Inspection on 31/08/05 for Latimer Lodge

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 01/12/05

Latimer Lodge 03/03/05

Latimer Lodge 02/11/04

Latimer Lodge 29/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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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 Unannounced 31 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Latimer Lodge Address 38 Preston Road Yeovil Somerset BA21 3AQ 01935 474520 01935 432380 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Christopher Michael Bruce Wharton Mrs. Pauline Purnell Personal Care Home Only 14 Category(ies) of Old Age (14) registration, with number of places Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 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. All bedrooms are currently registered for single occupancy. A passenger lift is available for service users. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector and took place over one day between the hours of 10.30 am – 3.00 pm. 13 residents were at the home on the day of the inspection. There is currently 1 vacancy at the home. The inspector was able to interact with 8 residents and see most others. Some residents went out at times during the inspection visit into Yeovil or for a walk or to the afternoon tea party on the lawn at Tyndale nursing home. 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 registered manager Ms. Purnell 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. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff and any visiting relatives. Records examined during the inspection were resident care and support plans, resident risk assessments, medication records, accident records, activity records, Statement of Purpose and Service User’s Guide; other records will be examined at subsequent inspection visits. What the service does well: What has improved since the last inspection? At the last inspection one requirement and two recommendations were made. The requirement was that all residents must have a completed care plan. The Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 6 inspection has found that on this occasion all permanent residents had a care plan but the one respite stay resident did not have a sufficiently complete care plan in order to refer to the planned management of the resident’s respite care whilst at the home. Therefore, this requirement has not been met. The two recommendations made regarding information to be stated on resident’s contracts and cleaning of an assisted bath seat, have both been met. Provision is being made at the home for a staff room, which enhances the work environment for duty staff by giving them a space where they can take scheduled breaks. A replacement bath has been ordered where one bath is cracked and now beyond use. The fairly recent managerial arrangement of a general manager for both Latimer Lodge and Tyndale nursing homes appears to be settling and working well at Latimer Lodge. Residents spoke in a complimentary manner regarding both the general manager and her deputy manager for Latimer Lodge. 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 D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,4,5. Standard 6 is not applicable. Information is provided about the home to enable residents to make an informed choice before deciding to move into the home. Staff are able to meet the current needs of residents. Pre-admission visits to the home are encouraged so that prospective residents know how the home’s routines work before moving in. EVIDENCE: The home has a Statement of Purpose and Service User’s Guide, which are available in the foyer of the home alongside the two most inspection reports. The dependency level in the home is fairly low with residents able to express their views of the service provision. Resident’s spoke with said that they were happy at the home with the standard of care given. One person who was receiving respite care said that their family had visited the home before deciding to move in. The resident did not visit the home them self, but said that this was offered. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10. Care plan recording needs to improve in order to demonstrate that the current needs of residents and their on-going health care support required is recorded accurately. Medication recording needs to improve to protect residents. Charts need to be free from ambiguity so that staff can be clear to the prescribed medication. Residents expressed satisfaction with living at the home and reported that staff aptitudes and attitudes made them feel well cared for. EVIDENCE: 6 resident care plans were inspected in detail. The other care plans were inspected briefly. Some risk assessments had not been reviewed for more than a year despite care plans recording that a monthly review had taken place. The recording of community health care professionals visits was not clear and on one occasion GP instructions for medication prescribed did not tally with the medication administration chart (MAR) exactly. One sample sent for analysis at the hospital laboratory was not followed up to check if the resident concerned was infectious. One respite resident did not have a care plan that identified care needs. A requirement is made that monthly review of care planning is critical and meaningful. This includes the recording and Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 10 following up of any community health care professional involvement. Residents confirmed that they had been referred to community health care professionals as need occurred, but this was not sufficiently recorded in care plan records. Medication management was inspected. Stock levels and storage was satisfactory. Several MAR charts were hole punched through the instructions for medication dosage. The home is advised to punch through charts either at the top or bottom of charts, where this problem would then be avoided. Some residents are supported to self-medicate following a risk assessment. Some of these risk assessments needed routine reviewing. The strength of some medications was not recorded on one hand transcribed chart. This must be recorded. The annual GP review for homely remedies authorisation was also past the review date for some residents. This needs to be followed up. Where a medication was omitted the reason for this was not always stated. This is required. A requirement has been made for staff training in the recording of MAR charts to address these issues identified in order to ensure a safe management of medications in the home. During the inspection all residents spoken with confirmed that staff were kindly and caring and that staff respected resident’s privacy and dignity when attending to personal care or entering resident’s rooms. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15. The atmosphere at the home is relaxed with residents free to move around the home at their own pace. Residents said that there are enough activities scheduled although many people choose to spend a lot of time on their own or with family visitors. Residents are consulted on menu choices and are offered at choice at each meal. Residents reported that meals were generally good. EVIDENCE: The home arranges a number of scheduled activities and get together events with Tyndale and Coverdale Court. On the day of the inspection there was a tea party on the lawn at Tyndale open for all residents at the complex. There is a resident committee that is consulted for the type of activities that residents want to have. Many residents at Latimer Lodge choose to spend time on their own and base their social time around families and friends or individual crafts such as knitting or letter writing. Residents spoken with said that there were enough activities for their liking. One person wished that there were more people who spent more time in the lounge for an afternoon chat as many residents choose to return to their rooms independently following lunch. At the beginning of September 2005 an activity worker will commence in their role for 25 hours per week, shared by both Latimer Lodge and Tyndale nursing home following an identified need for more coordinated activities for the complex. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 12 Community events are advertised in the home and residents said that families are made welcome when they come to visit at Latimer. Residents at Latimer Lodge seem assertive and spoke freely of their experiences at the home. They described staff and management as approachable. During lunch several residents were speaking to staff about menu choices and their preferred way that they liked meals to be cooked. Lunch was observed at the home. The dining room is used for meals and lunch is a social occasion where there is a lot of resident interaction. The chef confirmed that residents are consulted for menu changes. The kitchen is equipped satisfactorily and staff handling food have essential food hygiene certificates. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17. Residents spoken with said that they felt able to express any concerns to staff or managers at the home as the home was friendly. Resident’s rights are respected via the civil process. EVIDENCE: The home displays its complaints procedure in the foyer at the home. It was reported that the home has not received any complaints since the last inspection. Some residents spoken with said that they exercised their right to vote in the May elections. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,26. The environment at Latimer Lodge is homely and comfortable. Resident’s bedrooms are of sufficient size and are personalised. The home is socially clean but the manager needs to seek infection control advice for washing commode pots. 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 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. Fixtures and fittings in the home are homely and in good repair. There is a large lounge off the dining area for communal space. Bedrooms reflect the personalities of residents and eight rooms have en-suite facilities. Bedrooms without en-suite facilities have a wash hand basin. The home is about to replace a bath that is now beyond its useful life. The replacement bath will be Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 15 an assisted bath. This would be a welcomed addition should the dependency level in the home rise. There is one other bath and a separate shower at the home. There is a staff room provided since the last inspection. This room is awaiting decoration before being commissioned for staff use. Staff will then have an area away from the work environment where they can take a scheduled break from work duties. The home shares its laundry with Tyndale nursing home. Residents spoke with reported no problems with laundry going astray or getting lost. The home has gloves and aprons for staff attending to personal care. Chemicals are required by the home to be locked away after staff usage. On the day of the inspection not all chemicals were stored securely away. This was brought to the attention of the manager, although the risk of the current residents accidentally or deliberately tampering with cleaning chemicals in the home is low. The home is also advised to contact the local Health Protection Unit, as there is no ‘dirty’ facility in the home for washing commodes. A bath not used by residents is where commode pots are presently washed. The home needs to consult the infection control nurses to discuss how commodes can be washed in a manner that does not compromise cross infection that is also away from an area that residents have access to. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27. Current staffing levels are sufficient to meet resident needs. The home has a low reliance on agency staff. EVIDENCE: The allocated staffing levels at the home have remained unchanged since the last inspection. There are a minimum of 2 care staff and 1 waking night staff. There is a second on-call night staff member. This meets the needs of current residents but would need reviewing should dependency levels arise. Managerial hours at the home are in addition to the care hours provided. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,36,37. The managerial arrangements of a general manager for both Tyndale nursing home and Latimer Lodge, supported by a deputy at both homes appears to working well. Residents said that managers are approachable and staff said that they felt supported. The owner continues to invest into the structure and physical environment at the home to improve facilities for residents. Records are stored appropriately to protect resident confidentiality. EVIDENCE: There is a general manager for both Tyndale and Latimer Lodge homes. The general manager is a registered nurse offering additional care support and advice for Latimer Lodge residential home. There is a deputy manager for Latimer Lodge who is completing the NVQ level 4 awards in care and management. Staff and residents said that the home is managed well and that the managers are approachable and foster a relaxed, friendly atmosphere in the home. The general manager arrangement for both homes commenced in early 2005 and is being reviewed by the CSCI in October 2005 to assess Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 18 suitability as a permanent arrangement. The general manager has already completed the Registered Manager’s award. The home displays a current certificate of employer’s liability insurance and there continues to be capital investment into the environment and facilities at the home. Occupancy and referral levels remain constant. Staff have formal supervision and staff meetings. Some staff spoken to said that they felt supported by the management but would appreciate more 1:1 supervision with management. Records examined were stored in accordance with Data Protection guidance ensuring residents confidentiality. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x 3 x 3 3 x Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement All residents must have a completed care plan. This includes respite stay residents. Visits from comminity health care professionals must be clearly recorded in individual care plans. Monthly care plan reviews must be carried out critically. Staff administering medicines must receive a training update in the administration medicines that is led by a registered nurse or pharmacist. The medication issues highlighted by the inspector at this inspection must be addressed and staff competence must be assessed. Timescale for action 26/10/05. Timescale of 3/4/05 not met. 2. OP9 13 (2) 12/10/05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations It is recommended that the registered manager contacts the Health Protection Unit for advice regarding cross contamination at the home in light of there not being a D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 21 Latimer Lodge dirty facility for the cleaning of commode pots in the home. Latimer Lodge D53 - D02 S16088 Latimer Lodge V246703 310805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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. 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