedure has been translated into languages which are representative of the languages spoken by those living at the home. We found no evidence to support that staff have been given a copy of the General Social Care Council (GSCC) Codes of Conduct which outlines good practise and the role and responsibilities of staff, these Codes of Conduct if given to staff, provide a useful resource to staff in informing them as to what is expected of them. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Herrick Lodge provides an environment which supports the diverse cultural needs of people living at the home, however there are areas that would benefit from improvement and decoration. Evidence: We had a tour of Herrick Lodge, all communal areas of the home were decorated to a reasonable standard, and provide people with areas in which to sit, communal areas which are heavily used such as the Summer Lounge and corridors could be improved by being decorated. Corridors were in places dark, with minimal natural light, and were not easily distinguishable from each other, this could cause some people living at the home to be dis-orientated as to where they were. We noted that the home has pictures along with other items which reflect the diverse cultural needs of people living in the home. Herrick Lodge has a central garden, which is mainly lawned with a few bushes. The garden is not well maintained and does not provide an attractive and accessible area for people living at the home to access. Improvements to the garden, including the planting of shrubs and flowers, along with seating areas would provide an additional area for people to sit and enjoy. Care Homes for Older People Page 20 of 31 Evidence: There are a range of bathing, shower and toilet facilities at Herrick Lodge, which have aids and adaptations that meet the needs of people living at the home. Care Homes for Older People Page 21 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Herrick Lodge are supported by staff who have undergone a robust recruitment process and are employed in sufficient numbers to meet their personal care needs, the care people receive could be improved by staff receiving specialist training. Evidence: We spoke with staff who worked at the home and asked them about staffing levels, all staffing including the Assistant Manager told us that there are six care staff on duty in the morning, supported by a Senior carer, and in the afternoon and evening a Senior carer supports four members of care staff, our observations were that staffing levels were able to meet the personal care needs of people living at the home, but that time was very limited in how much time they could spend with people talking to them or engaging them in activities. Surveys we received from staff working at the home and health and social care professionals indicated that staff receive training which enables them to support people living at the home, we did look at the training records, and found that the range of training staff accessed was mainly limited to topics relating to health and safety of people living at Herrick Lodge, with few staff attending training on specific aspects of care such as Dementia. Care Homes for Older People Page 22 of 31 Evidence: Information provided by the Manager prior to our visit, in the self assessment tool stated that 74 of staff have gained a National Vocational Qualification in Care, whilst the assessment tool stated that staff access internal and external training courses but did not state what these courses were or how it impacted on the care provided to people living at the home. We wanted to find out how staff were recruited and whether the recruitment of staff promotes the health and well being of people who use the service. The recruitment process at Herrick Lodge is managed by the Human Resources Department of Leicester City Council, where records are kept, we therefore could not view these. Information provided by the Manager in the self assessment tool stated that enhanced Criminal Record Bureau (CRB) disclosures are carried out prior to staff working at the home, and surveys completed by staff indicated that they had undergone a robust recruitment, which included completing an application form, providing two satisfactory references and attending an interview. Herrick Lodge is registered to care for people with a range of needs including Dementia, Mental Disorder, Physical Disability and Sensory Impairment, however training records showed that very few staff have received training within these specialist areas. If the service is to further develop to provide person centred care and to build on current care practises staff need to undertake training which represents the range of needs people living at the home require. Care Homes for Older People Page 23 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Herrick Lodge is managed on a day to day basis, however the development of the home is hindered by the changes to personnel within the management and senior staff team. Evidence: The Registered Manager of Herrick Lodge, is currently not managing the home, and therefore the home is being managed by the Assistant Manager who has taken up the role of acting Manager, supported by an Assistant Manager. The Manager on the day of our visit was attending a training course, and therefore we spoke with the Assistant Manager and Team Manager (line manager of Herrick Lodge). The Manager has attained a National Vocation Qualification (NVQ) at level 4. Information provided within the self assessment tool completed by the Manager provided minimal information about the running of the home, and how the way the home operates on a day to day basis is influenced by people who live there. People Care Homes for Older People Page 24 of 31 Evidence: who live at the home attend meetings, and we saw the minutes of these meetings, which have resulted in some changes in the home, such as changes to meals, however the minutes of meetings are not available in languages representative of the people living at the home, the Team Manager spoke of the cost of translation which made translation financially prohibitive. We asked the Assistant Manager about quality assurance, and how the views of people living at the home are sought. They told us that keyworkers ask people at the point of reviewing a care plan there views about the home, but comments are generally not recorded, and do not cover all aspects of the service provided by the home. We saw that people who access respite care are given a questionnaire to complete at the end of their stay, however there was no evidence to suggest that the information is collated or used to develop the service. The Manager of the home is supported by the Team Manager, however there is no record of there visits or discussions held. The self assessment tool states that Leicester City Council, employs someone to undertake regular visits to the home to ensure that the home is being managed well, our discussions however identified that these visits ceased several months ago, and no other arrangement has been implemented. Information detailed within the self assessment tool, completed by the Manager said that staff meetings and supervisions, are now held more frequently, this was supported by some staff that we spoke to, who expressed general satisfaction with the support they receive from the Management Team, but some felt that the continuous changes within Management Team, and the shortage of Senior Carers, impacted on communication and a systematic way of working. The assessment tool highlighted that recruitment and a consistent staff team were barriers to improving the service. Discussions with Senior care staff revealed that whilst they are responsible for the management of the home in the absence of the Manager and Assistant Manager, they have not in all instances been given training which would enable them to respond to all events, and therefore they would have to consult with the Manager. Care Homes for Older People Page 25 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The registered person to establish and have written information that the cabinet which stores Controlled Drugs at Herrick Lodge complies with the Misues of Drugs (Safe Custody) Regulation 1973. If it is found current storage facilities do not meet the regulations then a storage system, which does comply with the Misuse of Drugs (Safe Custody) Regulation 1973 is to be purchased and installed. To ensure the safe storage of Controlled Drugs. 17/04/2009 2 18 4 The registered person to 17/04/2009 ensure that all staff are provided with a copy of the GSCC Codes of Conduct, and that they are aware of the significance related to their role and responsibility. Staff to be aware as to their Care Homes for Older People Page 27 of 31 role and responsibility in providing care and support to people as detailed within the GSCC Codes of Conduct. 3 18 13 The registered person to 17/04/2009 establish a programme of training which ensures that all staff receive training as to the forms that abuse may occur and the signs which may indicate that abuse may be taking place. Staff to have the knowledge and understanding as to the forms and types of abuse, and training that enables them to identify when abuse may be occurring. 4 30 18 The registered person to develop a training plan, reflective of the registration categories the home is registered to provide. Care provided to people living at the home is delivered by competent and knowledgeable staff who can meet indivdual needs. 5 33 24 The registered person to 17/04/2009 develop a quality assurance process, which seeks the views of people who use the service, and that views expressed are collated and a report produced which details the outcome of the quality assurance process, and the plans the home intends to make to address the issues raised. The outcome of the quality 17/04/2009 Care Homes for Older People Page 28 of 31 assurance process to be communicated to people receiving a service and other interested parties. To provide an opportunity for people who use the service to express their views and influence the day to day management of the home and the service they receive. 6 33 26 The registered person to 20/03/2009 ensure that a representative of the company visits the home at least once a month, and speaks with people living at the home, staff and visitors. Undertakes an inspection of the premises and views records, and prepares a written report as to the conduct of the care home. To ensure that the home is being managed well. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Individuals upon moving into Herrick Lodge, are assessed which includes a discussion with the themselves to determine the persons wishes and abilities in the management of all or any aspect of their medication, and that a record of the assessment and discussion is kept within the persons care plan and records. The range and style of activities available to people in the home to be reviewed, to establish whether the needs and wishes of people are being met, and whether activities provided are reflective of the cultural expectations of people living at the home, including the use of the 2 12 Care Homes for Older People Page 29 of 31 television and the channels available. 3 19 A review as to the homes standard of decor and furnishings to take place, with consideration as to the needs and preferences of people living at the home, and that a programme of redecoration be implemented reflective of the findings of the review. Garden and outside areas of the home to be improved, by providing outdoor space which is attractive and well maintained and has seating which encourages people living at the home to spend time in the garden and relax. A consistent management and senior care staff would improve management of the home. Staff who are responsible for the day to day management of the home in the absence of the Manager and Assistant Manager should be inducted and provided with information necessary to undertake their duties. 4 20 5 31 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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