Inspection on 01/12/05 for Latimer Lodge

This inspection was carried out on 1st December 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.

Other inspections for this house

Latimer Lodge 14/05/10

Latimer Lodge 29/03/10

Latimer Lodge 25/08/09

Latimer Lodge 16/09/08

Latimer Lodge 08/09/06

Latimer Lodge 31/08/05

Latimer Lodge 03/03/05

Latimer Lodge 02/11/04

Latimer Lodge 29/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ Lead Inspector Judith Roper Announced Inspection 1st December 2005 10:00 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 Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Latimer Lodge Address 38 Preston Road Yeovil Somerset BA21 3AQ 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) 01935 474520 01935 432380 MR CHRISTOPHER MICHAEL BRUCE WHARTON Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Latimer Lodge Residential Home is part of a continuing care complex that includes Tyndale Nursing Home, which provides nursing care and Coverdale Court, which is a sheltered housing complex. All businesses are run entirely independently but come together to share resources, interests and activities. Mrs. Pauline Purnell is the general manager for both Latimer Lodge and Tyndale care homes. Latimer Lodge Residential Home is a fourteen-bed care home providing personal care for older people. It is situated close to the centre of Yeovil. It stands in its own gardens, in close proximity to Tyndale Nursing Home and Coverdale Court. There is good access for frail people and wheelchair users, including pleasant garden areas. Car parking is available. Communal rooms and some bedrooms are located on the ground floor with further bedrooms are on the first floor, some of which are very spacious. One bedroom is for a shared room whilst a married couple are resident at the home. A passenger lift is available for service users. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by one inspector and took place over one day between the hours of 10.00 am – 16.15 pm. 14 residents were at the home on the day of the inspection. This includes one person who was in hospital. There are currently no vacancies at the home. The inspector was able to interact with 3 residents and see most others. Some residents went out at times during the inspection into Yeovil shopping or for a walk. There were several relative visitors at the home during the inspection visit. Staff on duty were able to give time to speak with the inspector. The deputy manager Mrs. Copeland and the owner Mr. Wharton were available for comment during the inspection. The inspector would like to thank the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and informal. Staff carried out their duties in a friendly and professional manner. The focus of this inspection was to revisit Standards not met and assess Standards not inspected at the previous unannounced inspection in August 2005. Some core Standards were also inspected. Records examined during the inspection were all resident care and support plans, medication records, resident contracts, 2 newly appointed staff recruitment files and records where the home handles resident pocket monies. The home submitted a pre-inspection questionnaire to the CSCI prior to the inspection. This included details about the service including policies and procedures, information about residents and staff, servicing records, menus and staff rosters. Prior to the inspection feedback cards were sent to the home to be distributed to residents and relatives. 5 cards were returned to the CSCI by relatives and 6 by residents. Feedback was overwhelming positive, with one comment describing Latimer Lodge as’ next best to home’. 4 comment cards said that suitable activities were provided at the home ‘sometimes’. The deputy manager has been advised to consult with residents to see if there is any way that this perception can be improved. 3 comment cards were also received at the CSCI from GP/community nurses regarding care at Latimer Lodge and professional dealings with the home. All responses were positive. What the service does well: The home is welcoming and has a relaxed atmosphere. Routines are flexible. Residents move around the home and out into the community at their volition, respecting the rules to inform staff when they leave the home and when they expect to return. Residents reported general satisfaction with the care they receive at the home and that staff and management are approachable in order to raise any issues or concerns that they may have. Meals are social events that residents enjoy at an unhurried pace taking time to engage socially with Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 6 other residents and staff. The home is clean and bedrooms are personalised. Management is dedicated to improving the service and staff work well as a team. What has improved since the last inspection? 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. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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 the following standard(s): 2, 3, 4, 5. Resident contracts give clear terms and conditions regarding admission to the home. Staff receive appropriate training and supervision in order to meet the needs of residents within the home’s registration category. Pre-admission visits to the home are encouraged so that prospective residents know the home’s routines would suit their lifestyle prior to moving in. Providing prospective residents or their representatives with more written information about the home before admission should be considered to enable prospective residents to have detailed information about the home to assist their decision whether to move into the home. EVIDENCE: The deputy manager confirmed that all current residents have contracts. One contract was inspected in detail and all residents asked reported that they had a contract with the home. One comment received during the inspection was that although they were satisfied with the home and the standard of care provision, it was expressed that the home could provide more information about its services and facilities at point of initial enquiry about the home. This was discussed with the management, who accepted this as a fair observation. The home’s Statement of Purpose should therefore be offered to be sent to room enquirers at the point of initial enquiry. The home displays its Statement Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 9 of Purpose in the main foyer at the home alongside the two most recent inspection reports. The home is managed well to meet the needs of fairly low dependency residents with social needs. Following re-assessment, one person is now outside this category and the home has taken appropriate steps to request an alternative placement from the placement manager. There is a commitment to staff training and development at the home and staffing levels are appropriate to meet the current resident dependency levels. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 11. There has been considerable work and effort put into improving care planning at the home since the last inspection. All residents have a care plan and needs are regularly reviewed. Community health care professionals are appropriately consulted in times of resident need. Medication management issues identified at the last inspection have been improved but there remain some issues regarding medication record keeping and medication administration that must be addressed. There have been no deaths at the home since in 2005. EVIDENCE: Every resident has a care plan and needs have been regularly reviewed. The inspector examined care plans for every resident in detail. The inspector and deputy manager had a very useful discussion regarding developing a useful care planning system for the home. Current care planning is based on a medical model and this is somewhat difficult to adapt to the needs of a residential home. The inspector suggested that by shifting the emphasis in care planning to a social care model with short term medical/physical needs entered when applicable, this may improve care planning and make care records more meaningful. Care records recorded when community health care professionals had been consulted or visited residents for individual issues. Advice was given where a Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 11 resident has diabetes that the home ought to establish what normal and stable blood sugar ranges are for the individual. Recording this would aid care planning and alert staff to an abnormal blood sugar reading. Medication storage, record keeping and administration was inspected. There has been medication training for staff since the last inspection as this was made a requirement. There is also a useful and instructive booklet to accompany the in-house staff training on medications accessible to staff. Medications were stored appropriately. Issues in medication recording identified in the previous inspection report for improvement have been met. Staff have the usual practice of signing for medications when it has been dispensed into a pot and before the resident has taken the medication. This is poor practice. Medication needs to be signed for as a witnessing to the medication being taken by the resident. The drug trolley needs taken around the home when medications are being administered, putting medications into individual pots and taking on a tray to resident’s rooms is unsafe practice. Medication records were on the whole maintained well. Variable dose recording was not consistent, however, and must be recorded so that therapeutic doses of medication can be established. There have been no deaths at the home in 2005 and appropriate nursing care or terminal care placements have been found for residents requiring them on reassessment of need. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12, 14, 15. The atmosphere at the home is relaxed with residents free to move in and around the home at their own liking. Residents spoken with confirmed the flexibility and social focus of the home. A minority of responses from feedback cards said that there were ‘sometimes’ suitable activities at the home. The management will pursue investigating this as the site complex offers a variety of group and individual activities and social events. Residents rated meals as good and choice is respected in menu planning. EVIDENCE: The home arranges a number of scheduled activities and events with Tyndale and Coverdale Court. Forthcoming activities are advertised clearly in the home. There is an activity organiser who shared her time between Latimer Lodge and Tyndale nursing home. Residents confirmed flexible routines at the home. One person said that they were pleasantly surprised at the support offered and friendliness given by fellow residents at the home following their recent admission. This made the move from home into residential care easier to cope with. The dining area is pleasing and residents come to the dining room for meals. The mealtimes are a focus for socialising in the home and there is a lot of conversation at meal times. Residents often suggest meal ideas to the kitchen staff. The home received an environmental health officer (EHO) inspection in Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 13 October 2005. In the report, were one recommendation was made to the home, it states. “Very high standards of hygiene.” All staff food handlers in the home hold at least a current essential food hygiene certificate. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16, 18. The home displays its complaints procedure and residents said that staff are friendly and approachable. Staff have received a recent thorough training update in the recognition and prevention of abuse. EVIDENCE: The home reports no complaints received since the last inspection and the CSCI has not been approached directly with any complaints about the home. There is staff training in abuse via the NVQ training award and in-house updates. Policies in the home are available to direct staff on how to handle or report a suspicion or allegation of abuse. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 19, 22, 23, 25, 26. The environment at Latimer Lodge is homely, comfortable and clean. Resident’s rooms are of good sizes and are personalised. Some residents hold their own cash and need to be provided lockable storage facilities in their rooms, as rooms are not lockable. EVIDENCE: The home is situated in a pleasant complex with Tyndale nursing home and Coverdale Court sheltered housing. The gardens are accessible and attractively maintained. The environment is suitable and adapted for residential care for fairly independent residents. There is a passenger lift to the first floor. A coded entry system provides security but does not prevent resident independence in going out of the home. One room is currently being used as a double room for a married couple and this room is sufficiently large for this purpose. All other rooms are for single occupancy only. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 16 Fixtures and fittings are in good repair. There is a large lounge off the dining area for communal space. A new large television is on order and the carpet in the dining area has been replaced since the last inspection. Rooms are not lockable but current residents are not requesting this. Lockable storage must be provided in bedrooms for residents to use. This is not currently available. Eight bedrooms have en-suite facilities. Bedrooms without en-suite facilities have a wash hand basin. Since advice being given at the last inspection the home has effectively converted a shower not used into a sluice. This is now a staff only area. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The staffing levels at the home are sufficient to meet current resident’s needs. There is an annual staff training plan and good commitment and investment into NVQ training for staff at the home. Recruitment practices are not sufficiently robust in order to protect residents. Recruitment processes need reviewing to rectify this. EVIDENCE: Staffing levels were examined through rosters for four weeks submitted to the CSCI prior to the inspection on request. Staffing levels were reported as sufficient on feedback cared received from relatives and residents. One person noted that there had been an occasion when an escort was not available for their relative and this was acknowledged by the management. During the day there are a minimum of 2 staff in the home and 1 waking night worker with on-call support. No residents require 2 staff for assistance. Managerial hours in the home are additional to the care hours provided. There is an annual staff training plan and individual staff training records are maintained and staff have supervision recorded ‘job chats’, which help to identify training needs. NVQ training is supported and most staff are working toward an NVQ. Some staff already have NVQ qualifications and staff are encouraged to reach level 3 in this award. The general manager holds the registered manager award and the deputy manager is working toward NVQ level 4 in health and social care. One recently employed staff member did not have a recorded induction. This is required. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 18 Recruitment files for two recently employed staff were inspected. One person was employed prior to POVA clearance and references being received. This is unsafe and poor practice. It does not protect residents. The home is required to review its employment procedures. An employment checklist should help identify records not received in an application and prevent a person being employed before required employment checks have been made. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 38. The managerial arrangement of a general manager for both Tyndale nursing home and Latimer Lodge works well, supported by deputy management at each home. The home has both formal and informal quality assurance measures and Latimer will submit its application to be Quality Rated by Somerset County Council in the New Year. Resident monies held by the home is managed robustly in order to protect residents from financial abuse. Health and safety issues are managed competently. Two suggestions have been made regarding health and safety, which were received positively by the management during the inspection. EVIDENCE: The home has formal processed for quality assurance in planned annual questionnaires and resident consultation groups. The managers also solicit feedback from residents to the quality of the service on a day-to-day basis. Residents said that the staff and managers were sympathetic and listen to concerns. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 20 The handling and record keeping of resident’s pocket money was inspected. This was recorded clearly and is audited regularly. Staff receive training in understanding and identifying potential financial abuse of residents at induction and thereafter at abuse prevention updates in the home. Health and safety equipment servicing records were submitted to the CSCI on request prior to the inspection. The inspector suggested to the management that residents should be invited into fire training sessions and take part in twice yearly fire drills, considering the physical ability of the majority of residents. It was also suggested that samples of lying water be taken from the water system at least annually for microbiological analysis, in particular to test for Legionellas organisms. It was suggested that further professional advice be taken on this. The home’s proprietor acted upon this during the inspection. Other health and safety issues inspected were in order and maintained systematically with accurate clear record keeping. Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 22 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. 1 Standard OP9 Regulation 13 (2) Requirement Medication administered must be signed for after witnessing the resident taking the medicine. Where a prescribed medication has a variable dose, the amount of dose given must be recorded. 2 3 OP24 OP29 23 (2) (m) Lockable storage facilities must 01/03/06 be provided in resident bedrooms. 19 (1) (b) Staff recruitment practices must 01/01/06 (i) be reviewed and processes put in place to ensure that staff recruitment is robust in order to protect residents from potential harm. 18 (1) (c ) All newly appointed staff must 01/01/06 (i) have an induction that is recorded. Timescale for action 01/01/06 4 OP30 Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 23 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 Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Latimer Lodge DS0000016088.V258536.R01.S.doc Version 5.0 Page 25 - 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!