Inspection on 25/11/05 for Laura Chambers Lodge Care Home

This inspection was carried out on 25th November 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

Laura Chambers Lodge Care Home 07/12/06

Laura Chambers Lodge Care Home 20/07/05

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 Rob Cooper Unannounced Inspection 25th November 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 Laura Chambers Lodge Care Home DS0000037303.V262266.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. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Laura Chambers Lodge Care Home Address Swansdowne Drive Clifton Nottingham NG11 8HW 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) 0115 9157900 0115 9157902 steff.wilkinson@nottinghamcity.gov.uk Nottingham City Council Mrs Stephanie Wilkinson Care Home 30 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (30) of places Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 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) 20th July 2005 Date of last inspection Brief Description of the Service: Laura Chambers Lodge is a care home primarily for older people who have dementia. It is situated in the residential area of Clifton, approximately five miles to the south west of the city centre. The care home is owned, managed and staffed by Nottingham City Council. Laura Chambers Lodge is located on two floors with the upper floor being accessed via a passenger lift and stairs; there is also a range of assisted bathing for those people who need additional physical support. The City Council’s Domiciliary Care service – The Jack Dawe team is also located within the building, as is a small day care service, which serves the local community. Laura Chambers Lodge is a very well presented care home, with high quality fixtures and fittings. To the rear of the property is a pleasant, enclosed garden area, designed with numerous sitting areas. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection lasted approximately three and a half hours through the middle of the day, with one Inspector present. The methodology used was to visually inspect the premises, consider the requirements and recommendations from the previous report, case track three residents – which involves looking at a range of care records, and making a judgement about the quality of the care on offer to those people, considering the total care package on offer and to talk with visitors who had come to see their relatives or friends. Initially a Senior Team Leader facilitated the Inspection, as the Manager was out of the building interviewing, although the manager did return before the Inspection was completed. What the service does well: What has improved since the last inspection? What they could do better: The Service User Guide needs to be updated, and care plans need to be reviewed on a monthly basis. Formal supervision sessions for staff should be carried out. Staff members should receive training in Abuse and the Protection Of Vulnerable Adults. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 6 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 DS0000037303.V262266.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 Laura Chambers Lodge Care Home DS0000037303.V262266.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): 1235&6 Prospective residents at Laura Chambers Lodge would not have all of the information they would require to make an informed choice about coming to live there. Each resident has a copy of the terms and conditions of residence. Residents are assessed prior to moving into Laura Chambers Lodge. Trial visits form part of the admission procedure for Laura Chambers Lodge. Intermediate Care does take place at Laura Chambers Lodge, and the residents are helped to maximise their independence prior to returning home. EVIDENCE: The Statement of Purpose and Service User Guide were seen, and while the Statement of Purpose contained all of the information required by Care Homes Regulations, the Service User Guide did not, and the information within the Service User Guide needs to be updated. In addition the Registration Certificate issued by the Commission for Social Care Inspection was not displayed, and could not be located. It is a legal requirement for the Certificate of Registration to be prominently displayed. Three resident’s files were seen, and each contained a copy of the terms and conditions of residence. In all three resident’s files there were copies of Standard Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 9 Community Care Assessments and Extended Community Care Assessments. Documentary evidence was seen to support that introductory visits take place prior to anyone moving into Laura Chambers Lodge, either day visits or sometimes overnight stays. There is an Intermediate Care wing at Laura Chambers, with five bedrooms. A visual inspection of this wing and talking to residents living there evidenced that the Intermediate care wing is arranged to maximise independence, and support residents before they return home. Laura Chambers Lodge Care Home DS0000037303.V262266.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 & 10 Each resident has an individual plan within their case file, setting out their personal and social needs. Resident’s health care needs are not being fully met. Residents at Laura Chambers Lodge are protected by the home’s policies and procedures for dealing with medication. Residents are treated with respect and their privacy is upheld. EVIDENCE: All three residents files had a detailed plan of care covering personal and social care needs. All three resident’s files showed that care plans are not being reviewed on a regular basis. The National Minimum Standards state: “The Service user Plan is reviewed by care staff in the home at least once a month.” (Standard 7.4) Care records showed that they had not been reviewed since June, July and September. Laura Chambers Lodge uses a monitored dosage system (MDS) for its medication, with all medication being supplied through Boots the chemists. On the day of the Inspection no residents were selfmedicating. Medication administration records were seen, and found to be correct and complete, as were the records relating to the delivery of medication to Laura Chambers Lodge by Boots. During the Inspection staff Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 11 were observed interacting with the residents. In all cases communication was respectful and dignified. Staff members were seen to be knocking on doors before entering, and residents were asked rather than being told during conversations. Laura Chambers Lodge Care Home DS0000037303.V262266.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 13 14 & 15 Residents at Laura Chambers Lodge do find that the lifestyle expectations meets and satisfies their social, cultural, religious and recreational interests and needs. Family and friend contact is maintained and encouraged. There is the element of choice in many aspects of Laura Chambers Lodge’s daily routines. Residents do receive a wholesome and balanced diet in pleasant surroundings EVIDENCE: Among the facilities on offer at Laura Chambers Lodge is a reminiscence room, which was being set up with a fireplace, and donated ‘old’ objects, which would be familiar to the older residents. There is also a hobbies room with arts and crafts materials, together with two separate smoking rooms – both equipped with extractor fans and windows and a hairdressing salon. During the Inspection two visitors were spoken with, one a relative, and one a friend of a resident. Both visitors spoke very positively about their experiences of visiting Laura Chambers Lodge; they said that visiting was easy, and that the staff were very welcoming. Both also said that they were able to see their relative/friend alone and in private if they wished. There was evidence of choice is many areas of practice, with residents making choices around food, and activities during the Inspection. Staff members were seen to be asking residents to make choices during the activities of daily living. Menus are Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 13 displayed in the dining areas telling residents what is for lunch. The residents are asked in advance what choice they would like for their meal, and records relating to the choices made are held within the kitchen, along with a range of other records relating to food temperature probes and refrigerator temperatures. All of these were checked and found to be in order. Laura Chambers Lodge Care Home DS0000037303.V262266.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 17 & 18 Residents and their relatives are confident that their complaints would be dealt with, and taken seriously. Resident’s legal rights are protected at Laura Chambers Lodge. Residents are potentially at risk of abuse. EVIDENCE: The complaints procedure was seen displayed around the building, in addition records of past complaints were seen – the last two were in April & June 2005. Both of these complaints were dealt with in line with the complaints policy, and the outcomes were recorded. Both visitors when asked said that they knew who to complain to, and how to complain, although both added that they had not needed to make a complaint. Every resident is on the electoral role, although at the last election all residents either chose not to vote, or were unable due to the level of dementia, that they had at that time. Staff training records show that abuse training has not yet happened at Laura Chambers Lodge, although there is ongoing discussion about providing this training. The lack of training around abuse and the Protection of Vulnerable Adults does leave residents potentially at risk. Laura Chambers Lodge Care Home DS0000037303.V262266.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 21 22 & 26 Laura Chambers Lodge is a safe, well-maintained environment. The residents have a sufficient number and range of bathroom and toilet facilities. There is a range of specialist equipped designed to assist residents maximise their independence. Throughout the building Laura Chambers Lodge is clean, tidy and hygienic. EVIDENCE: The entire building underwent a complete refurbishment five years ago; this saw the creation of en-suite facilities for all bedrooms, and the installing of high quality fixtures and fittings. Laura Chambers Lodge employs a handyman to carry out simple routine maintenance, and the City Council Maintenance Department carry out any major repairs. A visual inspection showed that there are sufficient bathrooms and lavatories, and that these are equipped to a high standard with a range of different bathing options – including Parker baths and baths with a Jacuzzi facility. There are also a number of hoists and handrails to assist those who may have a physical infirmity. The building is equipped with a passenger lift, which will assist residents with accessing the upper floor. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 16 Outside there is a level access to the garden area, which is laid out with comfortable sitting areas. The Intermediate care wing is obviously designed to maximise resident’s independence, with a view to returning home, and has a wide range of equipment to assist with this process. The entire building appeared clean, and smelt fresh, during the Inspection domestic staff were seen to be cleaning and tidying, and cleaning regimes and rotas were seen. Laura Chambers Lodge Care Home DS0000037303.V262266.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 Resident’s needs are met by the number and skill mix of the staff team. EVIDENCE: The staffing rota was seen covering a two-week period. This showed sufficient numbers of staff on duty, together with a degree of seniority and experience to meet the resident’s needs. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 & 38 Staff members at Laura Chambers Lodge could have better formal supervision. The Health & Safety of residents and staff at Laura Chambers Lodge, is protected. EVIDENCE: Records of formal staff supervision showed that some staff had not had a formal supervision session since January 2005, and that for others it was very occasional – the National Minimum Standards suggest six times a year. (National Minimum Standard 36.2). The minutes of full staff meetings were seen, and these showed that staff meetings were well attended. Two members of staff were spoken with, and both said that while they were not receiving regular formal supervision, the management team were very supportive, and they (the staff members) felt that the Manager was very approachable. A range of Health & Safety records including fire and Control Of Substances Hazardous to Health (COSHH) were seen and found to be correct Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 19 and complete. In addition to an automatic Fire detection system there is an automatic sprinkler system in place. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 X 3 3 X X X 3 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 X X X X X 2 X 4 Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation Requirement Timescale for action 28/02/06 2 3 OP7 OP18 Regulation The Registered Person shall keep 6a&b under review and, where appropriate, revise the statement of purpose and the service user guide; and notify the Commission and service users of any such revision within 28 days. Regulation The Registered Person shall keep 15 (2) the service user plan under review. Regulation The Registered Person must 18 (1) c ensure that persons employed to work in the care home receive training appropriate to the work that they are to perform. 28/02/06 31/07/06 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 OP7 Good Practice Recommendations The Registered Person must ensure that the service user plan is reviewed by care staff in the home, at least once a DS0000037303.V262266.R01.S.doc Version 5.0 Page 22 Laura Chambers Lodge Care Home 2 OP36 month. The Registered Person must ensure that care staff receive formal supervision at least six times a year. Laura Chambers Lodge Care Home DS0000037303.V262266.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Nottingham Area Office 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 DS0000037303.V262266.R01.S.doc Version 5.0 Page 24 - 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. 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