Inspection on 25/08/09 for Latimer Lodge

This inspection was carried out on 25th August 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Latimer Lodge 14/05/10

Latimer Lodge 29/03/10

Latimer Lodge 16/09/08

Latimer Lodge 08/09/06

Latimer Lodge 01/12/05

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 16/02/2010.

Key inspection report Care homes for older people Name: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Poole     Date: 2 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Latimer Lodge 38 Preston Road Yeovil Somerset BA21 3AQ 01935474520 01935432380 cmbw@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Christopher Michael Bruce Wharton care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who may be accommodated is 14. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home 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. 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 Care Homes for Older People Page 4 of 29 Over 65 14 0 Brief description of the care home 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 on the first floor, some of which are very spacious. A passenger lift is available. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over a one day period. During this time we, the Commission, were able to talk with people living and working at the home, observe care practises, tour the building and view records. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA.) Care Homes for Older People Page 6 of 29 7 people living at the home completed questionnaires and some of their comments have been incorporated into this report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 29 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move to Latimer Lodge are able to visit the home, to make sure that it meets their needs and expectations, before deciding to move in . Intermediate care is not provided. Evidence: The home has a statement of purpose and service user guide. There is also a colour brochure that can be given to people thinking of moving to the home. The service user guide is available in each room. The Annual Quality Assurance Assessment (AQAA) states that in the last 12 months the home has implemented a new, more searching pre admission assessment form. The manager gave assurances that no one is admitted to the home unless they are sure they have the appropriate staffing levels and skills to meet their needs. The pre admission assessment for the most recently admitted person could not be found on Care Homes for Older People Page 11 of 29 Evidence: the day of the inspection but others were seen. People living at the home said that they, or family members, had been able to visit the home before deciding to move in. Two people said that the homes manager had visited them in hospital before they moved to Latimer lodge. People who completed questionnaires said that they had received enough information about the home before they moved in. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are treated with respect and dignity. People have access to healthcare professionals according to their individual needs. Evidence: The home currently uses the Kadex system for care planning. Two were viewed and these contained assessments of need and very basic details of how needs would be met. In addition to this the home is in the process of creating personal risk assessments and daily routines. Those seen gave much more person centred information. People spoken with during the inspection were able to clearly express their needs and were very satisfied with the care that they received. Staff were able to demonstrate a good knowledge of the people who lived at the home and the support that they required. All appointments with healthcare professionals are recorded in the Kardex. People said Care Homes for Older People Page 13 of 29 Evidence: that the home were always quick to contact professionals if they requested it or if they were unwell. District nurses visit people on a regular basis if needed. The home carries out assessments of need in respect of skin care and mobility. Basic pressure relieving equipment is available in the home. Everyone who completed a questionnaire answered ALWAYS to the question Does the home make sure that you receive the medical support that you need? Throughout the day it was observed that staff respected peoples privacy and spoke to people in a friendly, respectful manner. One person commented that staff were gentle and kind when assisting with personal care. The home uses a Monitored Dosage System for medication. All staff who administer medication undertake training in this area and the manager carries out supervisions to ensure that staff continue to be competent in this role. Medication Administration Records (MARs) were viewed. These were well kept and signed when administered or refused. There were two instances when the instruction on the MAR differed from the administration practise and this was highlighted to the manager to clarify. There are safe storage facilities including storage for controlled drugs and medication that requires refrigeration. Controlled drugs were checked and records kept correlated with stocks held. Since the last inspection the dispensing pharmacy have carried out an audit in the home and no major concerns were raised. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices about their day to day lives. There is a variety of organised activities that people can join in with if they wish. Evidence: Everyone spoken to said that there were no strict routines in the home and they were able to choose how they spent their time. There are no set times to get up or go to bed and people are able to continue with their preferred routines when they move in. More than one person said that they considered Latimer Lodge their home and made choices about their day to day life. Everyone asked said that they were able to have visitors at anytime and that their visitors were always made welcome. Many people said that one of the best things about the home was that there was always something going on. There is an activity programme which includes gentle exercises, card games, quizzes, talks and visiting entertainers. The home also has use of a minibus and trips out are arranged. Everyone who completed a questionnaire said that there was always activities that they could take part in. One person commented Care Homes for Older People Page 15 of 29 Evidence: that one of the best things about the home was that they try to keep everyone interested and involved. It was observed that some people chose to occupy themselves in their personal rooms whilst others enjoyed socialising in the communal areas. There is a four week menu that gives a good selection of food and choices at every meal. People said that the food was generally good and that they could always request an alternative if they did not like anything on the menu. Lunch on the day of the inspection was well presented and cooked. Portion sizes were ample and people were able to help themselves to vegetables and condiments in line with their likes. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are confident that any concerns would be listened to and acted upon. Evidence: The home has received no complaints since the last inspection. Everyone asked said that they would be happy to raise any worries or concerns with the manager or a member of staff. One person said that I would complain if I had anything to complain about and I am confident it would be sorted. Another person said that resident meetings are an opportunity to express any grumbles and issues always get sorted. Minutes of residents meetings showed that if any issues were raised action was taken to address them. Everyone who completed a questionnaire said that they knew how to make a complaint and all answered ALWAYS to the question Do staff listen and act on what you say? The majority of staff have completed training in issues of abuse as part of the National Vocational (NVQ) training. The home also uses a certificated distance learning training system that covers issues of abuse. Staff spoken with had limited knowledge of the homes whistle blowing policy but all stated that they would raise any concerns with the manager or provider. Care Homes for Older People Page 17 of 29 Evidence: Throughout the day it was observed that people moved around freely and had unrestricted access to their personal rooms and all communal areas. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Latimer Lodge provides a comfortable environment for the people who live there but some areas would benefit from upgrading. Aids and adaptations have been put in place to promote peoples independence. Evidence: Latimer Lodge is an older property in Yeovil. There is a nursing home and sheltered housing complex located on the same site. There are shops and other local facilities close by. All areas are fitted with a fire detection and call bell system. Accommodation is arranged over two floor with a passenger lift between. All areas are accessible to people with all levels of mobility. There are assisted bathing facilities on each floor and a level access shower for those who prefer. There are hand rails along corridors and other equipment has been put in place according to individual need. Rooms vary in size and outlook. All bedrooms are for single occupancy and rooms seen had been personalised to reflect the tastes and needs of the occupant. The main communal lounge/diner is on the ground floor and there is a small sitting Care Homes for Older People Page 19 of 29 Evidence: room on the first floor. The small sitting room did not appear to be well used by people living at the home. Outside there are attractive gardens that some people said they enjoyed spending time in. Some areas of the home appear tired and would benefit from redecoration and refurbishing. The manager stated that there is an ongoing maintenance and upgrading programme in place. Since the last inspection the home have replaced dining chairs and some lounge chairs. All areas seen were clean and fresh. There is a purpose built laundry outside the home. This facility is shared with the nursing home on the same site and is staffed independently of the home. Throughout the home there are hand washing facilities, protective aprons and gloves to promote good infection control practises. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The are adequate staff on duty to meet the needs of the people who currently live at the home. Recruitment practises could be improved to ensure they fully protect people who live at the home. Evidence: The home employs 11 care staff, 6 (55 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. A further 4 people are currently completing the award. In addition to care staff 3 ancillary staff are employed. (Figures taken from AQAA) Throughout the day there are two care staff on duty and overnight there is one member of staff with a second person on call. People living at the home felt that this was adequate and all said that staff responded quickly if they rang their bell for assistance. There was a calm relaxed atmosphere in the home and it was observed that staff were prompt to offer assistance when requested. There is no clear staffing structure in the home and therefore no clear lines of accountability or responsibility. On arrival at the home neither the manager or provider were at the home and no one was clear about who was in charge. One Care Homes for Older People Page 21 of 29 Evidence: member of staff phoned the manager who came to the home and was present throughout the inspection. Staff spoken with appeared happy in their jobs and there was good interaction between people living and working at the home. Staff said that they received a good induction when they began work and were able to shadow more experienced members of staff. Staff were happy with the training opportunities available and felt supported by the homes manager. People living at the home were very complimentary about the staff who supported them. One person said that staff were all happy and smiling. The recruitment records of two recently appointed members of staff were viewed. Both had been checked against the Protection of Vulnerable Adults (POVA) register before they began work. Dates on written references showed that both staff had begun work when only one written reference had been received. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent to manage the home and there are now systems in place to seek the views of the people who live there. Evidence: The registered manager of the home is Heather Neal. She is a qualified nurse and has registered to undertake the Leadership and management for care services award. Heather has 4 years experience of working in care home management. There is no deputy manager and therefore no one who oversees the day to day care when the manager is away. On arrival at the home the manager was not present and staff were unclear about who was in charge. The manager was telephoned and came to the home and was present for the whole inspection. Since the last inspection the home has formalised the on call system and the person on call is now marked on the duty rota. Care Homes for Older People Page 23 of 29 Evidence: Prior to the inspection the manager completed the AQAA this gave details about the home but limited information about the plans for future improvements. However since the last inspection the home has made improvements. The manager has made the pre admission assessment more robust and it is clear that she takes account of staff levels and skills when offering a placement to a new person. Care plans and risk assessments are being up dated and the new information is much more person centred. There are now more systems in place to seek the views of people who live at the home. There are regular meetings for people living at the home and the manager is carrying out individual recorded meetings with each person to seek their views. There are also meetings and supervision sessions for staff where information is shared and training needs are identified. Staff stated that they are able to express their views at team meetings and their opinions are taken account of. Staff said that the registered provider spends significant periods of time at the home and is always available to offer advice and support. Monthly recorded visits are carried out by the provider as part of the homes quality assurance systems. The AQAA states that they plan to make greater use of audits in the coming year to further monitor the quality of care and facilities. The home does not act as a power of attorney or financial appointee for anyone who lives there. There is a facility to enable people to deposit small amounts of money for safe keeping. Records of these monies are kept and records seen matched money held. There are systems in place to ensure the health and safety of people living and working at the home. There is a fire risk assessment in place and records of weekly fire safety checks. Staff stated that they received training in health and safety issues including fire safety, food hygiene and moving and handling. Records seen confirmed that training had been undertaken. All accidents in the home are recorded. Equipment in the home is serviced by outside contractors to ensure that it remains in Care Homes for Older People Page 24 of 29 Evidence: safe working order. Up to date certificates of insurance and registration are displayed in the home. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 (2)Medication must be 26/09/2009 administered in line with the instructions on the Medication Administration Records. To ensure that people receive the prescribed dosage and that its effectiveness can be monitored. 2 29 19 (1) schedule 2. No staff should begin work in the home until two written references have been received. To minimise the risk s of abuse to people who live at the home. 31/08/2009 3 31 18 (1) The registered person must keep the management arrangements under review. 31/12/2009 Care Homes for Older People Page 27 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action To ensure that at all times there are clear lines of responsibility and accountability. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 3 18 31 The manager should ensure that pre admission assessments are available in individual care plans. The manager should ensure that all staff are familiar with the the homes whistle blowing policy. A deputy manager should be appointed to oversee day to day care management when the registered manager is away. The home should expand the quality assurance systems to include the views of all interested parties, such as relatives and healthcare professionals. 4 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!