Inspection on 03/04/07 for Hunter`s Lodge

This inspection was carried out on 3rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Hunter`s Lodge 07/02/06

Hunter`s Lodge 03/10/05

Hunter`s Lodge 05/01/05

Hunter`s Lodge 20/07/04

Hunter`s Lodge 11/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Hunter`s Lodge Church Lane Old Dalby Melton Mowbray Leicestershire LE14 3LB Lead Inspector Ruth Wood Key Unannounced Inspection 01:10 3rd April 2007 X10015.doc Version 1.40 Page 1 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 Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 2 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. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hunter`s Lodge Address Church Lane Old Dalby Melton Mowbray Leicestershire LE14 3LB 01664 823064 01664 822769 office@hunterslodge.org www.hunterslodge.org Hunter’s Lodge Retirement Homes Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Heather Lillian Cowley Miss Allison Cowley Mrs Monica Gardner Care Home 36 Category(ies) of Past or present alcohol dependence (36), Past or registration, with number present alcohol dependence over 65 years of of places age (36), Past or present drug dependence (36), Past or present drug dependence over 65 years of age (36), Dementia (36), Dementia - over 65 years of age (36), Learning disability (36), Learning disability over 65 years of age (36), Mental disorder, excluding learning disability or dementia (36), Mental Disorder, excluding learning disability or dementia - over 65 years of age (36), Old age, not falling within any other category (36), Physical disability (24), Physical disability over 65 years of age (24), Sensory Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 4 impairment (24), Sensory Impairment over 65 years of age (24) Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 5 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No person under 55 years of age falling within Categories LD, A, D, PD or SI may be admitted into the Home. No person under 50 years of age falling within categories MD or DE may be admitted into the home. Service User Numbers. No person falling within categories PD, PD(E), SI or SI(E) may be admitted to the home when 24 persons in total of these categories/combined categories are already accommodated within the home. Date of last inspection 7th February 2006 Brief Description of the Service: Hunter’s Lodge is a residential care home registered to provide accommodation and care for service users with a wide range of needs who are over the age of 50. The home was built from the conversion of stables in the grounds of a large house, and accommodation is on the ground and lower floors, accessed by stairs (with stair lift). There are twenty-two single and seven double bedrooms most having en-suite toilet facilities. There are four lounges and two dining rooms. Some lounges have been designated quiet areas, others are equipped with TV, stereo and video recorder. Access to the home is gained through the conservatory lounge, which also contains a pleasant water feature. The home is located in the quiet village of Old Dalby and is set within its own grounds. There are seating areas in the front garden for service users to enjoy as well as an enclosed garden to the rear of the home. Gardens are attractive and well kept, the rear containing some mature fruit trees. The home has three registered managers, one of whom is currently not actively involved in the running of the home; the remaining two share ongoing day-today responsibility. Current charges at the home are between £400 to £480 per week. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit took place on a weekday between 1.10pm and 6.30pm. During the visit the communal areas of the home were seen along with three residents’ bedrooms. The inspector looked in detail at two residents’ assessments and care plans and discussed how their care needs were met with the residents themselves, staff members and one of the registered managers, Monica Gardener. Records relating to staff training, medication, fire safety and staff training and recruitment were examined and how staff interacted with residents was observed. Discussion was held with two staff about their experiences of working in the home and with two further residents and a relative about what it was like to live in and visit the home. As well as the inspection visit, this report reflects information sent to the Commission since the previous inspection and the results of ten questionnaires sent to people who live in the home of which six were returned. What the service does well: What has improved since the last inspection? Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 7 No requirements or recommendations were made at the previous inspection. The home’s high quality of service has been maintained. 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. The summary of this inspection report can be made available in other formats on request. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3, 4, 5 Quality in this outcome area is excellent Good quality information and opportunities to visit the home help residents to make an informed decision while thorough systems of assessment ensure that their needs are consistently well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents’ records were examined. These contained detailed and comprehensive assessments, written by the manager together with assessments from previous carers and commissioning workers. The manager had visited both residents in their existing settings and spoken to existing carers prior to their move into the home. One resident came to Hunters Lodge for day care before coming to live in the home; this allowed them to get used to the setting and helped managers to ascertain whether the home could meet their needs successfully. The Statement of Purpose and Residents’ Guide have been recently updated to reflect the changes made to the Care Homes Regulations in 2006. The Guide is available in large print and other languages. Four of the six people who returned Commission surveys said that they felt they had received sufficient Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 10 information before moving into the home and one person commented that they had received a ‘comprehensive guided tour’. All six people had received a contract detailing the terms and conditions of their stay, as had the two residents whose files were examined. The home does not provide intermediate care Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is excellent Residents are treated with respect their health and medication needs are well met and their needs are accurately reflected in comprehensive plans of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents’ care plans were examined and the information was verified through discussion with the residents. These were comprehensive and contained evidence of regular review such as signatures of the resident and modifications to the information. Information given by staff as to how they would meet the needs of the residents corresponded to the information written in plans. All six respondents to the Commission’s survey said that they always received the medical support that they needed. All aspects of health needs are detailed in care plans including pressure area care, action to prevent falls, nutritional assessments and foot care. Staff are available to support residents to access health care; on the day of inspection a staff member had taken a resident to visit their dentist in Nottingham while another staff member accompanied a resident on an emergency admission to hospital. A diary entry, prescriptions and discussion with residents indicated that an optician had recently visited. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 12 A staff member recently designated as competent to administer medication explained current procedures and practice in this area. The staff member explained that they had received comprehensive training, which included obtaining a high level of knowledge about the medication being administered, shadowing experienced members of staff and having their own practice observed. The process involved in being deemed competent had taken approximately 6 months. The staff member displayed a good knowledge of the two residents’ medication discussed and records checked appeared accurate. At all times residents were observed as being treated with dignity and respect by care staff and tasks were undertaken in a calm unhurried manner. Two residents spoken with stressed how kind care staff were. Residents also appeared to be well supported to maintain their physical appearance thereby ensuring their dignity. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent Residents enjoy a good lifestyle, which matches their individual needs and preferences and includes a healthy and varied diet served in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A newsletter is produced every two months containing details of all the activities and trips organised; for February and March these included reminiscence bingo, arts and crafts, a ‘Chas and Dave’ sing-a-long and a visit to the Market Harborough museum land army exhibition. Both residents and staff spoke enthusiastically about this trip, which included lunch and an opportunity to go shopping in the town. Two staff members are allocated each day to promote group activities or spend one to one time with individuals – this may involve just chatting or helping someone to write letters or read a book or newspaper. Staff felt this system worked well and enabled them to get to know residents individually. Residents have recently been encouraged to make a ‘Memory box’ to contain items such as photographs that have particular significance for them. Two of these were seen and residents and staff commented on how interesting and enjoyable this process had been. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 14 Two relatives of previous residents visit the home regularly to organise art and craft activities; recently these have involved making cards and bonnets in preparation for the home’s Easter Bonnet Parade. Written information about arrangements for visiting are in the Residents’ Guide and relatives are encouraged to visit at any reasonable time and can stay for a meal with their relative at no additional cost. One relative visiting at the time of the inspection said that they visited everyday and often stayed to have tea. Information as to how to contact advocates is available in the Residents’ Guide, which also states that residents can gain access to their personal records. The three residents’ bedrooms visited all contained residents’ personal items and the home encourages residents to bring such items in to the home and will arrange transport within certain limits. Menus showed a wide variety of food is served of a good nutritional standard. Residents can choose from a full breakfast menu each day including cooked items. If a resident does not like anything on the menu they will be offered an alternative of their own choosing. Care plans contain nutritional assessments and several staff have completed training in nutrition. Observation of meals showed that these were very relaxed – residents can choose to eat in the dining room or their own rooms and there is a separate dining room, which can be used for family celebrations if required. Of the five residents for which this question was applicable four said that they always liked the meals in the home and one said they usually did. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good Residents’ and relatives’ concerns are taken seriously and acted upon and good procedures and practice ensure residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the manager indicated that complaints and concerns are welcomed and that staff will endeavour to “get things right”. Residents and relatives spoken with said that they felt they could speak to staff and the manager and were confident that things would be sorted if they were unhappy with anything. Of the six residents who responded to the Commission’s survey all said they knew how to make a complaint and that staff listened to and acted on what they said. Training records indicated that staff had received training in how to recognise abuse and one staff member was able to outline what this entailed and the correct response to take if abuse of residents was observed. Recruitment records showed that two written references and a criminal records bureau check are obtained for staff before they start work in the home; their names are also checked against the vulnerable adults register. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good Residents live in a safe, clean, comfortable, well-maintained environment, which meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided to the Commission before the inspection stated that several areas of the home had been redecorated, including the main dining room and corridors in the home; observation of these areas confirmed this. The lower garden has also been re-landscape and was full of spring flowers and looked very attractive. On-site staff carry out routine maintenance promptly and the home appeared to be in a good state of repair throughout. Fire records indicated that systems and equipment were regularly maintained and tested. All areas of the home appeared clean and fresh smelling and training records showed that staff have received training in infection control. Of the six residents who responded to the Commission’s survey five said that the home is always fresh and clean with one saying it sometimes was. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent Residents are well supported and protected by well-trained staff and thorough recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information sent to the Commission before the site visit stated that over 90 of staff hold a National Vocational Qualification in care at level 2 or above. Staff members spoken to at random held the qualification and this was confirmed by examination of their training records. Training records also showed that staff had access to a regular programme of both internal and external training in areas pertinent to their work including falls awareness, best practice in dementia care and pressure area care. The staff rota showed sufficient staff on duty to meet the needs of residents. Two care staff are routinely allocated to encourage residents to participate in activities; kitchen and domestic staff are employed in addition to care staff. Of the six residents who responded to the Commission’s survey two felt there were always staff available when they needed them, four said they usually were. All staff, whatever their role, receive training in moving and handling, dementia care and other ‘core’ training which enables flexibility and ensures that the whole team have an understanding of residents’ needs. Recruitment records showed that two written references and a criminal records bureau check are obtained for staff before they start work; their names are also checked against the vulnerable adults register. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is excellent Good management ensures that the health and safety of residents and staff is actively promoted and that the home is run in the best interests of residents. This judgement has been made using available evidence including a visit to service. EVIDENCE: The home currently has three registered managers of which one, Heather Cowley has minimal involvement with the home. Monica Gardner has completed her NVQ level 4 in management and care, together with her Registered Manager’s Award. Registered Manager, Allison Cowley, has a NEBSS Management Certificate and extensive experience in care and management. Both managers regularly take part in training to ensure that their skill base remains up-to-date. There is considerable evidence that the home’s managers are constantly reevaluating the service to ensure that it meets residents’ needs. For example imminent changes to mental health legislation have led to a review of care Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 19 planning and assessment documentation that takes into account definitions of capacity. There is a well-developed quality assurance programme which involves an annual written survey of residents’, relatives’ and professionals’ views of the home as well as the views of relatives of previous residents. Residents’ monies are not administered by the home. Any charges are initially met by the home and relatives or the resident’s solicitor are subsequently invoiced. The pre-inspection questionnaire indicated that fire equipment and systems were regularly tested and serviced – this was confirmed through examination of records. Staff stated that they had received training in fire safety. There was evidence that gas and electrical appliances are also regularly serviced. Staff records indicated that training had been received in infection control, first aid, food hygiene and moving and handling training is regularly updated. Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 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 HOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Hunter`s Lodge DS0000001743.V330148.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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