CARE HOMES FOR OLDER PEOPLE
Laurel Lodge Care Home 19 Ipswich Road Norwich Norfolk NR2 2LN Lead Inspector
Mrs Marilyn Fellingham Unannounced Inspection 22nd November 2005 11:00 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 Laurel Lodge Care Home DS0000044217.V266402.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. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Laurel Lodge Care Home Address 19 Ipswich Road Norwich Norfolk NR2 2LN 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) 01603 502371 01603 443872 Mr Brian Jones Mrs Linda Jones Mr Brian Jones Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: Laurel Lodge is located in a residential area close to Norwich city centre. Formerly a large period residence, the premises have been adapted and extended to provide accommodation to a maximum of 20 older people. There are 14 single and 3 double rooms, all having en suite facilities. The care home has one spacious TV lounge and a second quiet lounge. There is a conservatory that grants access to a large garden and a private car park at the front of the premises. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over four and a half hours. Opportunity was taken to speak with service users, relatives and staff, opportunity was also taken to examine staff and care records. What the service does well: What has improved since the last inspection?
Care planning has improved since the last inspection. Many areas of the environment have been re decorated including the main corridor; this corridor has also been re carpeted throughout and better domestic lighting applied. One bedroom has been re decorated and there are new tables in the dining room. A raised garden has been added outside with new railings positioned in the front of the home, which now give adequate lighting and more of a view for the residents. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 6 A new entry system to the home has been installed making it much safer for the service users. All those service users now have their own front door key if they wish which enables them to come and go as they please. The fire panel has been up graded. On the day of inspection the two down stair toilets were in the process of being decorated and improved. The home now has its own in house trainer for manual handling. All medication that enters the home is now audited and records maintained for this activity. 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. Laurel Lodge Care Home DS0000044217.V266402.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 Laurel Lodge Care Home DS0000044217.V266402.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): 1, 2, 4. Prospective service users are provided with sufficient information to enable them to make an informed choice before admission to the home. EVIDENCE: The statement of purpose and service user’s guide has been updated to provide adequate information for prospective service users and their relatives. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 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 the following standard(s): 7,8, 9. The care planning system still needs to improve to provide staff with clear and ample guidance for care to be given. Service users health and personal care are well attended to with a slight improvement to detail. Medication procedures are adequate. EVIDENCE: Individual acre plans were reviewed, these have much improved since the last inspection, however further improvement is needed to ensure that they are detailed enough in order for the assessed needs to be met. The care plans also need to reflect if the resident is at risk of developing pressure sores; in addition to this they need to reflect that nutritional assessments have been carried out. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 10 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): 13,14. Visitors are made welcome to the home. As far as possible depending on individual conditions residents are encouraged to take control over their lives and make decisions in relation to every day living. EVIDENCE: The Inspector spoke with many of the service users, relatives, visitors and staff who were on duty at the time of inspection. The service users confirmed that they were helped to make decisions about daily living activities. Those relatives and visitors spoken with during the inspection stated that they were always made welcome. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 11 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): No standards assessed. EVIDENCE: Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 12 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): 19,20,21,24,25, 26. Service users live in a well-maintained and safe environment. EVIDENCE: A tour of the home took place and there was much improvement to the internal and external environment. A lot of refurbishment has taken place since the last inspection and will continue according to the manager and provider. It was noted that the downstairs corridor has been re decorated and the floor re carpeted, pictures have also been hung the walls and the lighting has been made more domestic in nature. New rail fencing has been provided outside giving the service users a more panoramic view from inside the home. A raised garden has also been provided and many bulbs were already peeping through the ground, which should prove to be very attractive in the Spring.
Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 13 The home appeared very clean and tidy through out and free from hazards and offensive odours. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 Deployment of staff is adequate to meet the assessed needs of the service users. Staff have a very good understanding of service users support needs and maintain good communication with service users. EVIDENCE: Examination of the duty rosters revealed that the home is always staffed sufficiently providing a staffing level more than adequate to meet the needs of the service users. Service users spoken to indicated that they felt well looked after and that they were in safe hands; good staff induction and training supports this. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 15 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): 31,32,35,38 The home is managed well. The service users welfare is promoted and their safety is protected. EVIDENCE: The Inspector gained the impression that the home is well managed; a senior carer has been promoted to deputy manager who is most ably supported by the manager and the provider. This deputy had just completed a team leading and management course which she felt has given her many more skills in the art of management; she stated that she felt she was very well supported in this new role. Many of the service users commented on the management of the home and felt very happy with the way the home was managed. One service user stated that “any problems, were always sorted out”. Another service user commented that the “management were very approachable”.
Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 16 Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 17 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 3 3 X 3 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action 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 OP8 Good Practice Recommendations It is recommended that the registered person encourages best practice by assessing all residents for skin integrity and planning appropriate care. Laurel Lodge Care Home DS0000044217.V266402.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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