CARE HOMES FOR OLDER PEOPLE
Lodore Nursing Home 9 Mayfield Road Sutton Surrey SM2 5DY Lead Inspector
Alison Ford Unannounced 10.30.am 04 May 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. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lodore Nursing Home Address 9 Mayfield Road, Sutton, Surrey, SM2 5DY 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) 020 8642 3088 Mr Stephen Pittman Ms Kalsum Mohd Noh Care Home 36 Category(ies) of Old age, Dementia - over 65, Terminally ill, registration, with number Terminally ill - over 65 of places Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1) A maximum of 10 service users in the Dementia - over 65 category 2) A maximum of 8 service users in the Terminally ill and Terminally ill - over 65 categories aged 40 or over Date of last inspection 16 August 2004 Brief Description of the Service: Lodore is a home providing nursing care for up to 36 older people. Up to eight of these beds may also be used for younger service users requiring palliative care and the home has forged strong links with the local hospice to devlop a level of expertise in this field. The home is situated in a pleasnt tree-lined road in Sutton within walking distance of the town centre. it is an edwardian building which has been tastefully extended to provide accomodation over three floors. There has been an extensive programme of redecoration and refurbishment and this has been completed to a very high standard. All but two of the rooms are accessible by means of a passenger lift and a stair lift is provided for those two. There are eighteen single and nine double rooms. There are newly appointed bathrooms on each floor and a variety of aids and adaptations have been provided. The home is staffed twenty-four hours a day by a mix of trained nurses and care staff and the registered manager of the home is also a trained nurse. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes first inspection of 2005/2006 and was an unannounced visit starting at 10.30 am and lasting for three hours. During this time a partial tour of the premises was undertaken, a sample of care planes were assessed, and the majority of the staff on duty were spoken to informally. Fifteen service users and one relative, who was visiting at the time, were spoken to. Since the last inspection a new registered manager has been appointed who was on duty at this inspection. She has many years experience in working with this client group and has already improved much of the documentation being used in the home. All of the requirements resulting from the last inspection have been complied with and there have been no complaints about the service either directly to the home or to the Commission for Social Care Inspection. What the service does well:
This home has a warm and friendly atmosphere and recent redecoration has been undertaken to a high standard. All areas were clean and free from odour on the day of the inspection. All of the residents appeared well cared for and happy. Those who were able to communicate expressed their satisfaction with the home and the staff who were described by several as being “angels “ and “extremely kind “. The various activities were obviously favourably received and all the residents had enjoyed a recent party. Complimentary letters were also seen which supported theses comments. The food served in the home and the choices offered were praised and menus seen were varied and nutritious. Maintenance records were in good order as were records required for the protection of residents. Many of the staff have been in post for some while and there is a positive commitment to staff training and development. Staff displayed an awareness of the issues experienced by this client group and were observed treating them in a respectful manner Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 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 Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 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) 1,3,6 Service users are given all of the information that they require prior to admission to the home so that they can make an informed judgment as to its suitability. A comprehensive assessment is undertaken prior to admission to ensure that the home can meet the assessed needs of all service users EVIDENCE: The service user guide has been reviewed in line with previous requirements and was seen at the inspection. It now contains all of the detail required by the minimum standards and includes service user feedback and complimentary letters sent into the home. Pre admission assessment documentation has been updated and now provides a comprehensive needs assessment. This then forms the basis for care plans some of which were seen. For those residents funded by the local authority a care managers assessment is also present. At the time of the inspection there were two residents in the home receiving short-term care and input was being supplied from community physiotherapists and occupational therapists.
Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 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) 7,8,10 Service users in this home are treated with dignity and respect. Their health needs are identified and reviewed regularly so that they continue to be met and they are able to access care from additional healthcare services. EVIDENCE: Care plans were seen pertaining to five residents. The plans were generated from the initial assessment and showed evidence of regular review. A new book was seen which now documents involvement from other members of the multi-disciplinary healthcare team including chiropodists and opticians. Waterlow scores are undertaken regularly in order to identify those at risk from developing pressure sores. Risk assessments are present in care plans as are manual handling assessments and review. Medication was not assessed at this visit however a recent pharmacy inspection had not revealed any problems. Residents were observed being treated in a respectful manner and all personal care is delivered in private. Staff were seen to knock on doors and call out before entering. Those residents who were in shared rooms were happy to do so and adequate screening is provided.
Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 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 standard(s) 12,13,14,15 Service users are able to exercise choice over their lives within the home and activities are provided which suit their needs. This provides interest and variation in their daily lives. Relatives and friends are always made to feel welcome. The food served within the home is well balanced, and nutritious and specialist diets are catered for as required. EVIDENCE: Service users explained that they were able to exercise choice over how they spent their days and whether they took part in organised activities. Several were very appreciative, and had especially enjoyed a recent party. Others preferred to remain in their rooms and watch television or read. An activities organiser is employed and the weekly plan was seen displayed. Church representatives also come into the home regularly. A visitor confirmed that she was always made to feel welcome and there are no restrictions to her coming in to the home. All the service users bedrooms that were seen contained personal possessions from home such as photographs, ornaments and small items of furniture. The service users that were spoken to were all very complimentary about the food served in the home, menus were seen, they were varied and there was always a choice. There is a small dining room however most service users choose to eat from tables in the lounge or in their rooms. On the day of this
Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 11 inspection there were sufficient staff to offer assistance to those who required it. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 12 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 Service users are made aware of the homes complaints policy and are confident that their concerns would be dealt with accordingly. EVIDENCE: There is a complaints policy in the home and details are displayed in the hall. Service users spoken to were confident that any complaints would be dealt with however did not think that they would have any. There had not been any complaints made either to the home or to the Commission For Social Care Inspection since the last inspection. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 13 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) 19,24,26 This home provides a well-maintained, clean, and comfortable environment, which meets resident’s needs. Automatic door closers that operate in the event of a fire need to be fitted to ensure the safety of service users. EVIDENCE: The home is an attractive property, which has been refurbished to a high standard and is well maintained. Adaptations have been provided throughout to aid those with reduced mobility. There is rear garden, which is accessible to all the residents and is much enjoyed in the summer months. A tour of the premises included a sample of resident’s bedrooms, which are comfortable and tastefully decorated. There are appropriate door locks and lockable facilities have been provided. Radiators have been guarded. On the day of the inspection the home was clean and free from odour. The laundry was not inspected on this occasion. A sluicing disinfector has now been installed. Automatic door closers, which operate in the event of a fire, have still not been fitted to bedroom doors despite a previous requirement. This requirement is therefore reissued and dealt with as a priority.
Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 14 Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 15 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) 27,29,30 Residents in this home are cared for by well-trained and competent staff who are able to meet their assessed needs. The home’s robust recruitment policies and procedures ensure as far as possible that service users are protected. EVIDENCE: On the day of the inspection there were two trained nurses on duty, in addition to the registered manager; with five care staff in the morning and four in the evening. At nighttime there are two nurses and two carers. The off duty rotas were seen and reflected that this was the always the case. In addition there were domestic and kitchen staff on duty. All of the care staff have either undertaken an NVQ level 2 qualification or are enrolled on the course. All of those spoken to were able to detail recent and relevant training that they had undertaken. This has included manual handling, first aid and venepuncture. Training schedules were seen which supported this. There is a robust recruitment process in place in the home. Staff files were seen of three newly appointed members of staff and all complied with the standard. There was evidence of Criminal Records Bureau clearance, appropriate references, photographs and contracts. A work permit had been applied for as necessary. All staff have job descriptions however a recommendation was made that a signed copy of this be kept in staff files for future reference.
Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 16 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) 35,36,38 Service users in this home are confident that the management of the home and the home’s health and safety policies and maintenance programmes will minimize risks to their safety. EVIDENCE: Small amounts of money are held in safekeeping for residents. This is mainly used to pay hairdressing bills. The records were seen and were accurate and well maintained. Staff supervision has now been introduced; all staff have received supervision at least once and the intention is for this to occur six times a year. This will be checked at future visits. Maintenance certificates were viewed and were in good order. Several of them expire in the near future and these will be checked at future visits. Fire alarms are checked weekly and staff were able to confirm a recent fire drill. The accident book was seen, all incidents had been minor and none had required admission to A/E. Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 3 x 3 Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 18 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 OP 19 Regulation 23(4)(c ) (i) Requirement The Registered Provider must fit closing devices, which operate automatically in the event of a fire, to the bedroom doors of those residents who wish them to remain open. Previous timescale of 30/11/04 not met Timescale for action 30/9/05 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 29 Good Practice Recommendations It is reccommended that a copy of their job description, signed by the member of staff, should be kept in their staff file, Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 19 Commission for Social Care Inspection Croydon, Kingston & Sutton Office 8th Floor, Grosvenor House 125 High Street Croydon, CR0 9XP 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 Lodore Nursing Home G53-G53 S19104 Lodore V211383 040505 Stage 0.doc Version 1.30 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
