CARE HOMES FOR OLDER PEOPLE
Homer Lodge Care Home 23-26 Monson Street Lincoln Lincolnshire LN5 7RZ Lead Inspector
Ann Day Unannounced 5 July 2005 13:30
th 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. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Homer Lodge Care Home Address 23-26 Monson Street Lincoln Lincolnshire LN5 7RZ 01522 530108 01522 511291 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) Mr A Pradhan Premierbell Limited Mrs A Ryan Care Home (with nursing) 35 Both 35 Category(ies) of OP Old Age registration, with number of places Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Within the total number registered - one service user can be accommodated within the OP category aged 62 years and over. Date of last inspection 20/12/04 Brief Description of the Service: Homer Lodge is a care home, which provides both personal care and nursing care for older people. It is a purpose built home situated in a residential area close to the centre of the City of Lincoln and is within walking distance of local shops and facilities. The home is situated off a main bus route and there is car parking off street to the front of the home, in the home’s own car park (limited space) at the rear of the home or in a nearby public car park.Accommodation is provided in 15 single and 10 twin bedrooms on the ground, first and second floor levels. Rooms to the first and second floor are served by a lift. The home is in a residential part of the city, it does not have a garden area but there is a block-paved terrace leading out of the ground floor lounge accessible by wheelchair where service users are able to sit.This homes service users guide states that, ‘Homer Lodge aims to create and maintain a happy and safe and homely environment and to establish a partnership with service users in planning and implementing their care.’ Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on one afternoon and evening in July 2005. The inspection focused on the requirements placed on the home at the last inspection and progress made by the home to address those requirements. The inspector undertook a tour of the premises and examined samples of the home’s documentation. The inspector was able to speak to a visitor during the inspection and to members of the Intermediate Care Team following the visit to the home. The inspector was able to interview the assistant manager and members of staff; the Registered Manager was on annual leave at the time of the inspection. Case tracking was employed as the main inspection tool, which involves following the experience of a sample of service users, past and present and assessing the service they received. Six comment cards were received from service users and seven comment cards were received from relatives/visitors, all comment cards indicated that they were happy with the overall care provided and did not wish to speak to an inspector. The manager provided the Commission with a pre inspection questionnaire. All service users spoken to during the inspection were complementary about the service they receive. What the service does well:
Service users commented; “so open, wouldn’t mind staying, love the dining room, not the look of a home—5 star” “ a very nice home, good food and nice staff” A visitor commented that he was always made to feel welcome “happy with the care provided”. Members of staff described the home and the atmosphere they work in as wonderful. The home offers intermediate care for four residents, the home works well to provide rehabilitation for those discharged from hospital with the input from the intermediate care team. The relationship with the professionals that visit the home is excellent, which is complimented by comprehensive record keeping. The home has an activities coordinator, who ensures that residents are offered a variety of leisure and social activities including planned outings. A service user writes the home’s newsletter, which is sold to raise money to provide funds for activities.
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 6 Service users and staff commented that there was “always something going on, bingo, pub lunches, entertainer visiting” What has improved since the last inspection? What they could do better:
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 7 Maintenance and repair of a walk in shower room needs attention, particularly the tiling, which was cracked, there was one room awaiting decoration. An offensive odour was noted in one room of the home, this was brought to the attention of the assistant manager. 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. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 The home working in partnership with the Intermediate Care Team plays a pivotal role in aiding service users who are referred solely for intermediate care to maximise their independence and return to their own home. EVIDENCE: A service user commented that they wouldn’t mind staying and described the home as “5 star”. The home offers intermediate care to 4 residents with the support of the intermediate care team. Individual Intermediate care records are comprehensive, detailed and evidence clearly the involvement of the individual service users and the visiting professionals. The assistant manager described the support they receive from the hospital as fantastic. The home has bespoke kitchen facilities on the first floor which are used to promote the independence and early return home of those service users resident solely for intermediate care following discharge from hospital. Care records identified the individual nature of the support given and the varied nature of the rehabilitation programmes, goals achieved and time taken to achieve those goals.
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 10 Members of staff told the inspector that the average length of stay for a service user offered intermediate care was eighteen days; records confirmed this. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,10,11 Service users’ health, personal, and social care needs are set out in individual care plans, that evidence their involvement. Service users are treated with dignity, sensitivity and respect at all times. They can also be assured that at the time of their death, staff will treat them and their family with care and sensitivity. EVIDENCE: Service users spoken to were aware of their individual care plans. Seven relatives who completed comment cards said that they were kept informed of important matters affecting their relative and that if their relative is unable to make decisions, they are consulted about their care. All care records examined were comprehensive, detailed and evidenced the involvement of service users or their representative. All care records seen, contained detailed risk assessments, consent to photographs and access to health records. All six service users who completed a comment card indicated that they liked living at Homer Lodge, were well cared for and that their privacy was respected. Members of staff were seen knocking on doors and awaiting an
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 12 invitation before entering a bedroom. Members of staff spoken to were able to identify the importance of privacy. The assistant manager told the inspector that since the last inspection service users last wishes had been recorded if identified. Members of staff spoken to were able to demonstrate their understanding and sensitivity to the needs of both the service user and their family. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 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) 12,13,14,15 Service users are offered a varied activities programme and are enabled to maintain contact with family and friends. Service users exercise choice and control over their lives and receive a wholesome appealing balanced diet. EVIDENCE: A service user writes the home’s newsletter, which is sold to raise money to provide funds for activities. The home employs an activities coordinator, service users and staff commented that there was “always something going on, bingo, pub lunches, entertainer visiting” One service user chooses to stay upstairs reading, reviewing books, writing letters and goes downstairs to meet up with a close friend. A hairdresser visits the home regularly. The activities coordinator takes individual residents out on shopping trips and out to lunch on a weekly basis. Six service users who completed a comment card indicated that they believed that the home provided sufficient activities. Seven relatives who completed a comment card said that they were made to feel welcome in the home, and they were able to meet with their relative in private if they wished. A service user told the inspector that they had two regular visitors, who were always made to feel welcome by the home’s staff. A visitor confirmed that they are always made to feel welcome in the home. The home’s “Visitor Book”
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 14 identified that a number of visitors visited 4/5 times a week or more and that the time of visiting varied, covering both evenings and weekends. A service user commented that they “ I can choose to have a bath or a shower; and choose my own times to get up or go to bed” Members of staff confirmed that residents are asked when they wish to get up and when they want to go to bed. Six service users who completed comment cards said that they did not wish to be more involved in decision making in the home. Six service users who completed a comment card said that they liked the food. Service users spoken to said that meals were very good. Members of staff told the inspector that service users are offered cooked breakfast twice a week, a choice at dinner and tea time, home baked cakes; residents are asked their likes and dislikes, and staff go to the nearby shop if there is nothing the resident likes in the home. They went on to say that if a resident is hungry in the evening there is always biscuits, cakes and milk drinks available. Menus and records confirmed that there is a varied diet offered. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 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, 17 Service users and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. Service users able to exercise their legal right to vote are encouraged to do so. EVIDENCE: Six service users and seven relatives who completed a comment card said that if they were unhappy with the care provided they knew who to talk to, but had not ever had to make a complaint. Service users spoken to said that they would tell members of staff if they were unhappy. A visitor said that they had no complaints, but would talk to the manager or assistant manager if they had any concerns. Members of staff interviewed were clear about their responsibilities regarding bringing concerns to the manager’s attention. The home has a comprehensive Complaints policy and procedures, which were available for examination. The home has not received any complaints since the last inspection. The assistant manager informed the inspector that members of staff accompanied seven service users, enabling to them cast their vote at the last election. Those able to exercise their legal right to vote are encouraged to do so. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 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) 19,26 Service users live in a safe, clean, pleasant, tidy and much improved environment, which is subject to a maintenance and repair programme. However there was some repair and decoration required and the home was not completely odour free. EVIDENCE: Six service users who completed a comment card and service users spoken to during the visit said that they felt safe at Homer Lodge. The home was found to be clean, tidy and pleasantly decorated. Five bedrooms have been redecorated since the last inspection, and a number of beds have been replaced recently. The home has a maintenance and repair programme that was available for examination. One bedroom was in need of redecoration and the walk in shower tiles were cracked, these were brought to the attention of the assistant manager and a requirement was placed on the home.
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 17 An offensive odour was noted in one room, this was brought to the attention of the assistant manager, and a requirement was placed on the home. Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,29,30 Service users needs are met by sufficient numbers of skilled and competent staff. Service users are supported and protected by the home’s recruitment policies and practices. EVIDENCE: Seven relatives who completed comment cards said that in their opinion there are always sufficient numbers of staff on duty. This was confirmed by examination of the staff rosters and speaking to the assistant manager and staff on duty at the time of the visit. The home has robust recruitment policies and procedures, which were available for examination. Staff files examined were complete; and included, application forms, two written references, Criminal Records Bureau and POVA checks. Members of staff interviewed confirmed that they had completed the TOPSS induction, NVQ Level2 & 3 and were never asked to undertake tasks that they were not skilled to complete. A service user commented that if they were unwell and asked to see a doctor, staff would arrange it. Staff training records were available for examination Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 19 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) 32,35 Service users benefit from the ethos, leadership and management approach of the home and their financial interests are safeguarded. EVIDENCE: All service users and relatives consulted were happy with the care provided and enjoyed living in/visiting the home. Members of staff said that they held the manager in high regard “ I think the home is wonderful, Angela is brilliant, so many changes, all for the better, she is very good at her job” The manager is sourcing the Registered Managers Award and will be restarting in the near future, on target to complete the award by 2007. The financial records of a service user were examined and were found to be accurate and countersigned. The home’s administrator keeps detailed records that were available for examination.
Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 20 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 x x x x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x 3 x x 3 x x x Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 21 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. Standard 19 26 Regulation Reg. 23 Reg.16(2) (k) Requirement The walk in shower tiles require repair and one bedroom requires redecoration. Required to keep the home free from offensive odours Timescale for action 30.9.05 30.9.05 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 Homer Lodge Care Home C53 C04 S2609 Homer Lodge V232679 050705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection CSCI, Unity House The Point, Weaver Road off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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