Inspection on 31/08/06 for Lostock Lodge

This inspection was carried out on 31st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lostock Lodge 26/06/07

Lostock Lodge 01/02/06

Lostock Lodge 11/07/05

Lostock Lodge 09/11/04

Lostock Lodge 29/06/04

Lostock Lodge 02/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lostock Lodge 34 Wateringpool Lane Lostock Hall Preston Lancashire PR5 5AP Lead Inspector Mr Patrick Rooney Unannounced Inspection 31st August 2006 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 Lostock Lodge DS0000005884.V299447.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. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lostock Lodge Address 34 Wateringpool Lane Lostock Hall Preston Lancashire PR5 5AP 01772 626141 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) care@lostocklodge.com Lostock Lodge Limited Miss Christine Wilkes Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 32 service users of the category OP - Old Age not falling within any other category (aged over 65 years). The service should at all times employ a suitably qualified and experienced manager who is registered With the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines Which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 1st February 2006 Date of last inspection Brief Description of the Service: Lostock Lodge is a residential care home providing 24 hour personal care and accommodation for up to 32 older persons aged 65 and above. The home is situated close to the centre of Lostock Hall, near to shops, pubs, a post office and other amenities. It is a large detached property with a purpose built extension set in its own gardens. Accommodation is mainly on the ground floor and there is a passenger lift to the first floor accommodation. All rooms are single and have ensuite facilities. The home is furnished and decorated to a high standard. facilities are provided. Assisted bathing There are a number of lounge areas, a conservatory, dining areas. The front lounge is a designated smoking area. Fees for the home range from £324 to £405 per week. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit and took place on two days, 18th and 31stAugust. A pre inspection questionnaire was completed by the manager. The inspector consulted care records and spoke to residents living at the home. He discussed their care with them and visiting relatives. There were good comments received from residents and relatives, however there were concerns voiced regarding some residents having to wait when they required assistance. The inspector toured the building, spoke to individual staff, had discussion with management and consulted records and policies and procedures. Questionnaires were issued to residents and relatives. What the service does well: What has improved since the last inspection? Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 6 Recruitment procedures have improved and ensure the right staff are appointed to work in the home. There have been on going improvements to the environment of the home, which is comfortable and well maintained. 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. Lostock Lodge DS0000005884.V299447.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 Lostock Lodge DS0000005884.V299447.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is adequate, this judgement has been made using available evidence including a visit to this service. There are systems in place to assess the needs of new residents, however these are not being used completely. EVIDENCE: The assessments for six residents were looked at, while these contained basic details there was very little personal profiles of the individual. One person had a diagnosis of dementia, which had been written on the initial application form. The home is not registered to take people who have dementia and therefore this person was admitted out of category. Further discussions with residents indicated that there had been problems in adequately supervising this person. All assessments must be thoroughly carried out and care taken to ensure the home is equipped to provide the care required. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 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 and 10 Quality in this outcome group is adequate, this judgement has been made using available evidence including a visit to this service. There is a system in place for planning care, however plans are not completed as fully as they could be. Medication procedures are not being adhered to. Care is provided in such a way, which respects the privacy and dignity of residents. EVIDENCE: The care plans of six residents were looked at and the care of these residents was discussed with them. While there are systems in place for care planning, these are not being fully completed and were not clear as to care to be given. Some residents said that they are happy with the care they receive however feedback was received that in some instances residents had to wait as, they felt that staff were busy at the other end of the home. Some attention needs Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 10 to be made to the deployment of staff throughout the home because of the distance from one end to the other. Medication records were looked at for a number of residents in each there were errors in the recording of medication. In one case a medication was recorded as given when in fact it had not. In other cases paracetamol was being given to other residents than whom it had been prescribed for. A controlled drug had been given out without the controlled drug register being signed and witnessed. Not all staff administering medication have received accredited training to do so. A referral has been made to the pharmacy inspector to carry out an inspection. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome group is good; this judgement has been made using available evidence including a visit to this service. The routines of the home are flexible and enable residents to have choice and control and to receive visitors when they wish. The home provides residents with a good varied diet with choices always available. EVIDENCE: It was noted that residents and their families are consulted on admission regarding their finances. Those able to control their own finances are able to do so. Most resident’s finances are managed by their families. The home only administers one resident’s finances and there were records available detailing this. Personal allowances are kept in a safe by the home and made available Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 12 to residents when they wish to pay for items. Records for this were seen and are well kept. Residents said that they are able to decide for themselves what they wish to do during the day and are assisted in this by two activity coordinators who are employed for twenty hours a week. They provide both individual and group activities for residents. Entertainers are booked to provide music and singing sessions. Visitors to the home are able to see their relatives/friends in private and there is a relaxed atmosphere in the home. One resident said, “It is the next best thing to home. Leaflets and information is available in the home to enable resident’s access to independent advocacy services if required. Menus showed that residents are offered a good variety of food with choices always available. The inspector had lunch during the inspection, this was of good quality and well presented. Residents spoken to say they had good food one residents said, “I’m quite happy here, the food is very good.” Another said, “We have good food and are always asked what we want.” Resident’s views are included when new menus are produced; the cook asks residents what they like and has a good knowledge of resident’s likes and dislikes. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome group is good; this judgement has been made using available evidence including a visit to this service. There are good arrangements in place for residents to raise concerns and the homes policies ensure residents are protected from abuse. EVIDENCE: The home has a complaints procedure, which is accessible to residents and their families. Copies are on the homes notice board and are contained in the service users guide. Residents said that they are aware of the procedure and feel able to raise any concerns with the owner and manager who are always available in the home. The home has a protection of vulnerable adults procedure including a whistle blowing policy. Staff were able to tell the inspector the procedures to be taken if they had any concerns regarding care practice in the home. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 14 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 and 26 Quality in this outcome group is good; this judgement has been made using available evidence including a visit to this service. The home is well maintained and the environment is clean and comfortable. EVIDENCE: A tour of the home was carried out and resident’s rooms were seen, all parts of the home are well maintained and improvements are always being made. There is a programme of maintenance and improvements in place to ensure this is the case. The home was clean and tidy, there are good infection control systems in place and protective aprons and gloves are supplied staff. Staff are trained on induction in good hand-washing procedures to follow in between dealing with residents. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 15 A professional carpet cleaner is used to ensure carpet areas are kept clean. There is a good laundry system in place, clothing and bedding can bee cleaned and disinfected to good standards. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 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 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): 27,28,29 and 30. Quality in this outcome group is good; this judgement has been made using available evidence including a visit to this service. Arrangements for staffing the home ensure there are sufficient skilled staff on duty to meet the needs of residents. However some attention is needed to ensure staff deployment throughout the home is improved. EVIDENCE: There are approximately 50 of staff qualified to NVQ 2 in care and more staff are encouraged to undertaking this training. There are good induction and training programmes in place to ensure staff are equipped with knowledge to perform their duties. Twenty-six staff have been trained in first aid and there is always a member of staff on duty with this training. Because the distance from the front to the back of the home is considerable there have been instances when all staff have been in one part of the home and residents in the other having to wait for attention. Some consideration should be given to deploying two of the staff on a shift to the front of the home and two at the back. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 17 Recruitment procedures are good and ensure that appropriate staff are employed by the home. All new staff are required to have an enhanced Criminal Records Bureau clearance before taking up post. This was verified from staff records. Lostock Lodge DS0000005884.V299447.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome group is good; this judgement has been made using available evidence including a visit to this service. The home is well managed, which ensures residents interests are protected and health and safety issues are promoted. EVIDENCE: The owner of the home is regularly available in the home and has a registered manager who is qualified and experienced. Residents and staff are happy with how the home is run and there are clear lines of accountability. Resident’s views are taken seriously and resident surveys have been carried out. Residents meetings are arranged and issues concerning residents are able to be raised. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 19 The home looks after resident’s personal allowances, these are kept in a safe and good records are maintained of any transactions. All the homes policies and procedures have been reviewed and updated. Health and safety is taken seriously and staff receive training in moving and handling, health and safety and first aid. There are safety certificates and risk assessments are carried out. Lostock Lodge DS0000005884.V299447.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13(2) Requirement Administration: The registered manager must ensure all medication is administered as prescribed. A full detailed assessment must be carried out with prospective residents prior to a place being offered in the home. A full detailed care plan must be available, which describes care to be given by staff. Timescale for action 27/09/06 5 OP3 14(1)(a,b, c and d) 15(1)(a,b, c and d) 31/10/06 6 OP7 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP9 OP9 Good Practice Recommendations 1. 2. All handwritten records should be double-checked and countersigned. Regular documented medication audits should be carried DS0000005884.V299447.R01.S.doc Version 5.2 Page 22 Lostock Lodge out and retained as evidence. 3. 4 5 OP9 OP9 OP9 The recording of medicines disposal should be reviewed and updated. Staff administering medication should have accredited training. Reviews of residents self medicating should be more regular. Lostock Lodge DS0000005884.V299447.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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. 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