Inspection on 01/09/05 for High Peak Lodge

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

High Peak Lodge 14/09/07

High Peak Lodge 13/03/07

High Peak Lodge 13/02/06

High Peak Lodge 02/02/05

High Peak Lodge 29/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE High Peak Lodge Bedford Square Leigh Greater Manchester WN7 2AA Lead Inspector Lindsey Withers Unannounced 1 September 2005 st 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. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service High Peak Lodge, Address Bedford Square, Leigh, WN7 2AA. 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) 01942 262021 01942 261811 European Care (UK) Ms Adele Kettle Care Home with Nursing 39 Category(ies) of Old Age 39 & Terminally Ill 3 registration, with number of places High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 39 service users to include:-up to 39 service users in the category of OP (Older People) up to 3 service users in the category of TI (Terminal Illness under 65 years of age). 2.The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 2nd and 11th February 2005 Brief Description of the Service: High Peak Lodge is a purpose-built care home, located close to Leigh town centre. High Peak Lodge is registered to provide nursing and personal care services to 39 male and female residents over the age of 65, three of whom may be terminally ill. The home is no longer registered to provide care services for people under the age of 65. Accommodation for residents is provided in single rooms, all of which have en suite toilet and wash hand basin. Car parking for visitors is located to the front and side of the home. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over six hours on one day, and was unannounced. The home had had a change of Manager since the last inspection. In the absence of the new Manager on holiday, the Deputy Manager assisted with the inspection. Part of the time was spent in the office looking at residents’ contract files, and part in the main dining area and lounge looking at residents’ records that set out their plan of care, talking to residents, and observing staff as they went about their work. The Inspector sampled the one course salad option at lunch. Events arising as a result of a complaint were followed up on during this inspection, in order to find out whether the required improvements had been made. What the service does well: What has improved since the last inspection? The information package provided to prospective and new residents is better. This has been reviewed and improved as a result of a complaint made to the CSCI about High Peak Lodge. The result is that every part of the admission process is checked so that people know exactly what the service will provide for them, together with any costs that might be involved. Information regarding residents’ backgrounds (their social history) had been improved. From this information, staff would have a better understanding of the people for whom they were providing care. The lunch served during this inspection, though still served on small plates for the majority of residents, was presented so that it appeared much more appetising than was the case at the last inspection. There was some evidence, too, of residents making a choice about what they had to eat. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.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. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.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 High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.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, 2, 3, and 4. Information provided to prospective residents is good, and a system is in place to make sure there is no confusion about the admission process. An assessment of a person’s needs is done before admission so as to make sure their individual needs can be met. Each resident has a contract that sets out the service to be provided to them. Residents can be assured they will be given access to any special care services they need. EVIDENCE: During the investigation by CSCI of a complaint made against the home, it had been found that insufficient information about fees was being sent to new or prospective residents. Since the complaint, the Administrator has made significant changes, not only to the Service User’s Guide, but also to the written communication that goes between the home and residents (or their relatives), such that there is now little opportunity for people to be confused about the amount of fees and who is responsible for paying them. The Administrator has initiated a check-list which has also helped to ensure that information is flowing properly. A note has been put at the nurses’ station so that they are reminded to ask questions about funding when they receive enquiries for placements. Looking at the paperwork for a recently-admitted person, it could be seen that the new process was working well. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 9 Contracts (the ‘Terms and Conditions’) were seen on resident’s files. Some had been signed by the resident, and others by the resident’s supporter. The records for four residents was looked at to see if their needs and expectations had been assessed prior to admission. Each file contained a detailed assessment document which clearly indicated the health and personal care needs of the individuals, together with any risks that might need to be assessed in order to keep the person safe and well. The home does not provide special care services other than for those who are terminally ill. The records show that access to the services of a specialist is arranged for residents, as they become needed, for example, for the management of Parkinson’s Disease or mental health conditions. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 10. Each person has an individual plan of care that sets out their needs. However, records are maintained to different standards. This, combined with significant errors and omissions in the records, raise concern that residents’ needs are not being fully met. Residents are not consistently treated with respect, which is against the home’s stated philosophy of care. EVIDENCE: Four residents’ files (the “care plan”) were looked at to see if full consideration had been made for the each resident’s health, personal, and social care needs. In the four files looked at, there were three different sets of papers. Staff said that they were in the process of changing over to a different set of paperwork that will comprise the care plan, and that they were hopeful that this latest method of recording will stay in place so that they can maintain some level of consistency. The Inspector would support this: with records being different one from another, files had to be checked and re-checked to make sure information had been properly incorporated. This leads to there being more opportunity for errors and omissions to be made. In producing the latest version of the care plans, the Inspector would also recommend that a contents list to be added at the front of the file, and that the different parts be sectioned High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 11 off. The contents list would act as a checklist for staff compiling the files, and the sections would make the file easier to read. The standard of the care plans had deteriorated since the last inspection. At least one error was found on each of the four files: a moving and handling risk assessment was missing from one file (significant because the person was entirely reliant on assistance from staff); the Waterlow score (for tissue viability) was recorded for one person but there was no way of knowing how the score had been arrived at; a resident’s dietary preferences had not been updated (significant as the resident had previously chosen to be vegetarian and now eats meat). On one file, following a complaint by the family, changes were required to the plan of care that had not been recorded. Where bed-rails had been deemed necessary, none had been fitted in line with the home’s policy (care plan 16.2). It was not clear, therefore, that the risks of using bedrails had been discussed with the resident or their supporter, nor were any signatures obtained to confirm agreement to their use. None of the care plans in this sample could demonstrate that they had been drawn up or reviewed with the involvement of the resident or their supporter. This is disappointing as some improvement in this area had been identified at the last inspection. Furthermore, this issue had been raised during the recent complaint investigation when a deadline for compliance had been set at 1st August 2005. The deadline had not been met. However, staff said that the new documentation should help with this as it clearly guides staff to obtain this information. Another of the outcomes from the complaint investigation required that the home keep proper records about food that is provided to residents, and that a record of weights be maintained. Notwithstanding the comment made above in relation to dietary preference, there was some evidence to show that these elements are now being covered in the care plans. One improvement to care plans since the last inspection had been the work done on recording information about a resident’s social history – their background, work history, interests, etc. This short profile helps staff to understand a little about the person to whom they are providing care, and offers topics that can be used to generate conversation. While in the main residents were seen to be treated with respect, there were several incidents that gave the Inspector cause for concern: For example, this was a hairdressing day. Two residents were lined up in their wheelchairs outside the hairdressing salon which was closed at the time – according to staff, because these residents like to be first. However, this looked like institutional practice. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 12 Two members of staff were observed pushing one resident in a wheelchair at the same time speaking loudly about another resident. One member of staff was heard to give commands to a resident, rather than explaining her actions and seeking confirmation. Two members of staff were heard to tell residents to “wait a minute”, rather than acknowledging the need of the resident and arranging assistance. One member of staff began clearing condiments from dining tables at the point when residents were served their meals, and before they had fully finished with them. All issues were raised with the Deputy Manager at the time, and action requested to change practice. In a recent written survey, conducted by the home, residents had recorded their overall satisfaction with the care provided to them. Satisfaction ranged from “OK” to “very good”. During this inspection, one resident told the Inspector she was happy at High Peak Lodge. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 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 standard(s) 12, 13, 14, and 15. Residents living at High Peak Lodge can make choices about how they live their daily lives, with help from staff if it is needed. Residents benefit from a varied activities and entertainment programme, that they can join in with as they wish. Residents enjoyed the food provided and were satisfied with the times at which meals were served. EVIDENCE: Speaking to residents, it was clear that there were those who liked to join in with the activities and entertainments programme, and others who preferred their own company. Staff were on hand to assist residents with their choice. A number of residents liked particularly to return to their own bedrooms after lunch, where they would rest, meet with visitors, or follow their own pursuits. An entertainer had been arranged for the afternoon of this inspection, and residents - and their visitors - were enjoying the music and joining in with the singing. Some residents had joined in the communion service during the morning. Visitors to the home are required to sign in at reception and are made welcome at any reasonable time. Information about the home is provided at the reception desk. There was anecdotal evidence to confirm that, where certain visitors had been proving problematic for residents, staff had provided support, excluding or monitoring visitors according to the wishes of the resident. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 14 Residents spoke about the choices that they made during their daily lives, such as deciding what to wear, what to eat, or whether to join in social events or not. The Inspector joined residents for breakfast, which was served from 8.30 a.m., and lunch, which, on this occasion, was served at 11.50 a.m. Staff said that tea would be served at 4 p.m. and supper at 8 p.m. Residents had a variety of breakfast items, both hot and cold, with fresh juice and a choice of hot drinks. Eight residents said they had enjoyed the hot lunch-time meal of minced beef in a rich gravy, croquette and mashed potatoes, carrots and turnips. One resident had chosen a different meal. All meals were served already plated. Plates were small but food appeared to be served in quantities sufficient for the resident. One person was still hungry following the main course, but refused a second-helping. Some residents had bowls instead of plates, to help them to eat independently, and staff were available to offer assistance, should it be needed. The dessert of apricots and evaporated milk was taken by most residents, and one person chose to have a yogurt. The food served was not strictly according to the menu but was close to it. A menu card is placed on the dining table for all residents to see, but the majority of residents could not say what they would be having for lunch and asked staff to tell them what the meal was. One resident was heard to be making her choices for her tea-time meal known to staff. Two issues were raised with the Deputy Manager during the lunch-time serving. One wheel-chair user had not been positioned at the table so she could reach her meal without spilling it into her lap. The Inspector asked for the resident to be re-positioned. The dessert served to residents who were dining in the lounge was transported on a trolley in an unhygienic way. This appeared to be normal practice, which the Inspector asked to be stopped and reviewed. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 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 standard(s) 16 There is a complaint policy and procedure that people have used to raise their concerns. Investigations by the home have been done promptly and have been thorough. However, records could not show that outcomes and solutions had been acted upon. EVIDENCE: The home has a complaints policy and procedure which is easily accessible at the reception area. Information on how to make a complaint is included in the Service User’s Guide. Two complaints had been received at High Peak Lodge both of which had been upheld. One was about the management of continence, and the second about care practice issues. While complaints had been investigated and a solutions found, no adjustments had been made to care files to confirm that the outcome of the complaint had had any impact on the quality of the person’s care. One complaint had been received by the CSCI which was investigated and upheld. There were a number of components to the complaint relating to poor standard of care practice and the lack of information about fees. The home had met the majority of the timescales for improvement that were set by the CSCI; one remained outstanding at the time of this inspection. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 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 standard(s) EVIDENCE: This section was not assessed on this occasion. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 17 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) EVIDENCE: This section was not assessed on this occasion. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 18 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) EVIDENCE: This section was not assessed on this occasion. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.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 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x x High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 20 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 7 Regulation 12 Requirement Care plans must be complete and up to date so as to demonstrate that proper provision for the health and welfare of each resident is made. Risk assessments must be complete and up to date for each resident. Bedrails must be fitted to residents beds only if done in line with the homes policy. Care plans must be drawn up and reviewed in consultation with the resident or representative. (Brought forward.) Staff must receive refresher training to ensure residents are treated with respect. Records must be available to demonstrate that the outcomes and solutions resulting from complaints are acted upon. Timescale for action 30th October 2005 30th October 2005 30th October 2005 30th October 2005 30th October 2005 30th October 2005 2. 3. 4. 7 7 7 13 13 15 5. 6. 10 16 12 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 21 No. 1. 2. 3. Refer to Standard 7 15 15 Good Practice Recommendations All care plans should be transferred to the same form of documention, with a contents page, and section cards. Residents seated in wheelchairs should be seated at the dining-table so they have good posture when eating. Food served in locations away from the main dining area should be transported in a hygienic way. High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. 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 High Peak Lodge F06 F56 S5682 High Peak Lodge V231035 Stage 4 01.09.05.doc Version 1.40 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!