Inspection on 20/07/05 for Laura Chambers Lodge Care Home

This inspection was carried out on 20th July 2005.

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

Laura Chambers Lodge Care Home 07/12/06

Laura Chambers Lodge Care Home 25/11/05

Laura Chambers Lodge Care Home 19/03/05

Laura Chambers Lodge Care Home 01/02/05

Laura Chambers Lodge Care Home 28/01/04

Laura Chambers Lodge Care Home 26/02/03

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

CARE HOMES FOR OLDER PEOPLE Laura Chambers Lodge Care Home Swansdowne Drive Clifton Nottingham NG11 8HW Lead Inspector Richard Ramsden Unannounced 20 July 2005 10:00 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. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laura Chambers Lodge Care Home Address Swansdowne Drive Clifton Nottingham NG11 8HW 0115 9157900 0115 9157902 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) Nottingham City Council Mrs Stephanie Wilkinson Care home 30 Category(ies) of DE(E) Dementia - over 65, x 25 registration, with number OP Old age, 65 years and over, x 30 of places Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Out of the total number of beds 25 beds may be used for the category of DE(E) Date of last inspection 19 March 2005 Brief Description of the Service: Laura Chambers Lodge is a care home providing personal care and accommodation for 30 people, 20 of the places are for longstay residents, 5 for respite residents and 5 for residents receiving intermediate care. It is owned and managed by Nottingham City Council Social Services and was completely refurbished and reopened in May 2002. The home is situated opposite a park on a large housing estate 3 miles from Nottingham City Centre. There are a variety of local shops, a post office and doctors surgeries. The accommodation is provided on two floors with a shaft lift to assist independent access. All of the bedrooms have ensuite facilities with walk in showers. The home is divided into units each having its own assisted bathing facilities, kitchenette, dining area and lounge. Each unit fulfills a separate function and is staffed appropriately. The home also has a day centre operated in partnership with the Methodist Foundation. The grounds are very well-designed, reasonably secure and provides easy access for service users. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 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 completed in one day and lasted for approximately 4 hours. It included the inspection of care and other records, a discussion with the manager and 3 residents. A partial tour of the building was also completed. What the service does well: What has improved since the last inspection? The staff have received a considerable amount of training since the last inspection. This is good practice as it ensures that staff have sufficient experience and training to meet the assessed needs of residents. The inspector also noted that additional staff have been recruited since the last inspection. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 6 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. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 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 Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 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) 3,6. Prospective residents needs are comprehensively assessed prior to admission. The Intermediate Care Unit is helping people to maximise their independence and where possible return home. EVIDENCE: Of the three residents records checked during this inspection, two people had Extended Social Work Assessments, which had been obtained prior to their admission to the home. The other person was admitted to a residential home some considerable time ago and the manager believes that this persons preadmission assessment has now been archived. She stated that residents would never be admitted without a social work assessment. One of the residents spoken with during the inspection stated that she had visited the home prior to her admission so that she could decide if he would meet her individual needs. Intermediate care is provided in a separate unit within the main building of the home. This unit has specialist facilities, equipment and trained staff to provide intensive rehabilitation to enable service users to return home. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 9 Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 Not all Care Plans are implemented within the first 48 hours of a resident’s admission to the home, nor are they all reviewed at least once a month, to ensure that staff are always aware of what assistance and support each resident requires. Residents health care needs are being met, they are treated with respect and their rights to privacy is upheld. EVIDENCE: The care plan of one of the residents in the Intermediate Care Unit was viewed during the inspection. It was comprehensive and had been completed by a multidisciplinary team including a physiotherapist, trained nurses and support staff. Staff are obviously working hard to produce care plans for all of the residents, which clearly set out how their personal and care needs should be met. However the majority of residents who are receiving respite care have not had a care plan produced. This was highlighted at the last inspection and the requirement was made that care plans must be completed within 48 hours of service users being admitted to the home. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 11 The residents and their representatives had not signed any of the care plans viewed during the inspection. There was also no evidence to show that these care plans are being updated/reviewed at least once a month. It was noted that many of the residents weight had not been recorded at the time of their admission, and subsequently had only been recorded occasionally. It is important that staff are aware of any significant changes in residents weight as this can indicate that they may be unwell. One service user had developed a pressure sore after their admission to the home. The staff had noticed quickly and made a referral to the district nurse. However if an appropriate pressure care risk assessment had been completed it may have been possible to provide preventative treatment. Staff record details of when each resident has a bath or shower, however this information is recorded on a communal record in each unit. It is recommended that this information is recorded on a separate page for each resident so that it can be viewed in a confidential manner. The homes medication systems were checked, the medication is stored safely and the records of receipt and disposal of medication are well maintained. The staff who administer medication have all received appropriate training. At the time of inspection one resident was administering her own medication, an appropriate risk assessment had been completed. (This is good practice). The manager was reminded that staff must record the temperature in the room where the medication is storred on a daily bacis. Medication should not be stored at more than 25 C. All of the residents spoken with during this inspection said that staff are always friendly and respectful and that they ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 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 standard(s) 13,15. People are encouraged to make contact with family and friends. The diet provided for residents are wholesome, well balanced and a varied. EVIDENCE: The manager stated that residents could have visitors at any time up to 10 p.m. and that visitors are welcome to stay for a meal. However relatives, friends and representatives are not given written information about the homes policy on maintaining relative and friends involvements with residents. All of the people spoken with during this inspection, said that they can have visitors at any time and that their visitors are always made welcome. The lunch on the day of this inspection appeared appealing and nutritious there is a choice of food at each meal. There is a four weekly rotating menu, which provides a good variety of food. All of the residents spoken with were full of praise for the food provided within the home, they stated that there is always plenty of food available and that an alternative will be provided if they do not want the food suggested on the menu. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 13 Each of the units at Laura Chambers Lodge has a small kitchen area where people can make themselves drinks or snacks if they are assessed as safe to do so. (This is good practice). The record of food, refrigerator and freezer temperatures had all been well maintained, helping to ensure the health and safety of the residents. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 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 standard(s) None EVIDENCE: None of the standards in this section were assessed as part of this inspection. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 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 standard(s) None EVIDENCE: None of the standards in this section were assessed as part of this inspection. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 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) 30 Staff are trained and competent to do their jobs. EVIDENCE: The staffs training records were checked at random, there had been a considerable amount of training provided since the last inspection. Eight members of care staff have completed NVQ level 2 and four team leaders have completed NVQ level 3. The manager has NVQ level 4 in management and is currently completing her manager’s award. Three members of staff who complete domestic duties have also completed NVQ training. At the last inspection a requirement was made, that all staff must receive training in the management of challenging behaviour. The inspector was informed that this training had been commissioned and that the homes line manager was waiting for confirmation of when the training would actually be provided. This will need to be checked at the next inspection. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 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) 33 The home does not an effective quality assurance/quality monitoring system, based on seeking the views of residents. EVIDENCE: The home has a Residents Questionnaire, which contains relevant questions and is produced in the user-friendly format. However the information that has been gathered from residents has not been used to develop the services provided. The registered person must establish and maintain a system for reviewing and improving the quality of care provided at the care home. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 18 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 x x 3 x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 1 x x x x x Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 19 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 7 Regulation 15 Timescale for action It is required that care plans be Immediate completed for all residents within 20/7/05. 48 hours of them being admitted to the home. (Previous timescale of 30/4/05 not met) It is required that care plans 31/8/05 include appropriate risk assessments and that they are reviewed at least once a month in consultation with the individual residents or where appropriate their representatives. (Previous timescale of 30/4/05 not met). It is required that a quality audit 31/8/05 is introduced which includes the views of the residents. (Previous timescale of 30/6/05 not met). Requirement 2. 7 15 3. 33 24 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 7 Good Practice Recommendations It is recommended that the homes staff complete a basic tissue viability risk assessment so that those residents who are at risk of developing pressure sores can be referred for C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 20 Laura Chambers Lodge Care Home 2. 3. 7 13 preventative treatment. It is recommended that the records showing when residents have baths/showers are recorded on individual record sheets to ensure confidentiality. It is recommended that the homes policy which encourages residents to make contact with their family and friends is included in the literature supplied to prospective residents/their representatives. Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Laura Chambers Lodge Care Home C53 C03 S37303 Laura Chamber Lodge V239459 200705 Stage 4.doc Version 1.40 Page 22 - 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. 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