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Inspection on 14/07/05 for Howard Lodge

Also see our care home review for Howard Lodge for more information

This inspection was carried out on 14th July 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well managed and provides a very high standard of care to the residents. The home provides more than required members of staff on duty throughout the day and night to ensure that resident`s individual needs are appropriately met. Training is a high priority of the home and is regular and on going for all staff. The menu is wholesome, varied and nutritious, alternatives are offered to the residents. All foods, vegetables and fruit are fresh.

What has improved since the last inspection?

Visitors are made very welcome. All staff have carried out P.O.V.A. training and have completed self-assessment questionnaires on this area. New windows have been fitted to a number of rooms. A new cover has been fitted to the pagoda, which protects resident, and the chairs and tables from the rain. Two tumble dryers in the spacious laundry room have been resited to a more appropriate position.

What the care home could do better:

The home should provide the C.S.C.I. a report on all the information, which is collected from the questionnaires. The home already provides a rest room/staff room where staff can take their breaks, the proprietor intends to provide an additional staff room for staff who smoke.

CARE HOMES FOR OLDER PEOPLE Howard Lodge Howard Lodge Road Dudbrook Brentwood Essex CM14 5TQ Lead Inspector Valerie Buckle Unannounced 14 July 2005 2.15pm 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. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Howard Lodge Road Address Howard Lodge Road Dudbrook Brentwood Essex CM14 5TQ 01277 373909 01277 357297 Stmichaelshomes@aol.com St Michaels Homes Limited 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) Ms Elaine Hatton CRH Care Home 43 Category(ies) of OP Old Age (43) registration, with number DE Dementia (20) of places Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Personal Care to be provided for one service user under the age of 65 years whose name is know to the commission. Date of last inspection 23 November 2005 Brief Description of the Service: Howard Lodge is a large established care home providing personal care and accommodation for 43 older people including 20 people who have dementia. It is privately owned and the providers have another home in the same area. It is a purpose built home providing single occupancy over two floors, some of the bedrooms have en-suite facilities. Some have small conservatories attached, the ground floor bedrooms with conservatories lead out to the large pleasant gardens. There is a passenger lift access to the upper floors. Communal accommodation consists of a choice of lounges, a quiet room, two dining rooms and a small chapel. The home is situated in a rural location with the nearest bus route, approximately one mile away. There is a large attractive garden for the residents use. Most of the downstairs rooms lead directly into the area. There is ample car parking to the front and rear of the property. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two hours in the home. There was a tour of the premises, and inspection of some records and documentation. Five residents and two family members spoke about life at the home, two members of staff were spoken to and the proprietor and Team Leader assisted in the process of the inspection. The four requirements and one good practice recommendation from the last inspection were met. There were no requirements arising from this inspection. What the service does well: What has improved since the last inspection? What they could do better: The home should provide the C.S.C.I. a report on all the information, which is collected from the questionnaires. The home already provides a rest room/staff room where staff can take their breaks, the proprietor intends to provide an additional staff room for staff who smoke. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 6 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. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 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 Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 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) 1,2,5 New residents and their families are given adequate information about the home, so that they can make informed choices about where to live. Detailed assessments are made before residents are admitted to the home, admissions to the home are planned. EVIDENCE: The home has developed a service users guide and Statement of Purpose, these include all the required information. A copy of these documents have been forwarded to the C.S.C.I. Initial assessments and a planned admission which includes a visit to the home, an overnight stay, ensure that new residents needs and wishes are properly assessed before moving into the home before a final decision is made, all residents have a signed contract and statement of terms and conditions with the home. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9,11 Systems are in place to ensure the safe use of medication. Residents and their families are supported and treated with dignity and respect at all times. EVIDENCE: A medication policy and procedure are in place. Medication was seen to be appropriately recorded and stored safely. All senior carers and team leaders at the home have completed in-house training on medication and medication training, provided by Boots the Chemist. There was evidence of all staff training available to the inspector. Resident’s last wishes are recorded in their individual files. Residents who are ill are given extra support by staff; extra staff are available to support the family at the time when a resident is dying, there is a bereavement policy in place, staff, family and other residents living in the home are treated with sensitivity and respect and understanding. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 10 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 Daily routines in the home are flexible. Residents take place in activities of their choice. EVIDENCE: Regular activity sessions take place which include singing, dancing, socialising in small groups, outside entertainers come into the home, garden parties take place throughout the summer. The residents go out in small groups to planned places of interest including garden centres, the farm, educational trips and to the shops. Religious ministers from different faiths visit the home regularly and use the chapel also the local church holds regular coffee mornings for the residents. Residents were observed socialising with each other, in the lounges and outside in the garden, some were seen reading, others relaxing in the privacy of their own rooms or in the lounges. Some residents were sleeping. Five residents spoken to during the course of the inspection commented that the home is excellent, the atmosphere is very relaxing, the staff are very kind, the bedrooms are homely and comfortable. The food is of a high standard and there is always choices. Two visitors commented that the home is good, the resident is well cared for and happy. The resident expressed “this is my home, I live here and it’s a good home”. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 11 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) 18 There are systems in place to protect residents from abuse. EVIDENCE: A POVA procedural manual was in place, most of the staff have completed training in the Protection of Vulnerable Adults. Staff files included C.R.B and POVA sheets. All residents have family or friends to support them and there is an advocacy service that is available. All staff are aware of the procedures for reporting accidents and incidents. Staff spoken to were aware of different kinds of abuse and whistle blowing. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 12 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) 20,21,23,24,25 Howard Lodge continues to provide a high standard of care and accommodation to the residents. The environment is relaxed and comfortable. The large attractively presented gardens are well maintained and accessible to residents. Many rooms on the ground floor, including bedrooms lead out to this area. EVIDENCE: The home continues to be decorated, furnished and maintained to a high standard. There are a variety of comfortable communal areas on both floors of the home. The home also has a separate chapel for communion on Sundays. All bedrooms were seen to be clean and personalised to individual taste, some had en-suite facilities and most had an attractive conservatory space attached. The home was in excess in the requirement for sufficient and suitable washing facilities and toilets. There were six bathrooms with toilets and five separate toilets. These were clean and fresh, and pleasantly decorated. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 13 All the residents can access the pleasant garden which has a separate patio area and a secured pond to the front of the building and there is a large well presented garden to the rear of the property. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 14 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 The staff team are qualified and experienced to do their job. There are more than sufficient numbers of staff employed throughout the day and night to meet the resident’s needs. EVIDENCE: There are sixty care staff employed at the home, the staffing rota showed that at least eight members of staff plus the person in charge were on duty throughout the day. Four staff files were studied and these evidenced that a thorough recruitment procedure was being followed, which protects the residents. All new staff undertake a programme of induction. The majority of the staff group are involved in NVQ training, at least twenty members of staff have completed NVQ Level 2,3,4. Training is a high priority to the home and is on-going for all staff. The two staff members spoken to said that the manager is very supportive, and that they receive regular training and appraisals. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 15 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) 31,32,37,38 The home is well managed, the manager is committed to providing a good service and high standard of accommodation and care. The home is financially viable, systems are in place to protect the health, safety and well being of residents and staff. EVIDENCE: The manager is qualified, experienced and well trained. In addition to NVQ Level 4 she has completed the Registered Managers Award and is a Manual Handling Trainer. Staff comments were that the Manager is very approachable and supportive. A system of quality monitoring is in place. Questionnaires are regularly completed by residents, relatives and visiting professionals, this information is collated in the form of a report, a copy of this report should be provided to the C.S.C.I. A sample of records were seen, these were all appropriately recorded and up to date. Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 16 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 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 4 3 x 3 3 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 4 3 x x x x 3 3 Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 17 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. Standard Regulation Requirement Timescale for action 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 Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea SS2 6BG 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 Howard Lodge I56 I06 S18095 Howard lodge V229524 140705 Stage 4.doc Version 1.30 Page 19 - 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!