Inspection on 29/09/07 for Leonard Lodge

This inspection was carried out on 29th September 2007.

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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Leonard Lodge Roxwell Gardens Hutton Brentwood Essex CM13 1AQ Lead Inspector Helen Laker Unannounced Inspection 28th September 2007 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 Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leonard Lodge Address Roxwell Gardens Hutton Brentwood Essex CM13 1AQ 01277 263939 01277 261433 leonardlodge@barchester.com 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) Barchester Healthcare Homes Ltd Penny Hammond Care Home 60 Category(ies) of Dementia - over 65 years of age (29), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (29), Old age, not falling within any other category (28), Terminally ill (3) Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. Personal and nursing care to be provided to up to 28 older people. Personal and nursing care to be provided to up to 29 people with dementia. Personal and nursing care to be provided to up to 29 older people with mental disorder excluding learning disability and dementia. Personal and nursing care to be provided to up to 3 people with terminal illness aged 55 years or over. Maximum number to be cared for shall not exceed 60. Personal and nursing care for people under 65 years of age is limited to 1 service user who is known to the CSCI. Personal and nursing care for people with dementia under 65 years of age is limited to one service user who is known to the CSCI. Date of last inspection 17th October 2006 Brief Description of the Service: Leonard lodge is a purpose built, two storey Care Home with Nursing set within its own well maintained grounds, on the outskirts of Brentwood. It is situated close to a local bus route and is close in proximity to all community amenities and services. Car parking spaces for several cars are located to the side of the property. Leonard Lodge is decorated, furnished and maintained to a good standard throughout and provides nursing care for 60 Older People with dementia or mental disorder, physical disability and up to 3 service users with terminal illness. Residents are accommodated on two floors and a separate EMI unit looks into a garden courtyard. The Service User Guide and Statement of Purpose are available for residents and their representatives and they are provided with this information. The manager stated that the home has current Commission for Social Care Inspection reports are available to review. At the time of this report the inspector was advised that the scale of the homes charges and fees range from £950.00 to £1000.00 per week. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection, which took place over six hours with one inspector in the home. This unannounced inspection was undertaken on the 28th September 2007 with the assistance of the manager. The inspection took place over two days with one spent in the home viewing records and files. There was a tour of the premises and grounds and an inspection of records and documentation. Time was spent observing the care of the residents and eight were spoken to about life at Leonard Lodge. Further feedback was also received from service users and staff through completed surveys, telephone contact and discussion. Survey responses have been included in the relevant sections of the report. An AQAA questionnaire and other reports and correspondence provided by the home were also used as evidence to inform this report. Twenty one National Minimum Standards were inspected on this occasion. Discussion of the inspection findings took place with the home’s representative who on this occasion was the manager. At the end and throughout the inspection advice and guidance was given. What the service does well: What has improved since the last inspection? What they could do better: Care plans must continue to be developed to ensure consistency as the home has two floors and differing ways of writing and what content to include. Fire drills must be held regularly and evidenced for both day and night staff. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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 Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good 3&6 This judgement has been made using available evidence including a visit to this service. Present and prospective service users and their supporters are given adequate information about the home so that they can make informed choices. The admission procedure includes an adequate assessment, which ensures that service users needs overall can be met. EVIDENCE: This standard overall remains unchanged. The manager overseeing the home described the admission process whereby either they themselves or the deputy ensure pre-admission assessments are carried out to identify whether the home could meet the individual needs. Pre admission documentation seen for three service users was completed in sufficient detail to evidence a full person centred assessment had been undertaken. Residents and their visiting relatives have confirmed that a pre-assessment by the home was carried out and they Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 9 were encouraged to visit the home before making a decision. Placements are confirmed in writing. The home does not provide intermediate care. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 7,8,9,10 This judgement has been made using available evidence including a visit to this service. Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment. Improvement has been made to the care planning process, some further progress and consistency is required to ensure that service users needs are met. Medication administration and recording was noted to be in order. Personal support is provided in a way that promotes dignity. EVIDENCE: Care plans seen have been reorganised and covered all residents’ assessed needs. The quality of content although generally to a good standard did vary according to the member of staff completing the care plans. Discussions were held with the manager regarding the inconsistencies and specific incidences highlighted. There was some evidence of residents’ or their families being involved in the care planning process. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 11 Service users and their relatives spoken with were positive about the way personal care and health needs were being met and felt that staff treated them in an appropriate way, respecting their privacy and dignity. The manager’s medication policy was seen to be appropriate and medication administration records and storage were inspected and were found to be organised well. Air conditioning units purchased for the medication storeroom ensure temperatures remain under 25oC. Staff receive appropriate training and the home has good links with their community pharmacist. The home’s G.P. visits every Thursday to review medication for service users who are presented by the staff. A record is overall maintained by staff, ensuring that individual residents’ medication is reviewed at least once every six months to a year. It was noted that a neuro psychotherapist visits the home for 11/2 hours a week to assess residents and provides list of exercises for staff to follow and liaises closely with the activity organiser. Comments from residents and relatives included:“The staff have always got time for you” “They listen” “They care about us well” “The staff here are all very kind and the new manager is good” Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good 12,13,14,15 This judgement has been made using available evidence including a visit to this service. Daily routines are generally flexible. Social activities take place and service users are generally happy with the choices in routine available to them Visitors are made welcome and overall the service users rights and responsibilities are recognised in their daily lives. EVIDENCE: On the day of inspection a coffee morning was being held for the residents. Discussions with residents, visiting relatives and staff highlighted, routines in the home were flexible and service users’ individual choices were well accommodated. Regular resident’s meetings are held and minutes were available to review. The home has two activity organisers who work a total of 50 hours a week. An additional 10 hours incorporate outings with carers. A volunteer comes in on either a Saturday or a Sunday to do jigsaws with residents and a young lady who gained lottery funding also comes in to do arts and crafts. The home’s 10 year celebration is planned for the 5th November 2007 incorporating a themed phantom of the opera lunch. Residents spoken with said they can generally join in any activity if they wanted to. A weekly Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 13 activities sheet is provided to each resident so they can choose what activities they want to take part in. Care plans do reflect social care but greater detail and assessment would clarify individual needs more. A mini bus is available to take residents on trips. The home has an open visitors’ policy. This was confirmed by staff and visiting relatives. Menus seen are varied, seasonally themed, appeared nutritional and contained a choice of food. Menus are discussed every three months in residents’ meetings. Residents were complimentary regarding the quality and quantity of food provided. Hot and cold drinks are available throughout the day. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 16 & 18 This judgement has been made using available evidence including a visit to this service. The home has appropriate policies, procedures and staff training in place to protect vulnerable adults. EVIDENCE: The manager has an appropriate complaints procedure. Seven complaints had been received since the last inspection. Only two of those related to care issues and records and a POVA, five regarded a recent fee increase. Evidence was seen of appropriate investigation into the same. The home has policies and procedures regarding protecting vulnerable adults from abuse. All staff have now received POVA training. A copy of the Essex County Council’s procedures for the protection of vulnerable adults was available in the home. Staff spoken to were aware of whistle blowing procedures and policies and procedures relating to POVA legislation. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 19 & 26 This judgement has been made using available evidence including a visit to this service. Leonard Lodge was clean, bright and well maintained and provides the service users with safe, homely and comfortable surroundings. EVIDENCE: The home is purpose built and provides a high standard of accommodation for the residents and provides sufficient aids and adaptations to meet the resident’s needs. The home has a full time maintenance person who carries out routine maintenance in the home. The EMI unit has been refurbished previously and is much more open planned. New curtains carpets and flooring have been placed in a number of areas and furniture purchased. The present manager has been lucky enough to obtain a grant to redevelop areas of the home. A lot of this has been used to develop a large new garden terrace area Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 16 and furnish existing parts of the gardens. The manager has a plans to ensure that redevelopment and improvements be an ongoing process to benefit the service users. The home was found to be clean and tidy and odour free throughout. Sluice facilities are provided on each floor and appropriate infection control procedures are in place. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 27,28,29,30 This judgement has been made using available evidence including a visit to this service. Staffing levels are maintained at a standard, which meets the needs of service users. Recruitment practices have some minor shortfalls, which need addressing. Staff training is addressed but more prominence should be paid to appropriate updates being undertaken to provide a competent work force. EVIDENCE: Staff rotas show that the home is maintaining the agreed staffing levels previously set by the local authority. 70 of staff are now NVQ trained. A random sample of staff files inspected show that overall the necessary recruitment checks had been made. Some attention is required to ensuring permissions to work are checked fully. The manager’s induction process continues to meet the ‘Skills for Care’ requirements and documentation is held in staff files. A wide range of relevant training including manual handling, POVA, health and safety, dementia and food and hygiene is provided to all levels of staff. Residents spoken with were very complimentary regarding the staff. Comments included “are always polite”, “they look after us well”, “staff are always busy but not too busy to help”. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 31,33,35,38 This judgement has been made using available evidence including a visit to this service. There is guidance and direction to staff and the home has in place practices that will promote and safeguard the health, safety and welfare of the people using the service. Regular fire drills must be undertaken and maintained. EVIDENCE: A new manager has been appointed, who at the time of this inspection had been in post approximately nine months. The home continues to operate an open door policy. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 19 The home’s insurance policies were seen to be appropriate and there was sufficient evidence gathered throughout the report to ensure that the home is financially viable The Commission has previously been informed that service users and their families where possible are aware of the manager’s policy regarding access to records. Service users are protected by the homes accounting and financial procedures and although a random check of service users monies did not take place on this occasion all previous inspections of the home, have highlighted due diligence in this area. These records seen were generally well maintained, regularly updated and stored securely. A recent audit by an external company had found that the home was achieving 91 of the areas looked at and the manager and home’s staff team are proud of this. Ongoing internal quality monitoring is done at head office level and the new manager is still in the process of developing processes in this area. Maintenance certificates were seen to be up to date however the home does not have regular fire drills and the last one documented was in July 2007. It is recommended these be undertaken on a more regular basis and include both day and night staff members and appropriate documentation kept. Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 21 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. 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 OP7 Good Practice Recommendations The home should continue to develop consistency in the care planning process and ensure that all staff have training to ensure blanket content is to a sufficiently clear standard. The home should ensure that more regular fire drills are carried out and the outcome and persons attending recorded. 4. OP38 Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Leonard Lodge DS0000069331.V343493.R01.S.doc Version 5.2 Page 23 - 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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